Chapter 10: Cerebrospinal Fluid
What are the 3 layers of the the mininges?
1. Arachnoid 2. Dura mater 3. Pia meter
What are the 3 major function of cerebrospinal fluid (CSF)?
1. Supply nutrients 2. Remove wast 3. Cushion from Trauma
How many cells to be counted in a differential?
100 cells
What is the norm range for protien?
15 to 45 mg/dL
What helps to see WBC's better?
3% acetic acid; methmol blue
Neonates WBC range?
30 mononuclear cells(Pg. 181)
What is the volume of CSF in neonates?
60 to 100mL
Volume of CSF in adults?
90 to 150mL and 20mL per hour
What is pleocytosis?
An increase in normal cells (Pg. 183)
What is the clinical significance of increased NEUTROPHILS?
Bacteria meningitis
When do you see nRBC's in CSF TAP?
Bone marrow contamination
Which microbiology and immunology test may aid in the diagnosis of meningitis?
CSF Glucose
Appearance if increased in PROTIEN or LIPID concentration are?
Cloudy or turbid (pg. 179)
What is the outer layer that lines the skull and vertebral canal?
Dura mater
Clinical Significance of seeing MACROPHAGES?
Hemorrhage
What is meningitis?
Inflamation of meninges
What is an elevated CSF protein result indicative of?
MENINGITIS and/or HEMORRHAGE which leads to BLOOD BRAIN BARRIER damage
Appearance if infection is present shows?
Milky
Heavy hemolysis causes what color?
Orange
Clinical Significance of EOS?
Parasitic and/or Fungal meningitis.
RBC and light amounf OXYHEMOGLOBIN causes what color?
Pink
What is the most common cause of the appearance of XANTHROCHROMIC?
RBC degradation
What is the clinical significance of increased LYMPH (with NORMAL CSF glucose)?
Viral Meningitis
Immature liver function, RBC DEGRADATION, a new hemorrhage, and elevated CSF protein: All of the following can cause xanthochromia except?
a new hemorrhage
Decreased protein levels =?
fluid leakage
What is the lining of the brain and spinal cord
meninges
HOW is CSF produced?
via active transport
CAPILLARY NETWORK that uses mechanisms of selective filtration under hydrostatic pressure and active transport secretion?
Choriod plexuses (Pg. 178)
What are the most common causes of increaed damgage to blood brain barrier?
Hemorhage/Meningitis
Waht is the diffrence between a hemorrhage and traumatic tap?
Hemorrrhage: 1. EVENLY distributed throught the 3 tubes 2. Does not clot (due to know hemorhage Traumatic tap: 1.Has the heavies concentrarion of blood in tube 1 and diminsihing to 2 and 3. 2. Clots (Pg 175)
CSF gamma globulin is primarily what immunoglobulin?
IgG (few IgA) (Pg. 190)
What is caused by damage to blood brain barrier, Ig production, less clearance, and degeneration of tissue?
Increased protein levels
Opening space where volume of CSF is removed?
Subarachnoid space (Pg. 179)
Where does CSF flow through?
Subarachnoid space between arachnoid and pia meter (Pg. 178)
What are the 3 (+ 1) tubes used for specimen collection?
Tube 1. Chemistry/sserology Tube 2. Microbiology Tube 3. Hematology Left over tube: save for additional testing (Pg. 179)
Normal adult of WBC's?
0-5 (Pg. 181)
What is the mixture when centrufuging in a DIFFERNTIAL?
0.1 mL CSF and 1 drop of albumin (Pg. 183)
What are the different terms for appearance of CSF?
1. Crystal Clear 2. Cloudy or turbid 3. Milky 4. Xanthochromic 5. Hemolyzed/bloody
Term to describe a filamentous inner membrane...
Arachnoid
Where does the CSF flow through?
Arachnoid Space
Where is CSF reabsorbed?
Arachnoid granulations/villae (one-way valves) (Pg. 178)
When do you see pyknotic nucleii?
Bacterial Meningitis
What is the Tight-fitting structure of the endothelial cells inside the choroid plexuses?
Blood brain
Substances present in the CSF are controlled by the?
Blood brain barrier
What is plasma fibrinogen?
Causes Clots in CSF
How are all sterile tubes stored?
Chemistry/serology = Frozen Microbiology = Room Temp. Hematology
What CAPILLARY NETWORK form the CSF from plasma?
Choriod Plexuses (Pg. 178)
What is the clinical significance of increased LYMPH (with DECREASED CSF glucose)?
Tubercular meningitis
Pink, orange, and yellow pigment is caused by?
Xanthochromic
Wat can you see in jaundice, increased protein, and carotene?
Xanthochromic
Conversion of oxyhemoglobin to unconjugated bilirubin causes what color?
Yellow
How do you perform a cell count
[(Number of cells counted) • (dilution)] / [(Number of squares coutned) • VOL of 1 square (0.1)] (Pg. 181)
