CSF 1

100問 • 2年前

問題一覧

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

CEREBROSPINAL FLUID (CSF)

not an ultrafiltrate of plasma

CEREBROSPINAL FLUID (CSF)

Brain & spinal cord are lined by

Meninges

3 parts of meninges

1. DURA MATER, 2. ARACHNOID MATER, 3.PIA MATER

outer layer; lines the skull & vertebral canal

DURA MATER

Spider web-like/ filamentous inner membrane

ARACHNOID

Thin membrane lining the surfaces of brain & spinal cord

PIA MATER

PRODUCTION OF CSF

Produced in CHOROID PLEXUS of lumbar ventricles & third & fourth ventricles

Flows through _________(Between arachnoid & pia mater)

SUBARACHNOID

Reabsorbed by the _______________into the superior sagittal sinus

ARACHNOID VILLI/ GRANULATION

CSF VOLUME:

20 ML/PER HOUR

Adults: CSF VOLUME

40-170 ML/ 90-150 ML

CSF VOLUME Neonates:

10-60 mL

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

BLOOD BRAIN BARRIER (BBB): >500 daltons

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

BLOOD BRAIN BARRIER (BBB)

Increased WBC, proteins, and coagulation factors in CSF

Meningitis, Multiple Sclerosis

Routine method for CSF collection

LUMBAR PUNCTURE

Between _____ Lumbar Vertebrae:

3RD, 4TH, 5TH

Lumbar Vertebrae: ADULTS

3RD AND 4TH

Lumbar Vertebrae: CHILDREN

4TH AND 5TH

Patientis position in lumbar puncture

FETAL POSITION OR LATERAL DECUBITUS POSITION

infants w/ open fontanels

VENTICULAR PUNCTURE

collected in sub-occipital region

CISTERIAL PUNCTURE

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

TUBE 1 CHEMISTRY AND SEROLOGY

TUBE 2 AND PRESERVATIVE

MICROBIOLOGY, ROOM TEMPERATURE

Least likely fo contain C cells introduced by the tap procedure

HEMATOLOGY/ CELL COUNT, REF TEMPERATURE; TUBE 3

LAST TUBE

MICROBIOLOGY

Tests are performed on a ? WITHIN?

STAT basis: 30 MINS

Supernatant fluid that is left over in every section:

CHEMISTRY/ SEROLOGY

IF ONLY 1 TUBE: ORDER OF COLLECTION

MICROBIOLOGY-> HEMATOLOGY-> CHEMISTRY/SEROLOGY

PHYSICAL EXAMINATION OR APPEARANCE OF CSF: ¥ Color:

COLORLESS

PHYSICAL EXAMINATION OR APPEARANCE OF CSF: Viscosity:

Same w/ water

PHYSICAL EXAMINATION OR APPEARANCE OF CSF: CLARITY

Crystal Clear

PHYSICAL EXAMINATION OR APPEARANCE OF CSF: SPECIFIC GRAVITY

1.006-1.008

PHYSICAL EXAMINATION OR APPEARANCE OF CSF: pH:

7.30-7.45

PHYSICAL EXAMINATION OR APPEARANCE OF CSF: Pressure:

50-200 mmH2

Slightly Hazy

200-500 WBC/UL

Slightly Hazy

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

Turbid/ Milky

Meningitis, blockage of CSF circulation in subarachnoid

Clotted

Clotted CSF DISEASE ASSOCIATED

MENINGITIS, FROINS DISEASE

Bloody = Pathologic:

INTRACRANIAL HEMORRHAGE (SUBARACHNOID HEMORRHAGE)

Bloody =NON Pathologic:

