Serous Fluid Flashcards
each closed cavity is lined by 2 membranes known as
serous membranes
what are the 3 closed cavities
pleural, peritoneal, and pericardial
pleural fluid
found in lungs
peritoneal fluid
found in intestinal tract
pericardial fluid
from the heart
Under normal conditions all of these 3 fluids will have 2 different membranes that help to keep them contained
visceral and parietal layer
visceral layer
covers the organs
parietal layer
lines the cavities on the outside
normal fluid at all times is
clear, non clotted, viscosity of water
normally all fluid should be
self contained, provide lubrication, relatively in small amounts (because reduction and reabsorption take place at same time), very little fluid able to aspirate
the presence or buildup of fluid always mean
something is wrong
build up of fluid is called
effusion
effusion can happen because
change in osmotic pressure- due to albumin
change in chemical composition
increase in permeability of blood vessels
transudate
non inflammatory fluid that may be caused by mechanical factors affecting formation and reabsorption of fluids
membranes still in tact
in transudate ________ in hydrostatic pressure
increase
in transudate _______ in colloid pressure
decrease
biggest reason for transudate
congestive heart failure
other reasons
kidney disease (albumin is lost)
cirrhosis of the liver (albumin not being made)
other characteristics of transudate
clear fluids, no clots, protein levels <3 g/dL and this makes specific gravity lower as well (<1.015), LDH <200, total protein ratio <0.5 (total protein in fluid/ total protein in serum), # WBCs <1000/ mL, <25 % neutrophils
exudate
inflammatory effusions caused by damage to one of the membranes
caused by acute or chronic
in exudate the _____ is compromised which makes it more serious
membrane
other characteristics of exudate
○ High protein >3.0 grams/dL
○ Specific gravity >1.015
○ LDH >200
○ Total protein ratio >5??
○ Increased WBCs >1000/mL
Increased in whatever cell is causing the transudate be formed
color of exudate fluid
milky, yellowish, red, some clotting
depends on whats happening
how do we draw fluid out?
via needle aspiration guided by ultrasounds
name of draw fluid from any body cavity
paracentesis
reason: examine the fluid and get as much fluid off the organ
most common reason for buildup of fluid in plural fluid
congestive heart failure
drawing out plural fluid is called
thoracentesis
for pleural fluid if upon testing its a transudate you do not have to do
cell counts or culture because membrane in tact
if there is an increase in pleural fluid
pneumonia and exudate because bacterial infection
what other testing can be done of plural fluid
cholesterol levels
it is transudate if <60?
if fluid is milky in pleural fluid =
chyle
what does chyle consist of
lymph, chylomicron, and triglycerides
if chyle is present there is a leak in
thoracic duct (chylothorax)
if true chyle specimen the triglyceride level is
> 110 mg/dL
if use sudan 3 stain + because trigs
pseudo-chylous effusion is seen in
chronic conditions such as TB and RA
pseudo-chylous has increased presence of
cholesterol
also see cholesterol crystals
sudan 3 -
trigs <50
pH testing can be done on
pleural fluid
decrease in pH= pneumonia
increase in pH= malignancies
ph below 6 is associated with
esophilg??
if not treated esophagus will rupture
you have gastric fluid buildup because stomach acid
amylase testing can be done on
pleural fluid
increased amylase is seen in pancreatitis
-this can be first indication of pancreatic condition
1 reason for buildup of peritoneal fluid
alcoholic cirrhosis of liver
2- malignancies
build up of peritoneal fluid=
ascites
testing done in peritoneal fluid
alkaline phosphate- increases indicate obstruction
also look for amylase?
1 reason for drawing pericardial fluid
congestive heart failure - transudate
bacterial infections surrounding the heart
endocarditis
main bacterial cause around heart
strep viridans
factor= surgery can cause infection
1 reason we see blood in pericardial fluid
mis dosage of anti-coag drugs
-another reason is malignancies
