Urinalysis and Body Fluids, 5th Edition Cerebrospinal Fluid Chapter 10 Quiz

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Questions and Answers

What is the primary function of the choroid plexuses in the formation of cerebrospinal fluid (CSF)?

Storing CSF in the ventricles

Producing CSF from plasma (correct)

Reabsorbing CSF into the blood

Filtering large molecules from CSF

What prevents the filtration of large molecules into the cerebrospinal fluid (CSF)?

Pia mater

Blood-brain barrier (correct)

Arachnoid granulations

Dura mater

Where does CSF flow through in the central nervous system?

Between arachnoid and pia mater (correct)

Within the ventricles of the brain

Between dura mater and arachnoid

Outside the meninges

What is the approximate adult volume of cerebrospinal fluid (CSF)?

90-150 mL Signup and view all the answers

What is the main role of the arachnoid granulations/villae in relation to CSF?

Reabsorption of CSF into the blood Signup and view all the answers

Which part of the meninges is located closest to the brain and spinal cord surfaces?

Pia mater Signup and view all the answers

Which of the following substances are excluded from passing through the blood-brain barrier?

Immunoglobulins Signup and view all the answers

What is the standard order for collecting cerebrospinal fluid (CSF) in sterile tubes?

Chemistry/serology, Hematology, Microbiology Signup and view all the answers

What should be done to handle cerebrospinal fluid (CSF) requests that are usually STAT (urgent) requests?

Handle carefully and avoid repeat taps Signup and view all the answers

What does the term 'xanthochromic' refer to when describing CSF appearance?

Yellow, pink, or orange appearance Signup and view all the answers

What does uneven blood distribution in the collection tubes indicate during a traumatic tap of CSF?

Decreasing blood distribution in tubes 1 through 3 Signup and view all the answers

What does the presence of clots indicate during a CSF collection?

Traumatic tap (plasma) Signup and view all the answers

What differentiates a traumatic tap from a hemorrhage based on clot formation?

Decreasing blood distribution in tubes 1 through 3 Signup and view all the answers

What is indicated by the presence of a web-like pellicle after refrigeration in nonbloody CSF?

TB meningitis Signup and view all the answers

What causes an even distribution of blood in all tubes during a hemorrhage of CSF?

'D-dimer' test for hemorrhage Signup and view all the answers

What is the primary function of the blood-brain barrier?

Preventing harmful substances from passing through to protect the brain Signup and view all the answers

What differentiates cloudy and milky appearance of cerebrospinal fluid (CSF)?

Infection and lipid or protein content respectively Signup and view all the answers

Which layer of the meninges is located closest to the brain and spinal cord surfaces?

Pia mater Signup and view all the answers

What is the primary source of production for cerebrospinal fluid (CSF)?

Choroid plexuses Signup and view all the answers

How is cerebrospinal fluid (CSF) reabsorbed into the blood?

One-way valves in the arachnoid granulations Signup and view all the answers

What is the approximate volume of cerebrospinal fluid (CSF) in adults?

90-150 mL Signup and view all the answers

Which of the following best describes the blood-brain barrier?

Specialized endothelial cells preventing filtration of large molecules Signup and view all the answers

Through which space does cerebrospinal fluid (CSF) flow in the central nervous system?

Subarachnoid space Signup and view all the answers

What does the term 'xanthochromic' indicate when describing the appearance of CSF?

Jaundice and elevated protein levels Signup and view all the answers

What differentiates a traumatic tap from a hemorrhage in terms of clot formation during CSF collection?

Lack of fibrinogen in hemorrhage Signup and view all the answers

What is the primary role of the arachnoid granulations/villae in relation to CSF?

Drainage of CSF into venous circulation Signup and view all the answers

What is indicated by an uneven distribution of blood in the collection tubes during a traumatic tap of CSF?

Clot formation due to plasma in traumatic tap Signup and view all the answers

What causes an even distribution of blood in all tubes during a hemorrhage in CSF collection?

Hemorrhage has enough fibrinogen Signup and view all the answers

What is the main function of the choroid plexuses in the formation of cerebrospinal fluid (CSF)?

Production of CSF by filtration from blood Signup and view all the answers

What is indicated by the presence of clots during a cerebrospinal fluid (CSF) collection?

Damage to blood-brain barrier Signup and view all the answers

Where is cerebrospinal fluid (CSF) collected from during a spinal fluid tap?

Between 4th and 5th ventricles Signup and view all the answers

Which substances are excluded from passing through the blood-brain barrier?

Chemicals and medications Signup and view all the answers

Study Notes

Choroid Plexuses and CSF Formation

Choroid plexuses are specialized structures in the ventricles of the brain that produce cerebrospinal fluid (CSF).
They filter blood to create CSF, allowing for the passage of water and small solutes, while excluding larger molecules.

Blood-Brain Barrier

The blood-brain barrier (BBB) prevents the filtration of large molecules into CSF, maintaining the brain's tightly regulated environment.
Substances like large proteins and certain toxins are excluded from passing through the BBB, ensuring neuronal protection.

CSF Flow in the Central Nervous System

CSF circulates through ventricular spaces, the central canal of the spinal cord, and the subarachnoid space surrounding the brain and spinal cord.

CSF Volume

The approximate adult volume of CSF is around 150 mL, ensuring adequate cushioning and buoyancy for the brain.

Arachnoid Granulations/Villae

Arachnoid granulations serve as points where CSF is reabsorbed into the bloodstream, facilitating CSF turnover and homeostasis.

Meninges Layers

The pia mater is the layer of the meninges located closest to the brain and spinal cord surfaces, providing a protective barrier.

Cerebrospinal Fluid Collection and Analysis

CSF is typically collected in sterile tubes in the following order: tube 1 for chemistry, tube 2 for microbiology, and tube 3 for cytology.
STAT requests for CSF should be prioritized and handled swiftly to ensure timely diagnosis and treatment.

Xanthochromia and CSF Appearance

'Xanthochromic' describes CSF that appears yellowish and indicates the presence of bilirubin, often related to hemorrhage or other pathological processes.
Uneven blood distribution during a CSF collection indicates a traumatic tap, suggesting blood has contaminated the sample due to spinal needle insertion.
The presence of clots in collected CSF can indicate a traumatic tap or a traumatic hemorrhage, necessitating careful interpretation based on clot formation patterns.

Trauma vs. Hemorrhage in CSF Analysis

A traumatic tap typically shows blood tapers off in subsequent tubes, while a hemorrhage shows uniform blood distribution across all collection tubes.
Clot formation differentiates the two conditions: formation suggests trauma, while a true hemorrhage may not clot rapidly.

Pellicle Formation

The presence of a web-like pellicle after refrigeration of nonbloody CSF samples indicates the potential presence of meningitis or other infections.

CSF Reabsorption

CSF is reabsorbed into the blood primarily through arachnoid granulations, allowing for fluid balance.

Conclusion on CSF and the BBB

The primary function of the blood-brain barrier is to protect the CNS by controlling the influx of substances from the bloodstream into the CSF.
Cloudy appearance in CSF may indicate infection or inflammation, while milky appearance often suggests chylous material or other issues such as elevated triglycerides.

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Description

Test your knowledge on the formation, physiology, and characteristics of cerebrospinal fluid (CSF) as covered in Chapter 10 of the 5th edition of 'Urinalysis and Body Fluids'. Explore the production, volume, and composition of CSF in adults and neonates.