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AUBF > finals - serous and synovial > Flashcards

finals - serous and synovial Flashcards

1
Q

Viscous liquid found in the cavities of the movable joints

A

Synovial Fluid

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2
Q

synovial membrane is composed of specialized cells called ___

A

synoviocytes

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3
Q

The closed cavities of the body—namely, the pleural, pericardial, and peritoneal cavities—are each lined by two membranes referred to as the serous membranes. One membrane
lines the cavity wall (____), and the other
covers the organs within the cavity (_____)

A

parietal membrane; visceral membrane

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4
Q

The fluid between the membranes is called
___, and it provides lubrication between the parietal and visceral membranes.

A

serous fluid

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5
Q

Lubrication in the joints

A

Synovial Fluid

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6
Q

Lubrication is necessary to prevent
the ___between the two membranes that occurs as a
result of movement of the enclosed organs, such as in the
expansion and contraction of the lungs.

A

friction

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7
Q

Normally, only a small amount of serous fluid is present, because production and reabsorption take place at a ___.

A

constant rate

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8
Q

how Synovial Fluid works

A

Reduces the friction between joints

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9
Q

Provides nutrients to the articular cartilage

A

Synovial Fluid

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10
Q

Lessens the shock of joint compression that occurs during activities
such as walking and jogging

A

synovial fluid

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11
Q

Production and reabsorption are subject to ____ and ___from the capillaries that serve the cavities and the capillary permeability.

A

hydrostatic pressure; colloidal pressure (oncotic pressure)

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12
Q

Ultrafiltrate of plasma across the synovial membrane

A

Synovial Fluid

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13
Q

the filtration of synovial fluid or the filtration of the plasma to become a synovial fluid is non selective except ___

A

high molecular weight proteins

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14
Q

the synoviocytes secrete mucopolysaccharide to the the fluid, what mucopolysaccharide is it?

A

hyaluronic acid

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15
Q

the secreted hyaluronic acid and its hyaluronate molecules contribute to what characteristic of synovial fluid?

A

its viscosity

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16
Q

damage to the articular membrane causes pain and stiffness, this condition is referred to

A

arthritis

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17
Q

Abundant fluid
(____) is usually collected;

A

> 100 mL

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18
Q

which anticoagulant is used for cell counts and the differential.

A

EDTA

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19
Q

which anticoagulants are used for microbiology and cytology.

A

Sterile heparinized or sodium polyanethol sulfonate (SPS)

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20
Q

Under normal conditions, colloidal pressure from serum proteins is the same in the capillaries on both sides of the membrane. Therefore, which pressure causes fluid to enter between the membranes.

A

hydrostatic pressure

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21
Q

aspiration procedures in plueral cavity

A

thoracentesis

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22
Q

aspiration procedures in pericardial cavity

A

pericardiocentesis

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23
Q

lab findings in non inflammatory joint disorders

A

clear, yellow synovial fluid
good viscosity
wbc <1000 ul
Neutrophils <30%
Similar to blood glucose

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24
Q

lab findings in inflammatory joint disorders

A

Cloudy, yellow fluid
Poor viscosity
WBCs 2,000 to 75,000 L
Neutrophils >50%
Decreased glucose level
Possible autoantibodies present

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25
Q

lab findings in crystal induced origin joint disorders

A

Cloudy or milky fluid
Low viscosity
WBCs up to 100,000 L
Neutrophils <70%
Decreased glucose level
Crystals present

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26
Q

lab findings in septic origin joint disorders

A

Cloudy, yellow-green fluid
Variable viscosity
WBCs 50,000 to 100,000 L
Neutrophils >75%
Decreased glucose level
Positive culture and Gram stain

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27
Q

lab findings in hemorrhagic origin joint disorders

A

Cloudy, red fluid
Low viscosity
WBCs equal to blood
Neutrophils equal to blood
Normal glucose level

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28
Q

do normal synovial fluid clots?

