CSF

Question 1

3rd Major fluid of the body

Answer 1

CEREBROSPINAL FLUID

Question 2

CEREBROSPINAL FLUID FUNCTION

Answer 2

Function:
o Supply nutrients to the nervous system
o Removes metabolic waste
o Produces a mechanical barrier to cushion the brain and the spinal cord

Question 3

CSF produced in the?

Answer 3

choroid plexuses (third and
fourth ventricles)

Question 4

3 layers of the meninges

Answer 4

Dura matter, Arachnoid, and Pia matter

Question 5

called the hard matter, the outermost layer of the meninges

Answer 5

Dura matter

Question 6

called the spider-web like

Answer 6

Arachnoid

Question 7

known as the gentle
matter; near the spinal cord or brain

Answer 7

Pia matter

Question 8

CSF flows through the _______________________ located between the arachnoid and pia matter

Answer 8

CSF flows through the subarachnoid space located between the arachnoid and pia matter

Question 9

Tight fitting structures of endothelial cells in the choroid plexuses

Answer 9

BLOOD-BRAIN BARRIER

Question 10

BLOOD-BRAIN BARRIER FUNCTION

Answer 10

Functions:
o To protect the brain from foreign
organism in the blood
o shields the brain from hormones and neurotransmitters the rest of the body
o Maintains homeostasis

Question 11

region of the brain where the blood-brain barriers is weak

Answer 11

Circumventricular organ

Question 12

List of Circumventricular organ

Answer 12

o Pineal gland
o Neurohypophysis – posterioir pituitary gland
o Area Postrema – vomiting center
o Subfornical organ
o Vascular organ of The Lamina terminalis
o Median Eminence

Question 13

These are capillary networks that forms the CSF from the plasma by mechanism of selective filtration under Hydrostatic Pressure and Active Transport Selection

Answer 13

CHOROID PLEXUS

Question 14

A pressure from across choroidal capillary wall and aids the filtration

Answer 14

HYDROSTATIC PRESSURE

Question 15

Process by the choroidal epithelial cells that allows by the hydrostatic pressure to create CSF

Answer 15

ACTIVE TRANSPORT SELECTION

Question 16

NORMAL VOLUME OF CSF:
* ADULTS =
* PEDIA =

Answer 16

NORMAL VOLUME OF CSF:
* ADULTS = 90 ML to 150 ML / 140 ML to 170 ML
* PEDIA = 10 ML to 60 ML

Question 17

RATE OF PRODUCTION:
* ___/min
* ___/hour
* ___/ day

Answer 17

RATE OF PRODUCTION:
* 0.3 to 0.4 ML/min
* 20 ML/hour
* 500 ML/ day

Question 18

SPECIFIC GRAVITY:
pH:
Osmolality:

Answer 18

SPECIFIC GRAVITY: 1.006 – 1.008
pH: 7.30 – 7.45
Osmolality: 281 mosmo/L

Question 19

Specimen Collection of CSF
Collected by lumbar puncture via the:

Answer 19

o 3rd, 4th, 5th Lumbar Vertebrae (Lumbar region) and subdural tap
o Cisternal magna
o Ventricular region

Question 20

Specimens are collected in three sterile tubes:

o Tube 1 =
o Tube 2 =
o Tube 3 =
o Tube 4 =

Answer 20

Specimens are collected in three sterile tubes:

o Tube 1 = chemical and serological test
o Tube 2 = microbiology →less
contamination of bacteria
o Tube 3 = cell count→ less contamination of the blood
o Tube 4 = Microbiology →chemistry/serology

Question 21

Excess CSF should not be discarded and should be ______ until there is no further use for it

Answer 21

Excess CSF should not be discarded and should be frozen until there is no further use for it

Question 22

Most important tube?

Answer 22

Microbiology

Question 23

2nd priority tube?

Answer 23

cell count or hematology

Question 24

Last priority tube?

Answer 24

chemical and serological test

Question 25

If STAT is not possible, CSF specimen should be maintained: * Hematology spx = * Microbiology spx = * Chemistry and Sero spx =

Answer 25

If STAT is not possible, CSF specimen should be maintained: * Hematology spx = refrigerated (2 8oC) * Microbiology spx = room temperature (19-26oC) * Chemistry and Sero spx = Frozen (-15 to -30oC)

Question 26

CSF INTRACRANIAL PRESSURE - Infant: - Adult:

Answer 26

CSF INTRACRANIAL PRESSURE - Infant: 10-100 mm of water - Adult: 90-180 mm of water

Question 27

Cause of Increase Pressure in CSF Intracranial

Answer 27

- Intracranial hypertension - Hemorrhage - Meningitis - Subarachnoid bleeding - Brain tumor or brain abscesses

Question 28

Cause of Decrease Pressure in CSF Intracranial

Answer 28

- Spinal subarachnoid block

Question 29

Test for Spinal subarachnoid block

Answer 29

Queckenstedt Test

Question 30

CSF APPEARANCE - Normal: - Turbid or Milky:

Answer 30

CSF APPEARANCE - Normal: crystal clear - Turbid or Milky: increased protein or lipid concentration; also indicate infection.

