Cerebrospinal Fluid - Clin Lab

CSF originates from _____

the fluid occupies these ventricles and the subarachnoid space over the surfaces of the ____ and around the ____

the composition of CSF is derived from ____, ______ _______, and _____ _____

______ drugs work better to enter the brain (ex - ____)

functions of CSF: - fluid medium to enhance _____ of the brain; remove ______; protect against _____

concentration of electrolytes of CSF varies with changes in ____; most constituents of CSF are present in _____ concentrations than in plasma

with pathologic conditions, elements that are typically restrained by the blood brain barrier may ____ and establish ____

CSF typically lacks ________, and ____

RBCs and WBCs can only enter CSF through ____ or by ___

____ is not typically seen in CSF, but it may be seen in the setting of intracranial hemorrhage. this is called ____

CSF is essentially enclosed in a rigid container, and normal pressure is maintained by ____ of CSF through _____ in equal amounts to its production by the choroid plexus

indications for lumbar puncture: determine the diagnostic objective; typically utilized in diagnosis of 3 things, what are they?

what is the classic presentation of a subarachnoid hemorrhage?

Lumbar punctures were used in the past to document possible impairment of _____; by measuring spinal fluid pressure... now ___ and ___ can provide info via non-invasive methods

pre-procedure considerations of LP: prior to the test, evaluate the possibility of increased ___

___ is necessary to rule out the presence of papilledema (swelling of the optic disc)

reason for caution in LP is rapid removal of fluid alters the pressure relationships within ___

brain stem can be dislocated from a region of high pressure (____) to region of low pressure ( ______); this hernatiion or coning is potentially ____

a case by case analysis of risks vs benefits must be considered in ____

a ____ may be given to decrease intracranial pressure

procedure of LP: the ___ may alarm the patient, but should not cause persistent discomfort

during a LP, temporary ____ may occure

post puncture (LP) headaches occur in ~ ____ % of patients and may last from several hours to several days due to loss of CSF

post puncture headaches are typically bilateral ____ or _____ and occur only in ____postion; lying ____ typically relieves pain quickly

how should the patient be positioned for a LP?

where should fluid be collected for an LP?

what should the appearance/consistency of CSF be?

what does turbidity of CSF signify?

haziness of CSF begins with ___

xanthochromia of CSF indicates

pH of CSF?

blood in CSF (bloody tap)- if blood is due to local trauma, fluid in 3rd tube will be ____ than fluid in 1st tube

after CSF centrifuge, if blood came from traumatic puncture, the fluid will be ____; if it remains yellow than blood was in the CSF _____

xanthochromia occurs within ____ hours after a subarachnoid hemorrhage, and typically clears ___weeks after the event; brown CSF indicates presence of ______ which is associated with _____

spontaneous clotting can occur when the protein content is ____. why?

mean CSF pressure

slight elevation of CSF pressure may occur when ???

decrease in CSF pressure is rare in ____ but may be seen in ___

elevations in CSF pressure: 4 causes

removal of CSF causes a ____ in CSF pressure; average is ____ in pressure for every mL of fluid removed; small drop in pressure suggests that the total quantity of CSF is ____ (hydrocephalus), large pressure drop indicates a _____ (tumors)

normal CSF is virtually free of ___; adults may have up to _____; children may have up to ____; ____ and ___ should never be seen

CSF may clot of a traumatic tap allows a lg amount of blood and plasma to _____; does bloody CSF from a subarachnoid hemorrhage clot?

how do we evaluate leukocytes/protein content of spinal fluid that is contaminated by traumatic bleeding?

differential white count evaluating leukocytes

200-500 mixed cell type when evaluating leukocytes

> 500 granulocytes

immature cells

chemical tests - csf protein; normally ____ protein

causes of elevated CSF protein

elevated protein w/o cells - suspect ____ such as ____ or ____; or subarachnoid blockage (ex - ____) which permits protein accumulation in fluid distal to the block

CSF glucose is normally ____ of blood glucose level

changes in blood sugar are reflected in CSF after a _____ lag period; critical evaluation of CSF glucose requires comparison against a blood sample. (if possible draw the blood _______ to the lumbar puncture)

a dramatic drop in CSF glucose is typically seen with ___

glucose metabolism continues after the sample has been collected, therefore, if you suspect the specimen to contain granulocytes or microbes (bacteria, fungi, protozoa), then _____

viral meningitis causes _______ glucose

lactic acid reflects _____; an isolated increase in CSF lactate indicates increased ____;

in early bacterial/fungal meningitis, CSF cellular population and glucose levels may be difficult to differentiate from _____; lactate levels above ____ typically only occur in bacterial/fungal meningitis

any question of meningitis or CNS infection should be studied w/ smears of the ______ and stained with ____

failure to isolate organisms on the smear does not mean that _____; must be ____ in order to demonstrate by this technique; culture the CSF on _____