CEREBROSPINAL FLUID Flashcards

(99 cards)

1
Q

third major body fluid

A

CEREBROSPINAL FLUID

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2
Q

Functions of CEREBROSPINAL FLUID

A
  1. Supply nutrients to the nervous system
  2. Remove metabolic waste
  3. Produce a mechanical barrier to cushion the brain and spinal cord against trauma
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3
Q

An ultrafiltrate of plasma

A

CEREBROSPINAL FLUID

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4
Q

Covers and lines the brain and spinal cord

A

Meninges

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5
Q

the outer most layer, directly lines the skull and vertebral canal

A

Dura Mater (tough mother

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6
Q

filamentous inner membrane

A

Arachnoid Mater (spider-like)

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7
Q

filaments are called___

A

traberculae

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8
Q

found between arachnoid and pia mater. It is where CSF flows

A

Subarachnoid space

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9
Q

innermost later directly lines the brain and spinal cord

A

Pia Mater (tender mother)

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10
Q

it is where the plasma filtered producing CSF

A

Choroid Plexus

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11
Q

Rate of production of CSF

A

20mL/hr. (approx. 500 mL/hr. or 0.3-04 mL/min)

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12
Q

tight junctions of endothelial cells, it will prevent passage of many molecules. Protect the brain from toxins, infections and other substance that can harm the brain

A

Blood Brain Barrier (BBB)

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13
Q

maintains and regulate the volume of CSF by reabsorbing the circulating CSF back to the peripheral circulation to prevent reflux of fluid

A

Arachnoid villi/Granulations

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14
Q

Rate of absorption of CSF

A

20mL/hr. (approx. 500 mL/hr. or 0.3-04 mL/min)

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15
Q

needle is inserted between the 3rd and 4th vertebrae or 4th and 5th vertebrae

A

Lumbar puncture (spinal tap)

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16
Q

needle is inserted directly below the occipital bone (back of skull)

A

Cisternal puncture (suboccipital puncture)

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17
Q

More dangerous than lumbar because it near the brainstem

A

Cisternal puncture (suboccipital puncture)

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18
Q

Volume collected of CSF

A

20mL (maximum amount)