A

nope - but if diseased, it may contain fibrinogen and will form clot

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29
Q

aspiration procedures in peritoneal cavity

A

paracentesis

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30
Q

Hyaluronic acid is secreted by ___ in the synovial membrane, making the fluid viscous

A

synoviocytes

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31
Q

Damage to the articular membrane produces pain and stiffness in the joints

A

Arthritis

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32
Q

needle aspiration or a way of collecting synovial fluid

A

Arthrocentesis

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33
Q

normal amount of synovial fluid in adult knee cavity

A

less than 3.5 ml - but can increase to 25 ml due to inflammation

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34
Q

in some instances that drops of synovial fluid is the only amount collected, it must be subjected to what test

A

microscopic or culturing

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35
Q

non inflammatory causes of joint disorders

A

degenerative joint disorders
osteoarthritis

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36
Q

inflammatory causes of joint disorders

A

immunologic disorders, rheumatoid arthritis, systemic lupus erythematosus, scleroderma, polymyositis, ankylosing spondylitis, rheumatoid fever, lyme arthritis
crystal induced gout
pseudogout

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37
Q

septic causes of joint disorders

A

microbial infection

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38
Q

hemorrhagic causes of joint disorders

A

traumatic injury
tumors
hemophilia
other coagulation disorders
anticoagulant overdose

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39
Q

For better recovery of microorganisms and abnormal cells, ___ of large amounts of fluid is performed by centrifugation.

A

concentration

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40
Q

Sterile heparinized tube is for what test of synovial

A

Gram Stain and Culture

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41
Q

Specimens for pH must be
maintained anaerobically in __

A

ice

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42
Q

Heparin or EDTA
Non-anticoagulant is for what test of synovial

A

Cell count

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43
Q

Non-anticoagulant Tube is for what test of synovial

A

Other Tests

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44
Q

Sodium Fluoride is for what test of synovial

A

Glucose Analysis

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45
Q

specimens for crystal analysis should not be refrigerated because they can produce additional crystals that can interfere with identification of significance

true or false

A

true

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46
Q

normal color of synovial

A

less to pale yellow

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47
Q

synovial comes from the latin word for egg “ovum” why is it

A

the normal viscosity is the same with the egg white’s

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48
Q

a simple and bedside technique to measure the viscosity of a synovial fluid is a string test formed using the tip of a syringe, approx how many cm is considered normal?

A

4-6 cm

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49
Q

hyaluronate - a primary component for the viscosity of a synovial fluid

is can be measured using what test

A

ropes or mucin clot test

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50
Q

a normal response of synovial fluid to 2-5% acetic acid in mucin clot test

A

forms a solid clot surrounded by clear fluid

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51
Q

even though mucin clot test is not performed routinely in synovial testing, it can be use to __

A

identify questionable liquid as synovial

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52
Q

most frequently cell count performed in synovial fluid

A

total leukocyte count

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53
Q

cells primarily seen in a normal synovial fluid

A

mononuclear cells - macrophage and monocytes

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54
Q

normal neutro and normal lympho % in normal synovial fluid

A

> 25% in neutro
15 % in lympho

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55
Q

significance of increase neutrophil in synovial fluid

A

bacterial sepsis
crystal induced inflammation

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56
Q

significance of increase lymphocyte in synovial fluid

A

non septic inflammation

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57
Q

significance of increase neutrophil in synovial fluid

A

normal
viral infections

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58
Q

significance of increase synovial lining cells in synovial fluid

A

normal
disruption from arthrocentesis

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59
Q

this cell is similar to macrophage, but multinucleated, and resembling mesothelial cell

A

synovial lining cell

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60
Q

significance of LE cell in synovial fluid

A

lupus erythematosus

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61
Q

neutrophil containing characteristics ingested round body

A

LE cell

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62
Q

vacuolated macrophage with ingested neutrophil

A

reiter cell

63
Q

significance of reiter cell in synovial fluid

A

reactive arthritis in other parts of the body

64
Q

neutrophil with dark cytoplasmic granules containing immune complexes

A

RA cell (ragocyte)

65
Q

significance of RA cell (ragocyte)

A

rheumatoid arthritis
immunologic inflammation

66
Q

significance of cartilage cells

A

osteoarthritis

67
Q

macroscopically resemble polished rice

A

rice bodies

68
Q

significance of rice bodies

A

tuberculosis
septic and rheumatoid arthritis

69
Q

significance of fat droplets in synovial fluids

A

traumatic injury
chronic inflammation

70
Q

microscopically show collagen and fibrin

A

rice bodies

71
Q

crystals of synovial fluid that is found in cases of gout

A

monosodium urate (uric acid)

72
Q

crystal of synovial fluid found in pseudogout

A

calcium pyrophosphate dihydrate

73
Q

is most often associated with degenerative arthritis, producing cartilage calcification, and endocrine disorders that produce elevated serum calcium

