Serous Body fluids Flashcards
What cavities are lined by two membranes?
Which membrane lines the cavity wall and which covers the organs?
- Pleural
- pericardial
- peritonial
- Parietal membrane
- Visceral membrane
Why is only a small amount of serous fluid present?
production and reabsorption take place at constant rate
Production and reabsorbtion of serous fluid are maintained by?
- Hydrostatic pressure
- Colliodal (oncotic) pressure
Under normal conditions colliodal pressure is ____________. Therfore, hydrostatic pressure in the parietal and visceral capillaries causes___________________.
- the same on both sides of capillaires membranes
- fluid to enter between the membranes
Disruption of serous fluid mechanisms causes?
increase in fluid between the membranes called Effusion
Primary causes of effusion? (4)
- congestive heart failure (CHF)
- decreased oncotic pressure (hypoproteinemia)
- increased capillary permeability (inflammagtion and infection)
- Lymphatic obstruction (tumors)
How is serous fluid collected?
How much fluid is collected?
- Thoracentesis (pleural)
- pericardiocentesis (pericardial)
- paracentesis (peritoneal)
- abundant >100 mL
How are serous specimens maintained forpH tests?
Anaerobically on ice
What are the two classifications of Effusions?
Trasudate and Exudate
What is a transudate effusion?
Systemic disorder that disrupts balance of fluid filtration and reabsorbtion.
- changes in hydrostaic pressure
- CHF
- hypoprotienemia ass. w/ nephrotic sydrome
***** INDIRECT CAUSES
What causes an exudate effusion?
conditions that DIRECTLY involve/affect membranes of particular cavity.
- malignancies/infections
What is the most reliable method for differentiating transudates from exudates?
- Determine fluid-blood ratios of protein and lactic dehydrogenase
RBC and WBC counts not freq. done on serous fluid because?
WBC >1000 /uL and RBC >100,000/uL are indicative of?
- provide little diagnostic info
- Exudate
Plueral fluids are of what effusion origins?
What differntiates them?
- Transidative or Exudative
- Plueral fluid cholesteral >60 mg/DL = exudate
- Plural fluid: serum cholesterol ration >0.3 = exudate
- fluid: serum bilirubin 6> = exudate
blood in plural fluid can indicate?
hemothorax
How to differentitate hemothorax from hemorrhage?
- Hematocrit
- Fluid Hct > 50% of whole blood Hct = hemothorax (because blood pouring in from injury)
What can cause milky plural fluid?
- Chylous material from thoracis duct leakage
- pseudochylous material from chronic inflammatory conditions
How to differentiate Chylous from Pseudochylous effusions?
Pseudochylous = higher [cholesterol]
Chylous = higher [triglyceride]
Sudan III strongly positive with chylous material
Neutros increased in plural fluid indicate? (2)
- bacterial infection (pneumonia)
- Effusions from pancreatitis and pulmonary infarction
Plueral fluid: increased lymp. seen in? (4)
- tuberculosis
- viral infections
- malignancy
- autoimmune disorders (artritis & systemic lupus)
Plueral fluid: increased EOS >10% seen in? (3)
- trauma from air or blood in cavity (pneumothorax / hemothorax)
- allergic reaction
- parasitic reaction
Lack of mesothelial cells is associated with?
tuberculosis
Plueral fluid pH <7.0 may indicate?
pH as low as 6.0 indicates?
ADA (adenosine deaminase) >40 UIL indicate?
Elevated amalyse is associated with?
- Need for chest tube drainage
- eosophigeal rupture
- tubercolosis
- Pancreatitis
Pericardial fluid: How much is found between membrance?
10 - 50 mL
Pericardial fluid: Effusions result from?
Changes in membrane permeability due to
- infection
- malignancy
- trauma
Pericardial fluid: transudate effusions are primarily caused by? (2)
- Metabolic disorders
- uremia
- hypothyroidism
- Autoimmune disorders
Peritoneal Fluid: Accumulation between membranse is called?
Ascites
Peritoneal Fluid: Causes of ascitic transudases?
- hepatic disorders
- cirrhosis
Peritoneal Fluid: Exudative effusions caused by? (2)
- bacterial infections (peritonitis)
- intestinal perforation
- rutured apendix
- malignancy
Peritoneal Fluid: What is a sensitive test for intr-abdominal bleeding in blunt trauma cases?
What RBC count iindicates traum?
- Peritoneal Lavage
- >100,000/uL
Peritoneal Fluid: what tests are recommened for the detection of hepatic origin transudates?
- Serum-ascities albumin gradient (SAAG) is resommended over:
- fluid: serum total protein
- LD ratios
Peritoneal fluid: using the Serum-ascities albumin gradient (SAAG) what indicates hepatic transudate and exudate effusion?
- Difference gradient 1.1> = transudate (hepatic)
- <1.1 = exudate
Peritoneal fluid:
What WBC count is normal?
- <350 cells uL
Peritoneal fluid: WBCs increase in bacterial peritonis and cirrhosis. How are the two distinguished?
Absolute neutrophil count done
