Other Body Fluids

• Cerebrospinal Fluid (CSF)


  3rd major body fluid
• Cerebrospinal Fluid FUNCTIONS:


  1. Supplies nutrients to the nervous system
  2. Remove metabolic wastes
  3. Produces a mechanical barrier to cushion the brain and spinal chord against trauma.
• SPECIMEN COLLECTION AND HANDLING (CSF)

  • CSF is routinely collected by lumbar puncture between the third, fourth, or fifth lumbar vertebra.

  • Specimens are collected in three sterile tubes, which are labeled 1, 2, and 3 in the order in which they are withdrawn
• SPECIMEN COLLECTION AND HANDLING (CSF): Tube 1 


  is used for chemical chem and serologic tests; least affected by blood or bacteria introduced by spinal tap

  • TEMP: freezing temp
• SPECIMEN COLLECTION AND HANDLING (CSF): Tube 2

  for the microbiology laboratory

  most sterile

  • TEMP: Room temp
• SPECIMEN COLLECTION AND HANDLING (CSF): Tube 3


  is used for cell count (Hematology section)

  • TEMP: Ref temp
• SPECIMEN COLLECTION AND HANDLING (CSF): Tube 4


  additional tube for serology and microbiology studies
• SPECIMEN COLLECTION AND HANDLING (CSF): If 1 CSF tube only

  Microbiology

  Hematology

  Chem/Sero
• CSF TOTAL VOLUME

  ADULTS:

  • 90-150 mL

  NEONATES:

  • 10-60 mL
• CSF APPEARANCE: Crystal clear

  Normal
• CSF APPEARANCE: Hazy/Turbid/Milky/Cloudy


  High WBCs and RBCs, lipids, proteins, microorganisms
• CSF APPEARANCE: Xanthochromic(Pink/Yellow/Orange)

  Due to Hgb degradation products (most common)

  • Pink- slight amount of oxyhemoglobin

  • Yellow- Oxyhemoglobin -> Bilirubin

  • Orange- Heavy Hemolysis

  Other causes: High Carotene, Melanin, Protein
• CSF APPEARANCE: Bloody

  High RBCs present

  • Intracranial Hemorrhage- Bleeding within the braincase

  • Traumatic tap- punctured blood vessel
• Traumatic Collection (Tap)


  • Grossly bloody CSF can be an indication of intracranial hemorrhage, but it may also be due to the puncture of a blood vessel during the spinal tap procedure.

  • Uneven Blood Distribution

  • Clot Formation
• Xanthochromic Supernatant: 


  the result of blood that has been present longer than that introduced by the traumatic tap