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AUBF > F2: CSF (Part 1: Intro-Composition) > Flashcards

F2: CSF (Part 1: Intro-Composition) Flashcards

1
Q
  • A clear bodily fluid that occupies the subarachnoid space and the ventricular system around and inside the brain and spinal cord
  • the brain “floats” in it
  • Makes our head lighter because of buoyancy
  • provides a physiological system to supply nutrients to the nervous tissue, remove metabolic wastes, maintain intracranial pressure, and produce a mechanical barrier to cushion the brain and spinal cord against trauma
A

CEREBROSPINAL FLUID

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2
Q

T or F

Cerebrospinal fluid makes out head lighter due to buoyancy

A

T

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3
Q

Which is false about Cerebrospinal fluid

a. a physiological system to supply supply nutrients to the nervous
tissue
b. remove metabolic wastes
c. maintain extracranial pressure
d. produce a mechanical barrier to cushion the brain and spinal cord against trauma

A

c. maintain extracranial pressure

c. maintain extracranial pressure - should ba INTRACRANIAL

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4
Q

Occupies the space between the arachnoid mater and the pia mater

A

MENINGES

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5
Q

MENINGES

What are the 4 parts of meninges?

A
  • Dura mater
  • Arachnoid mater
  • Subarachnoid space
  • Pia mater
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6
Q

4 parts of meninges

  • Outer layer lining skull
  • Very hard
  • Latin for “hard mother”
A

Dura mater

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7
Q

4 parts of meninges

  • Contains blood vessels
  • “Spiderweb-like filamentous”
A

Arachnoid (mater)

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8
Q

4 parts of meninges

filled with csf

A

Subarachnoid space

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9
Q

4 parts of meninges

  • Covers the brain
  • Adhesive to the brain
  • Latin for “gentle mother”
A

Pia mater

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10
Q

Production of CSF

CSF is produced in the (blank) by modified ependymal cells in the (blank) and small amount is formed around (blank) and along (blank)

A

CSF is produced in the brain by modified ependymal cells in the choroid plexus and small amount is formed around blood vessels and along ventricular walls

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11
Q

Production of CSF

T or F

CSF is produced in the brain by simple ependymal cells in the choroid plexus

A

F (produced in the brain by modified ependymal cells in the choroid plexus)

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12
Q

Production of CSF

T or F

Small amount of CSF is formed around blood vessels and along ventricular walls

A

T

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13
Q

Circulation of CSF

(1) CSF circulates from ?

A

lateral ventricles

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14
Q

Circulation of CSF

(2) Blood in CSF circulates from lateral ventricles to the ?

a. foramen of monro
b. third ventricle
c. aqueduct of Sylvius
d. fourth ventricle
e. foramina of Magendie and Luschka
f. ALL
g. NOTA

A

f. ALL

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15
Q

Circulation of CSF

(3) After circulation trhough monro, 3rd ventricle, aqueduct of slyvius, 4th ventricle and foramina, it returns to the?

A

vascular system

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16
Q

Circulation of CSF

(4) After returning to vascular system, it enters through?

A

dural venous sinuses via the arachnoid granulations or villi

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17
Q

Circulation of CSF

(5) Circulation also flows along what two (2) parts of the brain into lymphatic channels (in neonate)?

A
  • Cranial nerves
  • Spinal nerve roots
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18
Q

Circulation of CSF

Familiarize the circulation of CSF

A
  1. Circulates from the lateral ventricles to the foramen of Monro, third ventricle, aqueduct of Sylvius, fourth ventricle, and foramina of Magendie and Luschka
  2. Returns to the vascular system by entering the dural venous sinuses via the arachnoid granulations or villi
  3. Also flows along the cranial nerves and spinal nerve roots
    into the lymphatic channels (in the neonate)
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19
Q

Volume

Production rate in mL/day and mL/hour

A

500 ml/day
20ml/hour

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20
Q

Volume

Space in the brain can only contain how much volume of CSF?

clue: range

A

135 to 150 ml

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21
Q

Volume

Space in the brain can only contain how much volume of CSF? (in ventricles)

A

25 ml in ventricles

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22
Q

Volume

Adult volume of CSF

clue: range din

A

90-150 ml

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23
Q

Volume

Neonates volume of CSF

A

10-60 ml

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24
Q

Volume

Turns over per day?

A

3.7x

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25
Q

Volume

To maintain the volume in adults and neonates, the circulating fluid is reabsorbed back into blood capillaries by what structure?

