FINALS - CSF

Question 1

Considered as 3rd Major body fluid

Answer 1

Cerebrospinal Fluid

Question 2

FUNCTIONS of CSF

Answer 2

• Supply nutrients to the CNS
• Remove metabolic waste
• Produce a mechanical barrier to cushion the
  brain and spinal cord against trauma

Question 3

Lines the brain and spinal cord

Answer 3

Meninges

Question 4

outer layer, lines the skull and vertebral
canal

Answer 4

Dura Mater

Question 5

▪ spider-like, filamentous inner
membrane

Answer 5

Arachnoid mater

Question 6

▪ innermost layer
▪ lines the surface of the brain and
spinal cord

Answer 6

Pia Mater

Question 7

▪ In between Arachnoid mater and Pia
mater
o where CSF flows

Answer 7

Subarachnoid space

Question 8

specific part of the brain that produces CSF

Answer 8

Choroid Plexus

Question 9

Choroid Plexus Ventricles

Answer 9

○ Choroid plexus of the third ventricle
○ Choroid plexus of the fourth ventricle
○ Choroid plexus of the lateral ventricle

Question 10

Choroid Plexus are capillary networks that form the CSF from plasma by mechanisms of:

Answer 10

• selective filtration under hydrostatic
  pressure;
• active transport secretion

Question 11

T or F

The chemical composition of the CSF resemble an ultrafiltrate of plasma

Answer 11

False

Question 12

Rate of CSF Production

Answer 12

20 ml/hr

Question 13

Reabsorbs CSF

Answer 13

Arachnoid vili / Granulations

Question 14

● tightly fitting junctures structure of endothelial cells in choroid plexus
● Protects the brain from chemicals and other
substances circulating in the blood that can harm the brain tissue

Answer 14

Blood Brain Barrier (BBB)

Question 15

Disruption of BBB allows substances to enter the CSF such as:

Answer 15

WBC
Protein
Other Chemicals (High Molecular Weight)

Question 16

CSF SPECIMEN COLLECTION

Answer 16

○ Lumbar puncture/tap
■ (Between the 3rd, 4th, or 5th lumbar vertebrae)
○ Cisternal puncture

Question 17

CSF SPECIMEN Volume to be collected

Answer 17

• Up to 20 ml collected under normal pressure, which is approximately 15% of the estimated total CSF volume

Question 18

IF CSF is not normal (lesser, greater), what is the volume to be removed?

Answer 18

only 1-2 ml

Question 19

Normal CSF Volume of ADULT

Answer 19

90-150 mL

Question 20

Normal CSF Volume of NEONATES

Answer 20

10-60 mL

Question 21

CSF Tube 1 - Lab Section

Answer 21

● Chemistry
● Immunology
● Serology

Question 22

CSF Tube 2 - Lab Section

Answer 22

● Microbiology
○ Gram Stain
○ Culture and Sensitivity

Question 23

CSF Tube 3 - Lab Section

Answer 23

● Hematology (Cell count)
● Cytology studies

Question 24

CSF Tube 4 - Lab Section

Answer 24

● Microbiology (better exclude skin
contamination)
● Serology (for additional serologic test)

Question 25

○ Tubed used to check cellular contamination=

Answer 25

Tube 1 and 4

Question 26

CSF Appearance - Crystal Clear

Answer 26

Normal

Question 27

CSF Appearance - Cloudy, Turbid, Milky

Answer 27

● Increase WBC= >200/uL ● Increase RBC= >400/uL ● Presence of Microorganisms ● Increased Proteins and Lipids

Question 28

CSF Appearance - Xanthochromic - PINK

Answer 28

slight amount of oxyhemoglobin

Question 29

CSF Appearance -Xanthochromic - YELLOW

Answer 29

Bilirubin

Question 30

CSF Appearance - Xanthochromic - ORANGE

Answer 30

in case of heavy hemolysis

Question 31

CSF Appearance - Xanthochromic - BROWNISH

Answer 31

Methemoglobin Formation

Question 32

CSF Appearance - Xanthochromic - OTHER CAUSES

Answer 32

● Increase dietary carotene ● Increase rifampin intake ● Increase melanin ● Normal neonate ● Protein concentration exceeding 150mg/dL ● Previous traumatic tap

Question 33

CSF Appearance - Bloody/Grossly bloody

Answer 33

● RBCs: >6000/uL due to ○ Traumatic tap ○ Intracranial hemorrhage/ Cerebral hemorrhage

Question 34

CSF Appearance - Oily

Answer 34

Radiographic contrast dye

Question 35

CSF Appearance - Clotted

Answer 35

● Protein and clotting factors ● Meningitis ● Froin's syndrome

Question 36

CSF Appearance - Pellicle

Answer 36

Tubercular meningitis

Question 37

Clear Appearance - DILUTION

Answer 37

Undiluted

Question 38

Slightly Hazy Appearance - DILUTION

Answer 38

1:10

Question 39

Hazy Appearance - DILUTION

Answer 39

1:20

Question 40

Slightly cloudy Appearance - DILUTION

Answer 40

1:100

Question 41

Cloudy/Slightly bloody Appearance - DILUTION

Answer 41

1:200

Question 42

40% of WBC disintegrates within

Answer 42

2 hours

Question 43

CSF WBC Count diluting fluid

Answer 43

3% glacial acetic acid (HAc) with Methylene Blue

Question 44

Normal CSF WBC Count of Adults

Answer 44

0-5 WBCS/ul

Question 45

Normal CSF WBC Count of Neonates

Answer 45

0-30 WBCs/ul