synovial fluid Flashcards
- VISCOUS FLUID SEEN IN DIARTHROSES (JOINTS/MOVABLE JOINTS)
- joint fluid
- latin word: egg
synovial fluid
- Lubrication for the movable joints
- Nutrients for articular cartilage
- Lessens shock of joint compression
- Ultrafiltrate of plasma across synovial membrane
- No high weight molecules
synovial fluid
secrete hyaluronic acid that makes the fluid viscous (lubrication)
synoviocytes
TO DECREASE FRICTION AND INCREASE VISCOSITY = NEEDS (?)
HYALURONIC ACID
- Needle aspiration called (?)
- Normal knee fluid amount (?)
- Normal fluid (?); diseased fluid (?)
- arthrocentesis
- <3.5 mL
- does not clot
- clots
spx collection
- chemistry: (?)
- immunologic eval: (?)
- microbio: (?)
- hema: (?)
- red top/heprinized
- red top/heparinized
- heparin/sps
- liquid EDTA
liquid or solid
versene
liquid edta
liquid or solid
sequestrene
solid edta
powdered edta will create (?)
artifacts (crystals)
presence of chronoctic shards (black pepper appearance)
ochronosis
apperance
- normal: (?)
- infection: (?)
- hemorrhagic/traumatic tap: (?)
- crystal induced: (?)
- turbodity: (?)
- clear/pale yellow
- deeper yellow, green tinge
- red
- milky
- wbc, cellular debris, fibrin
used to identify synovial fluid
acetic acid
decreses polymerization
ahrthritis
infection decreases (?), and high chances of (?)
- hyaluronidase
- clotting
prevents clooting of S.F.
hyaluronidase
(?) cm string from aspirating needle
4-6
rope/mucin clot test
Add fluid to (?) acetic acid to form clot
2%–5%
cell counts
- (?) most common
- Do not use normal WBC diluting fluid; use normal (?)
- May have to treat viscous fluid with hyaluronidase first: pretreat with a pinch of hyaluronidase to (?) mL of fluid or one drop of (?) hyaluronidase in phosphate buffer per mL of fluid àt (?) for (?) minutes
- Perform in same manner as cerebrospinal fluid counts
- Normal: (?) WBCs/μL, septic may reach (?)
- wbc
- saline/methylene blue
- 0.5,
- 0.05%
- 37ºC
- 5
- <200
- > 100,000
differential count
- Incubate with (?), then (?)
- Normal cells: monocytes, macrophages, synovial tissue cells
- Neutrophils: (?)%
- Lymphocytes: (?)%, noninflammatory higher
- All cells may appear more (?)
- hyaluronidase, cytocentrifuge
- <25
- <5
- vacuolated
Similar to macrophage, but may be multinucleated, resembling a mesothelial cel
synovial lining cell
Neutrophil containing characteristic ingested: “round body”
LE cell
Vacuolated macrophage with ingested neutrophils
reiter cell
Neutrophil with dark cytoplasmic granules containing immune complexes
RA cell (ragocyte)
Pigmented villonodular synovitis
hemosiderin granules
crystals
- needle:
- rhombic square, rods:
- notched, rombic plates:
- flat, variable-shaped plates:
- envelope:
- small particles, require electron microscopy:
- monosdium urate
- calcium pyrophosphate
- cholesterol
- corticosteroid
- calcium oxalate
- apatite
needle-shaped; seen intra- and extracellularly; may be seen sticking through cytoplasm
MSU crystals
rhombic, square shaped, or short rods; often seen in vacuoles of neutrophils
CPPD crystals
slide ecamination
Continued examination is done under (?) and compensated (?) light of wet preparation
polarized
compensated polaraized light
- MSU molecules run (?) to the long axis, aligned with slow vibration; (?) light is impeded, producing a (?) color (negative birefringence)
- CPPD molecules run (?) to long axis and impede the (?) light producing a (?) color (positive birefringence)
- parallel
- fast
- yellow
- perpendicular
- slow
- blue
chem test
- Plasma-synovial fluid glucose difference = within 10mg/dL
- Decreased in various joint diseases (Bacterial infection)
glucose
chem test
- Normal: <3g/dL
- Increased in inflammatory (RA, crystal synovitis) & septic arthritis
protein
chem test
- Establishes the presence of gout
- Elevated result should correlate with serum uric acid
uric acid
chem test
Provides rapid differentiation between inflammatory and septic arthritic
lactate test
normal SF values
- volume:
- color:
- clarity:
- viscosity:
- leukocyte count:
- NEUT:
- crystals:
- glucose:
- total protein:
- <3.5
- colorless to pale yellow
- clear
- form 4-6 cm string
- <200 cells/ul
- <25% of differential
- none
- <10 mg/dl
- <3 g/dl
are the most common autoimmune causes of arthritis
RA and LE
arthritis is frequent complication; test serum for Borrelia burgdorferi antibodies
lyme disease
