CSF Flashcards
CSF functions (3)
- Supply nutrients to the CNS
- Remove metabolic waste
- Produce a mechanical barrier to cushion the brain and spinal cord against trauma
Lines the brain and spinal cord and are composed of three layers
Meninges
An outer layer, lines the skull and vertebral canal
Dura mater
Spider-like, filamentous inner membrane
Arachnoid mater
Innermost layer, lines the surface of the brain and spinal cord
Pia mater
in between arachnoid mater and pia mater; where CSF flow
Subarachnoid space
specific part of the brain that produces CSF
Choroid Plexus
The choroid plexuses are capillary networks that form the CSF from plasma by mechanisms of selective filtration under ________ and _______
hydrostatic pressure and active transport secretion.
T/F. The chemical composition of the CSF does resemble an ultrafiltrate of plasma
FALSE. The chemical composition of the CSF does NOT resemble an ultrafiltrate of plasma
rate of CSF production
20 ml/hr
A tightly fitting junctures structure of endothelial cells in the choroid plexus;
Protects the brain from chemicals and other substances circulating in the blood that can harm the brain tissue
Blood-Brain Barrier
Disruption of BBB allows _____, _____ and other chemicals to enter CSF
WBC; protein
CSF Collection (2)
Lumbar puncture/tap and cisternal puncture
Pressure before CSF is collected
between 90 and 180 mmHg
Volume collected when CSF is normal.
20 mL of specimen may be removed
On closing, the pressure should be between ____ and ____
10 and 30 mmHg
A marked decrease in pressure following this procedure suggests __________________ or ____________
cerebellar herniation or spinal cord compression
If the CSF pressure is less than or greater than normal 90-180 mmHg, only _____ is used
1-2 ml
Not more than _____ can be removed when the pressure is greater than ______
2 ml; 200 mmHg
Normal CSF Volume
Adult:
Neonates:
Adult: 90 to 150ml (adults), 10 to 60ml (neonates)
Tube #1 Lab Section and Storage Temp
Chemistry, Immunology, Serology; Freezer Temp
Tube #2 Lab Section and Storage Temp
Microbiology; Room Temp
Tube #3 Lab Section and Storage Temp
Hematology (Cell count), and Cytology studies; Refrigerator Temp
Tube #4 Lab Section and Storage Temp
Microbiology (Better exclude skin contamination) or Serology (for additional serologic test)
Order of section if 1 tube is used;
(Microbiology, Hematology, Chemistry/Serology)
Microbiology is first to avoid contamination
T/F. Excess CSF should not be discarded and should be frozen until there is no further use of it.
Trueeeee
T/F. Excess CSF should not be discarded and should be frozen until there is no further use of it.
Trueeeee
Normal CSF Appearance
Crystal Clear
Increase WBC that is greater than 200 /ul
Hazy
Increase RBC that is greater than 400/ ul
Cloudy
Presence of microorganism
Turbid
Increase Proteins and Lipid
Milky
Color of Xanthochromic sample
reddish to pinkish
Slight amount of oxyhemoglobin color
Pink
bilirubin traces color
Yellow
Color in case of heavy hemolysis
Orange
methemoglobin formation color
Brownish
Greater than 6000 RBCs / ul due to: Traumatic tap or Intracranial hemorrhage / cerebral hemorrhage
Bloody / grossly bloody
Radiographic contrast dye Appearance
Oily
Protein and clotting factors
Meningitis, Froin’s syndrome appearance
Clotted
Tubercular meningitis appearance
Pellicle
Tube 1 has the highest blood followed by Tube 2 and Tube 3
Traumatic Tap
Equal distribution of blood in 3 tubes
Intracranial Hemorrhage
Matchy
True of Intracranial Hemorrhage
1. Presence of clot
2. Xanthochromic after 1 hour
3. D-dimer test positive
4. Absent Erythrophages
a. 1&2 b. 2&4 c. 1,2,&3 d. all e. none
only 3 is true :D.
Presence of clot and absent erythro is traumatic tap
Xanthocromic after 2 HOURS
Matchy
1. No clot formation
2. Clear Supernatant
3. Supernatant will be Xanthochromic after 2 hours
4. Presence of clot
a. Traumatic Tap
b. Intracranial Hemorrhage
- b
- a
- b
- a
Matchy
1. Presence of Erythrophage
2. D-dimer negative
3. D-dimer Positive
4. Absence of Erythropage
a. Traumatic Tap
b. Intracranial Hemorrhage
- b
- a
- b
- a
