Cerebrospinal fluid

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

2. Introduction of CSF
 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 of CSF
 It helps to protect the brain and spinal coard from injury by acting like a fluid
buffer .
 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 formed by the Choroid plexuses , Situated within 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
 Specific gravity :-. 1.003 – 1.008
 Reaction : - slightly

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

8. Specimen collection for CSF
 Specimen should be collected by a physician,a specially trained technician or
nurse.
 Sterile lumbar puncture needle is inserted between the 3rd and 4th lumbar
vertebrae to a depth of 4-5 cm
 Stylet the fluid is collected through the needle into 2 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, Faty Acid
 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

13. Important Precautions
 The collected CSF specimen must be examined immediately (within 1
hours).
 Specimen collected for bacterial culture should not be stored in the
refrigerator (Neisseria meningitis is killed by exposure to cold).
 Cells are trypanosomes are rapidly lysed after the collection of csf .

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

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 formation takes 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