ch 9 Flashcards
formation of CSF
selective secretion
higher levels of sodium and chloride and magnesium
lower levels of potassium and calcium
normal volume of CSF
85-150 mL
where do you collect CSF
between 3rd and 4th lumbar spaces
testing CSF
measure pressure (should be between 50-180)
tubes in sequential order (chemistry, microbiology culture, cell counts)
examination
measure clarity vs turbidity
xanthochromia
abnormal color of CSF (either yellow, orange or pink)
causes of xanothochromia
hemorrhage, hyperbilirubinemia, hypercarotenemia, meningeal melanoma,
presence of visible blood can be caused by
traumatic tap or hemorrhage
–> recognize traumatic tap by performing cell counts of 1st and 3rd tube (should decrease)
microscopic examination
normal cell count (0-5 lymphocytes and monocytes
–> NOT RBCS
WBC count
diluted with acetic acid and counted
pleocytosis
increased number of cells in CSF that causes turbidity/cloudiness
increased neutrophils mean
bacterial meningitis
increased lymphocytes means
viral, TB, fungal or aspectic meningitits,
multiple sclerosis
plasma cells mean
tuberculous and syphilitc meningitis
eosinophils means
parasitic or allergic
macrophages means
hemorrhage
total protein in CSF
normal is 15-45 mg/dl
–> assess integrity if blood brain barrier
increased protein is due to
contamination during tap or change in blood barrier
CSF associated conditions
meningitis, multiple sclerosis, trauma
decreased protein is due to
intracranial pressure
protein electrophoresis
4 bands that predominate CSF
1. transthyretin, albumin, and 2 differing transferrin bands
what is 2nd transferrin band called
tau protein
microbiological examination
gram stain –> bacteria
acid-fast –> TB meningitis
wrights stain –> naegleria fowleri
