Cerebrospinal Fluid (CSF) Quiz

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Questions and Answers

Most CSF originates in the _ _

choroid plexus

What is the definition of choroid plexus?

A highly vascular portion of the lining of the ventricles that secretes cerebrospinal fluid.

What are the three main functions of cerebrospinal fluid?

Protect brain and spinal cord from trauma.

Supply nutrients to nervous system tissue.

Remove waste products from cerebral metabolism.

All of the above (correct)

The protein level of normal CSF is dramatically _____ than that of plasma.

lower Signup and view all the answers

In an adult, ____ WBC/µL is considered normal.

0 - 5 Signup and view all the answers

Children will have slightly higher cell counts. Up to __ WBC/µL is within normal limits for newborns.

30 Signup and view all the answers

Lymphocytes account for ___% of these cells.

60 - 100 Signup and view all the answers

What is the approximate volume of spinal fluid in an adult?

90-150 mL Signup and view all the answers

A CSF sample is obtained by a physician usually via?

lumbar puncture (usually L3-4) Signup and view all the answers

Hematologic analysis of CSF samples should be performed within _____ of fluid aspiration.

one hour Signup and view all the answers

What may indicate the presence of a thin membrane or 'scum' on the surface of the CSF specimen?

pellicle Signup and view all the answers

CSF samples from patients who have suffered a subarachnoid hemorrhage (SAH) may have a _____ supernatant when the sample is centrifuged within one hour following collection.

pink- to-yellow-tinged Signup and view all the answers

The term used to describe the colored supernatant is?

xanthochromia Signup and view all the answers

What is xanthochromia the result of?

breakdown products of RBCs that are present in the CSF due to the SAH Signup and view all the answers

_____ could also cause the CSF to be xanthochromic.

A high serum bilirubin Signup and view all the answers

What is the Neubauer counting chamber formula used for?

Signup and view all the answers

What are the CSF counting guidelines?

100 Dilute for nucleated cell count Signup and view all the answers

When do you count the 4 corner squares for WBCs?

10 - 100 Signup and view all the answers

The nucleated cells seen in normal adult CSF are predominantly?

lymphocytes and monocyte/macrophages Signup and view all the answers

What does pleocytosis refer to?

Increased number of cells in CSF Signup and view all the answers

_____ are indications that an SAH had occurred sometime prior to collection of the CSF sample.

Macrophages that have phagocytized red blood cells (erythrophages) or hemosiderin (siderophages) Signup and view all the answers

The formation of hemosiderin deposits and hematoidin crystals occurs approximately __ hours following a subarachnoid hemorrhage.

18 Signup and view all the answers

The hemosiderin deposits, hematoidin crystals, and siderophages may be present in the CSF for _____.

several months Signup and view all the answers

Bone marrow contamination of CSF:

both immature myeloid cells and erythroid cells may be seen but are not a reflection of the patient's peripheral blood picture Signup and view all the answers

Blast cells may be seen in the spinal fluid when cell proliferation in _____ spreads to the central nervous system.

acute leukemia or lymphoma Signup and view all the answers

Which of the following are characteristics of malignant cells?

All of the above Signup and view all the answers

Where does most cerebrospinal fluid (CSF) originate?

choroid plexus Signup and view all the answers

Study Notes

Cerebrospinal Fluid (CSF) Overview

Most CSF originates in the choroid plexus, a network of blood vessels in the ventricles.
Choroid plexus plays a crucial role in the secretion of cerebrospinal fluid.

Functions of CSF

Protects the brain and spinal cord from mechanical trauma.
Supplies essential nutrients to nervous system tissues.
Removes metabolic waste products.

Analyte Reference Intervals

Reference intervals for analytes differ between CSF and plasma; normal CSF protein levels are significantly lower than those in plasma.

Normal Cell Counts in CSF

In adults, a normal CSF white blood cell (WBC) count is between 0 to 5 WBC/µL.
Newborns may have counts up to 30 WBC/µL, which is also considered normal.
Lymphocytes typically account for 60-100% of the nucleated cells present in CSF.

CSF Volume and Collection

The approximate volume of CSF in an adult is between 90-150 mL.
CSF samples are commonly obtained via lumbar puncture (usually at L3-4).

Hematologic Analysis Timing

Hematologic analysis of CSF should be conducted within one hour following aspiration to maintain cell stability, as both RBCs and WBCs can rapidly lyse in the hypotonic CSF.

CSF Characteristics

Clots may create a thin membrane called pellicle, made of fibrinogen and WBCs.
CSF from patients with subarachnoid hemorrhage (SAH) can present a pink- to yellow-tinged supernatant after centrifugation.
This colored supernatant is referred to as xanthochromia, resulting from RBC breakdown products.

Causes of Xanthochromia

Xanthochromia can also occur due to high serum bilirubin levels.

Counting Cells in CSF

Use a Neubauer counting chamber for nucleated cell counts in diluted CSF samples.
For WBC counts, assess four corner squares when diluted cell counts range between 10 and 100.

Nucleated Cells in Adult CSF

Normal adult CSF contains predominantly lymphocytes and monocyte/macrophages.

Pleocytosis and SAH Indications

Pleocytosis refers to an increased number of cells in CSF.
Presence of macrophages (erythrophages) that have ingested RBCs, or hemosiderin-laden cells (siderophages), indicates prior subarachnoid hemorrhage.

Temporal Aspects of Hemorrhage Indicators

Hemosiderin deposits and hematoidin crystals appear around 18 hours post-SAH, remaining detectable for several months.

Bone Marrow Contamination

Bone marrow contamination in CSF can show immature myeloid and erythroid cells, which do not reflect the patient's peripheral blood status.

Malignant Cells in CSF

Acute leukemia or lymphoma may result in the presence of blast cells in the spinal fluid.
Characteristics of malignant cells include:
- Giant cells and multinucleation.
- Cellular crowding with irregular nuclear shapes.
- High nuclear to cytoplasmic ratio and vacuolation in cytoplasm and nucleus.

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Description

Test your knowledge about cerebrospinal fluid with this quiz. Learn about its origins, functions, and the importance of the choroid plexus in CSF production. Perfect for students studying neuroanatomy and physiology.