CSF Flashcards

1
Q

is a major fluid of the body

A

Cerebrospinal fluid (CSF)

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2
Q

This fluid provides physicians with a tool by which to evaluate the ______________

A

central nervous system (CNS).

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3
Q

CSF Function:

A

•supply nutrients to the nervous tissue
•remove metabolic wastes
•produce a mechanical barrier to cushion the brain and spinal cord against trauma

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4
Q

Brain and spinal cord are lined with

A

Meninges

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5
Q

Lines the skull and vertebral canal (hard mother)

A

Dura mater

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6
Q

filamentous; spider like (spiderweb- like)

A

Arachnoid mater

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7
Q

thin membrane lining the surfaces of the brain and spinal cord (gentle mother)

A

Pia mater

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8
Q

CSF is produced in the __________ of the two lumbar ventricles and the third and fourth ventricles

A

choroid plexuses

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9
Q

In adults,
approximately ____mL of fluid is produced every hour.

A

20 mL

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10
Q

To maintain a volume of
______ to _______ mL in adults

A

90 to 150

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11
Q

To maintain a volume of ____ to______ mL in neonates,

A

10 to 60 mL

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12
Q

are capillary networks that form the CSF from plasma by mechanisms of selective filtration under hydrostatic pressure and active transport secretion

A

Choroid plexuses

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13
Q

The fluid flows through the _____________ space located between the arachnoid and pia mater

A

subarachnoid

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14
Q

tight-fitting structure of the endothelial cells in the choroid plexuses is termed the ____________

A

blood–brain barrier

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15
Q

The procedure for obtaining CSF is known as a

A

Lumbar puncture

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16
Q

mL of CSF is slowly removed into three or four sterile tubes that are numbered sequentially

A

10 to 20 mL

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17
Q

Tube 1 used

A

Chemistry and serology

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18
Q

Tests are least affected by blood
or bacteria introduced as a result
of the tap procedure

