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AUBF 2 CSF/ AMNIOTIC (FINALS) > CEREBROSPINAL FLUID > Flashcards

CEREBROSPINAL FLUID Flashcards

1
Q

third major body fluid

A

CEREBROSPINAL FLUID

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2
Q

Functions of CEREBROSPINAL FLUID

A
  1. Supply nutrients to the nervous system
  2. Remove metabolic waste
  3. Produce a mechanical barrier to cushion the brain and spinal cord against trauma
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3
Q

An ultrafiltrate of plasma

A

CEREBROSPINAL FLUID

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4
Q

Covers and lines the brain and spinal cord

A

Meninges

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5
Q

the outer most layer, directly lines the skull and vertebral canal

A

Dura Mater (tough mother

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6
Q

filamentous inner membrane

A

Arachnoid Mater (spider-like)

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7
Q

filaments are called___

A

traberculae

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8
Q

found between arachnoid and pia mater. It is where CSF flows

A

Subarachnoid space

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9
Q

innermost later directly lines the brain and spinal cord

A

Pia Mater (tender mother)

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10
Q

it is where the plasma filtered producing CSF

A

Choroid Plexus

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11
Q

Rate of production of CSF

A

20mL/hr. (approx. 500 mL/hr. or 0.3-04 mL/min)

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12
Q

tight junctions of endothelial cells, it will prevent passage of many molecules. Protect the brain from toxins, infections and other substance that can harm the brain

A

Blood Brain Barrier (BBB)

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13
Q

maintains and regulate the volume of CSF by reabsorbing the circulating CSF back to the peripheral circulation to prevent reflux of fluid

A

Arachnoid villi/Granulations

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14
Q

Rate of absorption of CSF

A

20mL/hr. (approx. 500 mL/hr. or 0.3-04 mL/min)

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15
Q

needle is inserted between the 3rd and 4th vertebrae or 4th and 5th vertebrae

A

Lumbar puncture (spinal tap)

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16
Q

needle is inserted directly below the occipital bone (back of skull)

A

Cisternal puncture (suboccipital puncture)

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17
Q

More dangerous than lumbar because it near the brainstem

A

Cisternal puncture (suboccipital puncture)

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18
Q

Volume collected of CSF

A

20mL (maximum amount)

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19
Q

least affected by blood or bacteria that is introduced during the tap

A

Chemistry/Serology

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20
Q

what tube and storage temp for chem/sero tube

A

First; Frozen

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21
Q

no longer at risk of bacterial contamination due to collection

A

Microbiology

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22
Q

what tube and storage temp for mricro tube

A

sec; @RT

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23
Q

what tube and storage temp for hema tube

A

third; refrigerated

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24
Q

least likely to contain skin cells

A

Hematology

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25
Q

If 1 tube only:

A

Microbiology → Hematology → Chemistry and Serology

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26
Q

Normal Volume: *maintained by the reabsorption of fluid by arachnoid villi
* Adults:
* Neonates:

A
  • Adults: 90 to 150mL
  • Neonates: 10-60mL
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27
Q

Normal appearance

A

Crystal Clear

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28
Q

WBCs (>200/uL)
RBC (>400/uL)
Microorganisms
Proteins, Lipids

A

Hazy/Turbid/Milky/Cloudy (*meningitis)

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29
Q

(Abnormal discoloration of CSF)

A

Xanthochromia

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30
Q

Presence of RBC degradation products:
- slight amount of oxyhemoglobin

A

Pink

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31
Q

Presence of RBC degradation products:
- heavy hemolysis

A

Orange

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32
Q

Presence of RBC degradation products:
– conversion of oxyhemoglobin→ bilirubin (bilirachia)

A

Yellow

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33
Q

due to damage to the BBB

A

Increased:
Protein (>150 mg/dL)
yellow discoloration

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34
Q

due meningeal melanosarcoma

A

Increased:
Melanin
brownish

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35
Q

Presence of Carotene

A

(hypervitaminosis A) → orange discoloration

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36
Q

due to Rifampicin

A

red orange

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37
Q

due to Iodine

A

(antiseptic contamination)
yellowish

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38
Q

Increased RBC (>6000/uL)

A

Bloody

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39
Q

Radiographic contrast media

A

Oily

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40
Q
  • Meningitis
  • Froin syndrome (Xanthochromia, increased protein, hypercoagulability)
  • Blockage of CSF circulation
  • Traumatic tap
A

Clotted

41
Q

Tubercular meningitis (pellicle is present if the CSF is stored overnight in refrigerator)

A

Pellicle (web-like surface)

42
Q

Accidental puncture of the blood vessel during
puncture

A

Traumatic tap

43
Q

Bleeding inside the skull

A

Intracranial Hemorrhage

44
Q

Uneven Distribution of blood

A

Traumatic tap (1>2>3)

45
Q

Even Distribution of blood

A

Intracranial Hemorrhage (1=2=3)

46
Q

(+) Clot formation Due to fibrinogen

A

Traumatic tap

47
Q

Supernatant of Traumatic tap

A

Clear

48
Q

Supernatant of Intracranial Hemorrhage

A

Xanthochromic

49
Q

Intracranial Hemorrhage:
Erythrophages (macrophage with
ingested RBC)

