LP and CSF Flashcards

1
Q

how much CSF is there normally?

A

150ml

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2
Q

how much CSF is produced daily?

A

500ml

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3
Q

how many times is CSF replenished completely?

A

3

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4
Q

which epithelial layer produces CSF?

A

choroid plexus

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5
Q

what helps CSF flow around?

A

beating cilia

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6
Q

where is the main production of the CSF?

A

lateral ventricles

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7
Q

what structure resorbs the CSF?

in what space is this structure located?

A

arachnoid villi

sub-arachnoid space

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8
Q

through what two foramens does CSF get into the sub-arachnoid space?

A

foramen of luschka & magendie

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9
Q

through what structure does CSF flow in the 3rd ventricle?

through what structure does CSF flow into the 4th ventricle?

A

foramen of monro

cerebral aqueduct

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10
Q

outline the flow of CSF?

-8

A

lateral ventricles
(main production)

foramen of
monro

3rd ventricle

cerebral aqueduct

4th ventricle

via foramen of luschka & magendie & spinal cord opening

sub-arachnoid space

Arachnoid villi
(reabsoprtion)

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11
Q

most common side effect after lumbar puncture?

how do you manage this se?

A

headache

analgesia + rest

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12
Q

most severe se of LP?

explain mechanistically how this se can happen?

A

brainstem herniation

pt has high ICP –> LP causes big drop in ICP –> quick pressure drop can suck out brainstem

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13
Q

between which vertebrae do you do the LP?

A

l4/l5

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14
Q

what device is used to measure the pressure when doing LP?

A

Manometer

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15
Q

route of needle in LP?

A
Skin
↓ 
SCfat
↓
back muscles
↓
supraspinous ligametnum, 
↓
ligamentum flavum
↓
sub-arachnoid space.
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16
Q

what are the polymorph cells?

A

neutrophils (BEN)

17
Q

what are the mononuclear cells?

A

lymphocytes

18
Q

if pt has autoimmune disease.

what is the hallmark result seen on LP?

A

oligoclonal bands

19
Q

RBC in CSF on doing LP.

what is this a sign of?

20
Q

in a viral infection CSF fluid is usually what appearance?

21
Q

in a bacterial infection CSF fluid is what appearance?

22
Q

in a fungal infection CSF fluid is what appearance?

23
Q

pt has viral infection.

which cell type increase in the CSF?

A

mononuclear (lymphocytes)

24
Q

pt has pyogenic infection.

which leukocyte type increase in the CSF?

A

Polymorphs

neutrophils

25
pyogenic infection is a synonym for what microbial infection?
bacterial
26
in which infection type does glucose decrease in CSF?
pyogenic (bacterial)
27
in which infections does protein levels increase in CSF? -name all if more than one
pyogenic viral fungi
28
CI for an LP? | -5
``` raised idiopathic CSF bleeding disorders warfarin clopidogrel MSK deformities ```
29
which ligament comes after supraspinous ligament?
ligamentum flavum
30
which ligament precedes sub-arachnoid space?
ligamentum flavum
31
you put needle through someone's back. what is the first ligament you hit?
supraspinous ligament
32
which two medications (name them) if pt is on them means LP is contraindicated?
warfarin | clopidogrel
33
in which infection type does protein increase a lot on LP?
pyogenic (bacterial)
34
why does glucose decrease on LP in bacterial infection?
bacteria using glucose
35
why does bacterial infection have very very high protein in LP?
so much bacteria you just end up measuring the bacteria's protein