A

tube 1

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19
Q

Preservation/consideration tube 1

A

Frozen

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20
Q

Tube 2 used

A

Microbiology

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21
Q

Preservation/consideration tube 2

A

Room temperature

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22
Q

Least likely to contain cells
introduced by the spinal tap
procedure

A

Tube 3

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23
Q

Preservation/consideration tube 3

A

Refrigeration

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24
Q

Tube 4 used

A

Microbiology and additional serologic test

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25
Provide better exclusion of skin contamination
Tube 4
26
CSF APPEARANCE
Cystal-clear Hazy, Turbid, Milky, Cloudy Bloody Clotted Xanthochromic Pellicle
27
Hazy, Turbid, Milky, Cloudy cause
WBC Microorganisms Protein
28
Hazy, Turbid, Milky, Cloudy major significance
- Meningitis - Disorders affecting blood-brain barrier - Production of IgG within the Central Nervous System
29
Crystal clear significance
Normal
30
OILY major significance
Radiographic Contrast Media
31
BLOODY cause
Rbc
32
Bloody major significance
Hemorrhage Traumatic Tap
33
XANTHOCHROMIC cause
Hemoglobin Bilirubin Carotene Protein Melanin
34
XANTHOCHROMIC major significance
- Old hemorrhage; lysed cells from traumatic tap - RBC degradation; elevated serum bilirubin levels - Increased serum levels - Disorders affecting blood-brain barrier - Meningeal melanosarcoma
35
CLOTTED cause
Protein Clotting factor
36
PELLICLE cause
Protein Clotting factor
37
PELLICLE major significance
Disorders affecting blood-brain barrier Tubular Meningitis
38
Bloody CSF can be indication of:
- Intracranial haemorrhage - Traumatic tap
39
Clotted major significance
Disorder affecting blood brain barrier Introduced by traumatic trap
40
Distribution of Blood: traumatic trap
Tube 1 - heaviest concentration blood Tube 2 & 3 - less blood or no blood
41
Distribution of Blood: intracranial hemorrhage
Even distribution: red color for all containers
42
Clot formation: intracranial hemorrhage
Not enough fibrinogen to clot
43
Clot formation: traumatic trap
With fibrinogen
44
Xanthochromic Supernatant: traumatic trap
Clear supernatant
45
Xanthochromic Supernatant: intracranial hemorrhage
Rbc stay CSF for 2hrs Backup test: d-dimer test and microscopic finding of erythrophagocytosis
46
Quality Control of CSF & other Body Fluid Cell Counts: biweekly
Diluent under 4x magnification
47
Quality Control of CSF & other Body Fluid Cell Counts: monthly
Speed of the Cytocentrifuge with a Tachometer
48
If nondisposable counting chambers are used, they must be soaked in a bactericidal solution for at least ______ minutes then thoroughly rinsed with water and cleaned with isopropyl alcohol after each use
15 minutes
49
If nondisposable counting chambers are used, they must be soaked in a bactericidal solution for at least 15 minutes then thoroughly rinsed with water and cleaned with ____________ after each use
isopropyl alcohol
50
If nondisposable counting chambers are used, they must be soaked in a bactericidal solution for at least 15 minutes then thoroughly rinsed with ________ and cleaned with isopropyl alcohol after each use
water
51
Cell Count Should be performed immediately
WBC 0-5/ul
52
used for blood cell count
Neubauer calculation formula
53
Utilizes standard Neubauer calculation formula used for blood cell count
Cell count
54
Cell count contain up to _______ WBCs or _______ RBCs/μl may appear clear
200 WBCs or 400 RBCs/μl
55
Reagent used for Lysis of RBCs
3% glacial acetic acid
56
Reagent added to the diltuting fluid
Methylene blue
57
Performed on a Wright-stained smear.
Differential count
58
are counted in the four corner squares and center square on both sides of the hemocytometer and the number is multiplied by the dilution factor to obtain the number of WBCs per microliter
Wbc count
59
Differential count performed on smear
Wright- stained smear
60
Methods available for specimen concentration includes in differential count
sedimentation filtration Centrifugation cytocentrifugation
61
Differential Count Cytocentrifuge/ routine centrifuge for
5-10 mins
62
Non-pathologically Significant Cells
Choroidal Cells Ependymal Cells Spindle-shaped Cells
63
Malignant Cells: hematologic
Lymphoblast Myeloblast Monoblast Lymphoma cell
64
Malignant Cells: non hematologic
Astrocytoma Retinoblastoma Medulloblastoma
65
CSF PROTEIN Normal Value:
15-45mg/dl
66
is the second most prevalent fraction in CSF
Prealbumin
67
unique to CSF (carbohydrate-deficient transferrin)
Tau protein
68
To detect Oligoclonal Bands, which represent inflammation within the CNS
Electrophoresis & Immunophoretic Techniques
69
Bands, which represent inflammation within the CNS
Myelin basic protein
70
GLUCOSE Normal Value:
60%-70% plasma
71
Clinical Significance of CSF Glucose: decrease glucose + increases neutrophil
Bacterial
72
Clinical Significance of CSF Glucose: decrease glucose + increases lymphocytes
Tubercular
73
Clinical Significance of CSF Glucose: no glucose+ increase lymphocytes
Viral
74
CSF GLUTAMINE VALUE
8-18mg/dl
75
Significance of Increased Concentration: protein
Meningitis Hemorrhage Mutiple sclerosis
76
Significance of Decreased Concentration: protein
CSF leakage
77
Significance of Decreased Concentration: GLUCOSE
Bacterial, Tubercular, and Fungal Meningitis
78
Significance of Increased Concentration: lactate
> 35mg/dl bacterial meningitis
79
Glutamine Significance of Increased Concentration:
>35 mg/dl disturbance of consciousness
80
CULTURE (CONFIRMATORY) : 24h
Bacterial
81
CULTURE (CONFIRMATORY): 6weeks
Tubercular
82
GRAM STAIN bacteria
Streptococcus pneumoniae (gram positive cocci) Haemophilus influenza (pleomorphic gram negative rod) Escherichia coli (gram negative rod) Neisseria meningitidis (gram negative cocci)
83
Test for Fungal Meningitis c. Neoformans
Latex agglutination test
84
Preparation for Fungal Meningitis
India ink preparation
85
C. Neoformans gram stain result
Star burst pattern
86
Not as sensitive as the Fluorescent Treponemal Antibody - Absorption
Venereal disease research laboratories
87
Recommended of CBC as serologic test
Venereal disease research laboratories
88
Sensitive serologic test
Fluorescent treponemal antibody-absorption
89
Less sensitive serologic test
Rapid plasma regain
90
Test for neurosyphilis
Venereal disease research laboratories
91
Test for syphilis
Fluorescent treponemal antibody absorption
92
Not recommended serologic test
Rapid plasma reagin