FIXATION Flashcards
Steps (in order) in tissue processing
- Fixation
- Decalcification
- Dehydration
- Clearing
- Infiltration or impregnation
- Embedding
- Trimming
- Sectioning or Cutting
- Staining
- Mounting
- Labeling
MNEMONIC:
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Process of identifying the specimen WITHOUT WRITING THE PATIENT’S NAME on the specimen tag
NUMBERING
In numbering:
S is for ________
A is for ________
C is for _______
S is for SURGERY
A is for AUTOPSY
C is for CYTOLOGY
NOTE:
YEAR is indicated usually in 2 digits
ACCESSION NUMBER
PENCIL is utilized to label
Example: S23-143
S - Surgery
23 - Year sample received
143 - Accession number
FIRST and MOST CRITICAL STEP in routine tissue processing; The process of stopping all cellular activities so that cells can be viewed under the microscope
FIXATION
Most important reaction in maintaining the morphology of the tissue in fixation
Stabilization of proteins
PRIMARY AIM OF FIXATION:
Preserve the MORPHOLOGICAL AND CHEMICAL INTEGRITY of the cell in as life-like manner as possible
SECONDARY AIM OF FIXATION:
HARDEN AND PROTECT the tissue from trauma of further handling, so that it is easier to cut during gross examination
Main factors involved in fixation:
- Speed
- Rate of penetration
- pH
- Temperature
- Thickness of section
- Osmolality
- Concentration
- Amount of fixative
- Duration of fixation
Speed for fixation:
IMMEDIATELY fix after removal
Rate of penetration of fixation:
1 mm/hr for formalin from periphery to interior
pH of fixatives should be:
NEUTRAL (between 6 and 8)
BEST pH: 7 (formalin pH)
Temperature for fixation
Routine tissue processing:
For urgent biopsies/rapid fixation:
Electron microscope (EM):
Automatic tissue processor:
Routine tissue processing: ROOM TEMPERATURE
For urgent biopsies/rapid fixation: 60C
Electron microscope (EM): 0 to 4C
Automatic tissue processor: 40 to 42C
Thickness of section
Recommended size of the tissue:
Electron microscope (EM):
Light microscopy:
Thickness of section
Recommended size of the tissue:
- 2cm^2 and no more than 4mm thick
Electron microscope (EM): 1-2mm thick
Light microscopy: 4mm thick
Osmolality in fixation:
SLIGHTLY HYPERTONIC SOLUTIONS usually at 400-450 mOsm
<400 = SWELL
>450 = SHRINK
Concentration of fixatives
Formalin:
Glutaraldehyde:
Concentration of fixatives
Formalin: 10% working solution
Glutaraldehyde: 3% normal solution; for EM: 0.25% solution
Amount of fixative
Routine tissue processing:
Osmium tetroxide:
Electron microscope (EM):
Museum preparation:
Amount of fixative
Routine tissue processing: 20 TIMES the volume of the tissue
Osmium tetroxide: 5 to 10 TIMES the volume of the tissue
Electron microscope (EM): 20 TIMES the volume of the tissue
Museum preparation: <50 TIMES the volume of the tissue
NOTE:
RATIO OF TISSUE TO FIXATIVE = 1:20
RATIO OF FIXATIVE TO TISSUE = 20:1
**Traditionally 10-20 times the tissue
Duration of fixation:
Adequate fixation is 4 to 6 hours
Prolonged fixation can lead to:
SHRINKAGE
TOO MUCH HARDENING
INHIBITS CHEMICAL REACTIONS
Factors that HASTENS/ENHANCE fixation:
- Thin tissue sections
- Agitation
- Moderated heat (room temperature)
Factors that RETARDS/SLOWS fixation:
- Thick tissue sections
- Presence of FATS, MUCUS, and BLOOD
- Cold temperature
Remedies of there are presence of fats mucus and blood in tissue sections:
FATS - cut the tissue into smaller pieces
MUCUS and BLOOD - wash with NSS
Characteristics of GOOD FIXATIVE
- Cheap, stable and safe to handle
- Kills cells quickly; must inhibit bacterial decomposition and autolysis
- Make tissue resistant to damage and distortion
- Produce minimum shrinkage of tissue
- Rapid and even penetration of tissues
- Harden the tissue
- Must make cellular components INsoluble to hypotonic solutions and render them INSENSITIVE to subsequent processing (RECALL)
TWO (2) mechanisms of fixation:
- Additive fixation
- Non-additive fixation