Lumbar puncutre Flashcards

(43 cards)

1
Q

ph of csf

A

7.33 - 7.35

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2
Q

function of csf

A

shock absober for cns
immunologicla funciton

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3
Q

where is csf mainly produced

A

95% in laterl venticle
4th ventilce

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4
Q

what produces csf

A

choroid plexus

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5
Q

what is the ammmoujt of csf produced in 24 hours

A

450 - 750 mls/ 24 hours

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6
Q

how much csf is proudced by new borns and peads each day

A

25 mls new born
125 peads

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7
Q

what is the csf turn over

A

3 times per day

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8
Q

what is the volume of csf in adults

A

150 mls

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9
Q

what is the pressure in cm of csf

A

less than 15 with a mean of 10 , and between 9 - 12 in peads

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10
Q

how is csf absobped

A

by arachnoid villi projectsion of the aracnoid memnare into the dural sinsus to allow csf to pass form th subarachnoid space in to the venous system

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11
Q

what is the osmolatir of csf and how does it compare to plasma

A

it is the same as plasma - 295

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12
Q

what cells are not prenst in csf that re in blood

A

rbc, neutrophils, eosinophils, basophils, and mast cells. P

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13
Q

what is lower in csf compared to plasm

A

potasium, calcium , glucoise , proteing (signifcanlty) , albumin (signficialty) , Igg (signficilay)

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14
Q

what is higher in csf compared to plasma

A

clorine, lactose and water

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15
Q

what cells are seen in bacterial csf infection

A

leurkocytes, nurepils, low gluose, hihg protines, high opening pressure

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16
Q

what is seen in viral csf infection

A

slightly elevated opening pressure
slightl high leukocytes
if early - nerutropils, if late lymphocytic
low glucose
high protein

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17
Q

what is seen in fungal csf infection

A

high opeing pressure
mid leukocytes
lymphhoctyes
low glucose
hgigh protien
postive to cultures

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18
Q

what is seen in tb infection

A

fibrin web appareach
different opening pressure
hihg lymhoctyes,
lympocytes high
low glucose
very high proin
positive for afb

19
Q

what is seen in autimmine infection of csf

A

clear liquid
normal opeingi pruss
raided lueckiphyils
lymphocytes
normal glucose
high protein
negative to cultrues

20
Q

what to check before lumbar pucutes

A

any anticogaulatis and check coagulation
look for previous surgyes
look for brain tumour - which could lead to a death if tapped
congetila abnomaleis

21
Q

what are the congential abnoralies that a spinal tap should be avoided

A

chiari malforamtion, bifida

22
Q

what posistion should someone be in for lumbar punctture

A

lateral decubitus

23
Q

what is the level of lumbar punctre in adults/ childnr

A

adults - l3, or opposite supperio illiac spine
child below l4

24
Q

conuc medual end point adults and childern

A

adults - l1/l2
child - l2/l3

25
how to do lumbar punctures
insert needle along midline having te point of needle of the centre when feel pop put needle pull back to look for csf tnrn need to venture attachn manometer to hymb of needle and measure the pressure and collect csf fluid
26
why would a lumbar puncutre be required
look for tb, cns symphyisl, cns vasulitis, ms, gullian barre syndoem, tansvere myelits, menigitis, subaracnoid heamortage
27
what is tharputic lumbar puncture uses
spinal anethetic, injection of contrat media for myelography, treatment of reaide dinternactial presu post subarnoid bleed hydrocephalus hc, treat idiopathic intracrtal hyertenison injection of contrast media for myelography
28
what is hydrocephauls
where there is abdnomla build up of fluid within the ventrilces of the brain
29
types of hydrocephauls
subnomral csf reabospriton of csf overprodution
30
causes of hydrocepalus
obstuctive - e.g. stenois of aqueduct of sylvius communicating - defective reabospin in arachnoid granultion nomarlly due to csf overpuditon by tumorus
31
tumor of choroid plexus
choroid plexus papillomas
32
symptomns and signs of hydrocephaus in adults
Headache Nausea, vomiting Gait disturbance ( unsteady) Papilledema, blurred vision, reduced vision Abducens palsy Up gaze palsy Reduced conscious level Urinary incontinency Altered mental status Poor concentration
33
sympotns and signs of hydocephauls in childrne
Abnormal increased head circumference (OFC) Irritability Poor head control Poor feeding, N/V Bulging and full fontanelle, Prominent forehead (frontal bossing), Enlargement and engorgement of scalp veins McEwen's signs: cracked pot sound on percussing over –dilated ventricles Abducens palsy Upward gaze palsy ( sun setting sign) Hyperactive reflexes Irregular respirations with apneic spells Splaying of cranial Sutures
34
cause of congetial hydorpculs
chiarail malformaiton priarmy aqueduct stenois dandy walker malforamtin ie. atreatsi of fomraiton of luschka and magendie
35
what is chiari malformation
where the cerebllum misformes and bulges towards the spinal canal blocking it
36
etilogy of hydorpchs
post heamorrage, post infection, brain tumour
37
types of hydrocephaulus
idiopathic, intracrail hyperenteniosn, female, obse
38
invesigation s for hydrocephauls
Clinical assessment of the patient and history Ultrasound CT head MRI head ( different sequences)
39
treatment for hydrocephauls
Fontanel tap Ommaya reservoir External Ventricular Drain ( EVD) Lumbar puncture Lumbar drain Ventriculo-peritoneal Shunt Ventriculo-Atrial shunt Lumbo-peritoneal shunt
40
what is hte ommaya revosu
port just above head that has a father that isn inserted into the ventilce, alow easily table to take csf
41
what is a venticlr atrail shunt
port from the ventilce in brain into the right arturm though father in heart
42
how is shunts reguated
through a vavle
43