OTHER BODY FLUIDS

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Cards (72)

  • Cerebrospinal fluid (CSF)

    Provides a physiologic system to supply nutrients to the nervous tissue, remove metabolic wastes, and produce a mechanical barrier to cushion the brain and spinal cord against trauma
  • Cerebrospinal fluid (CSF)

    Refers to the liquid that surrounds brain & spinal cord
  • Cerebrospinal fluid (CSF) testing
    Used to diagnose meningitis and other disorders such as brain abscess, CNS cancer and multiple sclerosis
  • Specimen Collection and Handling of CSF
    1. CSF is routinely collected by lumbar puncture between the third, fourth, or fifth lumbar vertebra
    2. Specimens are collected in three sterile tubes, which are labeled 1, 2, and 3 in the order in which they are withdrawn
    3. Tube 1 is used for chemical and serologic tests
    4. Tube 2 for the microbiology laboratory
    5. Tube 3 is used for cell count
  • Traumatic Collection (Tap) of CSF

    1. Grossly bloody CSF can be an indication of intracranial hemorrhage, but it may also be due to the puncture of a blood vessel during the spinal tap procedure
    2. Uneven Blood Distribution
    3. Clot Formation
    4. Xanthochromic Supernatant: the result of blood that has been present longer than that introduced by the traumatic tap
  • CSF Laboratory Tests
    • Total Cell count
    • Differential count
    • CHEMISTRY TEST: CSF Proteins, GLUCOSE, Lactate, Glutamine
    • MICROBIOLOGY TEST: Gram Stain, AFB, India Ink, Latex agglutination, ELISA, BAT
    • SEROLOGIC TEST: neurosyphilis
  • Semen

    Seminal fluid is a thick yellowish-white fluid that contains sperm release during the male ejaculation
  • Semen analysis
    Done to evaluate the fertility and assess the effectiveness of sterilization after a vasectomy procedure but it is also ordered for forensic or legal reasons such as criminal investigations involving sexual assault
  • Semen Specimen Collection
    1. Specimens are collected following a period of sexual abstinence of at least 2 days to not more than 7 days
    2. Specimens collected following prolonged abstinence tend to have higher volumes and decreased motility
    3. When performing fertility testing, the World Health Organization (WHO) recommends that two or three samples be collected not less than 7 days or more than 3 weeks apart, with two abnormal samples considered significant
    4. Specimens are collected in warm sterile glass or plastic containers
    5. Whenever possible, the specimen is collected in a room provided by the laboratory
    6. The specimen should be kept at room temperature and delivered to the laboratory within 1 hour of collection
  • Semen Specimen Handling
    1. All semen specimens are potential reservoirs for HIV and hepatitis viruses, and standard precautions must be observed at all times during analysis
    2. Specimens are discarded as biohazardous waste
    3. A fresh semen specimen is clotted and should liquefy within 30 to 60 minutes after collection
    4. Failure of liquefaction to occur within 60 minutes may be caused by a deficiency in prostatic enzymes and should be reported
  • Semen Microbial and Chemical Testing
    • Routine aerobic and anaerobic cultures and tests for Chlamydia trachomatis, Mycoplasma hominis, and Ureaplasma urealyticum
    • Determining the levels of neutral a -glucosidase, free L-carnitine, glycerophosphocholine, zinc, citric acid, glutamyl transpeptidase, and prostatic acid phosphatase
  • Synovial Fluid

    Viscous liquid found in the cavities of the movable joints (diarthroses) or synovial joints
  • Synovial Fluid Analysis