TRAUMATIC TAP

Melastasizing mucin producing adenocarcinoma

VISCOUS

VISCOUS ASSO. DISEASE

CRYPTOCOCCAL MENINGITIS, ADENOCARCINOMA

Radiographic Conirast Media

OILY

OILY CAUSES

Radiographic Contrast Media

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

Peliicle FORMATION

Peliicle FORMATION CAUSES

TUBERCULAR MENINGITIS

Xanthocromia: COLOR--very slight amount of oxynemaoglobin

PINK

Xanthocromia: COLOR Heavy HEMOLYSIS

ORANGE

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

YELLOW

Brown

Methemoglobin, hematoma, malanin

BROWN

Intracranial Hemorrhage Causes

Haemorhage

Traumatic Tap Causes

Puncture of blood vessel during procedure

Distribution of blood Intracranial Hemorrhage

EVEN in all 3 tubes

Distribution of blood Traumatic Tap

UNEVEN T1>T2>13/ Streaks of blood

Itracranial Hemorrhage Clot formation

ABSENT

Traumatic Tap Clot formation

PRESENT

Xanthocromic supernatant Intracranial Hemorrhage

CLEAR

Xanthocromic supernatant Traumatic Tap

PRESENT

Erythrophagocytosis Intracranial Hemorrhage

PRESENT

Erythrophagocytosis Traumatic Tap

ABSENT

D-dimer Test Intracranial Hemorrhage

POSITIVE

D-dimer Test Traumatic Tap

NEGATIVE

CHEMISTRY EXAMINATION OF CSF ntracranial Hemorrhage

POSTIVE

CHEMISTRY EXAMINATION OF CSF Traumatic Tap

NEGATIVE

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

15-45 MG/DL

MOST FREQUENTLY PERFORMED IN CHEMISTRY TEST

CSF PROTEIN

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

ALBUMIN

major B-globulin

Transferrin

carbohydrate deficient fransferrin seen in CSF ONLY

TAU

y-globulin:

IgG>IgA

NOT FOUND IN NORMAL PLASMA CSF

BETA LIPOPROTEIN, FIBRINOGEN, IGM

Increased CSF CAUSES

Meningitis, Hemorrhage

Damage to BBB (INCREASED OR DECREASED)

INCREASED

Decreased protein clearance from fluid (INCREASED OR DECREASED)

INCREASED

Neural Tissue Degeneration (INCREASED OR DECREASED)

INCREASED

Meningitis, Hemorrhage (INCREASED OR DECREASED)

INCREASED

MS, Endocrine/ Metabolic disorders (INCREASED OR DECREASED)

INCREASED

Leakage of fluid from the CNS (INCREASED OR DECREASED)

DECREASED

Precipitates proteins using: TCA AND SSA

Turbidimetric Method.

reagent of choice, precipitates albumin and globulin

TRICHOLORO ACETIC ACID (TCA)

precipitates albumin, only unless combine with NA2SO4

SULFOSALICYLIC ACID (SSA)

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

Dye-binding index

Dye-binding index THAT IS AUTOMATED

PYROGALLOL RED MOLYBDATE

Dye-binding index THAT BINDS TO VARIETY OF PROTEINS

coomassie brilliant blue

IT IS USE TO CHECK BBB

PROTEIN FRACTIONS

USED TO MEASURE BBB INTEGRITY THROUGH CSF/ SERUM ALBUMIN INDEX

CSF/ SERUM ALBUMIN

CSF/ SERUM ALBUMIN Index value of <9=_

INTACT BBB

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

CSF- IgG INDEX

CSF/ SERUM ALBUMIN Index value

Index value of CSF-IgG INDEX

> 0.77

CSF/ SERUM ALBUMIN Index value of >0.77

INDICES IgG PRODUCTION WITHIN CNS

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

OLIGOCLONAL BANDS

Serum & CSF banding:

Leukemia, Lymphoma, Viral infection (HIV)

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

MULTIPLE SCLEROSIS

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

MULSTIPLE SCLEROSIS, MENIGITIS, ENCEPHALITIS, NEUROSYPHILIS, GUILLAIN BARE

100

Method of Choice when determining a true CSF specimen:

TAU IDENTIFICATION

other names parasitology

Yves Laure Pimentel · 70問 · 2年前

other names parasitology