Lecture 10: Chapter 9 Cerebrospinal Fluid Analysis

because cell count decreases as time goes on.

colorless

sample is turbid

before and after

50-180 mmHg

if it is outside the range: 50-180 mmHg

3 & 4 lumbar

4 & 5 lumbar

in the subarachnoid space

TRUE

80-150 mL

between pia and arachnoid

Cerebrospinal fluid (CSF) acts as a cushion that "floats" the brain, reducing its effective weight and softening the impact against the hard skull. This helps protect the brain from injury by absorbing shocks and reducing the force from sudden movements or impacts.

optimal ionic concentrations for action potentials

circulates nutrients and waste products to and from bloodstream

from arterial blood by the choroid plexuses

The choroid plexus is made up of clusters of capillaries with thin, fenestrated (small opening) endothelial cells. These capillaries are covered by specialized ependymal cells that have tiny hair-like projections called microvilli. This structure allows the choroid plexus to produce cerebrospinal fluid (CSF) efficiently, filtering substances from the blood while maintaining a controlled environment around the brain.

through arachnoid villi; which are grapelike clusters of arachnoid layer

both reabsorption rate and production rate are the same; so 20 mL/hour

a condition where there is an abnormal buildup of cerebrospinal fluid (CSF) in the brain’s ventricles, which are fluid-filled spaces.

tumor, inflammation, developmental malformation, meningitis, hemorrhage or injury

continued production of CSF causing an increase in pressure!

a drain shunting the CSF to the veins of the neck or the abdomen.

local anesthesia

with manometer attached to the spinal needle

50 to 180 mmHg

10-20 mm less

pressure values and amount collected!

3 tubes:
1. chemistry
2. microbiology
3. cell counts

to check for infections in the central nervous system, such as meningitis or encephalitis.

number of cells

increased number of cells in CSF

WBCs (>200 cells/mL)
or
RBCs (>400 cells/mL)
OR
microorganisms
OR
increased protein

glucose

abnormal color of CSF like orange, red/pink, yellow

pink bc blood is in sample.

occurs when blood unintentionally enters the cerebrospinal fluid (CSF) sample during a lumbar puncture (spinal tap) procedure. This usually happens when a small blood vessel is accidentally punctured as the needle is inserted into the spinal canal.

theres a lot of blood in tube1, least in tube 3
AND
After centrifugation, supernatant is colorless

There's consistent amount of blood in all 3 tubes; meaning there's internal bleeding
AND
After centrifugation, xanthochromic supernatant
AND
Macrophages containing phagocytosed RBCs within

0 to 5 WBCs/ uL

Noooooooo; could be due to traumatic tape or hemorrhage

because WBCs lyse pretty quickly, so we want to prevent that from happening

Store in fridge at 4oC

with hemacytometer on undiluted specimens counting all nine squares on both sides

early viral, fungal, TB, or parasitic infections
and
some non infectious conditions

Viral meningitis, TB, fungal or syphilitic meningitis particularly in later stages

multiple sclerosis and acute viral and chronic inflammatory conditions.

decrease in glucose; because bacteria uses it up!
increase in proteins; because of inflammatory proteins!

10% or greater with parasitic, fungal, or allergic reactions

fungal meningitis, TB, chronic bacterial meningitis, or rupture off cerebral abscess

contamination with blood during traumatic tap
change in blood-brain barrier
decreased reabsorption into venous blood
increased synthesis in central nervous system (CNS)

the body is rapidly producing spinal fluid &
loss of fluid

hemorrhage
bactieral, viral ,and other forms of meningitis
cerebral infarction
MS
obstruction of CSF flow
trauma

to assess permeability of blood-brain barrier

< 9 is normal

9 to 14

15 to 100

exceeding 100

plasma value is measured 30 to 90 minutes before CSF collection.

normal; other conditions are elevated.

autoimmune

a protective, fatty layer that surrounds nerve fibers (axons) in the nervous system; to insulate the nerve cells and to speed up the transmission of electrical signals (nerve impulses) along the axon

a type of glial cell in the peripheral nervous system (PNS) responsible for producing and maintaining the myelin sheath around peripheral nerve fibers.

cells can't communicate with other cells.

folded MBP (myelin basic proteins) becomes unfolded MBP which can not be phaocytized by a phagocytic cell.

multiple sclerosis and other demyelinating diseases

gram stain

India ink

Acid fast stain

Wright stain

culture!