CM LEC - Pleural Fluid Flashcards
Closed cavities
Pleural, pericardial, peritoneal cavities
Closed cavities
Pleural, pericardial, peritoneal cavities
type of serous membrane
lines the cavity wall
Parietal membrane
type of serous membrane
covers the organs within the cavity
Visceral membrane
– fluid between the membranes
serous fluid
why small amount of serous fluid is normally present
because production and reabsorption take place at a constant rate
function of serous fluid
provides lubrication
production and reabsorption of serous fluid subject to
hydrostatic pressure colloidal pressure (oncotic pressure)
needle aspiration procedures for pleural fluid
Thoracentesis
needle aspiration procedures for pericardial fluid
Pericardiocentesis
needle aspiration procedures for peritoneal fluid
Paracentesis
volume of serous fluid to be collected
> 100 ml
type of tube for cell counts and diff count
EDTA
type of tube for microbiology and cytology
sterile heparinized or sodium polyanethol sulfonate (SPS)
done for better recovery of microorganisms and abnormal cells
Centrifugation
what type of tests are performed on clotted specimens in plain tubes or in heparin tubes
chemistry tests
results of chemistry tests compared with __ chemical concentrations
plasma
Specimens for pH must be ___
maintained anaerobically in ice
Cause of an effusion may be
transudate or exudate
cause of an effusion
formed because of a systemic disorder that disrupts the balance in the regulation of fluid filtration and reabsorption (ex of systemic disorder: changes in hydrostatic pressure created by congestive heart failure or the hypoproteinemia associated with the nephrotic syndrome)
transudates
cause of an effusion
produced by conditions that directly involve the membranes of the particular cavity, including infections and malignancies
exudates
- most reliable differentiation between transudate and exudate
Fluid: blood ratios for protein and lactic dehydrogenase
• Serous fluid cell counts can be performed manually by using a ____ counting chamber
Neubauer
fluid obtained from the pleural cavity
pleural fluid
additional procedures helpful when analyzing pleural fluid
- -pleural fluid cholesterol and fluid:serum cholesterol ratio
- -pleural fluid:serum total bilirubin ratio
when is a pleural fluid/effusion classified as an exudate
- pleural fluid cholesterol >60 mg/dL
- -pleural fluid:serum cholesterol ratio >0.3
- -fluid:serum total bilirubin ratio of 0.6 or more
used to differentiate between hemothorax and hemorrhage exudate
Hematocrit
Hct > 50% = ?
hemothorax, effusion comes from the inpouring of blood from injury
Hct
chronic membrane disease effusion (has both blood and increased pleural fluid)
milky pleural fluid may be due to (2)
chylous
pseudochylous
most diagnostically significant hematology test performed on serous fluids
Differential count
what type of WBC increases in pulmonary infarction
neutrophils
what type of WBC increases in
- Presence of air or blood (pneumothorax and hemothorax)
- Allergic reactions
- Parasitic infections
eosinophil
– pleomorphic: resemble lymphocytes, plasma cells, and malignant cells, frequently making identification difficult
Mesothelial cells
what type of mesothelial cells: single small or large round cells with abundant blue cytoplasm and round nuclei with uniform dark purple cytoplasm
normal mesothelial cells
what type of mesothelial cells: in clusters; have varying amounts of cytoplasm, eccentric nuclei, and prominent nucleoli; and be multinucleated, thus more closely resembling malignant cells
reactive mesothelial cells
lack of mesothelial cells is due to
exudate covering pleural membranes
lack of mesothelial cells associated with
TB
What type of cells
nuclear and cytoplasmic irregularities
malignant cells
What type of cells
hyperchromatic nucleoli
malignant cells
What type of cells
cellular clumps with cytoplasmic molding (community borders)
malignant cells
What type of cells
abnormal nucleus:cytoplasm ratios
malignant cells
most common chemical tests for pleural fluid (4)
glucose
pH
Adenine deaminase (ADA)
Amylase
Decreased value for glucose in pleural fluid
