Glossary of CSF
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- In what 2 sites is CSF formed?
- 1. 70% in choroid plexus in lateral/3rd/4th ventricles.
2. 30% in ependymal lining of ventricles/subarachnoid space.
- What 'actions' allow CSF to be formed?
- 1. Filtration by capillaries
2. Active secretion by epithelial cells.
- Describe CSF composition:
-K+ Ca2+ Bicarb, Glucose/Protein
- -K+, Ca++, Bicarb, Glu and Protein are lower than blood.
-Sodium/osmolarity are same.
-More acidic than plasma.
- What can get into the Brain past the BBB without help?
- Only water! Relatively permeable to it in fact.
- What diffuses through the BBB?
- Lipid-soluble substances.
- What is transported actively into the brain?
- Glucose, Sodium, Chloride, Mg.
- What are the 3 ways to enter the CSF?
- 1. Diffuse if lipid-soluble
2. Facilitated/Active transport
3. Ion channels
- What causes CSF circulation?
- Pressure changes caused by:
- What are the 3functions of CSF?
- 1. Nourish brain
2. Take away wastes
3. Cushion from trauma/float.
- What are 4 ways to collect CSF?
- 1. Lumbar puncture
2. Cisternal puncture
3. Lateral cervical puncture
4. Ventricular cannular shunt
- 5 diagnostic indications for LP:
- 4 therapeutic indications of LP:
-Radiographic contrast media
-Amphotericin - for fungal meningitis.
- Normal CSF pressure:
- If there are only 1 or 2 tubes of CSF drawn, where do they go first?
- 1. Micro
- How Soon must CSF be run?
- Within ONE HOUR.
- What cells are normal on a CSF diff? in Whom?
- Adults: 65 lymph:35 mono
Newbrn: 70 mono: 30 lymph
-Rare choroid plexus, ependymal, neuroectodermal
- What are abnormal cells on a CSF diff?
- -PMNS many
- What is a siderophage?
- A macrophage that has hemosiderin in it.. and has been confirmed with PPB.
- Which cancers readily metastesize to the CNS?
- What do nRBCs indicate in the CSF?
- BM contamination.
- When are nRBCs normal in the CSF?
- When they are in the circulating blood of neonates.
- What might Eosinophils indicate when in the CSF?
- -Allergic rxtns
- What chemistries are most indicative of CSF abnormality?
- What others might be run?
- What is normal CSF Protein?
- 15-45 mg/dL
- Why would CSF protein be low?
- Leaking CSF
- What are 4 methods for protein on CSF?
- What should the CSF:serum albumin index be?
- Less than nine.
- What should the gammaglobulin component of total protien be?
- Less than 12%
- If the gammaglobulin fraction is increased, what is suspect?
- What especially indicates multiple sclerosis?
- Oligoclonal bands on protein fractionation EVEN when symptoms go away.
- What 3 pieces of data help diagnose MS?
- -Increased IgG index
-Myelin Basic PRotein increase
- What is normal CSF glucose?
What does Increase mean?
What does Decrease mean?
- 50-60% of the blood glucose
-Increase = increased blood glu
-Decrease = diseased state
- What is decreased CSF Glucose normally caused by?
- -Impaired transport across BBB
-Increased brain use
- What is CSF glucose decrease usually seen in?
- -Bacterial meningitis
- What is normal LD?
- 10-25 mg/dl
- When are Lactate and LD increased?
- -Oxygen deprivation to brain
-Bacterial, fungal, TB meningitis
- When are Lactate and LD normal?
- viral meningitis
- what is glutamine masurement useful for?
- indicating CSF amonia levels
-elevated puts patients at risk of coma.
- What are 6 tests used for microbiological and immunolog analysis of CSF?
- 1. Gram stain
2. India ink
4. Latex agglutination
6. Limulus lysate
- what is the limulus lysate test for?
- to detect gram negative rods.
- How does the limulus lysate test work?
- -Blood from horseshoe crabs has copper
-Coagulates in presence of GNB
- abrev. meaning for CSF
- cerebrospinal fluid
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