Other Non-blood Specimen

• To evaluate fertility and postvasectomy procedures

  1. Vasectomy - vas deferens of the male is constricted

  2. Abstain from sexual activity for 3 days and not longer than 5 days before collecting the sample

  3. Collected at the laboratory in a warm sterile container

  4. Not be collected in a condom because condoms frequently contain spermicidal agents

  5. If the sample is collected at home, it must be kept warm and delivered to the laboratory within 1 hour

  6. Semen needs to be liquify before testing (approx. 30min)
• Semenalysis


  • Record the time of sample collection, and the sample receipt, on the requisition form because certain parameters of the semen analysis are based on specimen life span
  • Kept at 37°C
• Normal values for semen analysis

  • Volume: 2-5 mL
  • Viscosity: Pours in Droplets
  • pH: 7.2 –8.0
  • Sperm Concentration: > 20 million/mL
  • Sperm Count: > 40 million/ejaculate
  • Motility: > 50% within 1 hr
  • Quality: > 2.0
  • Morphology: > 14% normal forms (Strict Criteria), > 30% normal forms (Routine Criteria)
  • Round Cells: <1.0 million/mL
• Cerebrospinal fluid (CSF)


  • Surrounds the brain and spinal cord to supply nutrients to the nervous tissue
  • Remove metabolic wastes
  • Produce a barrier to cushion the brain and spinal cord against trauma
  • Routinely collected by lumbar puncture between the third, fourth, or fifth lumbar vertebrae
• Normal CSF


  Clear and Colorless
• CSF is used to diagnose meningitis, subdural hemorrhage, and other neurological disorders
• Routine tests performed on CSF


  • Cell counts
  • Chemistry Tests (Chloride, Glucose, Total Protein)
• CSF collection


  1. Sterile tubes (numbered 1 through 3)

  2. Tube No. 1: Chemistry and Immunology

  3. Tube No. 2: Microbiology

  4. Tube No. 3: Hematology (Cell counts)
• Alternate CSF collection procedure

  1. Collect 4 tubes (numbered 1 through 4)

  2. Tube 1: Hematology

  3. Tube 2: Chemistry

  4. Tube 3: Microbiology

  5. Tube 4: Hematology
• CSF should be kept at room temperature, delivered to the lab stat, and analyzed immediately
• CSF fluid appearance


  • Crystal Clear: Normal
  • Hazy, Turbid, Milky, Cloudy: WBC's, Microorganisms, Protein (Meningitis)
  • Oily: Radiographic Contrast Media
  • Bloody: RBC's (Hemorrhage)
  • Clotted: Protein, Clotting Factors (Disorders affecting blood-brain barrier)
  • Pellicle: Protein, Clotting Factors (Disorders affecting blood-brain barrier, Tubular Meningitis)
  • Xanthochromic: Hemoglobin (Old Hemorrhage, Lysed Cells from traumatic tap), Bilirubin (Elevated Serum Bilirubin), Carotene (Increased Serum), Melanin (Meningeal Melanosarcoma)
• Synovial fluid


  Clear, pale-yellow, viscous fluid that lubricates and decreases friction in movable joints
• Synovial fluid normally occurs in small amounts but increases when inflammation is present
• Arthrocentesis


  Process of collecting synovial fluid (usually in knees)
• Synovial fluid collection


  1. Collected in three tubes:

  2. EDTA or heparin tube for cell counts, identification of crystals, and Smear preparation

  3. Sterile tube for culture and sensitivity

  4. Nonadditive tube for macroscopic appearance, chemistry, and immunology tests and to observe clot formation
• Normal values for synovial fluid

  • Volume: < 3.5 mL
  • Color: Colorless to Pale Yellow
  • Clarity: Clear
  • Viscosity: Able to form a string 4-6 cm long
  • Leukocyte Count: < 200 Cells/uL
  • Neutrophils: < 25% of the differential
  • Crystals: None present
  • Glucose: Plasma Difference: < 10 mg/dL lower than blood glucose
  • Total Protein: < 3 g dL
• Serous fluid