    Used to determine the pathologic origin of arthritis
  • Synovial Fluid Tests

    • white blood cell (WBC) count, differential, Gram stain, culture, and crystal examination
  • Synovial Fluid Specimen Collection and Handling
    1. Synovial fluid is collected by needle aspiration called arthrocentesis
    2. Normal synovial fluid does not clot; however, fluid from a diseased joint may contain fibrinogen and will clot
    3. Fluid is often collected in a syringe that has been moistened with heparin
    4. Cell Counts: total leukocyte count, Red blood cell (RBC) counts are seldom requested
    5. Very viscous fluid may need to be pretreated by adding one drop of 0.05% hyaluronidase in phosphate buffer per milliliter of fluid and incubating at 37°C for 5 minutes
  • Synovial Fluid Differential Count
    1. Performed on cytocentrifuged preparations or on thinly smeared slides
    2. Fluid should be incubated with hyaluronidase prior to slide preparation
    3. Mononuclear cells, including monocytes, macrophages, and synovial tissue cells, are the primary cells seen in normal synovial fluid
    4. Neutrophils should account for less than 25% of the differential count and lymphocytes less than 15%
    5. Increased neutrophils indicate a septic condition, whereas an elevated cell count with a predominance of lymphocytes suggests a nonseptic inflammation
  • Synovial Fluid Chemistry Tests
    1. Chemistry test values are approximately the same as serum values
    2. Glucose determination, because markedly decreased glucose values indicate inflammatory (group II) or septic (group III) disorders
    3. Simultaneous blood and synovial fluid samples should be obtained, preferably after the patient has fasted for 8 hours
    4. Normal synovial fluid glucose should not be more than 10 mg/dL lower than the blood value
    5. Total protein and uric acid determinations
  • Synovial Fluid Microbiologic Tests
    1. Gram stains and cultures are two of the most important tests performed on synovial fluid
    2. Bacterial infections are most frequently seen; however, fungal, tubercular, and viral infections also can occur
  • Synovial Fluid Serologic Tests
    1. Association of the immune system to the inflammation process
    2. Synovial fluid analysis actually serves as a confirmatory measure in cases that are difficult to diagnose
    3. Autoimmune diseases rheumatoid arthritis and systemic lupus erythematosus cause very serious joint inflammation and are diagnosed in the serology laboratory by demonstrating the presence of their particular autoantibodies in the patient's serum
  • Pleural, Pericardial, and Peritoneal fluids
    The serous fluid is found between the membrane that encloses that pleural, pericardial, & peritoneal cavities
  • Specimen Collection and Handling of Serous Fluids
    1. Collected by needle aspiration from the respective cavities: thoracentesis (pleural), pericardiocentesis (pericardial), and paracentesis (peritoneal)
    2. Abundant fluid (>100 mL) is usually collected
    3. An EDTA tube is used for cell counts and the differential
    4. Sterile heparinized or sodium polyanethol sulfonate (SPS) evacuated tubes are used for microbiology and cytology
    5. Chemistry tests can be run on clotted specimens in plain tubes or in heparin tubes
    6. Specimens for pH must be maintained anaerobically in ice
    7. Blood specimens should be obtained at the time of collection
  • Transudates
    Effusions that form because of a systemic disorder that disrupts the balance in the regulation of fluid filtration and reabsorption—such as the changes in hydrostatic pressure created by congestive heart failure or the hypoproteinemia associated with the nephrotic syndrome
  • Exudates
    Effusions produced by conditions that directly involve the membranes of the particular cavity, including infections and malignancies
  • Hematology Tests on Serous Fluids
    • Macrophages, neutrophils, lymphocytes, eosinophils, mesothelial cells, plasma cells, and malignant cells
  • Chemistry Tests on Pleural Fluid
    • Glucose, pH, adenosine deaminase (ADA), and amylase
  • Microbiologic and Serologic Tests on Serous Fluids
    • Gram stains, cultures (both aerobic and anaerobic), acid-fast stains, and mycobacteria cultures
    • Serologic testing
  • Transudates

    Changes in hydrostatic pressure created by congestive heart failure or the hypoproteinemia associated with the nephrotic syndrome
  • Exudates

    Produced by conditions that directly involve the membranes of the particular cavity, including infections and malignancies
  • Hematology Tests
    • Differential cell count
    • Macrophages
    • Neutrophils
    • Lymphocytes
    • Eosinophils
    • Mesothelial cells
    • Plasma cells
    • Malignant cells
  • Macrophages

    • Normally account for 64% to 80% of a nucleated cell count followed by lymphocytes (18% to 30%) and neutrophils (1% to 2%)
  • Chemistry Tests
    • Glucose
    • pH
    • Adenosine deaminase (ADA)
    • Amylase
  • Microbiologic and Serologic Tests
    • Gram stains
    • Cultures (both aerobic and anaerobic)
    • Acid-fast stains
    • Mycobacteria cultures
    • Antinuclear antibody (ANA)
    • Rheumatoid factor (RF)
    • Carcinoembryonic antigen (CEA)
    • CA 125 (metastatic uterine cancer)
    • CA 15.3 and CA 549 (breast cancer)
    • CYFRA 21-1 (lung cancer)
  • A count of >1000 WBCs/μL with a high percentage of neutrophils can indicate bacterial endocarditis
  • Malignant cells can be the result of metastatic lung or breast carcinoma
  • Bacterial cultures and Gram stains are performed on peritoneal fluid
  • Ascites
    Fluid is commonly referred to as ascitic fluid rather than peritoneal fluid
  • Causes of exudative peritoneal fluids
    • Bacterial infections (peritonitis) - often as a result of intestinal perforation or a ruptured appendix
    • Malignancy
  • Peritoneal lavage

    Aid in determining the need for surgery
  • RBC counts greater than 100,000/mL in peritoneal fluid are indicative of blunt trauma injuries
  • Amniotic fluid

    A clear and slightly yellowish liquid contained in the amniotic sac that is surrounding and cushioning the fetus during pregnancy