A

Arachnoid granulations/villae

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26
Q

Familiarize the (4) functions of CSF

A
  • Buoyancy
  • Protection
  • Chemical stability
  • Prevention of brain ischemia
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27
Q

(4) functions of CSF

  • Actual mass of brain 1400 gm, suspended in CSF equals 25 gm
A

Buoyancy

This buoyant force reduces the brain’s effective weight from 1400 grams to just 25 grams

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28
Q

(4) functions of CSF

  • Protects the brain tissue from injury when jolted or hit
  • Cushion when head is hit
A

Protection

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29
Q

(4) functions of CSF

  • Rinses metabolic waste through the blood-brain barrier
  • Stability and filteration
A

Chemical stability

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30
Q

(4) functions of CSF

  • Decreases total ICP and facilitates blood perfusion
  • Important in maintaining brain oxygenation
A

Prevention of brain ischemia

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31
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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32
Q

Choroid plexuses are capillary networks that form the CSF from plasma by using what (2) mechanisms of selective filtration

A
  • Hydrostatic pressure
  • Active transport secretion
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33
Q
  • Endothelial cells in choroid plexus with tight junctures
  • Prevents passage of large, water-soluble molecules, and high-electrical charged molecules
A

BLOOD BRAIN BARRIER

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34
Q

BLOOD BRAIN BARRIER

T or F

CSF comes from blood from endothelial cells

A

T

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35
Q

BLOOD BRAIN BARRIER

T or F

CSF is an ultrafiltrate of plasma, there are gap junctures to allow fluid

A

F (CSF is not an ultrafiltrate of plasma, does not have gap junctures)

Nothing goes in and out without active transport

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36
Q

BLOOD BRAIN BARRIER

T or F

Maintaining the integrity of the BBB is important to protect the brain from chemicals and other substances circulation the blood that could harm the brain tissue

A

T

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37
Q

Familiarize the (7) factors resulting in decreased blood brain barrier

A
  • Hypertension due to old age
  • Immaturity/Young age
  • Hyperosmolality
  • Microwaves
  • Radiation
  • Infection
  • Injury
38
Q

(7) factors resulting in decreased blood brain barrier

The most important factor is ?

mamili ka lang sa pito teh

39
Q

T or F

The reason why CSF is ordered is to diagnose disorders that affect the CNS

40
Q

Disorders that affect the CNS

Familiarize the disorders that affect the CNS

reason why CSF is ordered

A
  • Infections
  • Neoplasia
  • Bleeding
  • Others (GBS, Post-viral infection)
41
Q

Disorders that affect the CNS

Infections in brain include?

clue: ME

reason why CSF is ordered

A
  • Meningitis
  • Encephalitis
42
Q

Disorders that affect the CNS

  • Refer to Inflammation of meninges (in linings such pia mater and dura mater)

Infections

A

Meningitis

43
Q

Disorders that affect the CNS

The brain has an infection

Infections

A

Encephalitis

44
Q

Disorders that affect the CNS

This refers to metastasis to the brain such as leukemia, lymphoma, melanoma

45
Q

Disorders that affect the CNS

What are the 3 metastasis?

Neoplasia

A
  • Leukemia
  • Lymphoma
  • Melanoma
46
Q

Disorders that affect the CNS

Neoplasia of WBC

Neoplasia

3 metastasis

47
Q

Disorders that affect the CNS

Lymph node neoplasm

Neoplasia

3 metastasis

48
Q

Disorders that affect the CNS

  • Common in old people (Distance of blood vessels in brain is very far because it has thinned out)
  • Subarachnoid
  • Malformation of blood vessels in brain
  • Symptom: headache
49
Q

Disorders that affect the CNS

T or F

Bleeding in CNS is common in old people since distance of blood vessels in brain is very far because it has thickened

Bleeding

A

F (Bleeding in CNS is common in old people since distance of blood vessels in brain is very far because it has thinned out)

50
Q

Disorders that affect the CNS

Bleeding commonly occurs where?

Bleeding

A

Subarachnoid

51
Q

Disorders that affect the CNS

T or F

Common symptom of bleeding in subarachnoid is headache

Bleeding

52
Q

Disorders that affect the CNS

Other diseases affecting CNS are?

dalawa

A
  • Guillain-Barré syndrome (GBS)
  • Post-viral infection
53
Q

Disorders that affect the CNS

Immune system mistakenly attacks their peripheral nervous system

Other diseases affecting CNS

A

Guillain-Barré syndrome (GBS)

54
Q

Sampling

CSF is obtained by doing what procedure?

A

lumbar puncture

55
Q

Sampling

Lumbar segment punctured if adult?

56
Q

Sampling

Lumbar segment punctured if child?