  Pale yellow, watery, serum like fluid found between the double layered membranes enclosing the pleural, pericardial, and peritoneal cavities
• Serous fluid lubricates the membranes and allows them to slide past one another with minimal friction
• Serous fluid is normally present in small amounts, but volumes increase when inflammation or infection is present or when serum protein levels decrease
• Effusion


  Increase in fluid volume
• Collecting serous fluid


  1. Pleurocentesis (pleural cavity)

  2. Pericardiocentesis (pericardial cavity)

  3. Peritoneocentesis (peritoneal cavity)
• Serous fluid collection


  1. EDTA tubes if cell counts or smears are ordered

  2. Heparin or sodium fluoride tubes for chemistry tests

  3. Nonanticoagulant tubes for biochemical tests

  4. Sterile heparinized tubes for cultures
• Serous fluid identification


  • Pleural fluid – aspirated from the pleural space, or cavity, surrounding the lungs
  • Peritoneal fluid – aspirated from the abdominal cavity
  • Pericardial fluid – aspirated from the pericardial cavity surrounding the heart
• Amniotic fluid


  Clear, almost colorless to pale yellow fluid that fills the membrane (amnion or amniotic sac) that surrounds and cushions a fetus in the uterus

  
• Amniotic fluid is preferably collected after 15 weeks of gestation (pregnancy) and is obtained by a physician using a procedure called transabdominal amniocentesis
• Amniotic fluid can be analyzed to detect genetic disorders such as Down's syndrome, identify hemolytic disease resulting from blood incompatibility between the mother and fetus, and determine gestational age
• The most common reasons for amniotic fluid analysis are to detect problems in fetal development and assess fetal lung maturity
• Amniotic fluid creatinine levels

  Used to estimate gestational age
• Alpha fetoprotein (AFP)


  An antigen normally present in the human fetus that is also found in amniotic fluid and maternal serum
• AFP testing is initially performed on maternal serum, and abnormal results are confirmed by amniotic fluid AFP testing
• Abnormal AFP levels indicate problems in fetal development (such as neural tube defects or the potential for Down's syndrome)
• Fetal lung maturity


  Can be assessed by measuring the amniotic fluid levels of substances called phospholipids, which act as surfactants to keep the alveoli of the lungs inflated
• Lecithin to sphingomyelin (L/S) ratio


  Results are reported as this ratio, and lungs are most likely to be immature if the L/S ratio is less than 2
• Amniotic fluid testing to assess fetal lung maturity may be ordered on or near the patient's due date and is often ordered stat when the fetus is in distress
• Amniotic fluid collection


  1. Amniotic fluid is normally sterile and must be collected in a sterile container

  2. The specimen should be protected from light to prevent breakdown of bilirubin and delivered to the laboratory ASAP

  3. Specimens for chromosome analysis must be kept at room temperature

  4. Specimens for some chemistry tests must be kept on ice
• Gastric analysis


  Examines stomach contents for abnormal substances and measures gastric acid concentration to evaluate stomach acid production
• Basal gastric analysis


  Aspirating a sample of gastric fluid by means of a tube passed through the mouth and throat (oropharynx) or nose and throat (nasopharynx) into the stomach after a period of fasting tested to determine acidity prior to stimulation
• Gastric analysis with stimulant

  1. After the basal sample has been collected, a gastric stimulant, most commonly histamine or pentagastrin is administered intravenously and several more gastric samples are collected at timed intervals

  2. All specimens are collected in sterile containers

  3. The role of the phlebotomist in this procedure: help label specimens, draw blood for serum gastrin (a hormone that stimulates gastric acid secretion) determinations
• Sputum


  Mucus or phlegm that is ejected from the trachea, bronchi, and lungs through deep coughing
• Sputum is collected for the diagnosis or monitoring of lower respiratory tract infections such as tuberculosis (TB), caused by Mycobacterium tuberculosis