Lumbar Puncture Flashcards

1
Q

What position can you get an opening pressure

A

lateral recumbent

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2
Q

What position can you not get an opening pressure

A

upright position

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3
Q

Manometer

A

measures intracranial pressure

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4
Q

Normal opening pressure

A

18-20

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5
Q

4 tubes

A

Tube 1- collect cel count and differential
Tube 2- glucose and protein
Tube 3- culture and gram stain
Tube 4- cell count and differential

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6
Q

How much fluid do you collect?

A

4-8mL

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7
Q

If it is a subarachnoid hemorrhage what will you se in all tubes?

A

blood

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8
Q

How much does each tube collect

A

2cc

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9
Q

When measuring opening pressure which way is the valve on the stopcock

A

upward

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10
Q

CSF analysis WBC

A
>5cells/uL= possible infection
Bacteria= increase in neutrophils
Viral= increase in lymphocytes
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11
Q

CSF analysis RBC

A

<10 cells/UL is normal

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12
Q

How to rule out traumatic tap?

A

xanthrocromia

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13
Q

CSF analysis glucose

A
range= 50-80mg/dL
Low= bacterial meningitis, sarcoidosis, syphilis, subarachnoid hemorrhage
Variable= viral
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14
Q

What can mask a depressed CSF glucose

A

serum hyperglycemia

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15
Q

CSF analysis protein

A
normal= 15-45mg/dL
Elevated= infection
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16
Q

Gram negatie diplococci

A

N. meningitis

17
Q

Gram negative bacilli

A

H. influenzae

18
Q

Gram positive cocci

A

S. pneumoniae or strep

19
Q

How long to get a culture results

A

24-48hr

20
Q

Xanthrocromia

A

production of red cell lysis; yellow orange discoloration of CSF fluid

21
Q

If you see xanthrocromia think what?

A

subarachnoid

22
Q

What if opening pressure >30

A

bacterial, pseudotumor cerebri