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Body Fluids > Cerebrospinal Fluid > Flashcards

Cerebrospinal Fluid Flashcards

1
Q

Definition

A

Fluid that occupies spaces of the CNS
Surrounds the brain and spinal cord

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2
Q

Meninges

A

Layers of the brain

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3
Q

Membranes covering Brain and Spinal Cord

A

Dura Mater
Leptomeninges

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4
Q

Dura mater

A

Outside layer

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5
Q

Leptomeninges

A

Arachnoid mater
Pia mater

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6
Q

Arachnoid mater

A

Between the Dura mater and Pia mater
Considered to be part of the Leptomeninges

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7
Q

Pia mater

A

Inner most membrane
Considered to be part of the Leptomeninges

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8
Q

Primary production of CSF

A

Choroid plexus

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9
Q

Mechanism of production

A

Filtration under hydrostatic pressure
Modified by active transport and selective absorption

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10
Q

Rate of CSF production

A

Approximately 0.35 ml/min or 21 ml/hr

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11
Q

Total Adult Volume of CSF

A

140-170 mL

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12
Q

Total Neonate Volume of CSF

A

10-60 mL

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13
Q

Percentage of turnover CSF

A

14% per hour
Reabsorption through ventricle

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14
Q

CSF Function

A

Supplies nutrients
Removes waste
Blood/Brain barrier
Cushions and Lubricates

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15
Q

CSF Collection

A

Lumbar Puncture or Spinal Tap
Between 3rd and 4th or 4th and 5th Lumbar vertebrae

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16
Q

CSF Tubes in specific order

A

1 - Chemistry/serology
2 - Microbiology (never uses first tube due to poss contam)
3 - Hematology
4 - Hematology (if possible to obtain 4 tubes)

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17
Q

Intracranial pressure monitored

A

Prevents damage to neural tissue
Determine safe amount of fluid to remove
Reflection of size of CSF reservoir
Indication of disease

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18
Q

CSF Analysis Time Frame

A

Always considered a STAT sample
- Due to less friendly environment for cells
- Cells degrade quickly with no nutrients
Must be processed within 45 minutes

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19
Q

Quality Control for CSF

A

Daily Counts
Monitor diluent for contamination
Monitor centrifuge speed and timer

20
Q

Appearance of typical CSF

A

Color - colorless
Clarity - clear

21
Q

Normal TNC Count

A

0-5/cumm
100% mononuclear (lymphs and monocytes)

22
Q

Normal RBC Count

A

0/cumm

23
Q

Normal Glucose level

A

2/3 of plasma glucose
(bacterial infections cause glucose to decreased)

24
Q

Normal Protein level

A

15-45 mg/dL
(could increase due to blood or meningitis)

25
Q

Other chemical analysis

A

Lactate, Glutamine, Enzyme

26
Q

Lactate increase

A

in bacterial meningitis

27
Q

Glutamine increase

A

Liver disease

28
Q

Two reasons for Bloody, pink, red

A

Hemorrhage
Traumatic Tap

29
Q

Hemorrhage

A

Xanthochromic supernatant (red color)
Blood amount consistent between tubes 1 and 3
- long term bleed
- supernatant will have a yellowish/reddish hue

30
Q

Traumatic Tap

A

Capillary hit on insertion of needle
Clear supernatant
Blood amount decreasing between tubes 1 and 3
- Clots may be seen

31
Q

CSF Hazy or Cloudy

A

Increased number of cells
Increased protein
X-ray contrast media
Microorganisms

32
Q

CSF Increased RBCs

A

Hemorrhage
CVA/Stroke
Traumatic Tap
Bone Marrow Contamination

33
Q

Neutrophils increased in CSF

A

Bacterial meningitis (only report bacteria present)
Early viral meningitis
Hemorrhage
Contamination

34
Q

nRBCs increased in CSF

A

Hemorrhage
Contamination (Bone Marrow or Blood)

35
Q

Lymphocytes increased in CSF

A

Viral meningitis
TB, fungal infection
Multiple sclerosis

36
Q

Monocytes increased in CSF

A

Inflammation
Clean up
Post Hemorrhage
TB

37
Q

Eosinophils increased in CSF

A

Parasitic infection
Hydrocephalic Shunts
CNS Eosinophilic Leukemia (VERY RARE)

38
Q

Blasts present in CSF

A

CNS involvement of Leukemia

39
Q

Other Malignant Cells Present

A

Metastatic Solid Tumors
Lymphoma

40
Q

Macrophages Present

A

Clean up cells
Post hemorrhage
TB

41
Q

Plasma Cells

A

Lymphocytic Reaction
Multiple sclerosis
Multiple myeloma

42
Q

Other cells Present

A

Choroidal Cells
Ependymal Cells
Pia Arachnoid Cells

43
Q

Increased Glucose levels

A

Hyperglycemia or glucose loading

44
Q

Decreased Glucose levels

A

Disorder of glucose transport
Metabolism of glucose by organisms or cells
Glucose consumption by tumor or abcess

45
Q

Increased Protein levels

A

Most useful indicator
Lysis of contaminant blood
Infection and/or bleeding
Increased production of protein
Obstruction
Decreased removal of protein

46
Q

Decreased Protein levels

A

Result of lumbar puncture
CNS Leakage
Increased removal of protein

Body Fluids (6 decks)

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