A

(+) Hemosiderin and hematoidin crystals

50
Q

Intracranial Hemorrhage:
D-dimer (fibrindegradation product)

A

(+) Fibrin-formation in the bleeding site

51
Q

water-like

A

Normal

52
Q

Viscous CSF

A

Metastatic mucin-producing adenocarcinoma
Cryptococcal meningitis (C. neoformans → polysaccharide capsule → viscous)
Liquid Nucleus Pulposus

53
Q

Any cell count must be performed IMMEDIATELY!
WBC and RBC begin to lyse within____

A

1 hour after collection

54
Q

Any cell count must be performed IMMEDIATELY!
40% of WBCs disintegrate within____

A

2 hours after collection

55
Q

Routinely performed on CSF

A

WBC Count

56
Q

WBC Count
Normal values
▪ Adult:
▪ Neonates:

A

WBC Count
Normal values
▪ Adult: 0-5 WBC/uL
▪ Neonates: 0-30 WBC/uL

57
Q

Diluting fluid

A

3% acetic acid (lyse the RBC) with methylene blue (sustain the WBC)

58
Q

Not routinely performed on CSF

A

RBC Count; because it is not normal to find RBC in CSF unless it is for traumatic tap

59
Q

To correct for WBC count and total protein concentration:
Subtract for every ____ 700 RBCs seen

A

1WBC

60
Q

To correct for WBC count and total protein concentration:
Subtract in ____ total protein concentration for every 10,000 RBC/uL

A

8mg/dL

61
Q

Performed in stained CSF smear

A

CSF Differential Count

62
Q

Specimen should be _____ first before preparing a smear

A

concentrated

63
Q

Routine centrifugation

A

CSF is centrifuges for 5-10 minutes

64
Q

used for smear preparation

A

Sediment

65
Q

removed (can be used for other test ie. Chemistry)

A

Supernatant

66
Q

Cytocentrifugation

A

▪ Fluid is added to a conical chamber
▪ Cells are forced into a monolayer within a 6mm diameter circle on the slide
▪ Addition of 30% albumin
* Increase cell yield or recovery
* Decreases cellular distortion

67
Q

increase number of normal cells

A

Pleocytosis

68
Q

Lymphocyte (___)
Monocyte (___)
(*reverse the percentage for newborns)

A

Lymphocyte (70%)
Monocyte (30%)
(*reverse the percentage for newborns)

69
Q

Intracranial hemorrhage (erythrophage)

A

Macrophage

70
Q

Blast forms (lymphoblast, myeloblast, normoblast)

A

Acute leukemia

71
Q

Neutrophils (normally see on)

A

Bacterial meningitis
Early case of viral, tubercular and fungal menigitis
Cerebral hemorrhage

72
Q

Lymphoma cells

A

Disseminated lymphoma

73
Q

Multiple sclerosis, lymphocyte reactions

A

Plasma cells

74
Q

Diagnostic procedures (neurosurgery, pneumoencephalography *CSF are removed for better viewing brain during X-ray)

A

Ependymal, Choroidal and Spindle-shaped cells

75
Q

Metastatic carcinoma, primary CNS carcinoma

A

Malignant cells

76
Q

CSF Protein Normal Value
Adults:
Infants:
Immature:
NOTE: *CSF in infants and immature is higher because the BBB is not well intact

A

CSF Protein Normal Value
Adults: 15-45 mg/dL
Infants: 150 mg/dL
Immature: 500 mg/dL
NOTE: *CSF in infants and immature is higher because the BBB is not well intact

77
Q

Major CSF Protein

A

Albumin

78
Q

2nd most Prevalent

A

Pre-albumin

79
Q

Alpha-globulins

A

Haptoglobin, Ceruloplasmin

80
Q

Beta-globulins

A

Beta-2 transferrin, “Tau”

81
Q

(carbohydrate deficient transferrin, found in CSF ONLY)

A

Beta-2 transferrin, “Tau”

82
Q

Gamma-globulins

A

IgG and IgA

83
Q

NOT FOUND PROTEIN:

A
  1. IgM – they are big in size, they are filtered out
  2. Fibrinogen
  3. Lipoproteins (LDL/B-LPP
84
Q

Meningitis *damage to BBB

A

Elevated Result

85
Q

Hemorrhage *damage to BBB

A

Elevated Result

86
Q

Multiple sclerosis (Increase plasmacells)

A

Elevated Result

87
Q

Guillain-barre syndrome

A

Elevated Result

88
Q

Neurosyphilis

A

Elevated Result

89
Q

Polyneuritis

A

Elevated Result

90
Q

Myxedema

A

Elevated Result

91
Q

Cushing dse.

A

Elevated Result

92
Q

Connective tissue dse

A

Elevated Result

93
Q

CSF leakage/trauma

A

Decreased Result

94
Q

Recent puncture

A

Decreased Result

95
Q

Rapid CSF production

A

Decreased Result

96
Q

Water intoxication

A

Decreased Result

97
Q

Polyneuritis

A

Elevated Result

98
Q

Diabetes

A

Elevated Result

99
Q

Uremia

A

Elevated Result

AUBF 2 CSF/ AMNIOTIC (FINALS) (3 decks)

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