57
Q

Sampling

Positioning of patient during lumbar puncture

a. Missionary
b. Lateral
c. Knee-to-chest position
d. a and c
e. b and c
f. ALL
g. NOTA

A

e. b and c

search niyu nalang ano itsura basta nakatagilid

58
Q

Sampling

T or F

Lumbar puncture is not complicated and requires no precaution

A

F (not complicated but requires precaution)

59
Q

Sampling

Tool used for lumbar puncture

A

Very long stylus with long needles

60
Q

Sampling

Stylus with long needle is inserted in ?

A

Vertebrae

very close to the spinal cord

61
Q

Sampling

Stylus with long needle must go to what space?

A

subarachnoid space

not too far in or out

62
Q

Sampling

T or F

The area where the sample is obtained is under
pressure

63
Q

Sampling

Possible complications in CSF lumbar puncture

a. Hitting spinal cord
b. lipemic sample
c. ALL
d. NOTA

A

a. Hitting spinal cord

2 complications:
1. Hitting spinal cord
2. Bubbling

64
Q

Sampling

T or F

The volume collected is based on the volume available in the patient and closing pressure of the CSF

A

F (The volume collected is based on the volume available in the patient and opening pressure of the CSF)

65
Q

Sampling

Usual volume collected for CSF?

66
Q

Sampling

Usual volume collected for CSF is 10 mL, if sample reaches 20 mL what may be done?

A

normally be removed

remove excess

67
Q

Sampling

If opening pressure is >200mm H2O, what volume of CSF should be removed?

68
Q

Sampling

If pressure reaches this percentage, procedure should be stopped

what percentage

A

reaches 50%

69
Q

Sampling

If pressure drops rapidly after 1-2 mL is removed, what (2) conditions are suggested?

A
  • Herniation (Brain falls through a hole in the bone)
  • Spinal block
70
Q

Sampling

Match the condition to the following:
If opening pressure is >200mm H20

a. Remove 2L
b. Stop
c. Herniation or spinal block
d. ALL
e. NOTA

A

e. NOTA

a. Remove 2L - should be remove 2mL ot be correct

71
Q

Sampling

Match the condition to the following:
If pressure reaches 50% of opening

a. Remove 2mL
b. Stop
c. Herniation or spinal block
d. ALL
e. NOTA

72
Q

Sampling

Match the condition to the following:
Pressure drops rapidly after 1-2 mL is removed

a. Herniation
b. Spinal block
c. ALL
d. NOTA

73
Q

Sampling

a condition where brain falls through a hole in the bone

Pressure drops rapidly after 1-2 mL is removed

A

Herniation

74
Q

Sampling

CSF sample is extracted by?

A

Neurologist

75
Q

Sampling

T or F

If CSF chemistry or cell count is requested. First, get a blood sample for Chemistry & Complete Blood Count

76
Q

Sampling

T or F

One must remind the doctor in case he forgets to collect blood before CSF sample extraction

77
Q

This factor in CSF depends on position, BP, venous return, Valsalva, cerebral blood flow, and weight of the patient

78
Q

Pressure

  • Moving of bowels in the morning
  • Increases CSF flow
79
Q

Pressure

Normal pressure for < 6 years old

A

10-100 mm H2O

80
Q

Pressure

Normal pressure for > 6 years old

A

<200mm H20

81
Q

Pressure

T or F
250mm H2O diagnostic of increased intracranial pressure

82
Q

Composition

CSF composes of what percentage and volume of plasma proteins?

A

0.3% plasma proteins
15 to 40 mg/dL

83
Q

Composition

T or F

Diffusion of plasma proteins depends on molecular size

A

F (depends on molecular weight)

84
Q

Composition

  • Component of CSF which is Less than 1%
  • Very small amount
  • Diffusion will be very small
A

Plasma protein

85
Q

These (3) other component of CSF diffuses freely

A

Glucose, urea, creatinine approximate blood levels

86
Q

COMPOSITION OF CSF

Based on the lower and upper limit given, what is the apporpriate substance present in CSF:

45-80 mg/dL

87
Q

COMPOSITION OF CSF

Based on the lower and upper limit given, what is the apporpriate substance present in CSF:

15-45 mg/dL

88
Q

COMPOSITION OF CSF

Based on the lower and upper limit given, what is the apporpriate substance present in CSF:

0 cells/uL

89
Q

COMPOSITION OF CSF

Based on the lower and upper limit given, what is the apporpriate substance present in CSF:

0-3 cells/uL

90
Q

COMPOSITION OF CSF

g/dL

a. Glucose
b. Protein
c. ALL
d. nOTA

A

d. nOTA (mg/dL both)

91
Q

COMPOSITION OF CSF

cells/uL

a. RBC
b. Protein
c. ALL
d. nOTA

A

a. RBC (RBC and WBC ang cells/uL)

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