Serous Fluid Flashcards
Anatomy of linings
Visceral membrane: around organs
Parietal membranes: body wall
Formation and depends on
Ultrafiltrate of plasma
- Formed across parietal then absorbed into visceral
Depends on
- Oncotic and hydrostatic pressure
- Membrane permeability
- Reabsorption into lymph system
What is the accumulation of fluid within a body cavity, how is it diagnosed
Effusion
- Ultrasound, xray
Process of collection serous fluid
Paracentesis: puncture to aspirate fluid
Why do effusions happen
Change in pressure
Body response to infection/inflammation
Transudate causes
Usually systemic disease, increase in BP, decrease in plasma oncotic pressure
- Non inflammatory/non pathological
- Heart failure, cirrhosis, nephrotic syndrome
Exudate causes
Local pathological processes
Increased membrane perm. and decreased reabsorption into the lymph system
- If in pericardial, always exudate
Inflammatory contents, important to find the cause because of risk of organ damage
Transudate vs. exudate values
Transudate
- Color/clarity: clear colorless/ pale yellow, NO CLOTTING
- TP/LD ratio: both normal
- Glucose: difference <30 from plasma
- Cell counts: >1000
- Effusion types: pleural, peritoneal
Exudate
- Color/clarity: cloudy, +- clots, +- milky
- TP/LD ratio: 1 or both elevated
- Glucose: betwewn 30-60 difference from plasma
- Cell counts: >1000
- Effusion types: pleural, peritoneal, pericardial
Total protein and lactate dehydrogenase ratio values
>0.6 abnormal
One or both elevated = exudate
Increased TP: increased membrane permeability
Increased LD: tissue damage, WBCs
Glucose and amylase important value
<60 mls/dl difference in glucose confirms exudate
1.5-2x serum value for amylase increased in pancreatitis
Two lipid types and their significance
Chylous effusions
- triglycerides >110 mg/dl
- cholesterol, chylomicrons
- Damage to lymph system
Pseudocylous effusion
- triglycerides <60 mg/dl
- cholesterol NO CHYLOMICRONS
- chronic inflamm
Tumor marker for malignant effusions
Carcinoembryonic antigen (CEA)
Blood cells in serous fluid
RBCs not norm, hemorrhage or traum tap
WBCs low numbers
Increased cell count in types of fluid
pleural and peritoneal
Pleural
PMNs: bacterial
Lymphs: Tb, malignant, transudate
Peritoneal
PMNs: bacterial
Lymphs: decreased reabsorption, transudate
Mesothelial cells basic info
Line the membrane, can be reactive, uniform, smooth chromatin, dark blue cytoplasm, large cell
Normal in low numbers
