Synovial Fluids Flashcards

1
Q

Definition

A

Fluids that fill joint spaces
Resembles egg white

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2
Q

Joint Anatomy

A

Movable joints composed cartilage and fibrous capsule lined with a membrane

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3
Q

Membrane Anatomy

A

Composed of 2 cell types
- Phagocytic cells
- Cells that secrete hyaluronic acid

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4
Q

Production of fluid

A

Ultrafiltrate of plasma (macromolecules restricted)
Hyaluronic Acid secreted into fluid

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5
Q

Hyaluronic Acid

A

Large molecular weight mucopolysaccharide
High Viscosity

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6
Q

Fluid Function

A

Lubrication of joint
Supplies nutrients to cartilage

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7
Q

Fluid Collection

A

Aseptic needle aspiration
- Arthrocentesis

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8
Q

Tubes for Collection

A

Sterile - microbiology
Heparin - Chemistry/immunology/crystals
EDTA - Cell count and differential

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9
Q

Synovial Fluid STAT

A

45 minutes

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10
Q

Synovial Fluids Appearance

A

Color
Clarity
Volume

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11
Q

Normal Color

A

Colorless or pale yellow

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12
Q

Normal Clarity

A

Clear and no clots

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13
Q

Volume

A

Varies
Normal knee = <3.5 mL

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14
Q

Counting Method

A

Same as CSF
No Acid Diluents

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15
Q

Normal TNC/cumm

A

<200

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16
Q

Normal RBC/cumm

A

<2,000

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17
Q

Normal Differential

A

Primarily Mononuclear Cells
<25% neutrophils

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18
Q

Crystal Analysis

A

Primarily Uric Acid
Calcium Pyrophosphate
Cholesterol

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19
Q

Light Analysis of Crystals

A

Polarized light
Compensated Polarized

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20
Q

Color Appearance

A

Blue or yellow depending upon type and orientation

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21
Q

Uric Acid Crystals

A

Monosodium Urate or MSU
Needle-like
Strong negative birefringence

22
Q

Uric Acid Color with Polarized Light

A

Parallel = yellow
Perpendicular = blue

23
Q

Calcium Pyrophosphate Crystals

A

CPPD
Rhomboid
Weak positive birefringence

24
Q

Calcium Pyrophosphate Crystals Polarized Light

A

Parallel - blue
Perpendicular - yellow

25
Q

Viscosity

A

String test
Mucin clot test

26
Q

Normal Glucose

A

10% less than serum level

27
Q

Normal Protein

A

Approx 2 g/dL

28
Q

Normal Immunoglobulins

A

10% of serum levels

29
Q

Normal Uric Acid

A

Equal to or less than serum level

30
Q

Bloody, pink, red color

A

Traumatic Tap
Hemorrhage
Trauma

31
Q

Green color

A

Bacterial Infection

32
Q

Hazy or Cloudy

A

Increased numbers of cells, crystals, or microorganisms

33
Q

Increased RBCs

A

Traumatic Tap
Trauma
Hemorrhage

34
Q

Increased TNCs - Predom Neutro

A

Bacterial Infection
Inflammation

35
Q

Increased TNCs - Predom Lymphs

A

Non-septic Inflammation

36
Q

Increased TNCs - LE cells

A

Associated with SLE

37
Q

Increased TNCs - Reiter Cells

A

Macrophage with ingested neutrophils
Infection
Inflammation

38
Q

Increased TNCs - Rice Bodies

A

Associated with TB and arthritis

39
Q

Uric Acid Crystals Associated

A

Gout

40
Q

Calcium Pyrophosphate Crystal Association

A

Pseudogout

41
Q

Cholesterol Crystals Association

A

Increased cholesterol

42
Q

Fluid Viscosity

A

Decreased in a variety of diseases

43
Q

Microorganisms

A

Associated with infection

44
Q

Glucose

A

> 25% less than serum levels
- associated with infection and/or inflammation

45
Q

Total Protein

A

> 4.5 g/dL associated with inflammation

46
Q

Immunoglobulins

A

Associated with rheumatoid arthritis

47
Q

Non-inflammatory Joint disease

A

Osteoarthritis
Traumatic Arthritis

48
Q

Inflammatory Joint Disease

A

Rheumatoid Arthritis
SLE
Gout
Pseudogout

49
Q

Infectious/Septic Joint Disease

A

Bacterial
Fungal
TB

50
Q

Hemorrhagic Joint Disease

A

Hemophilia
Trauma
Sickle Cell Anemia