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Clin Lab > CSF > Flashcards

CSF Flashcards

1
Q

Where does CSF originate?

A

Choroid plexus of the intracranial ventricles

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2
Q

What spaces does the fluid occupy?

A

-Ventricles
-Subarachnoid space
(around the brain and spinal cord)

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3
Q

The composition of CSF is derived from these 3 things…

A
  • Filtration
  • Differential absorption
  • Active secretion
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4
Q

What are the functions of CSF?

A
  • Enhance nutrition of the brain
  • Remove metabolic biproducts
  • Protect against mechanical injury
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5
Q

The composition of electrolytes in CSF varies with the changes in _______ levels

A

Plasma

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6
Q

Most constituents in CSF are present in ______ or ______ concentration than the plasma

A

Equal or lower

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7
Q

Pathological conditions cause inflammation, this causes leaky vessels, this leads to…

A

Elements that are typically restrained entering the blood brain barrier getting into the CSF and causing high concentrations

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8
Q

Are proteins and lipids found in CSF?

A

Nope

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9
Q

Are RBC and WBC in the CSF?

A

Nope- only enter if there is a ruptured blood vessel of inflammation of the meninges

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10
Q

Is bilirubin in CSF

A

No- seen in intracranial hemorrhage (xanthochromia)

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11
Q

What color should the CSF be?

A

Clear

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12
Q

How is normal pressure maintained in the brain

A

By absorption of CSF through the arachnoid villi in equal amounts to its production by the choroid plexus

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13
Q

What are the steps for determining if you need a lumbar puncture

A

-Determine the diagnostic objective

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14
Q

When is a lumbar puncture normally used

A
  • Suspected meningitis
  • Subarachnoid hemorrhage
  • Other intracranial bleed
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15
Q

What are 2 tests that replaced some need for lumbar punctures

A
  • CT

- MRI

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16
Q

Do you have to consider the possibility of intracranial pressure?

A

Yes- if there is a pressure difference and you release it in a lumbar puncture you can pull the brainstem through the foramen magnum

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17
Q

When is a fundoscopy used?

A

To rule out the presence of papilledema (swelling of the optic disk)

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18
Q

What can be given to decrease the cranial pressures

A

Solute diuretic

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19
Q

What are 2 things to do before a lumbar puncture

A
  • explain procedure

- provide reassurance

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20
Q

When is the pop sound heard?

A

When the needle punctures the dura

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21
Q

What are 2 things that can occur after a LP?

A
  • Temporary parasthesias

- Post puncture headache

22
Q

Describe the post puncture headache

A
  • occurs in 25% of patients
  • bilateral occipital or frontal
  • occurs only in the upright position
  • lying suprine relieves the pain quickly
23
Q

How should the patient be positioned?

A
  • Knees to chest with the chin flexed towards the knees

- Breath slowly and naturally

24
Q

Where should the needle be inserted?

A

Between the 3rd, 4th, or 5th lumbar intervertebral spaces

25
Q

Should the opening pressure be recorded?

A

Yes

26
Q

What does turbitity signify

A

Leukocytes

27
Q

What does yellow discoloration mean?

A

Previous bleeding

28
Q

What is the pH of CSF compared to blood?

A 
CSF= 7.31
Blood= 7.41
29
Q

How do you know if the blood is due to puncture of a vessel on the way into do the LP

A

The tube will get lighter by the 3rd tube

30
Q

What does brown CSF mean?

A

-Presence of methemalbumin (which is associated with subdural hematoma)

31
Q

When can spontaneous clotting occur?

A

-Whenever protein content is high

32
Q

What is the mean CSF pressure

A

120 mmHg

33
Q

What happens when a patient holds their breath or tenses muscles

A

Increase in CSF pressure

34
Q

What causes a person to have decrease in CSF pressure

A

Dehydration

35
Q

These three things cause increase in CSF

A
  • Intracranial tumors
  • Purulent meningitis
  • Encephalitis
  • Neurosyphillis
36
Q

What is the average drop in CSF pressure

A

5-10 mm drop in pressure for every mL of fluid removed

37
Q

What kind of bloody tap does not clot

A

-subarachnoid hemorrhage

38
Q

What is the correction factor?

A

Allow 1-2 WBC for every 1000 RBC= anything greater is indicative of preexisting leukocytes

39
Q

10-200 cells=

A

Primarily lymphocytosis

  • viral meningitis
  • late neurosyphillis
  • MS
  • Tumor
40
Q

200-500 mixed cell type=

A
  • TB meningitis

- Herpes infection of CSF

41
Q

Over 500 granulocytes

A

-Acute bacterial meningitis

42
Q

Immature cells=

A

Meningeal leukemia

43
Q

Normal blood concentrations of protein are less than __%

A

1%

44
Q

What 2 things increase protein levels

A
  • Purulent meningitis

- Multiple sclerosis

45
Q

What do you suspect if you have elevated protein levels without cells

A

-Degenerative disease of CNS
(MS, neurosyphillis)
-Subarachnoid blockage

46
Q

What are the levels of blood glucose in the CSF

A

50-80% of the normal blood glucose levels

47
Q

How long is the lag period for glucose

A

30-40 minutes

48
Q

In purulent meningitis, you get a ____ in CSF glucose

A

Drop

49
Q

What do lactic acid levels reflect?

A

Local glycolysis

50
Q

An isolated increase in CSF lactate indicates….

A

-Increased glucose metabolism

51
Q

Are smears used?

A

Yes- if there is any question of meningitis or CNS infection - use a gram stain or acid fast stain

Clin Lab (23 decks)

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