Cerebrospinal Fluid Analysis Practice Flashcards

VOCABULARY style flashcards covering anatomy, formation, collection, physical characteristics, microscopic analysis, and chemical testing of Cerebrospinal Fluid (CSF) based on Chapter 10 of Graff’s Textbook of Urinalysis and Body Fluids.

Dura mater

The outer layer of the meninges lining the skull and vertebral canal; Latin for "Hard-mother."

Arachnoid

The filamentous inner layer of the meninges; Latin for "Spiderweb-like."

Pia Mater

The thin membrane lining the surface of the brain and spinal cord; Latin for "Gentle-mother."

Choroid plexus

Capillary networks located in the ventricles that produce cerebrospinal fluid (CSF) through selective filtration under hydrostatic pressure and active transport secretion.

Blood-brain barrier

Endothelial cells of the choroid plexus with tight-fitting junctures that prevent the passage of many molecules, including medications/antibiotics, into the CNS.

Arachnoid granulations

A series of one-way valves through which CSF is reabsorbed back into the blood capillaries at a rate equal to its production.

Tube 1 (CSF Collection)

The first tube collected during lumbar puncture, designated for Clinical Chemistry and serological testing; it may be frozen.

Tube 2 (CSF Collection)

The second tube collected, designated for the Microbiology laboratory; it should remain at room temperature.

Tube 3 (CSF Collection)

The third tube collected, designated for Hematology (cell counts) because it is least likely to contain cells introduced by the procedure; it is refrigerated up to $4$ hours.

Xanthochromia

A term describing CSF supernatant that is pink, orange, or yellow after centrifugation, most commonly caused by red blood cell degradation products from a sub-arachnoid hemorrhage.

Pleocytosis

An increase in the number of white blood cells (WBCs) in a body fluid; in CSF, types correlate with specific inflammation, infections, or malignancies.

Neutrophilic pleocytosis

The presence of neutrophils in CSF, associated with bacterial meningitis, early stages of other meningitis types, or cerebral abscesses.

Lymphocytic pleocytosis

The presence of lymphocytes in CSF, associated with later stages of viral, tubercular, fungal, and syphilitic meningitis, or degenerative disorders.

Siderophages

Macrophages containing stored iron (hemosiderin) typically appearing in CSF $2\text{--}4$ days after a CNS hemorrhage.

Lipophage

A macrophage with ingested fat, which may be seen in CSF following a brain infarct.

PAM cells

Pia arachnoid epithelial cells; lining cells that may be normal in neonates or increased in children with hydrocephalus.

CSF/serum albumin index

A calculation used to measure the degree of permeability of the blood-brain barrier; values from $15\text{--}30$ indicate moderate impairment.

tau transferrin

A specific protein band made primarily by the CNS; detecting it in fluid from the ear or nose confirms diagnoses of otorrhea or rhinorrhea.

Oligoclonal bands

Bands found in the gamma region of CSF protein electrophoresis that are not present in serum; they help establish a diagnosis of Multiple Sclerosis (MS).

Myelin Basic Protein (MBP)

A component of the myelin sheath whose presence in CSF at levels above $4\text{--}ng/mL$ indicates demyelinating diseases like Multiple Sclerosis.

CSF Glucose

A chemical component that normally measures $60\text{--}70\text{\%}$ of plasma glucose, typically ranging from $50\text{--}80\text{\,}mg/dL$.

India Ink

A special stain with a sensitivity of $25\text{--}50\text{\%}$ used to identify Cryptococcus neoformans in cerebrospinal fluid.