CSF Flashcards
3rd major body fluid
CSF
provides physiological system to supply nutrients to the nervous system
CSF
Functions of CSF
- Supply nutrients to CNS
- Remove metabolic waste
- Produce mechanical barrier to cushion the brain and spinal cord against trauma
Lines the brain and spinal cord
Meninges
3 Layers of Meninges
- Dura mater
- Arachnoid mater
- Pia mater
outer layer and lines the skull and vertebral canal
Dura mater
spider-like and filamentous inner membrane
Arachnoid mater
innermost layer and lines the surface of brain and spinal cord
Pia mater
It is between arachnoid mater and pia mater
It is where CSF flows
Subarachnoid space
specific part of brain that produces CSF
Choroid Plexus
The choroid plexuses are ____ that form the CSF from plasma by mechanisms of ____ under ____ and active transport secretion
capillary networks
selective filtration
hydrostatic pressure
T/F
chemical composition of the CSF
resemble an ultrafiltrate of plasma
FALSE
It does not resemble
rate of CSF production
20 mL/hr
A tightly fitting junctures structure of endothelial cells in the choroid plexus
Blood-brain barrier
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 WBC, protein and other chemicals to enter CSF
Blood brain barrier
specimen collected for CSF
lumbar puncture/tap and cisternal puncture
pressure of patient when CSF is collected
90 and 180 mmHg
Volume collected/removed for CSF if the pressure is normal
20 mL
On closing, the pressure should be between
10 and 30 mmHg
A marked decrease in pressure following this procedure suggests
cerebellar herniation or spinal cord compression
If the CSF pressure is less than or greater than normal 90-180 mmHg, what is the volume to be collected/ used
only 1-2 ml is used
If the CSF pressure is greater than 200 mmHg, what is the volume to be collected/ used
not more than 2 mL
Normal CSF volume for:
Adults
Neonates
90-150 mL
10-60 mL
Tube distribution should be:
- Chem/IS
- Microbio
- Hema/ Cytology studies
- Microbio or Sero
In tube distribution, what is the storage temp of Chem/ IS
Freezer temp
In tube distribution, Microbiology is for ____, what is the storage temp
better, exclude skin contamination
Room temp
In tube distribution, Hematology is for _____, and what is the storage temp
cell count
Ref temp
Tube distribution if there is 1 tube only
Microbiology, Hematology, Chem/Sero
T/F
Excess CSF should be discarded after
FALSE
should not be discarded and should be frozen until there is no further use of it.
Appearance of a Normal CSF
Crystal clear
- Increase WBC that is greater than 200 /ul
- Increase RBC that is greater than 400/ ul
- Presence of microorganism
- Increase Proteins and Lipid
Hazy, Cloudy, Turbid, Milky
Pink: Slight amount of oxyhemoglobin
Yellow: bilirubin traces
Orange: In case of heavy hemolysis
Brownish: methemoglobin formation
Xanthochromic (Reddish to pinkish)
- Increase dietary carotene
- Increase rifampin
intake - Increase melanin
- Normal neonate
- Protein concentration exceeding 150mg/dL
- Previous traumatic tap
Xanthochromic (Reddish to pinkish)
Greater than 6000 RBCs/ul due
to:
- Traumatic tap or
- Intracranial hemorrhage/cerebral
hemorrhage
Bloody / grossly bloody
Radiographic contrast dye
Oily
Protein and clotting factors Meningitis, Froin’s syndrome
Clotted
Tubercular meningitis
Pellicle
Distribution of blood in 3 tubes in Traumatic tap
1>2>3
Clot formation in Traumatic tap
Presence of clot
Supernatant in Traumatic tap
Clear
Erythrophages in Traumatic tap
Absent
D-dimer test in Traumatic tap
Negative
Distribution of blood in 3 tubes in Intracranial hemorrhage
1=2=3
Clot formation in Intracranial hemorrhage
No clot formation
Supernatant in Intracranial hemorrhage
After 2 hrs it will be Xanthochromic
Erythrophages in Intracranial hemorrhage
Present
D-dimer test in Intracranial hemorrhage
Positive