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19
Q

least affected by blood or bacteria that is introduced during the tap

A

Chemistry/Serology

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20
Q

what tube and storage temp for chem/sero tube

A

First; Frozen

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21
Q

no longer at risk of bacterial contamination due to collection

A

Microbiology

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22
Q

what tube and storage temp for mricro tube

A

sec; @RT

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23
Q

what tube and storage temp for hema tube

A

third; refrigerated

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24
Q

least likely to contain skin cells

A

Hematology

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25
If 1 tube only:
Microbiology → Hematology → Chemistry and Serology
26
Normal Volume: *maintained by the reabsorption of fluid by arachnoid villi * Adults: * Neonates:
* Adults: 90 to 150mL * Neonates: 10-60mL
27
Normal appearance
Crystal Clear
28
WBCs (>200/uL) RBC (>400/uL) Microorganisms Proteins, Lipids
Hazy/Turbid/Milky/Cloudy (*meningitis)
29
(Abnormal discoloration of CSF)
Xanthochromia
30
Presence of RBC degradation products: - slight amount of oxyhemoglobin
Pink
31
Presence of RBC degradation products: - heavy hemolysis
Orange
32
Presence of RBC degradation products: – conversion of oxyhemoglobin→ bilirubin (bilirachia)
Yellow
33
due to damage to the BBB
Increased: Protein (>150 mg/dL) yellow discoloration
34
due meningeal melanosarcoma
Increased: Melanin brownish
35
Presence of Carotene
(hypervitaminosis A) → orange discoloration
36
due to Rifampicin
red orange
37
due to Iodine
(antiseptic contamination) yellowish
38
Increased RBC (>6000/uL)
Bloody
39
Radiographic contrast media
Oily
40
* Meningitis * Froin syndrome (Xanthochromia, increased protein, hypercoagulability) * Blockage of CSF circulation * Traumatic tap
Clotted
41
Tubercular meningitis (pellicle is present if the CSF is stored overnight in refrigerator)
Pellicle (web-like surface)
42
Accidental puncture of the blood vessel during puncture
Traumatic tap
43
Bleeding inside the skull
Intracranial Hemorrhage
44
Uneven Distribution of blood
Traumatic tap (1>2>3)
45
Even Distribution of blood
Intracranial Hemorrhage (1=2=3)
46
(+) Clot formation Due to fibrinogen
Traumatic tap
47
Supernatant of Traumatic tap
Clear
48
Supernatant of Intracranial Hemorrhage
Xanthochromic
49
Intracranial Hemorrhage: Erythrophages (macrophage with ingested RBC)
(+) Hemosiderin and hematoidin crystals
50
Intracranial Hemorrhage: D-dimer (fibrindegradation product)
(+) Fibrin-formation in the bleeding site
51
water-like
Normal
52
Viscous CSF
Metastatic mucin-producing adenocarcinoma Cryptococcal meningitis (C. neoformans → polysaccharide capsule → viscous) Liquid Nucleus Pulposus
53
Any cell count must be performed IMMEDIATELY! WBC and RBC begin to lyse within____
1 hour after collection
54
Any cell count must be performed IMMEDIATELY! 40% of WBCs disintegrate within____
2 hours after collection
55
Routinely performed on CSF
WBC Count
56
WBC Count Normal values ▪ Adult: ▪ Neonates:
WBC Count Normal values ▪ Adult: 0-5 WBC/uL ▪ Neonates: 0-30 WBC/uL
57
Diluting fluid
3% acetic acid (lyse the RBC) with methylene blue (sustain the WBC)
58
Not routinely performed on CSF
RBC Count; because it is not normal to find RBC in CSF unless it is for traumatic tap
59
To correct for WBC count and total protein concentration: Subtract for every ____ 700 RBCs seen
1WBC
60
To correct for WBC count and total protein concentration: Subtract in ____ total protein concentration for every 10,000 RBC/uL
8mg/dL
61
Performed in stained CSF smear
CSF Differential Count
62
Specimen should be _____ first before preparing a smear
concentrated
63
Routine centrifugation
CSF is centrifuges for 5-10 minutes
64
used for smear preparation
Sediment
65
removed (can be used for other test ie. Chemistry)
Supernatant
66
Cytocentrifugation
▪ Fluid is added to a conical chamber ▪ Cells are forced into a monolayer within a 6mm diameter circle on the slide ▪ Addition of 30% albumin * Increase cell yield or recovery * Decreases cellular distortion
67
increase number of normal cells
Pleocytosis
68
Lymphocyte (___) Monocyte (___) (*reverse the percentage for newborns)
Lymphocyte (70%) Monocyte (30%) (*reverse the percentage for newborns)
69
Intracranial hemorrhage (erythrophage)
Macrophage
70
Blast forms (lymphoblast, myeloblast, normoblast)
Acute leukemia
71
Neutrophils (normally see on)
Bacterial meningitis Early case of viral, tubercular and fungal menigitis Cerebral hemorrhage
72
Lymphoma cells
Disseminated lymphoma
73
Multiple sclerosis, lymphocyte reactions
Plasma cells
74
Diagnostic procedures (neurosurgery, pneumoencephalography *CSF are removed for better viewing brain during X-ray)
Ependymal, Choroidal and Spindle-shaped cells
75
Metastatic carcinoma, primary CNS carcinoma
Malignant cells
76
CSF Protein Normal Value Adults: Infants: Immature: NOTE: *CSF in infants and immature is higher because the BBB is not well intact
CSF Protein Normal Value Adults: 15-45 mg/dL Infants: 150 mg/dL Immature: 500 mg/dL NOTE: *CSF in infants and immature is higher because the BBB is not well intact
77
Major CSF Protein
Albumin
78
2nd most Prevalent
Pre-albumin
79
Alpha-globulins
Haptoglobin, Ceruloplasmin
80
Beta-globulins
Beta-2 transferrin, “Tau”
81
(carbohydrate deficient transferrin, found in CSF ONLY)
Beta-2 transferrin, “Tau”
82
Gamma-globulins
IgG and IgA
83
NOT FOUND PROTEIN:
1. IgM – they are big in size, they are filtered out 2. Fibrinogen 3. Lipoproteins (LDL/B-LPP
84
Meningitis *damage to BBB
Elevated Result
85
Hemorrhage *damage to BBB
Elevated Result
86
Multiple sclerosis (Increase plasmacells)
Elevated Result
87
Guillain-barre syndrome
Elevated Result
88
Neurosyphilis
Elevated Result
89
Polyneuritis
Elevated Result
90
Myxedema
Elevated Result
91
Cushing dse.
Elevated Result
92
Connective tissue dse
Elevated Result
93
CSF leakage/trauma
Decreased Result
94
Recent puncture
Decreased Result
95
Rapid CSF production
Decreased Result
96
Water intoxication
Decreased Result
97
Polyneuritis
Elevated Result
98
Diabetes
Elevated Result
99
Uremia
Elevated Result