1. Test of Cerebrospinal Fluid and Serous Membrane Effusion Zhongsheng Xia The Second Affiliated Hospital, Sun Yat-sen University

7. The position of lumbar puncture: The patient is placed in lateral kneel-chest position with the neck flexed

8. http://www.chinavbox.cn/show/PWTVH3C3.html Video for lumbar puncture

17. Characteristic changes of CSF in common central nervous system diseases ↑ : increased; ↓ : decreased; -> : normal No No virus tubercular bacillus Can be found No Pathogen ↑ red blood cell -> or ↑ lymphocyte ↑ lymphocyte ↑ lymphocyte ↑ neutrophil 0~10 lymphocyte Cell count and differential (×10 6 /L) -> -> -> ↓ ↓ 119~129 Chloride (mmol/L) ↑ -> -> or ↑ ↓ ↓ 2.5~4.5 Glucose (mmol/L) ↑ ↑ ↑ ↑ ↑ 0.2~0.4 Protein (g/L) (quantitative) + + + + + - Protein (qualitative) red colorless or yellow clear or mild cloudy mild cloudy cloudy clear Gross appearance ↑ ↑ ↑ ↑ ↑ 80~180 Pressure (mmH 2 O) Subarachnoid hemorrhage Brain tumor Viral meningitis Tubercular meningitis Pyogenic meningitis normal

18. ascites Pleural effusion Pericardial effusion

26. Differentiation of transudate and exudate can be positive >0.5 >0.6 >200 IU negative <0.5 <0.6 <200 IU Pathogen Fluid/serum Protein Fluid/serum LDH LDH neutrophil, lymphocyte,etc lymphocyte Cell differential >500×10 6 /L <100×10 6 /L Cell count decreased Similar to serum glucose Glucose >30g/L <25 g/L Protein quantitate positive negative Rivalta test >1.018 <1.018 Gravity cloudy clear diaphaneity yellow, red or green light yellow Gross appearance infection, malignant, etc. not from infection or tumor Main cause exudate transudate

28. CSF is a clear, colorless liquid that fills the ventricles, the subarachnoid spaces surrounding the brain and the spinal cord. Its total volume is approximately 90~150ml.

29. Measure pressure of CSF with manometer