Cerebrospinal fluid || Part1|| Formation-Function-Composition & Collection

Dear friends subscribe to our channel and press the bell icon to receive our new videos notification on time Assalam U alikum Dear friends. I am Kamran and you are watching MLT Hub with kamran. How are you dear friends? I hope you all will be fine. Dear friends our today’s topic is Cerebrospinal fluid Today is the Ist part and I will deliver 3 more lectures on CSF We will discuss Physical’ Chemical and Microscopic Analysis of CSF in our next Lectures. But today in Part 1 I will teach you about Formation, Function, Composition and Collection of CSF So lets start Our Lecture. CSF is formed primarily in ventricular choroid plexus present in brain consist of ventricular system here in this pic you can see the choroid plexus and ventricles in which present fluid filled spaces and this csf is very important for brain which we discuss later beside this Beside this Cerebrospinal fluid is contained in the cavity that surrounds the brain in the skull and the spinal coloumn Choroid Plexuses present in Ventricles of the brain. Normally csf is secreted continuously at a rate of 500 ml/day daily so 500 ml/day csf is secreted each day in the body What is function of CSF? It nourishes the tissues of the central nervous system provide them energy and nutrients through CSF CSF provide protection to brain and spinal cord from injury so CSF provide cushion like effect or provide cushion like function Cushion means like pillow we keep under our head and it keep our head safe from hard objects So CSF provide same function like cushion and protect our brain and spinal cord when injured so our brain and spinal cord is protected so another function of CSF is it absorbs the waste produce in neuronal tissues or produce by brain cells so CSF absorbs this waste products so if this waste products are not absorbed by CSF Its accumulation can cause damage to brain Neuron (Brain Cells) produce waste in even greater quantities than other body cells ok Friends what is Normal Volume of CSF? normal volume of CSF is 100-150 ml 100-150 ml CSF is present normally around brain and spinal cord and the daily secretion of CSF is 500 ml/day ok friends beside this What is normal composition of CSF? These are the normal values of different parameters and substances present in normal CSF Normal volume of CSF is 90-150 ml we are talking about normal CSF Normal Specific Gravity is 0.006-1.008 Cells which are present in normal CSF is Mainly Lymphocytes 0-8 Lymphocytes per cubic millimeter There is no Neutrophil and Erythrocytes in Normal CSF so mainly 0-8 Lymphocytes are normally present in Normal CSF Protein in normal CSF is 20-50 mg/dl The normal range of Glucose in CSF is 50-80 mg/dl so these all are present in normal CSF and we can check all this in CSF chemical analysis Sodium normal range in csf is 144-154 mEq/L Potassium Normal Range is 2.0-3.5 mEq/L The normal range of Chloride is 118-132 mEq/L Beside this The pH of CSF is from neutral to slightly alkaline that is from 7.3—–7.4 Creatinine normal range in CSF is 0.5-1.2 mg/dl Cholestrol normal range is 0.2-0.6 mg/dl Glutamine normal range is 6-16 mg/dl Iron normal range is 1-2 mg/dl Thyroxine normal range is 0.1-0.2 mg/dl Urea is 6-16 mg/dl uric acid normal range is 0.5-4.5 mg/dl so this was the normal composition of different substances in CSF So we will discuss these parameters in our next lecture on chemical analysis of CSF and will learn that in which conditions their values increase and decrease How to Collect CSF? Normally Physician or Surgeon collect the CSF sample so how he collect the sample? Normally collected from subarachnoid space of the spinal cord at lumbar level by puncture with a long needle so here in this picture you can see the puncture is made just a little above from hip region in lying position with the help of needle and can be collected in sitting position so the punctured is made on L3 L4 and L5 region so one thing is very important that CSF is collected in drops 3 to 4 drops per second so here in this picture you can see the needle is placed in the area and CSF is coming in drop form in tube so CSF is collected very slowly because if CSF is collected fastly it causes complication like severe Headache so the patient will develop Headache if CSF is aspirated forcefully so A physician or Surgeon in the ward under strict aseptic conditions perform the procedure itself The area will be cleaned with antiseptic and than he or she will perform the procedure Normally 2-4 ml specimen is to be collected in 3 to 4 sterile screw capped bottles and placed 1 ml csf in each bottle and those bottles are serially numbered and must be sent to the laboratory immediately and start analysis as soon as possible so here are the bottles which can be use for CSF Collection and tags are present on this with name, age, sex, ward indicators and these bottles can be also use which are serially numbered and disposable and it must be sterile which are for one time use only so for CSF examination we can take normally 3-4 bottles In case the CSF is to be cultured for Mycobacterium Tuberculosis Then at least a 5 ml sample is needed CSF should be tested as soon as it arrives in the laboratory and do not delay the sample for analysis The CSF in the first bottle is sometimes contaminated with blood and should be kept aside Here in this picture you can see the bottle contaminated with blood is kept aside and this is not used for analysis and the 2nd bottle is used for routine tests which is used for chemical analysis and microscopy The 3rd bottle is used for bacterial culture If tuberculosis meningitis is suspected the 4th bottle is kept undisturbed in a refrigerator in standing position to see whether a Pellicle or Coagulum forms A web like clot forms if Tuberculosis Meningitis is present here in this picture you can see A web like structure in this tube same like spider web so due to presence of this web like structure we can say This is because of Tuberculosis Meningitis so this meningitis is caused by many bacteria like Neisseria Meningitidis But here the bacteria is Mycobacteria which cause Tuberculosis Meningitis so in tuberculosis meningitis coagulum or web like structure is formed in the CSF Otherwise CSF must never be refrigerated if indicated for bacterial culture as it kills H. influenzae and should be kept at 37 c The CSF is only refrigerated when Tuberculosis meningitis is suspected to check for Coagulum or Web like clot so this was lecture part 1 about the formation, function, collection, and composition of CSF

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