Cerebrospinal Fluid

Continuing Education Credits

• P.A.C.E.® Contact Hours: 1.5 hour(s)
• Florida Board of Clinical Laboratory Science CE Credit Hours -
  General (Hematology): 1.5 hour(s)

Objectives

• Identify the origin, function, and composition of cerebrospinal fluid (CSF).
• Identify proper CSF specimen handling procedures.
• Describe the macroscopic appearance of normal and abnormal CSF.
• Explain manual cell counting techniques for undiluted and diluted CSF samples.
• State CSF smear preparation techniques.
• Identify nucleated cells that may be observed on a stained CSF smear.
• Explain the significance of various cells that may be observed in CSF.

Course Outline

• Introduction to Cerebrospinal Fluid
• What is Cerebrospinal Fluid (CSF)?
• Three Main Functions of CSF
• Chemical Substances Present in CSF
• Cells Present in Normal CSF
• CSF Evaluation and Diagnosis
• What is the approximate volume of spinal fluid in an adult?
• Normal adult CSF may have 0–5 white blood cells (WBCs)/µL. Which of the following cell types account for 40–80% of these WBCs?
• Specimen Collection and Processing
• CSF Specimen Collection Process
• Collection Tubes
• Specimen Labeling and Transport
• Specimen Handling and Storage
• Initial Specimen Examination
• Safety Precautions
• Which of the following sites is used most often for CSF collection?
• Cell counts on CSF specimens should be performed within what time frame following collection of the CSF sample?
• Macroscopic Characteristics
• Abnormalities
• Turbidity
• Clot/Pellicle
• Bloody Specimen
• Detecting Subarachnoid Hemorrhage
• Xanthochromia
• Other Causes of Xanthochromia
• Important Aspects of Xanthochromia
• Which of the following are characteristics of normal CSF?
• Which of the following situations suggest a traumatic tap occurred?
• True or False: Xanthochromia in a premature infant may be due to an immature blood-brain barrier.
• Cell Counting Techniques
• Normal Cell Counts
• Examining CSF Using the Hemocytometer
• Examining CSF Using the Hemocytometer, continued
• Counting Nucleated Cells in a Bloody CSF Specimen
• Cell Counting Guidelines
• True or False: Clear cerebrospinal fluid samples should be examined and counted undiluted.
• A spinal fluid that is slightly hazy is briefly examined microscopically. The medical laboratory scientist performing the count decides to make a 1:10...
• In a moderately bloody specimen, 250 cells are counted in 10 squares. The dilution is 1:100. What is the count/µL?
• A 1:10 dilution is made on a CSF sample. Five squares on each side of the hemocytometer are counted for a total of 10 squares and a total of 150 cells...
• A cell count is ordered on a CSF sample that is bloody. Which of the following procedures would improve count accuracy?
• Cell Identification
• Stained Cytospin Preparations of CSF
• Cytocentrifuge Technique
• Nucleated Cells That May Be Present in CSF
• Lymphocytes
• Neutrophils
• Bacterial Meningitis
• Monocyte/Macrophage
• Macrophages As Indicators of Previous Subarachnoid Hemorrhage (SAH)
• Normal Peripheral Blood Cells
• Bone Marrow Contamination of CSF Sample
• Blast Cells
• More Blast Cells
• Malignant Cells
• Malignant Cells, continued
• Malignant Cells, continued
• True or False: Cytocentrifugation is the recommended method for preparing a cerebrospinal fluid (CSF) sample for examination of cellular morphology.
• Match the conditions listed below with the elements that may be seen on a stained CSF smear when this condition is present.
• The image on the right is a Wright-Giemsa stained CSF smear (1000x). What structures are indicated by the arrows?
• The arrows in the images below indicate cells that may be observed in CSF samples. Match each image to the cell's identification.
• References
• References

Additional Information