Lumbar Puncture Procedure

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Questions and Answers

What is a possible cause of abnormal results in CSF cell count?

Viral infection

Inflammation of the central nervous system

Tumor

All of the above (correct)

What is the percentage of chloride in CSF compared to plasma?

~50%

~60%

<50%

>100% (correct)

What is the normal range of white blood cells in CSF?

0-10 per micro

10-20 per micro

0-5 per micro (correct)

5-10 per micro

What is the significance of finding red blood cells in CSF?

Sign of bleeding Signup and view all the answers

What is the normal range of glucose in CSF?

50-80 mg/dL Signup and view all the answers

What is characteristic of pyogenic bacterial meningitis CSF?

Yellowish turbid fluid with markedly increased leukocytes Signup and view all the answers

What is characteristic of viral meningitis CSF?

Clear fluid with normal leukocytes Signup and view all the answers

What is characteristic of tuberculous meningitis CSF?

Yellowish turbid fluid with slightly increased leukocytes Signup and view all the answers

How much CSF is produced daily?

500 mL Signup and view all the answers

What is the primary purpose of a lumbar puncture?

To collect cerebrospinal fluid for diagnostic testing Signup and view all the answers

What is the purpose of a lumbar puncture?

To collect a sample of cerebrospinal fluid for examination Signup and view all the answers

What is typically evaluated in relation to blood levels during CSF analysis?

CSF protein and glucose Signup and view all the answers

What type of tests are performed to detect or measure chemical substances found in spinal fluid?

Chemical tests Signup and view all the answers

What can be detected in the CSF culture examination?

The microorganism that has caused the infection Signup and view all the answers

What is the term for the clear fluid that surrounds the brain and spinal cord?

Cerebrospinal fluid Signup and view all the answers

What is the layer of the meninges between which the CSF flows during a lumbar puncture?

Between the arachnoid and pia mater Signup and view all the answers

What is the purpose of measuring CSF pressure during collection?

To assess CSF circulation and absorption Signup and view all the answers

What is a potential complication of removing CSF during lumbar puncture?

Post-test spinal headache Signup and view all the answers

Why is it important to lie quietly in a flat position after a lumbar puncture?

To avoid a potential post-test spinal headache Signup and view all the answers

What is the term for the process of counting and identifying cells present in CSF under a microscope?

Microscopic examination Signup and view all the answers

What can be diagnosed using CSF examination?

Subarachnoid hemorrhage and central nervous system infections Signup and view all the answers

What is highly specific and sensitive for the detection of CSF leakage?

Beta-2 transferrin assay Signup and view all the answers

What is obtained during the lumbar puncture procedure?

A sample of cerebrospinal fluid Signup and view all the answers

What can be recognized by detecting oligoclonal bands in the CSF?

An ongoing inflammatory condition Signup and view all the answers

Why is it crucial to remain still during a lumbar puncture procedure?

To prevent injury to the spine Signup and view all the answers

Study Notes

Lumbar Puncture (Spinal Tap)

A procedure where a sample of cerebrospinal fluid (CSF) is taken for examination
Also called a spinal tap
Performed while lying on side in a curled up fetal position or sometimes in a sitting position
Crucial to remain still during the procedure

Procedure

Back is cleaned with an antiseptic and a local anesthetic is injected under the skin
A special needle is inserted through the skin, between two vertebrae, and into the spinal canal
Needle is gently advanced until it enters the subarachnoid space and CSF begins to flow
An "opening" or initial pressure reading of the CSF is obtained
A small amount of CSF is collected in multiple sterile vials
A "closing" pressure is obtained, the needle is withdrawn, and a sterile dressing and pressure are applied to the puncture site

Post-Procedure

Lie quietly in a flat position, without lifting head, for one or more hours to avoid a potential post-test spinal headache

CSF Analysis

CSF cell count: measures the number of red and white blood cells in CSF
Normal white blood cell count is between 0 and 5 per micro
Normal red blood cell count is 0
Increase in white blood cells indicates infection, inflammation, or bleeding into the CSF
Finding red blood cells in CSF may be a sign of bleeding

Composition of Cerebrospinal Fluid

CSF is produced at a rate of about 500 mL per day
All of the CSF is replaced every few hours
CSF is basically an ultrafiltrate of the blood
Constituents of CSF such as protein and glucose are a percentage of blood levels

Clinical Significance of CSF Tests

CSF tests can aid in the diagnosis of neurological diseases
Can detect levels of protein and glucose in CSF
Can detect the presence of microorganisms in CSF
Can aid in the diagnosis of subarachnoid hemorrhage and central nervous system infections

Reference Ranges for Ions and Metals in CSF

Sodium: 135-150 mmol/L
Potassium: 2.6-3.0 mmol/L
Chloride: 115-130 mmol/L
Calcium: 1.00-1.40 mmol/L
Magnesium: 1.2-1.50 mmol/L
Iron: 0.2-0.4 µmol/L
Glucose: 50-80 mg/dL
Protein: 15-40-45 mg/dL
Albumin: 7.8-40 mg/dL
Lactate: 1.1-2.4 mmol/L
Creatinine: 50-110 µmol/L
Phosphorus: 0.4-0.6 µmol/L
Urea: 3.0-6.5 mmol/L
Carbon dioxide: 20-25 mmol/L

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Description

This quiz covers the steps involved in a lumbar puncture procedure, including obtaining CSF pressure readings and collecting cerebrospinal fluid samples. Learn about the importance of remaining still and the post-procedure care.