CSF analysis Flashcards
it is a major fluid of the body. CSF provides a physiologic system to supply nutrients to the nervous tissue, remove metabolic wastes, and produce a mechanical barrier to cushion the brain and spinal cord against trauma
Cerebrospinal fluid (CSF)
Enumerate the purposes of CSF examination
1) Evaluate the function of the Central Nervous System
2) CSF greatly indicates presence of infections, autoimmune disorders, diseases of the brain & the spinal cord (such as encephalitis, meningitis, multiple sclerosis, & hemorrhage)
3) Detects early signs of seizures & dementia
CSF covers what parts of the CNS?
- Brain
- Spinal cord
Main source of CSF; Comprises 70% of the CSF formation
Choroid plexus
Comprises 30% of the CSF formation
Subarachnoid space
Epithelial cells that lines the choroid plexus; main cells responsible for the formation of the blood- brain barrier
Choroidal cells
Regulates the movement of ions, molecules, and cells between the blood and the brain
Blood brain barrier
What are the layers of the brain (meninges)?
- Dura mater
- Arachnoid space
- Pia mater
what are the three (3) types of epithelial cells?
- Ependymal cells
- Choroidal cells
- Pia Arachnoid Mesothelial cells (PAM)
*Cells that lines the cerebral ventricles & neural canals of the spinal cord
*Range in shape from squamous to columnar
*May be ciliated
Ependymal cells
these cells lines the mesoderm of the pia & arachnoid layers
Pia Arachnoid Mesothelial cells (PAM)
what are the CSF ion components?
- H, K, Ca, bicarbonate and, Mg
T or F: Glucose, urea and creatinine diffuse freely and require 2 or more hours to regulate
True
How many CSF is produced each day?
500 mL (0.3 - 0.4 mL/min)
Volume of CSF in adults?
- 90 - 150 mL
- 25 mL in the ventricles and subarachnoid space
Volume of CSF in neonates?
10 to 60 mL
How many hours does CSF is replaced?
every 5 to 7 hours
Common site for lumbar puncture is the intervertebral space
Adult:
Children:
- between L3 and L4
- between L4 and L5
CSF obtained through what procedure?
cisternal or lumbar puncture through ventricular cannulas or shunts
Normal opening pressures
adults:
obese:
infants & children:
- 90 to 180 mm of water
- 250 mm of water
- 10 to 100 mm of water (6-8 yrs)
greater then 250 mm of water opening pressure indicates what underlying conditions?
- increased intracranial pressure which might be caused by meningitis, intracranial hemorrhage & tumors
what precaution should be observed when there is >200 opening pressure in a relaxed patient?
- no more than 2.0 ml should be withdrawn
this tool indicates the pressure of the CSF fluid
Manometer
Distribution of CSF tubes
Which lab section does tube #1 belongs to and what tests are applied?
- Chemistry and/or Serology section
- protein, glucose, lactate, VDRL, latex agglutination test
Distribution of CSF tubes
Which lab section does tube #2 belongs to and what tests are applied?
- Microbiology section
- Gram stain, culture and India ink
Distribution of CSF tubes
Which lab section does tube #3 belongs to and what tests are applied?
- hematology section
- cell count and differential
Microbiology should be stored in what tube?
- tube 2 (sterile)
Gross examination
Normal CSF color and appearance
- Crystal clear and colorless
Gross examination
What are the causes for turbidity or cloudiness of CSF specimens?
- WBC > 200/uL
- RBC > 400/uL
- Microorganisms
- radiographic contrast media
- aspirated epidural fat
- proteins > 150 mg/ dL ( 1.5 g/L)