produce a mechanical barrier to cushion the cushion the brain and spinal cord against trauma trauma * Supply nutrients to the nervous tissue * Remove metabolic waste

not an ultrafiltrate of plasma

Brain & spinal cord are lined by

3 parts of meninges

outer layer; lines the skull & vertebral canal

Spider web-like/ filamentous inner membrane

Thin membrane lining the surfaces of brain & spinal cord

PRODUCTION OF CSF

Flows through _________(Between arachnoid & pia mater)

Reabsorbed by the _______________into the superior sagittal sinus

CSF VOLUME:

Adults: CSF VOLUME

CSF VOLUME Neonates:

Endothelial cells have ________to prevent passage of molecules: How many Daltons?

used to represent the control and filtration of blood components to the CSF and then to the brain

Increased WBC, proteins, and coagulation factors in CSF

Routine method for CSF collection

Between _____ Lumbar Vertebrae:

Lumbar Vertebrae: ADULTS

Lumbar Vertebrae: CHILDREN

Patientis position in lumbar puncture

infants w/ open fontanels

collected in sub-occipital region

"Least affected by blood bacteria as a result of the tap procedure

TUBE 2 AND PRESERVATIVE

Least likely fo contain C cells introduced by the tap procedure

LAST TUBE

Tests are performed on a ? WITHIN?

Supernatant fluid that is left over in every section:

IF ONLY 1 TUBE: ORDER OF COLLECTION

PHYSICAL EXAMINATION OR APPEARANCE OF CSF: ¥ Color:

PHYSICAL EXAMINATION OR APPEARANCE OF CSF: Viscosity:

PHYSICAL EXAMINATION OR APPEARANCE OF CSF: CLARITY

PHYSICAL EXAMINATION OR APPEARANCE OF CSF: SPECIFIC GRAVITY

PHYSICAL EXAMINATION OR APPEARANCE OF CSF: pH:

PHYSICAL EXAMINATION OR APPEARANCE OF CSF: Pressure:

Slightly Hazy

200-500 WBC/UL

WBC, RBC. proteins, concentration, INCREASE lipid Microorganisms, Aspirated epidural , fats, rodiogrephic contrast media

Meningitis, blockage of CSF circulation in subarachnoid

Clotted CSF DISEASE ASSOCIATED

Bloody = Pathologic:

Bloody =NON Pathologic:

Melastasizing mucin producing adenocarcinoma

VISCOUS ASSO. DISEASE

Radiographic Conirast Media

OILY CAUSES

(Web-ike peliicle- overnight ref 12-24 hrs)

Peliicle FORMATION CAUSES

Xanthocromia: COLOR--very slight amount of oxynemaoglobin

Xanthocromia: COLOR Heavy HEMOLYSIS

Xanthocromia: COLOR conversion of oxyhemoglobin to unconjugated bilirubin ! Other causes: 1 serum bilirubin, (+) carotene, tprotein (>150 mg/dl, melanoma pigment

Brown

Methemoglobin, hematoma, malanin

Intracranial Hemorrhage Causes

Traumatic Tap Causes

Distribution of blood Intracranial Hemorrhage

Distribution of blood Traumatic Tap

Itracranial Hemorrhage Clot formation

Traumatic Tap Clot formation

Xanthocromic supernatant Intracranial Hemorrhage

Xanthocromic supernatant Traumatic Tap

Erythrophagocytosis Intracranial Hemorrhage

Erythrophagocytosis Traumatic Tap

D-dimer Test Intracranial Hemorrhage

D-dimer Test Traumatic Tap

CHEMISTRY EXAMINATION OF CSF ntracranial Hemorrhage

CHEMISTRY EXAMINATION OF CSF Traumatic Tap

CSF PROTEIN » NORMAL VALUES: Values are higher in infants and older persons

MOST FREQUENTLY PERFORMED IN CHEMISTRY TEST

(most abundant) => pre- -albumin (2%) ->a-globulins (haptoglobin, ceruplasmin] OR THE MAJOR CSF PROTEIN

major B-globulin

carbohydrate deficient fransferrin seen in CSF ONLY

y-globulin:

NOT FOUND IN NORMAL PLASMA CSF

Increased CSF CAUSES

Damage to BBB (INCREASED OR DECREASED)

Decreased protein clearance from fluid (INCREASED OR DECREASED)

Neural Tissue Degeneration (INCREASED OR DECREASED)

Meningitis, Hemorrhage (INCREASED OR DECREASED)

MS, Endocrine/ Metabolic disorders (INCREASED OR DECREASED)

Leakage of fluid from the CNS (INCREASED OR DECREASED)

Precipitates proteins using: TCA AND SSA

reagent of choice, precipitates albumin and globulin

precipitates albumin, only unless combine with NA2SO4

Protein-Error of indicator: LESS INTERFERENCE USES coomassie brilliant blue AND PYROGALLOL RED MOLYBDATE

Dye-binding index THAT IS AUTOMATED

Dye-binding index THAT BINDS TO VARIETY OF PROTEINS

IT IS USE TO CHECK BBB

USED TO MEASURE BBB INTEGRITY THROUGH CSF/ SERUM ALBUMIN INDEX

CSF/ SERUM ALBUMIN Index value of <9=_

MS, stimulate immunocompetent cells in CNS, IgG synthesis in CNS

CSF/ SERUM ALBUMIN Index value

Index value of CSF-IgG INDEX

CSF/ SERUM ALBUMIN Index value of >0.77

(inflammation in the CNS) w/c is located in y region

Serum & CSF banding:

CSF bonding (+); Serum banding (-); {IgG index :

CSF bonding (+); Serum banding (-):

Method of Choice when determining a true CSF specimen: