Synovial Fluid/Serous Fluid Flashcards
ULTRAFILTRATE of plasma in synovial membrane
Synovial Fluid
Substance secreted by synoviocytes to lubricate joints and increased viscosity
Hyaluronic Acid
Method of Collection:
Volume of Collection:
Arthrocentesis
25 mL
Collection Tubes & Handling
Tube > Section/Test > Anticoagulant
Tube 1: _____________, ___________
Tube 2: _____________, ___________
Tube 3: _____________, ___________
Tube 4: _____________, ___________
Collection Tubes & Handling
Tube > Section/Test > Anticoagulant
Tube 1: Microbio(GS/C) - Heparinized Tube
Tube 2: Cell Count - EDTA/Heparinized Tube
Tube 3: Chem/Sero/Other Test - Plain Tube
Tube 4: Glucose - Na Flouride
____________ should not be used as they cause interference in crystal ID
Powdered Anticoagulant
Color and Clarity
Normal: Inflammation: Bacterial infection: Traumatic tap: hemorrhagic arthritis WBCs, fibrin: Presence of crystals:
Color and Clarity
Normal: Colorless - Pale Yellow Inflammation: Deep Yellow Bacterial infection: Greenish tinge Traumatic tap: Red Hemorrhagic arthritis: Red WBCs, fibrin: Turbid Presence of crystals: Milky
Color - Pale Yellow
Normal
Color - Deep Yellow
Inflammation
Color - Presence of crystals
Milky
Color - Bacterial infection
Greenish Tinge
Normal Values of Synovial Fluid
Volume Color Clarity Viscosity via String test WBC Count (Neutrophils) Crystals Glucose (vs plasma) Total Protein
Normal Values of Synovial Fluid
Volume: <3.5 ml Color: Colorless - Pale Yellow Clarity: Clear Viscosity via String test: 4-6 WBC Count (Neutrophils): < 25% Crystals: Neg (-) Glucose (vs plasma): <10 mg/dL Total Protein: < 3g/dL
6 strings is considered ___________
Normal
WBC Count of PMNs
<25%
Normal fluid ______________
DO NOT CLOT
Volume of >25 mL indicates for __________
INFLAMMATION
Best Anticoagulant
Na Heparin
Liquid EDTA
Used to Confirm if spx is Synovial Fluid
Ropes/Mucin Clot Test/Hyaluronate Polymerization Test
Mucin Clot Test
aka - _______________
Rgt - _______________
(+) - _______________
Mucin Clot Test
aka - Hyaluronate Polymerization Test
Rgt - 2-5% Acetic Acid
(+) - Solid Clot
Crystals are _______ in NORMAL fluid
ABSENT
Cells in Rheumatoid Arthritis
RA Cells/Ragocyte
Neutrophil with dark cytoplasmic granules containing
IMMUNE COMPLEXES - RHEUMATOID FACTOR
RA Cells/Ragocyte
Neutrophil containing characteristic ingested ROUND BODY
LE Cells
Macroscopically resemble POLISHED RICE
Rice bodies
VACUOLATED macrophages with INGESTED NEUTROPHILS
Reiter cell
Crystal associated to GOUT
Monosodium Urate
Crystal associated to PSEDOGOUT
Calcium Pyrophosphate
Associated in ASTEOARTHRITIS
Calcium Phosphate
Birefringent Crystal
Calcium Pyrophosphate
Monosodium Urate
Shape: ____________
Significance: ________
Birefringence: _____
Monosodium Urate
Shape: Needle-like
Significance: GOUT
Birefringence: Neg
Calcium Pyrophosphate
Shape: ____________
Significance: ________
Birefringence: _____
Calcium Pyrophosphate
Shape: Rhombic square rods
Significance: PSEUDOGOUT
Birefringence: Pos (+)
Calcium Phosphate
Shape: ____________
Significance: ________
Birefringence: _____
Calcium Phosphate
Shape: Small particle flat rectangular plates
Significance: OSTEOARTHRITIS
Birefringence: Neg
Detects the presence or absence of birefringence
Polarizing Microscope
Confirms type of birefringence if Positive or Negative
Compensated Polarizing Microscope
Compensated Polarizing Microscope
Positive:
Negative:
Compensated Polarizing Microscope
Positive: Blue
Negative: Yellow
Joint Disorders
Type 1; Type 2a: Type 2b: Type 3: Type 4:
Joint Disorders
Type 1; Non-inflammatory Type 2a: Inflammatory - IMMUNOLOGIC Type 2b: Inflammatory - CRYSTAL INDUCED Type 3: Septic Type 4: Hemorrhagic
Joint Disorder with the HIGHEST WBC COUNT (50, 000 - 100, 000)
Type 3 - Hemorrhagic
Type 2a - Inflammatory - IMMUNOLOGIC
Color/Clarity: Viscosity: WBC count: Glucose: PMNS: Others:
Type 2a - Inflammatory - IMMUNOLOGIC
Color/Clarity: Cloudy, Yellow Fluid Viscosity: POOR WBC count: 2,000 - 75,000/uL Glucose: Decreased PMNS: >50% Others: (+) Autoantibodies
Type 2b - Inflammatory -CRYSTAL INDUCED
Color/Clarity: Viscosity: WBC count: Glucose: PMNS: Others:
Type 2b - Inflammatory -CRYSTAL INDUCED
Color/Clarity: Cloudy, MILKY Viscosity: Low Viscosity WBC count: up to 100,000/uL Glucose: Decreased PMNS: >70% Others: (+) Crystal - Monosodium Urate/Calcium Pyrophosphate
Type 2b - SEPTIC
Color/Clarity: Viscosity: WBC count: Glucose: PMNS: Others:
Type 2b - SEPTIC
Color/Clarity: Cloudy, YELLO GREEN Viscosity: Variable WBC count: HIGHEST Glucose: Decreased PMNS: >75% Others: (+) C/S, G/S
