CSF Strasinger

Question 1

Meninges consists of three layers, namely

Answer 1

Dura mater - outer layer; lines the skull and vertebral canal

Arachnoid - filamentous (spider-like) inner membrane

Pia mater - thin membrane lining the surfaces of the brain and spinal cord

Question 2

The brain and spinal cord are lined by

Answer 2

Meninges

Question 3

In adults, approximately ____________ of CSF is produced every hour

Answer 3

20 mL, produced by choroid plexus

Question 4

The CSF flows through the

Answer 4

Subarachnoid space, located between the arachnoid and pia mater

Question 5

To maintain a volume of __________ in adults and ________ in neonates, the circulating fluid is reabsorbed back into the blood capillaries in the _____________ at a rate equal to its production.

Answer 5

90-150mL in adults;
10-60mL in neonates;
Arachnoid granulations/villae

Question 6

CSF is formed by

Answer 6

Mechanisms of selective filtration under hydrostatic pressure ad active transport secretion

Question 7

The tight-fitting structures if the endothelial cells in tbe choroid plexuses is termed the

Answer 7

Blood-brain barrier

Question 8

Diseases that can disrupt the BBB

Answer 8

Meningitis and multiple sclerosis

Question 9

CSF is routinely collected by lumbar puncture between the

Answer 9

Third, fourth, or fifth lumbar vertebra

Question 10

Elevated opening pressure of CSF requires the fluid to be withdrawn __________, with careful monitoring of the pressure, and may prevent collection of a _________ volume

Answer 10

Slowly; large

Question 11

CSF specimens are maintained in the following manner

Answer 11

Chemistry and serology tubes are frozen.
Microbiology tubes remain at RT.
Hematology tubes are refrigerated.

Question 12

Xanthochromia is

Answer 12

A term used to describe CSF supernatant that is pink, orange, or yellow.

Question 13

Most common factor or presence of xanthochromia

Answer 13

RBC degradation products.

Pink- very slight amount of oxyhemoglobin

Orange - heavy hemolysis

Yellow - conversion of oxyhemoglobin to unconjugated bilirubin

Question 14

Other causes of xanthochromia

Answer 14

Elevated serum bilirubin

Pigment carotene

Markedly increased protein

Melanoma pigment

Question 15

Diseases in which damage to the BBB allows ncreased filtration of protein and coagulation factors also cause clot formation but do not usually produce a bloody fluid. This conditions include

Answer 15

Meningitis, Froin syndrome, and blockage of CSF circulation through the subarachnoid space

Question 16

A classic ______________ is associated with __________ and can be seen after overnight refrigeration of CSF.

Answer 16

Web-like pellicle; tubercular meningitis

Question 17

Additional testing for differentiating intracranial hemorrhage and Traumatic tap includes

Answer 17

Microscopic examination: presence of macrophages containing ingested RBCs (erythrophagocytosis) or hemosiderin granules is indicative of intracranial hemorrhage.

Detection of the fibrin degradation product, D-dimer, by latex agglutination immunoassay indicates the formation of fibrin at a hemorrhage site.

Question 18

For total cell counts, dilute CSF with

Answer 18

Normal saline

Question 19

For WBC count, dilute CSF with

Answer 19

3% glacial acetic acid.

* methylene blue can be added for better differentiation between neutrophils and mononuclear cells.

Question 20

Formula to obtain WBC added

Answer 20

WBC blood x RBC CSF

OVER

RBC blood

Question 21

QC: on a __________ basis, all diluents should be checked for contamination by examination in a counting chamber under _______ magnification. Contaminated diluents should be discarded and new solutions prepared.

Answer 21

Biweekly; 4x

Question 22

QC: on a ___________ basis, the speed of the centrifuge should be checked with a ____________, and the timing should be checked with a __________.

Answer 22

Monthly; tachometer; stopwatch

Question 23

QC: if nondisposable counting chambers are used, they must be soaked in a ______________ for at least __________ and then thoroughly rinsed with water and cleaned with __________.

Answer 23

Bactericidal solution; 15 minutes; isopropyl alcohol

Question 24

For differential count, CSF should be

Answer 24

Concentrated and stained

Question 25

Methods for CSF concentration

Answer 25

Sedimentation, filtration, centrifugation, cytocentrifugation

Question 26

The CSF is centrifuged for ________. Slides made from suspended sediments are allowed to _______ and are stained with ________.

Answer 26

5-10 minutes; air dry; Wright’s stain