A

pseudogout

74
Q

monosodium urate’s shape

A

needles

75
Q

calcium pyrophosphate dihydrate’s shape

A

rhomboid, square, rods

76
Q

significance of corticosteroid crystals in synovial

A

injection

77
Q

how many fluids are collected in serous fluid

A

> 100 ml

78
Q

edta in serous fluid testing is for

A

cell counts and the differential

79
Q

sterile heparinized or sodium polyanethol sulfonate in serous fluid testing is for

A

microbiology or cytology

80
Q
A
81
Q

Increased capillary hydrostatic pressure is caused by

A

Congestive heart failure
Salt and fluid retention

82
Q

Decreased oncotic pressure is caused byy

A

Nephrotic syndrome
Hepatic cirrhosis
Malnutrition
Protein-losing enteropathy

83
Q

increased capillary permeability is caused byy

A

Microbial infections
Membrane inflammations
Malignancy

84
Q

Lymphatic obstruction is caused by

A

Malignant tumors, lymphomas
Infection and inflammation
Thoracic duct injury

85
Q

transudates or exudate?

involvement of systemic disorder that disrupts the balance in the regulation of fluid filtration and reabsorption—such as the changes in hydrostatic pressure created by congestive heart failure or the hypoproteinemia associated with the nephrotic syndrome

A

transudate

86
Q

transudates or exudate?

____
are produced by conditions that directly involve the membranes
of the particular cavity, including infections and malignancies.

A

Exudates

87
Q

Transudate
Exudate

clear appearance of serous fluid

A

transudate

88
Q

is obtained from the pleural cavity, located be
tween the parietal pleural membrane lining the chest wall and
the visceral pleural membrane covering the lungs.

A

Pleural fluid

89
Q

Pleural effusions may be ___.

A

either transudative or exudative

90
Q

. In addition to the tests routinely performed to differentiate between transudates and exudates, two additional procedures are helpful
when analyzing pleural fluid: __

A

the pleural fluid cholesterol and
fluid:serum cholesterol ratio and the pleural fluid:serum total bilirubin ratio

91
Q

A pleural fluid cholesterol _____ or a pleural fluid:serum cholesterol ratio ____ provides reliable information that the fluid is an exudate

A

> 60 mg/dL; >0.3

92
Q

A fluid:serum total
bilirubin ratio of ___ also indicates the presence of an exudate.

A

0.6 or more

93
Q

Normal and transudate pleural fluids
are what color

A

clear and pale yellow

94
Q

Turbidity of pleural fluid is usually related to the
presence of ____ and indicates bacterial infection, tuberculosis, or an immunologic disorder such as rheumatoid arthritis

A

WBCs

95
Q

The presence of blood in the pleural fluid can signify a ___

A

hemothorax (traumatic injury), membrane damage such as
occurs in malignancy, or a traumatic aspiration.

96
Q

a Milky pleural fluid may be caused by

A

Chylous material from thoracic duct
leakage

97
Q

a Brown pleural fluid may be caused by

A

Rupture of amoebic liver abscess

98
Q

a black pleural fluid may be caused by

A

Aspergillus

99
Q

a Viscous pleural fluid may be caused by

A

Malignant mesothelioma (increased hyaluronic acid)

100
Q

To differentiate between a hemothorax and hemorrhagic exudate, a ___ can be run on the fluid.

A

hematocrit

101
Q

If the blood is
from a hemothorax, the fluid hematocrit is more than____ of the whole blood hematocrit, because the effusion comes from the inpouring of blood from the injury.

A

50%

102
Q

A chronic membrane
disease effusion contains both blood and increased pleural fluid, resulting in a much ___ hct

A

lower hematocrit

103
Q

a milky pleural fluid is caused by Chylous material which contains a high concentration of
____

A

triglycerides

104
Q

a milky pleural fluid is caused by pseudoChylous material which contains a high concentration of
____

A

cholesterol

105
Q

which staining is
strongly positive with chylous materia

A

Sudan III

106
Q

pseudochylous effusions contain which crystals

A

cholesterol crystals

107
Q

____ is the most
diagnostically significant hematology test performed on serous fluids

A

differential cell count

108
Q

Primary cells associated with pleural fluid include

A

macrophages, neutrophils, lymphocytes, eosinophils, mesothelial cells, plasma cells, and malignant cells

109
Q

number of macrophages, lymphocytes, and neutrophil in pleural fluid

A

Macrophages 64% to 80%
lymphocytes (18% to 30%)
neutrophils (1% to 2%)

110
Q

Similar to other body fluids, an increase in pleural fluid neutrophils indicates a _____, such as pneumonia.

