Examination of csf

1. Cerebrospinal fluid (CSF)
Prepared by : -.Bipul Kumar Mahto

2. Introduction
 CSF is formed by selective dialysis of plasma by the
choroid plexue of the ventricles of the brain .
 Foramine in the fourth ventricle it passes into
subarachnoidal cisterns at the base of the brain .
 Absorbed into the blood in the cerebral veins and dural
sinuses .
 It is present in the cavity that surrounds the brain in the
skull and the spinal cord in the spinal column .
 It is a part of extracellular fluid .

3. Human Brain : Cerebrospinal fluid (CSF) synthesis

4. Function
 It helps to protect the brain and spinal coard from injury by acting like a
fluidbuffer .
 Also acts as a medium for the transfer of substances from the brain tissue
and spinal coard to blood .
 It maintain intracranial pressure.
 Protection
 Nutrition
 Removal of waste
 lubrication

5. Formation of CSF
 CSF is formedby the Choroid plexuses , Situatedwithin the ventricles.
 Choroid plexuses are tuft of capillaries present inside the ventricles.
 A large amount of CSF is formed in the lateral ventricles.
 Dura meter
 Arachnoid
 Pia

6. Properties of csf
 Color :-. Colorless
 pH. :-. 7.3 – 7.4
 Appearance. :-. Clear
 Volume. :-. 90 – 150 ml (Adult)
 Clot formation. :-. No clot formation on standing
 Specificgravity :-. 1.003 – 1.008
 Reaction : - Alkaline

7. Location of csf
 Two lateral ventricles
 Third ventricles
 Fourth ventricles
 Spinal cord central canal
 Subarachnoid space
 Contineous with extracellular fluidof brain parenchyma

8. Specimen collection
 Specimen should be collectedby a physician,aspecially trained
technician or nurse.
 Sterilelumbar puncture needle is insertedbetween the 3rd and 4t h lumbar
vertebrae to a depth of 4-5 cm
 Stylet the fluidis collectedthrough the needle into2 test tube .
 Tube 1st : (sterile tube ) : About 0.5ml or few drops of csf.
 Tube 2nd : About 3-5ml of csf

9. Composition of csf
1. 99.1% H2O
2. 0.1 % solids
1. Organic
 Sugar
 Creatinine , Cholesterol,FatyAcid
 Amino acid
 Lactic Acid
 Protein
 Urea , Uric acid
2. Inorganic
 Sodium
 Potassium
 Bicarbonates
 megnasium

10. Interpretation of Cerebrospinal fluid Analysis

11. Collection of CSF
 CSF is collected by 2 method.
1. Lumber Puncture
2. Cisternal Puncture
1. Lumber Puncture
 In this the needle is introduced into the subarachnoid space in the lumber region.

12. 2. Cisternall Puncture
 In this a needle between the occipital bone and atlas so that it enters the
cisterna magna.

13. Important Precautions
 The collectedCSF specimenmust be examined immediately (within
1 hours).
 Specimencollected for bacterial culture should not be stored in the
refrigerator(Neisseriameningitis is killedby exposure to cold).
 Cellsare trypanosomesare rapidlylysed afterthe collection of csf .

14. Routine examination of csf
 There are 3 examination of csf
1. Physical Examination
2. Chemical Examination
3. Microscopicexamination

15. Physical examination
 Observe the specimen
1. Color
2. Appearance
3. Presence of blood
4. Thick viscosity – presence of protein in csf
5. PH – 7.38 – 7.42
 Fibrin clot formationtakes place due to the presence of fibrinogen (blood
brain barrier disturbance )

16. Chemical Examination
1. Glucose
2. Protein
3. Globulin
4. Fats
5. Lactose
6. Chlorides in csf

17. Microscopic examination
 Direct wet mount
1. Candida
2. Anaerobic encepharits
 Indian ink
 Gram stain
 Zein neilsen stain
 Acid fast staining
 Leishman stain
 Differentail leukocyte count

18. Collection of Cerebrospinal fluid (CSF)

19. bipulkrmahto5@gmail.com