CSF

• Meningeal Layer that lie furthest outward, enveloping the brain and spinal cord.

  Dura Mater
• Specific cerebral structure primarily generates cerebrospinal fluid.

  Choroid Plexus
• What is the hourly rate of cerebrospinal fluid production in an average adult human?

  20 mL
• Where is the circulating CSF reabsorbed back in the blood capillaries?

  Arachnoid Granulations
• What is the main function of arachnoid granulation/villi within the nervous system?

  Preventing reflux of the fluid
• A structure that does not allow free passage of many molecules because of its tightly fitting junctures.

  Endothelial cells in the choroid plexus
• How is CSF primarily formed in the choroid plexus?

  Selective filtration and active transport secretion
• What is the function of BBB?

  Prevents the passage of many molecules
• What factors influence the volume of CSF that can be removed?

  • Patient's size
  • CSF opening pressure
  • Careful technique
• Most accurate vertebra spaces to collect CSF from.

  Between 3rd and 4th or between 4th and 5th lumbar vertebra
• How does the volume of CSF that can be removed depend on patient type?

  Adults may have more CSF volume than neonates
• What is the primary usage of Tube 1 when collecting CSF specimen?

  Chemical and Serological Test
• Why is Test Tube 3 predominantly used for CSF cell counts?

  Least likely to contain extraneous cells
• In CSF analysis, test tube 2 is designated for?

  Microbiology
• Why are specimens collected in three separate tubes?

  Different tests require varied contamination levels
• How should hematology tubes be stored if tests can't be performed STAT?

  Refrigerated for up to 4 hours
• Proper storage of Microbiology if immediate testing isn't possible?

  Kept at room temperature
• What could be the cause of a milky appearance in CSF?

  lipids or protein
• Indication of an infection in a CSF sample?

  Cloudiness caused by WBC
• Most common cause of CSF xanthochromia?

  Presence of RBC degradation products
• What could cause CSF Xanthochromia in premature infants?

  Bilirubin due to immature liver function
• Cloudy appearance of CSF often indicate?

  Infection
• Appearance of CSF: Bloody 


  Contaminant: RBC
• Appearance of CSF: Xanthochromic

  Contaminant: Bilirubin
• Appearance of CSF: Pellicle


  Contaminant: Clotting Factor
• Appearance of CSF: Oily


  Contaminant: X-ray media
• Appearance of CSF: Turbid


  Contaminant: WBC
• Possible cause for xanthochromic CSF

  Brain Hemorrhage
• Increased CSF pressure may suggest what medical condition?

  Brain Tumor
• Visual examination of CSF at bedside is required to differentiate traumatic tap and intracranial hemorrhage. How many visual examinations are usually enough to determine the source of blood in CSF?

  3
• Cells Seen: Malignant Cells Clinical Significance:

  Metastatic Carcinoma
• Cells Seen: Plasma Cells Clinical Significance:

  Multiple Sclerosis
• Cells Seen: Ependymal Cells Clinical Significance:

  Spinal Tap Complication
• Cells Seen: Macrophages Clinical Significance:

  Intracranial hemorrhage
• Cells Seen: Neutrophils Clinical Significance:

  Bacterial Meningitis
• Cells Seen: Monocytes Clinical Significance:

  Tubercular Meningitis
• Cells Seen: Lymphocytes Clinical Significance:

  Viral Meningitis
• Cells Seen: Lymphoma cells Clinical Significance:

  Disseminated lymphoma
• Cells Seen: Blast forms Clinical Significance:

  Acute Leukemia
• Reference Range of Protein:

  15-45 mg/dL