Body fluids—CSF Flashcards

1
Q

functions of CSF

A
  • supplies nutrients to nervous tissue
  • removes metabolic wastes
  • produces mechanical barrier to cushion CNS
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2
Q

3 layers that line CNS

A

meninges
- dura mater
- arachnoid mater
- pia mater

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3
Q

space where CSF flows

A

subarachnoid

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4
Q

produce CSF

A

choroid plexuses

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5
Q

—- mL/hour of CSF is produced

A

20

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6
Q

2 processes that contribute to CSF production

A
  1. filtration under hydrostatic pressure across capillaries of choroid plexuses
  2. active transport secretion by choroid epithelial cells
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7
Q

reabsorb CSF, regulating CSF pressure and volume

A

arachnoid villi

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8
Q

total volume CSF

A

adults: 140-170 mL
neonates: 10-60 mL

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9
Q

control and filtration of blood
bidirectional transport

A

blood brain barrier

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10
Q

lumbar puncture occurs where?

A

between 3rd, 4th or 5th vertebrae

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11
Q

where do CSF tubes go?

A
  1. chemistry/serology
  2. micro/PCR
  3. hematology
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12
Q

CSF sample handling & storage

A

highly contagious
never spin uncapped

Storage
chem/sero: freeze
micro: RT
heme: refrigerate

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13
Q

can remove up to —- mL CSF on an adult

A

20

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14
Q

ways to describe CSF appearance

A
  • crystal clear
  • cloudy
  • turbid
  • milky
  • xanthochromic
  • hemolyzed/bloody
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15
Q

causes of turbid CSF

A
  • protein
  • lipid
  • infection
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16
Q

causes of xanthochromic CSF

A

pink, orange or yellow
- RBC degradation products
- serum bilirubin (prematures)
- carotene
- high protein
- melanoma pigment

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17
Q

CNS production of IgG indicates…

A

MS

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18
Q

causes of bloody CSF

A
  • subarachnoid hemorrhage
  • traumatic tap
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19
Q

how to distinguish traumatic tap from subarachnoid hemorrhage?

A
  • distribution of blood (equal in all tubes or decreases)
  • clot formation (traumatic)
  • xanthochromic supernatant (hemorrhage)
  • macrophages with RBCs, hemosiderin (hemorrhage)
20
Q

RBCs begin to lyse in CSF within…
—–% WBCs will lyse within 2 hours

21
Q

for a proper CSF dilution, ——- cells/large square should be seen

22
Q

if <—– cells are counted in CSF, count more squares

23
Q

RBCs in CSF can be lysed with…

A

3% acetic acid

24
Q

concentrates cells in CSF for a diff

A

cytocentrifugation

25
add --------- during cytocentrifugation to keep cells intact
1 drop albumin
26
distortions common in cytocentrifuged CSF specimen
- vacuoles - misshapen nuclei - prominent nucleoli - cell clumping - pyknotics
27
QC for CSF albumin
periodically 0.2 mL saline + 2 drops albumin check for bacteria
28
QC for CSF diluents
daily fill chamber with each diluent check for bacteria/cells
29
normal WBCs found in CSF
lymphs and monos lymphs more in adults, monos more in children
30
increased number of normal cells in CSF
pleocytosis
31
plasma cells in CSF
MS
32
↑ WBC + high neuts in CSF
bacterial meningitis
33
↑ WBC + high lymphs/monos
viral, tubercular, fungal or parasitic meningitis
34
------ are seen in early stages of viral meningitis
↑ neuts
35
mod ↑ WBC + reactive lymphs + plasma cells in CSF
neurodegenerative disease/MS
36
↑ eos in CSF
parasitic or fungal infection Coccidioides immitis meds or shunts into CSF
37
macrophages appear -------- after RBCs enter CSF
2-4 hours
38
may be present in macrophages after subarachnoid hemorrhage
- RBCs - hemosiderin - hematoidin crystals
39
hematoidin crystals in CSF macros
40
normal cells in CSF, not clinically significant
- ependymal cells - choroid plexus cells - spindle shaped cells
41
cells from arachnoid lining that may show up in CSF after procedures/neurosurgery
spindle shaped cells
42
nrbcs in CSF
BM contamination or newborn with traumatic tap
43
nrbcs + immature whites in CSF
BM contamination
44
blasts in CSF
complication of ALL
45
CSF cells with fused membranes, irregularities, hyperchromic nuclei, mitotic cells
metastatic carcinoma cells