Chapter 10 CSF outline - BF 2010

Chapter 10 CSF outline - BF 2010 - CHAPTER 10:...

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C HAPTER 10: C EREBROSPINAL FLUID I. Volume a. Meniges(duramater, arachnoid, aracnoid space, pia mater) b. Choroid plexus of ventricles- where CSF is produced @ 20mL/hr, the same amount reabsorbed simultaneously flows in subarachnoid space reabsorbed in aracnoid granules(1-way flow). 1. Adult: 90-150mL TOTAL all the time 2. Child: 60-adult o Infants: 10-60mL II. Functions a. Cushion brain (mechanical buffer) b. Delivering nutrients to the brain c. d. Glucose is the ONLY source of energy (low-carb diet brain gets lazy) III. Ultrafiltrate? a. Urine has even [ ]s of things on each side of barrier CSF does NOT b. Blood-brain barrier (BBB) i. ii. ALL ACTIVE TRANSPORT in both directions 1. Different [ ]’s of things, Na+, Mg2+, Cl-(more [ ]ed) 2. Prevents medication (penicillin), toxins, immunoglobulins from passing. IV. C OLLECTION a. Method: i. Always done STAT ii. Take pressure of CSF (normal: 20mL ~15%), if less than OR greater than normal pressure, only take 1 or 2mL. iii. Take pressure after tap, record mL removed. 1. Spinal Tap (Lumbar puncture)-invasive, patient discomfort a. Adults: 3 rd or 4 th lumbar space b. Children: 4 th or 5 th lumbar space c. Risks: infection, paralysis, death
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V. T UBES – 3 ( OR MORE ) ~20 M L #1 – Chemistry and serology depts. DEFAULT Might introduce blood from procedure some cells in CSF don’t count. Immunological/immunoassay External bacteria storage temp Always done STAT, if delay=FREEZE then thaw when ready. #2 – Microbiology test for microorganisms on agar plate storage temp-MUST be kept @ room temp for organisms to thrive and live #3 – Hematology storage temp- REFRIDGERATE slows life span of cells. ONLY 1 TUBE=DIFFERENT ORDER 1 st -microbiology must be done on sterile hood so there’s no contamination. VI. CSF P HYSICAL A NALYSIS (similar to urine), Hold beside tube of water and white piece of paper. a. Clarity (normal: clear) i. Slightly hazy or cloudy 1. WBCs, bacteria, protein, lipids(milky) 2. 200-500 WBCs per microliter ii. Turbid 1. 500WBC< per microliter 2. Radiographic dye=oily appearance b. Clot formation (normal: no clotting) i. Viscosity is similar to water, ii. Clots should be reported as being present iii. Pellicle (cloudy/stringy) - ↑ fibrinogen (clotting protein)=compromised BBB 1. Stored in fridge longer than 8 hrs 2. Traumatic tap-blood as been introduced containing fibrinogen
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c. Color – supernatant (normal: colorless)
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Chapter 10 CSF outline - BF 2010 - CHAPTER 10:...

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