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18 Cards in this Set
- Front
- Back
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3 major functions of CSF |
1. Provides physiologic system to supply nutrients to the nervous tissue. 2. Removes metabolic wastes 3. Produce a mechanical barrier to cushion the brain and spinal cord against trauma. |
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Formation and function of CSF |
CSF is produced in the choroid plexus of the 2 lumbar ventricles and the 3rd and 4th ventricked. Approximately 20 mL of CSF is produced every hour in adults. |
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Where does the first collection tube go/how is it handled? |
Tube #1 - Chemistry Least affected by blood or bacteria introduced as a result of the tap procedure. Stored as frozen. |
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Where do 2nd collection tube go? |
Tube 2 - micro lab. Contains bacteria useful for diagnosis Specimens should remain at room temp |
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3rd collection tube |
3rd tube - hematology. Least likely to contain cells introduced by the spinal tap Must be refrigerated |
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Difference between a traumatic tap and intracranial hemorrhage |
Traumatic tap - a bad tap. Max amount of blood in first tube, with progressive decrease in subsequent tubes. Hemorrhage - bleeding in the brain, evenly mixed blood in all tubes. |
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Xanthochromia |
CSF supernatant that is pink, orange, or yellow. Causes: most common us RBC degradation products, elevated serum bilirubin, presence of carotene, markedly increased protein concentration, melanoma pigment. |
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Normal choroidal cells and malignant choroidal cells |
Choroidal cells are in little organized balls,malignant cells are blown up dark malignant circles. |
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Significance of chem test protein. |
Reference lvl is 15 - 45 mg/dL. Elevated values are most often seen in meningitis, hemorrhage and multiple sclerosis. Low values suggest fluid leak from CNS. |
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Significance of chem test glucose |
Normal value is 60 - 70% plasma concentration. Decreased levels seen in bacterial, tubercular, and fungal meningitis. Elevated levels are always the result of plasma elevations. |
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Bacterial meningitis |
Large % of neutrophils with markedly decreased glucose and increase in neutrophils. Lactate levels >35 mg/dL seen. |
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Viral meningitis |
Normal CSF glucose with increased number if lymphocytes. Lower lactate levels. |
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Tubercular meningitis |
Markedly decreased glucose and increased WBC and a large % of lymphocytes. Lactate levels of >5 25 mg/dL |
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Significance of the chem test lactate |
Destruction of the tissue within the CNS because of hypoxia causes the production of increased CSF lactic acid levels.
Any decrease in flow of oxygen to the tissues will result in elevated lactate levels. frequently used to monitor severe head trauma. |
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Significance of chem test glutamine |
Normal concentration - 8-18 mg/dL, levels >35 mg/dL are associated with some disturbance of consciousness. Provides an indirect test for the presence of excess ammonia in the CSF. |
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Significance of enzyme tests. |
Creatinine kinase CK-MB isoenzyme, elevated levels in patients post cardiac arrest indicate a poor prognosis. |
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normal volume of CSF |
10-60 mL in neonates 90-150 mL in adults. |
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Normal volume of CSF |
Adults: 90-150 mL Neonates: 10-60 mL |
