ch 11 Flashcards
what is synovial fluid
located in friction areas between joints (think knee)
–> fluid fills joint cavity
formation of synovial fluid
ultrafiltration of plasma from synovial membrane
composition of synovial fluid
glucose and uric acid concentrations are equal to that of plasma
total protein and immunoglobulin concentration are 1/4-1/2 that of plasma
volume of synovial fluid
less than 3.5
–> depends on joint cavity size
normal synovial fluid (color, viscosity, WBC count, glucose concentration)
pale yellow
high
less than 200
equal to plasma
group 1 noninflammatory synovial fluid (color, viscosity, WBC count, glucose concentration)
yellow
high
less than 3000
equal to plasma
conditions associated with group 1
osteoarthritis, osteochondritis, traumatic arthritis
group II inflammatory synovial fluid (color, viscosity, WBC count, glucose concentration)
yellow-white
low
2000-100000
less than plasma level
associated conditions with group 2
gout, rheumatoid arthritis lupus
group II septic (color, viscosity, WBC count, glucose concentration)
yellow-green
low
10,000-100000
less than plasma
associated conditions with group 3
bacterial, fungal infection
group IV hemorrhagic (color, viscosity, WBC count, glucose concentration)
red-brown
decreased
less than 5000
equal to plasma
associated conditions with group 4
trauma blood disease (sickle cell)
how is synovial fluid removed
arthrocentesis (sterile needles to remove fluid from joint)
are there any circumstances when synovial specimens should be rejected
no
collection of synovial fluid
tube 1: no anticoagulant (chemical)
tube 2: anticoagulant (microscopic)
tube 3: sterile anticoagulant (microbiological)
which anticoagulants are used
EDTA and sodium heparin because they do not form crystals
what temp should synovial fluid be analyzed
room temp
physical examination
pale yellow/colorless = normal
red/brown = trauma
green = infection
milky = arthritis or lupus
what changes clarity of synovial fluid
WBCs, RBCs, crystals, fat, rice bodies
should synovial fluid form clots
no
cell count (microscopic exam)
RBCs = less than 2000
–> increase = trauma
WBCs = less than 200
–> increase = bacterial
monosodium urate monohydrate
looks like needles
associated with gout arthritis
calcium pyrophosphate dihydrate
loos like rod
associated with pseudogout
cholestorol
looks flat and rectangular
associated with chronic arthritic conditions
corticosteroid
seen after steroid injection
chemical examination
glucose –> equivalent concentrations
total protein –> increase = inflammation
uric acid –> equivalent
gram stain
sensitivity depends on organism (does not require culture to grow)
