Serous Fluid

SEROUS FLUID

Serum-like fluids formed as ultrafiltrates of \\n plasma \\n

Provides lubrication in the cavities where they are \\n found

PARIETAL , VISCERAL

SEROUS FLUID Provides lubrication between two (2) membranes: ____ __and__ ____ as they move against \\n each other

Pericardial

Pericardium \\n (encloses the heart)

Pleural

Pleural cavity \\n (encloses the lungs)

Peritoneal

Peritoneum \\n (encloses the abdominal organs)

Parietal

lines the cavity wall

Visceral

Forms a sac around the organs (covers the organs within the \\n cavity)

Pericardiocentesis

Method of Collection

\
Pericardial

Thoracentesis

Method of Collection

\
Pleura

Paracentesis

Method of Collection

\
Peritoneal

Normal Values

\
Pericardial

< 50 mL

Normal Values

\
Pleural

< 100 mL

Normal Values

\
Peritoneal

EDTA tube

anticoagulant for cell counts and differential

Sterile heparinized or sodium \n polyanethol sulfonate (SPS) evacuated tubes

anticoagulant for microbiology and cytology

Plain tubes or heparin tubes

anticoagulant for Chemistry tests (clotted specimens)

centrifugation

For better recovery of microorganisms and abnormal cells, concentration of large amounts of fluid is performed by

anaerobically in ice

Specimens for pH must be maintained

CLEAR, PALE YELLOW

normal serous fluid appearance

brown

appearance

rupture of liver amebic abcess

black

Appearnce

asperigillosis

viscous

Apperance

malignant mesothelioma

turbid

Appearance

WBC

Milky

Appearance

Chylous or Pseudochylous effusions

Bloody

Appearance

Hemothorax, Hemorrhagic effusion, pulmonary embolus, tuberculosis, malignancy

transudate or exudate.

A general classification of the cause of an effusion can be accomplished by categorizing the fluid as either

EFFUSION

Increase in fluid volume between the 2 membranes

TRANSUDATE

serous effusions that result from disturbance of the fluid production and regulation between serous membranes

EXUDATE

purulent effusions that form in any body cavity as a result of an inflammatory process

Serum-Ascites Albumin Gradient \n (SAAG)

Recommended to detect transudates of hepatic origin

TRANSUDATE

Serum-Ascites Albumin Gradient (SAAG)

INTERPRETATION OF RESULTS:

≥ 1.1

EXUDATE

Serum-Ascites Albumin Gradient (SAAG)

INTERPRETATION OF RESULTS:

\

Transudate

Serum-Ascites Albumin Gradient (SAAG)

INTERPRETATION OF RESULTS:

\
Protein (g/dL)

< 3.0

Exudate

Serum-Ascites Albumin Gradient (SAAG)

INTERPRETATION OF RESULTS:

\
Protein (g/dL)

> 3.0

Transudate

Serum-Ascites Albumin Gradient (SAAG)

INTERPRETATION OF RESULTS:

\
Rivalta’s Test

(-)

Exudate

Serum-Ascites Albumin Gradient (SAAG)

INTERPRETATION OF RESULTS:

\
Rivalta’s Test

(+)

Serosamucin Clot Test

RIVALTA’S TEST is also known as

RIVALTA’S TEST

Differentiates exudates from transudates

Exudate

RIVALTA’S TEST

\
Heavy precipitation

PLEURAL CAVITY

located b/w parietal pleural membrane (lining the chest wall) and visceral pleural membrane (covering the lungs)

Hemothorax

Diffusion of blood is uneven

\
Pleural fluid HCT is __> 1/2__ of Whole blood hematocrit

Hemorrhagic Effusion

Diffusion of blood is even

\
Pleural fluid HCT is

pseudochylous

gold paint

Colon cancer

Significance of CEA (carcinoembryogenic antigen)

ovarian/metastatic uterine cancer

Significance of CA 125

Breast cancer

Significance of CA 15-3, CA 549

Lung cancer, breast cancer, urinary bladder cancer

Significance of Cyfra 21-1 (cytokeratin fragment)

clear, pale yellow

Significance of Testing of Peritoneal Fluid \n

normal

turbid

Significance of Testing of Peritoneal Fluid

\
microbial infection

green

Significance of Testing of Peritoneal Fluid

\
gall bladder/ pancreatic disorders

blood streaked

Significance of Testing of Peritoneal Fluid

\
trauma, infection, malignancy

milky

Significance of Testing of Peritoneal Fluid

\
lymphatic trauma

PERITONEAL (ASCITIC) FLUID \n WBC Count

\
Normal

>500 cells/uL

PERITONEAL (ASCITIC) FLUID \n WBC Count

\
bacterial peritonitis, cirrhosis

>100,000 RBC/uL

Peritoneal lavage

PSAMMOMA BODIES

Contain concentric striations of collagen-like material \n

Seen in: \n \n ✓ Benign conditions \n ✓ Associated with ovarian and thyroid carcinomas