- supply nutrients to the nervous tissue - remove metabolic wastes - produce a mechanical barrier to cushion the brain and spinal cord against a trauma

CSF Flashcards by therese timbal

a major fluid of the body

Cerebrospinal fluid (CSF)

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Functions of CSF

supply nutrients to the nervous tissue
remove metabolic wastes
produce a mechanical barrier to cushion the brain and spinal cord against a trauma

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brain and spinal cord are lined by

Meninges

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meninges consist of 3 layers

Dura mater, arachnoid, pia mater

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Latin for hard mother
outer layer that lines the skull and vertebral canal

Dura mater

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spiderweb like, filamentous inner membrane

Arachnoid

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gentle mother, thin membrane lining the surfaces of the brain and spinal cord

pia mater

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CSF is produced in the _ of the lateral, third, and fourth ventricles

Choroid plexuses

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Fluid produced every hour for adults

20 mL of fluid

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the fluid flows through the - located between the arachnoid and pia mater

Subarachnoid space

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volume of CSF maintained in adults

90 to 150 ML

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volume of CSF maintained in neonates

10 to 60 ml

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to maintain a specific volume in adults and neonates, the circulating fluid is reabsorbed back into the capillaries in the

Arachnoid granulations / villae

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Are capillary networks that form the CSF from plasma by mechanisms of selective filtration

Choroid plexuses

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capillary walls throughout the body are lined
with

endothelial cells

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loosely connected to allow passage of soluble nutrients and wastes between the plasma and tissue

Endothelial cells of capillary walls

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Have very tight fitting junctures that prevent the passage of many molecules

endothelial cells of choroid plexus

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tight fitting structure of the endothelial cells in the choroid plexuses

blood brain barrier

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CSF is routinely collected by

lumbar puncture

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location of CSF collection

between the 3rd, 4th, or 5th lumbar vertebra

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CSF specimens are collected in

three sterile tubes

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Tube I

chemical and serologic test, least affected by blood or bacteria

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Tube 2

usually designated for the microbiology laboratory

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Tube 3

is used for HEMA/ cell count, its the least
likely to contain cells introduced by the spinal
tap procedure

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how hematology tubes are maintained

refrigerated

microbiology tubes are maintained by

remain at room temp

chemistry and serology are maintained by

frozen

initial appearance of normal CSF

crystal clear

3 types of epithelial cells

ependymal calls, choroidal cells, PAM cells

used to describe CSF supernatant that is pink, orange, or yellow

Xanthochromia

most common cause of xanthochromia

RBC degradation products

grossly bloody CSF can be an indication of

Intracranial hemorrhage

Cause and indication of a hazy, turbid,milky, cloudy CSF

Meningitis

Microorganisms in CSF is an indication of

Meningitis

Protein in CSF is an indication of

- Disorders affecting blood-brain barrier - production of IgG within the CNS

Oily appearance of CSF may be the cause of

Radiographic contrast media

Cause and indication of bloody CSF

- RBC - hemorrhage or traumatic cap

Xanthochromic CSF because of hemoglobin is an indication of

Old hemorrhage, lysed cell from traumatic cap

Xanthocromic CSF because of bilirubin may be an indication of

RBC degradation, elevated serum bilirubin level

Xanthocromic CSF because of carotene may be an indication of

Increased serum levels

Xanthocromic CSF because of protein may be an indication of

Disorders affecting blood-brain barrier

Xanthocromic CSF because of melanin may be an indication of

Meningeal melanosarcoma

Clotted CSF because of clothing factors

Introduced by traumatic tap

Pellicle appearance in CSF because of dotting factors is an indication of

Tubercular meningitis

WBCs ( particularly granulocytes) and RBCs begin to lyse within

1 hour

40% of the leukocytes disintegrate after

2 hours

Dilution ratio for CSF

1:20 or 1:10 (if clear no need to dilute)

CSF cell count formula

Ave no. of cells counted x dilution/ no. of squares counted x volume of 1 square

Preferred centrifuge for CSF specimen

Cytocentrifuge

When one differential count is performed _should be counted, classified, and reported in terms of percentage

100 cells

High CSF WBC count of which the majority of the cells are neutrophils are indicative of

Bacterial meningitis

Major clinical significance of lymphocytes

- Normal - viral, tubercular, fungal meningitis - multiple sclerosis

Microscopic findings of lymphocytes

All stages of development may be found

Major clinical significance of neutrophils

- Bacterial meningitis - early cases of vital,tubercular, and fungal meningitis - cerebral hemorrhage

Microscopic findings of neutrophils

- Granules maybe less prominent than in blood - cells disintegrate rapidly

Monocytes major clinical significance

- Normal - viral, tubercular, fungal meningitis - multiple sclerosis

Microscopic findings of monocytes

Found mixed with lymphocytes

Major clinical significance of macrophages

RBCs in spinal fluid

Microscopic findings of macrophages

May contain phagocytized RBCs appearing as - empty vacuoles or ghost cells, - hemosiderin granules, and - hematoidin crystals

Blast forms major clinical significance

Acute Leukemia

Blast forms microscopic findings

Lymphoblasts, myeloblasts, or monoblasts

Major clinical significance of lymphoma calls

Disseminated lymphoma

Microscopic findings of lymphoma cells

Resemble lymphocytes with cleft nuclei

Major clinical significance plasma cells

Multiple sclerosis, lymphocyte reactions

Plasma cells microscopic findings

- Traditional and classic forms seen - reactive lymphs

Major Clinical Significance Of Ependymal, choroidal, and spindle-shaped cells Malignant cells

Diagnostic procedures

Microscopic findings of Ependymal, choroidal, and spindle-shaped cells

Seen in clusters with distinct nuclei and distinct cell walls

Major clinical significance of malignant cells

Metastatic carcinomas, primary CNS carcinoma

Malignant cells microscopic findings

Seen in clusters with fusing of cell border and nuclei