Question 31

CSF Components:

Answer 31

CSF Components: o Proteins o Glucose – 2/3 of blood glucose o Chloride – 1/3 of plasma fluoride o Sodium chloride o Magnesium o Potassium o Calcium

Question 32

Term to describe CSF supernatant depends on its color

Answer 32

XANTOCHROMIA

Question 33

CSF supernatant: o Pink – o Orange – o Yellow –

Answer 33

CSF supernatant: o Pink – very light amount of oxyhemoglobin o Orange – heavy hemolysis o Yellow – conversion of oxyhemoglobin to unconjugated bilirubin

Question 34

Factors that cause Xantochromia:

Answer 34

Factors that cause Xantochromia: o RBC degradation product → pink o Elevated bilirubin → yellow o Presence of carotene pigment → orange o Markedly increased protein concentration o Melanoma pigment

Question 35

A grossly bloody CSF sample due to the puncture of a blood vessel during the spinal tap procedure

Answer 35

TRAUMATIC TAP

Question 36

Clot Formation: o Clot formation + blood → o Clot formation but no blood→ o Web-like/pine tree clot, no blood → o Pellicle formation →

Answer 36

Clot Formation: o Clot formation + blood → traumatic tap o Clot formation but no blood→ meningitis, Froin’s syndrome o Web-like/pine tree clot, no blood → tubercular meningitis o Pellicle formation → suppurative meningitis

Question 37

Term use for small fine clots that may be seen in the surface of the CSF after 12 – 24 hours of the refrigeration, which consist of white blood against fibrinous background

Answer 37

Pellicles

Question 38

A Xantochromic Supernatant would be the result of blood that has been present in the CSF sample for________________________.

Answer 38

A Xantochromic Supernatant would be the result of blood that has been present in the CSF sample for more than 2 hours.

Question 39

NORMAL CELL COUNT: ADULT = INFANT =

Answer 39

NORMAL CELL COUNT: ADULT = 0 to 5 WBCs/ul INFANT = 30 WBCs/ul

Question 40

Routinely used chamber in cell count

Answer 40

Improved Neubauer Counting Chamber

Question 41

____________________ is used to lyse the RBCs addition of ______________ to the diluting fluid stains that WBCs, providing better differentiation between neutrophils and mononuclear cells.

Answer 41

3% Glacial Acetic Acid is used to lyse the RBCs addition of Methylene Blue to the diluting fluid stains that WBCs, providing better differentiation between neutrophils and mononuclear cells.

Question 42

All diluents should be checked for contamination by examination in a counting chamber under __ magnification _____ a week

Answer 42

All diluents should be checked for contamination by examination in a counting chamber under 4X magnification twice a week

Question 43

If non-disposable counting chamber are used. They must be soaked in a bactericidal solution for ______________ and thoroughly rinse with water and cleaned with ___________________

Answer 43

If non-disposable counting chamber are used. They must be soaked in a bactericidal solution for 15 minutes and thoroughly rinse with water and cleaned with isopropyl alcohol

Question 44

Time employed in centrifugation for differential count

Answer 44

5-10 minutes

Question 45

Lymphocytes and monocytes ratio for adults

Answer 45

70:30

Question 46

Lymphocytes and monocytes ratio for children

Answer 46

30:70

Question 47

______ are seen as a result of bone marrow contamination during spinal tap

Answer 47

NBRCs are seen as a result of bone marrow contamination during spinal tap

Question 48

Increased normal, reactive lymphocytes and plasma cells may indicate ________________

Answer 48

Increased normal, reactive lymphocytes and plasma cells may indicate multiple sclerosis

Question 49

Macrophage hours take to appear after RBCs enters the CSF

Answer 49

2-4 hours

Question 50

Increased of macrophage indicates

Answer 50

previous hemorrhage

Question 51

They are iron-free consisting the hemoglobin and unconjugated bilirubin

Answer 51

Yellow hematoidin crystals

Question 52

Normal values of CSF chemicals are ______________ as the plasma values

Answer 52

Normal values of CSF chemicals are not the same as the plasma values

Question 53

Frequently performed chemical test on CSF

Answer 53

Protein determination

Question 54

Normal CSF Protein

Answer 54

15 to 45 mg/dL

Question 55

It makes up the majority of CSF protein, followed by pre albumin

Answer 55

Albumin

Question 56

It is a separate carbohydrate deficient transferrin fraction that only seen in the CSF

Answer 56

Tau protein

Question 57

Presence of TWO or MORE oligoconal bands that are not present in the serum can be valuable tool for diagnosis of __________________

Answer 57

Presence of TWO or MORE oligoconal bands that are not present in the serum can be valuable tool for diagnosis of multiple sclerosis