Cerebrospinal Fluid (Online CE Course)

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Authors: Marjorie A. Spahn, MT(ASCP); Daniel Hapner, MA, MT(ASCP)
Reviewer: Barbara Cebulski, MS, MLS(ASCP)

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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.

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Continuing Education Credits

P.A.C.E.® Contact Hours (acceptable for AMT, ASCP, and state recertification): 2 hour(s)
Approved through 5/31/2024
Approved through 5/31/2024


  • 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.
  • Explain 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.

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Course Outline

Click on the links below to preview selected pages from this course.
  • Introduction to Cerebrospinal Fluids
      • 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 60-100% of these WBCs?
  • Specimen Collection and Processing
      • CSF Specimen Collection Process
      • Collection Tubes, continued
      • 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
      • Causes of Xanthochromia in Premature Infants
      • Important Aspects of Xanthochromia
      • Which of the following are characteristics of normal CSF?
      • Which of the following situations suggest a traumatic tap occurred?
      • 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
      • Clear cerebrospinal fluid samples should be examined and counted undiluted.
      • A spinal fluid that is slightly hazy is briefly examined microscopically. The technologist performing the count decides to make a 1:10 dilution using ...
      • 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
      • Cytocentrifugation is the recommended method for preparing a cerebrospinal fluid (CSF) sample for examination of cellular morphology.
      • When preparing a slide for morphologic examination, what is the reason for adding a drop of albumin to the cerebrospinal fluid (CSF) sample prior to c...
      • 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?
  • References

Additional Information

Level of Instruction: Intermediate
Intended Audience: Medical laboratory scientists, medical technologists and technicians, medical laboratory science students, and pathology residents.
About the Course: This revised course originated as 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.
Course Description: This illustrated course discusses cerebrospinal fluid analysis including specimen collection and handling, macroscopic characteristics, cell counting techniques, and cell identification. Numerous images of cells, and interactive questions throughout the course reinforce concepts and cell identification.

How to Subscribe
MLS & MLT Comprehensive CE Package
Includes 173 CE courses, most popular
$95Add to cart
Pick Your Courses
Up to 8 CE hours
$50Add to cart
Individual course$20Add to cart
Need multiple seats for your university or lab? Get a quote
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