Cerebrospinal Fluid (Online CEU Course)
Marjorie A. Spahn, MT(ASCP); Daniel Hapner, M.A., MT(ASCP)
This course covers the preanalytic processes of cerebrospinal fluid (CSF) specimen collection and handling and the analytic procedures for CSF analysis in the hematology laboratory. The participant will learn about the physical characteristics of normal and abnormal CSF and the possible cellular findings in an abnormal specimen. The course also provides a review of the manual procedures for counting cellular elements in CSF. The comprehensive treatment is perfect for laboratory cross-training, continuing education, and is appropriate for students preparing for exams.
Continuing Education Credits
- P.A.C.E.® Contact Hours (acceptable for AMT, ACSP / NCA, and state recertification): 3 hour(s)
- Florida Board of Clinical Laboratory Science CE - General (Hematology): 3 hour(s)
Objectives
- Define cerebrospinal fluid (CSF) and explain the importance of spinal fluid analysis.
- Learn the circulation, origin, function, composition, and diagnostic implications of CSF.
- Learn CSF collection procedures, including choosing puncture sites, removing the correct volume, specimen processing, and specimen handling precautions.
- Describe the macroscopic appearance of normal and abnormal CSF, including turbidity, fibrin clot formation, bloody samples, and xanthochromia.
- Learn cell counting techniques for undiluted and diluted samples, including diluting fluids, determining dilution and volume to count, calculations, and white blood cell (WBC) correction for traumatic taps.
- Explain the purpose, principle, and procedure of the cytospin differential technique.
- Describe appearance and function of neutrophils, eosinophils, lymphocytes, plasma cells, monocytes, macrophages, ependymal cells, pia arachnoid mesothelial cells, blasts, and tumor cells.
- Visually identify neutrophils, eosinophils, lymphocytes, plasma cells, monocytes, macrophages, pia arachnoid mesothelial cells, blasts, and tumor cells.
Course Outline
Click on a link in the outline to view a sample page from this course.
- Introduction to Cerebrospinal Fluids
- Specimen Collection and Processing
- CSF Specimen Collection Process
- Specimen Collection (continued)
- Purposes of Collection Tubes
- Collection Tubes (continued)
- Which Tests May Be Ordered?
- Specimen Labeling and Transport
- Initial Specimen Examination
- Specimen Handling and Storage
- Safety Precautions
- Which of the following sites is used most often for CSF collection?
- The tube used for hematologic examinations is:
- For best results, cell counts and differential smears should be processed within:
- Which of the following conditions can cause a sample to be uninterpretable?
- Macroscopic Characteristics
- Normal Characteristics
- Abnormalities
- Turbidity
- Clot/Pellicle
- Bloody Specimen
- Xanthochromia
- An Example of Xanthochromia
- Other Causes of Xanthochromia
- Causes of Xanthochromia in Premature Infants
- Important Aspects of Xanthochromia
- Which of the following are characteristics of normal CSF?
- Macroscopic abnormalities may include which of the following?
- A web-like clot may be seen in a sample when the patient has what condition?
- Which of the following situations indicate a clot is most likely due to a traumatic tap?
- Xanthochromic CSF may have which colors?
- Xanthochromia in a premature infant may be due to an immature blood-brain barrier.
- Cell counting techniques
- Normal Cell Counts
- Examining CSF with the Hemacytometer
- Examining CSF with the Hemacytometer (continued)
- Calculation of CSF Cell Count
- More on Undiluted Specimens
- Diluted Specimens
- Examining a Diluted Specimen
- Diluting Fluids
- WBC Correction for Traumatic Tap
- True or false: all clear samples should be examined undiluted.
- How many large hemacytometer squares contain a total volume of 1 µL (microliter) of fluid?
- When 5 large squares are counted, what is the volume of the enclosed fluid?
- Which of the following characteristics describe the appearance of red cells in CSF?
- Which of the following is the safest and most accurate tool for diluting spinal fluids?
- If the spinal fluid is slightly hazy, what is the best dilution?
- 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 hemacytometer are counted for a total of 10 squares and a total of 150 cells...
- Which of the following diluting fluids are suitable for spinal fluid counts?
- True or false: if a CSF specimen is bloody due to a traumatic tap, it may be necessary to correct the CSF WBC count.
- Cell Identification
- Table of Normal CSF Properties
- Stained Cytospin Preparations of CSF
- Cytospin Technique
- Cells Seen in CSF
- Mature Peripheral Blood Cells
- Table of Conditions
- Mature Lymphocytes
- Lymphocytes
- Neutrophils
- Neutrophil and Lymphocyte
- More Neutrophils and Lymphocytes
- Red Cells and Lymphocytes
- Monocytes
- Monocytes (continued)
- Cells
- Immature Hematopoietic Cells
- Blast Cells
- More Blast Cells
- Spinal Fluid Sample
- Tissue Cells
- Pia Arachnoid Mesothelial Cells
- Pia Arachnoid Mesothelial Cells (continued)
- Pia Arachnoid Mesothelial Cells (continued)
- Macrophage
- Malignant Cells
- Malignant Cells
- Another Malignant Cell
- More Malignant Cells
- True or false: cytospin smears distribute cells in a monolayer.
- Which of the following statements are true regarding spinal fluid differentials?
- Match the condition on the left with associated CSF cells on the right.
- Match the condition on the left with associated cells on the right.
- Bacteria are present in the background of this slide (indicated by arrow). What type are the other cells, primarily?
- What type is the indicated cell?
- What type of cell is indicated by the arrow?
- Increased numbers of the cells indicated by the arrows are associated with which of these conditions?
- What is the nucleated cell at the center of this field?
- Which of the following statements is true about the type of cell shown at the right?
- What are these cells?
Additional Information
Level of Instruction: Basic
Intended Audience: Clinical laboratory science students, and medical tehcnologists and technicians seeking review, cross training, or continuing education opportunities. It is also appropriate for medical students and pathology residents.
Course Description: This illustrated course cover the basics of cerebrospinal fluid physiology, specimen collection, macroscopic characteristics, cell counting techniques, and cell identification. Numerous images of cells, and interactive questions throughout the course reinforce concepts and cell identification.
About the Course: This course is part of a series of courses adapted for the web by MediaLab Inc. under license from Educational Materials for Health Professionals Inc. Dayton OH, 45420. Copyright EMHP.
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