1. Serous fluids are found between serous membranes covering body cavities and organs. They provide lubrication and are produced through an ultrafiltration of plasma.
2. Transudates result from increased hydrostatic pressure or decreased oncotic pressure, while exudates result from increased capillary permeability or lymphatic obstruction.
3. Analysis of serous fluids includes physical examination, cell count and differential, chemistry tests, and microbiology studies to determine the cause or site of effusion. Increased levels of certain substances can indicate conditions like infection, inflammation, or malignancy.
1. Serous fluids are found between serous membranes covering body cavities and organs. They provide lubrication and are produced through an ultrafiltration of plasma.
2. Transudates result from increased hydrostatic pressure or decreased oncotic pressure, while exudates result from increased capillary permeability or lymphatic obstruction.
3. Analysis of serous fluids includes physical examination, cell count and differential, chemistry tests, and microbiology studies to determine the cause or site of effusion. Increased levels of certain substances can indicate conditions like infection, inflammation, or malignancy.
1. Serous fluids are found between serous membranes covering body cavities and organs. They provide lubrication and are produced through an ultrafiltration of plasma.
2. Transudates result from increased hydrostatic pressure or decreased oncotic pressure, while exudates result from increased capillary permeability or lymphatic obstruction.
3. Analysis of serous fluids includes physical examination, cell count and differential, chemistry tests, and microbiology studies to determine the cause or site of effusion. Increased levels of certain substances can indicate conditions like infection, inflammation, or malignancy.
1. Serous fluids are found between serous membranes covering body cavities and organs. They provide lubrication and are produced through an ultrafiltration of plasma.
2. Transudates result from increased hydrostatic pressure or decreased oncotic pressure, while exudates result from increased capillary permeability or lymphatic obstruction.
3. Analysis of serous fluids includes physical examination, cell count and differential, chemistry tests, and microbiology studies to determine the cause or site of effusion. Increased levels of certain substances can indicate conditions like infection, inflammation, or malignancy.
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SEROUS FLUID
ANALYSIS TRANSUDATES EXUDATES SEROUS FLUIDS
= body fluids found between serous
membranes (parietal and visceral) covering of body cavities and organs(pleural, peritoneal, pericardial) = provides lubrication, small amount because production = reabsorption Formation & Physiology:
= ultrafiltrates of plasma = produced as an effect of balance between hydrostatic pressure and oncotic pressure = disruption of this balance --- EFFUSION Causes/Mechanisms: 1. increased hydrostatic pressure (CHF) 2. decreased oncotic pressure (hypoproteinemia) 3. increased capillary permeability (inflammation and infection) 4. Lymphatic obstruction (tumors, parasites) 2 Forms: 1. Transudates = 1 and 2 mechanism 2. Exudates = 3 and 4 mechanism Specimen Collection and Handling = Method: Needle Aspiration Thoracentesis = pleural fluid Paracentesis = peritoneal fluid Pericardiocentesis = pericardial fluid = Handling: EDTA = cell counts and differential counts Heparinized = chemical, serologic, microbial, cytologic studies Refrigerated = pH Routine Serous fluid Analysis A. Physical examination D. Microbiology 1. appearance 1. Gram staining 2. volume 2. AFS staining 3. spontaneous clotting 3. Fungal staining B. Cell count and differential 4. Culture and sensitivity count E. Cytology C. Chemistry detn 1. Protein detn 2. LD detn 3. cholesterol detn 4. fluid to blood ratios of above subs Pleural Fluid Pleural Fluid A. Appearance: Normal: clear, pale yellow Abnormal: a. turbid = increase wbc = infection, malignancies, arthritis b. milky = chylous material from thoracic duct leakage; chronic inflx c. bloody = hemothorax; hemorrhagic effusion B. Cell Count and differential Count
Cell Clinical significance
Neutrophils Pneumonia, pancreatitis, pulmonary infarction Lymphocytes TB, viral infections, autoimmune disorders, lymphoma Mesothelial Normal and reactive forms cells Decreased assoc with TB Plasma cells TB, MM Malignant cells Primary or metastatic C. Chemistry Test Test Clinical Significance
Glucose Decreased in inflammation &
purulent infection Lactate Elevated in bacterial infection
Triglyceride Elevated in hylous effusions
pH Decreased in pneumonia and esophageal rupture Amylase Elevated in pancreatitis, esophageal rupture, malignancy D. Microbiologic and Serologic tests 1. Routine 2. Serologic tests: a. ANA = SLE b. RF = rheumatoid arthritis c. CEA = adenocarcinoma Pericardial fluid Significance of Pericardial Fluid Testing Tests Clinical significance Appearance bloody Infection, malignancy, trauma milky Chylous and pseudochylous Diff count neutrophils Bacterial endocarditis malignant cells Metastatic tumors CEA Metastatic Ca Gram stain, C & S Infective endocarditis AFB stain, TB effusion Adenosine deaminase Peritoneal Fluid Significance of Peritoneal Fluid Testing Tests Clinical significance Appearance green/bilous GB, pancreatic disorders peritoneal lavage w/ Blunt trauma injury >100,000 rbc/uL
WBC >500/uL Bacterial peritonitis, cirrhosis
CEA Malignancy (GIT) CA 125 Malignancy (ovarian) Amylase Increased in pancreatitis, GIT perforation ALP Increased in perforation in GIT BUN/crea Ruptured or punctured urinary bladder Gram stain; C & S Bacterial peritonitis AFB stain TB Adenosine deaminase TB
