CSF EXAMINATION BY BIPUL Kumar matho
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Cerebrospinal fluid (CSF) is formed by selective dialysis of plasma by the choroid plexus in the ventricles of the brain. It circulates in the subarachnoid space around the brain and spinal cord, acting as a cushion and protecting the central nervous system. CSF is composed primarily of water, and also contains proteins, glucose, and other components. It is analyzed through physical, chemical, and microscopic examination to evaluate properties such as color, clarity, glucose and protein levels, and presence of cells, which can indicate various neurological conditions. CSF is collected through lumbar puncture between vertebrae in the lower back or cisternal puncture in the neck area for examination.
CSF EXAMINATION BY BIPUL Kumar matho
- 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)