A

bacterial infection

111
Q

rentiate be
tween a pleural transudate and a pleural exudate, the most
common chemical tests performed on pleural fluid are

A

glucose,
pH, adenosine deaminase (ADA), and amylase

112
Q

Glucose chem test for pleural signiies

A

Decreased in rheumatoid
inflammation

113
Q

Transudate
Exudate

cloudy appearance of serous fluid

A

exudate

114
Q

Synovial comes from the word → ___

A

Egg

115
Q

normal color of synovial

A

Colorless to Pale Yellow

116
Q

Deeper Yellow color of synovial fluid means

A

Inflammatory and
Noninflammatory effusions

117
Q

Green synovial means

A

Bacterial Infection

118
Q

red synovial means

A

Hemorrhagic arthritis

119
Q

Turbidity

A

o Presence of WBC
o Synovial cell debris and fibrin
o Can be milky (Presence of crystals)

120
Q

if the synovial is milky, it has a presence of __

A

crystals

121
Q

viscosity is Caused by __

A

hyaluronic acid

122
Q

Arthritis affects the production of __

A

hyaluronidase

123
Q

Arthritis ___ synovial viscosity

A

decreases

124
Q

Methods for viscosity

A

o String test → 4-6 cm
o Ropes (Mucin clot test)
o Synovial +2%-5% acetic acid → Clotti

125
Q

Reporting for synovial fluid

A

o Good → Solid Clot
o Fair → Soft Clot
o Low → Friable Clot
o Poor → No Clot

126
Q

good in synovial means

A

solid clot

127
Q

fair in synovial means

A

soft clot

128
Q

low in synovial means

A

friable clot

129
Q

poor in synovial means

A

no clot

130
Q

is the (Most Frequent) requested cell count

A

Total leukocyte counts

131
Q

Diluting fluid for synovial fluid

A

: Normal saline (0.3%)

132
Q

Methylene blue in synovial fluid is for

A

staining wbc nuclei

133
Q

Neutrophils

A

Polymorphonuclear leukocytes

134
Q

Mononuclear leukocytes

A

Lymphocytes

135
Q

Large mononuclear leukocytes
Maybe vacuolated

A

Macrophages (Monocytes)

136
Q

Similar to macrophage, but may be
multinucleated resembling a mesothelial cell

A

Synovial lining c

137
Q

Neutrophil containing characteristics
ingested: Round Body

A

LE cells

138
Q

Vacuolated macrophage with ingested
neutrophils

A

Reiter cells

139
Q

Neutrophils with dark cytoplasmic granules
containing immune complexes

A

RA cells (Ragocytes) Neutrophils with dark cytoplasmic granules
containing immune complexes

140
Q

Large, multinucleated

A

Cartilage cells

141
Q

Macroscopically resemble polished rice
Microscopically show collagen and fibrine

A

Rice bodies

142
Q

Refractile intracellular and extracellular
globules

A

Fat droplets

143
Q

Inclusions within clusters of synovial

A

Hemosiderin

144
Q
  • Important diagnostic tests in evaluation of arthritis
A

Crystal identification

145
Q

Crystal formation in a joint frequently results in:

A

Acute, painful inflammation

146
Q

Cause of Crystal formation:

A

o Metabolic disorders
o Decreased renal excretion
o Degeneration of cartilage and bones
o Injection of medication such as corticosteroids

147
Q

Monosodium
Urate shape

A

needle - gout

148
Q

Calcium
pyrophosphate
dihydrate shape

A

Rhombic
square, rods - psegout

149
Q

Cholesterol shape

A

Notched,
rhombic
plates - extracellular

150
Q

Corticosteroid crystal

A

Flat, variable
shape plates - injection

151
Q

Calcium oxalate crystal

A

envelop - renal dialysis

152
Q

Apatite (CA
phosphate)

A

Small
particles
require
electron
microscopy - osteoarthritis

153
Q
A
154
Q
A

AUBF (29 decks)

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