other body fluids

• CSF is not an ultrafiltrate of plasma
• CSF produce a mechanical barrier to cushion the cushion of the brain and spinal cords against trauma
• CSf supply nutrients to the nervous tissue
• CSF removes metabolic waste
• CSf is produced in choroid plexus of lumbar ventricles, and third and fourth ventricles
• CSF flows through subarachnoids (between arachnoids and pia mater) then reabsrobed by the Arachnoids granulation/vili
• CSF produces approximately 20mL/hr
• essential metabolites that can enter BBB: oxygen and glucose
• volume of CSF:

  adult- 140-170mL or 90-150mL/hr

  neonates- 10-60 mL/hr
• endothelial cells have blood brain barrier (BBB) to prevent passage of molecules
• BBB is used to represent the control and filtration of blood components to the CSF and then to the brain
• lumbar puncture is the routine method for CSF collection
• lumbar puncture is collected between 3rd, 4th, 5th lumbar vertebrae
• 3rd and 4th lumbar vertebrae for adults, 4th and 5th for children
• for lumbar puncture, patient is in fetal position or lateral decubitus position
• ventricular puncture is the method for collection of csf in infants with open frontanels
• cisterna puncture or lateral cervical punture is used to collect CSF in sub occipital region
• order of collection for CSF:

  1. chemistry and serology
  2. microbiology
  3. hematology/cell count
  4. microbiology
• if only 1 tube is used for CSF: microbiology- hematology/cell count- chemistry/serology
• test for CSF is performed on a STAT basis w/n 30 mins
• for CSF supernatant fluid that is left in every section if used in Chemistry and serology
• physical examination or appearance of CSF:

  • color: colorless
  • viscosity: same with water
  • clarity: crystal clear
  • SG: 1.006- 1.008
  • pH: 7.30-7.45
  • pressure: 50-200 mmH2
• CSF is not an ultrafiltrate of plasma. it produces a mechanical barrier to cushion the brain and spinal cord
• dura mater is an outer layer /hard mother that lines the skull and vertebral canal
• arachnoid is a spider web like/filamentous inner membrane lining the surface of the brain and spinal cords
• pia mater is the thin membrane lining the surface of brain and spinal cords or also known as the gentle mother.
• csf neonates volume: 10-60 mL/hr
• preservation fo csf :

  chem and sero= frozen temp

  microbiology= room temp

  hematology= ref temp
• physical examination of CSF:

  • color= colorless
  • viscosity= same as water
  • SG= 1.006-1.008
  • pH= 7.30-7.45
  • pressure= 50-200mmhg
• Froin's disease= clotted CSF
• causes of slightly hazy csf= 200-500 wbc/uL
• cause of cloudy csf= >500WBC/ul
• cause of clotted csf= meningitis
• cause of bloody csf:

  • pathologic= intracranial hemorrhage
  • non-pathological= traumatic tap
• cause of viscous csf: cryptococcal meningitis
• cause of oily csf: radiographic contrast media
• cause of pellicle formation csf: tubercular meningitis
• cause of intracranial hemorrhage: hemorrhage
• cause of traumatic tap: puncture of blood vessels during procedure
• distribution of blood in intracranial hemorrhage: even in all 3 tubes