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Year 2- CNS > CSF, Lumbar Puncture and Hydrocephalus > Flashcards

CSF, Lumbar Puncture and Hydrocephalus Flashcards

1
Q
A
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2
Q

Where would you find CSF?

A

Surrounding brain and spinal cord

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3
Q

What is the function of CSF?

A

Protection
Acts as shock absorber
Possible immunological function

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4
Q

In which space does CSF circulate?

A

Subarachnoid space between arachnoid and pia mater

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5
Q

Where is CFS produced?

A

Choroid plexuses

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6
Q

Where are the choroid plexuses?

A

Lateral ventricles
Fourth ventricle

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7
Q

What is CSF primarily absorbed by?

A

Arachnoid villi

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8
Q

What is the rate of absorption dependant on?

A

Pressure dependant

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9
Q

Which type of cells are found in CSF?

A

No cells found in CSF, no more than five lymphocytes

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10
Q

What is the appearance of CSF?

A

Clear and colourless

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11
Q

What differences are there in CSF in bacterial infection?

A

Raised protein
Raised pressure
Cloudy appearance
Reduced glucose
Raised WCC

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12
Q

What is the difference in CSF if there is viral infection?

A

WCC (white cell count) elevated a lot

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13
Q

What is the difference in CSF if there is fungal/TB infection?

A

Lower glucose
Raised WCC

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14
Q

List the normal constituents of CSF.

A

Sodium, potassium, chlorine, protein, glucose

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15
Q

How is CSF sampled?

A

Lumbar puncture

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16
Q

What position should the patient be in when taking a lumbar puncture?

A

Lateral recumbent position

17
Q

Which vertebral level is a lumbar puncture taken at?

A

L4-5

18
Q

What is the normal cause of hydrocephalus?

A

Abnormal CSF absorption

19
Q

What are the two types of hydrocephalus caused by abnormal CSF absorption?

A

Obstructive hydrocephalus
Communicating hydrocephalus

20
Q

What happens in obstructive hydrocephalus?

A

There is a block within the ventricular system causing obstruction of free fluid outlfow.

21
Q

What happens in communicative hydrocephalus?

A

Defect in the CSF reabsorption by the arachnoid granulations

22
Q

Apart from abnormal CSF absorption, what else can cause hydrocephalus?

A

Overproduction of CSF

23
Q

Give an example of an individual who might overproduce CSF.

A

Those with choroid plexus papilloma’s, a type of tumour

24
Q

What are some of the most common congenital causes of hydrocephalus?

A

Spina bifida, more specifically, myelomeningocele
Primary aqueduct stenosis
Dandy Walker Malformation

25
Q

What is the most general cause of hydrocephalus?

A

Infection

26
Q

After which incident may hydrocephalus be more likely to occur?

A

Post-haemorrhagic

27
Q

Give an example of something which can cause obstructive hydrocephalus.

A

Tumour of brain

28
Q

What are the signs and symptoms of hydrocephalus in older children and adults?

A

Increased intra-cranial pressure
Gait changes
Upgaze
Papilledema
Headache
Gaze palsy

29
Q

What are the signs and symptoms of hydrocephalus in young children?

A

Abnormalities in head circumference
Cranium enlarges at a rate greater than facial growth
Irritability
Poor head control
Fontanelle full and bulging
Enlargement and engorgement of scalp veins
Upward gaze palsy
6th nerve palsy
Irregular respirations with apneic spells

30
Q

Which investigations are used to identify hydrocephalus?

A

-> fundoscopy to check for papilledema
->CT
-> MRI, much more detailed

31
Q

Which type of imaging is used when dealing with a small baby with suspected hydrocephalus?

A

Ultrasound

32
Q

What is the treatment for communicating hydrocephalus?

A

Lumbar puncture
Lumbar drain

33
Q

What is the treatment for obstructive hydrocephalus?

A

External ventricular drain

->these patients tend to be more unwell hence why a lumbar puncture/drain are not as safe

34
Q

What will be carried out if someone needs a permanent diversion of excess CSF due to obstructive hydrocephalus?

A

Endoscopic third ventriculostomy

35
Q

What will be carried our if a patient requires permanent diversion of CSF due to communicating hydrocephalus?

A

VP shunt (ventriculo-pertioneal shunt)

36
Q
A

Year 2- CNS (49 decks)

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