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Presentation-1.pdfcjsjs js hisbsiks sowgwjks

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  Clinical Pathology Presented By:(Boys) Group 3 Submitted To: Madam Mishal From BS(Hons) MLT-3 1. Muhammad Asim (Head) 2. Khizar Hayat 3. Muhammad Usman 4. Ali Haider Topic: Examinationof CSF
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  CerebroSpinal Fluid :(CSF) • CSF is clear, colorless and transparent fluid present in the brain (subarachnoid space) and spinal cord. • Approximately 125 - 150 ml of CSF is present in brain and spinal cord. Formationof CSF: • CSF largely formed by the coroid plexus of the lateral ventricle and reminder in the third and fourth ventricles. • CSF is a selective ultrafiltration of plasma. • Approximately 500 – 600 ml CSF produced daily.
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  Function of CSF: •Provide protection and support to the brain and spinal cord. • It acts as a shock absorber and provide protection to the soft part of the brain. • Carries nutrients and remove waste products. • It keep moist brain and spinal cord. Purpose/Diagnosis of CSF collection: • Meningitis ( bacteria, virus, fungi, protozoa) • Infectious diseases of brain and spinal cord • Detect inflammatory conditions
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  • Spinal cordtumor • For diagnosis of virus infection such as Rabies virus present in the saliva of dogs. (Cats,mouse,foxes) Destroy brain cells Collection of CSF: • Cerebrospinal fluid is collected by lumber puncture (LP) under strict aseptic conditions similar to any surgical procedure. • An experienced physician or well trained nurse collect the CSF sample. • After properly positioning the patient the sterile LP needle with the stylet is inserted between third and fourth lumber vertebrae to a depth of 4 – 5 cm.
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  • The styletis withdrawn and the fluid flows freely into a sterile test tube through the needle. • The total amount between 6 – 7 ml of CSF is collected in three sterile tubes, which are chemically cleaned and washed with distilled or deionized water. • The needle is remove and the area is cleaned and bandage over the needle site. • After collection test start within hour. • Do not refrigerate sample if bacteriological examination. Because Neisseria meningitidis killed 2 – 8 degree Celsius.
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  Physical examination ofCSF : • Normally CSF is colorless and clean If color of CSF is change due to some reason: • Yellow CSF due to Bilirubin (jaundice) Xanthrochromia • Red CSF due to RBC • Turbid CSF due to WBC • Specific Gravity .…. 1.003-1.008 determined by Refractometer • Appearance ..…. Clear, liquid form If cloudy due to pus formation • PH … 7.3-7.4 check by litmus paper. • Normally no clot..… Clot is formed in the presence of fibrinogen when BBB is disturbed.
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  Microscopic examination ofCSF : • For direct microscopy take clean and dry slide. • Add one drop of CSF on slide. • Now place cover slip on drop and observeunder microscope. Blood cell examination : For the detection of cell in CSF special type of staining used called Leashman Stain. 1. Increase neutrophils: • Bacterial meningitis • The early stage of TB • cerebral abscess
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  2. Increase Lymphocytes: • Leukemia • Lymphoma • Tuberculosis meningitis 3. Increase Monocyte : • Chronic meningitis • Tumor 4. Increase Eosinophils : • Parasitic infection • Fungal infection
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  Bacteriological Examination : •CSF is best for diagnosis bacterial meningitis. • For diagnosis of bacteria a special type of staining used called Gram staining. • For diagnosis of TB bacteria Acid Fast Staining (AFS) used. Biochemistry Examination : Normal protein in CSF 15 - 45 mg/dl If increase due to : • Bacterial meningitis • Viral meningitis • Cerebral hemorrhage
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  Glucose Examination : Normalglucose level in CSF 50 - 80 mg/dl Increase glucose level in CSF due to Diabetes mellitus