OTHER BODY

FLUIDS
 DEFINITIONS
CEREBRO SPINAL FLUID AMNIOTIC FLUID

is a major fluid of the body present in the amnion, a membranous sac

that surrounds the fetus

SEROUS FLUID SYNOVIAL FLUID

•The fluid between the membranes is called often referred to as “joint fluid,” is a
serous fluid, and it provides lubrication viscous liquid found in the cavities of the
between the parietal and visceral membranes. movable joints (diarthroses) or synovial
joints
02
BASIC
CONCEPTS
 CSF
PHYSIOLOGY
produced in the chronoid plexus of the two lumbar ventricles and the
third and forth ventricle.
approximately 2oml is produced every hour
flows through the sub arachnoid sapce located between the
arachnoid and pia mater.
90-150 mL in adults ; 10-60 mL in children

SPECIMEN COLLECTION
CSF is routinely collected by lumbar puncture between the third,
fourth, or fifth lumbar vertebrae.
The volume of CSF that can be removed is based on the volume
available in the patient (adult vs. neonate) and the opening pressure
of the CSF taken when the needle first enters the subarachnoid space
 CSF
Specimens are collected in three sterile tubes,
which are labeled 1, 2, and 3 in the order in
which they are withdrawn

Tube 1 is used for chemical and serologic tests

because these tests are least affected by
blood or bacteria introduced as a result of the
tap procedure;

Tube 2 is usually designated for the

microbiology laboratory;

Tube 3 is used for the cell count, because it is

the least likely to contain cells introduced by
the spinal tap procedure
 SEROUS FLUID
PHYSIOLOGY
Lubrication is necessary to prevent the friction between the two
membranes that occurs as a result of movement of the enclosed
organs.
Serous fluids are formed as ultrafiltrates of plasma, with no
additional material contributed by the mesothelial cells that line
the membranes

SPECIMEN COLLECTION
Fluids for laboratory examination are collected by needle
aspiration from the respective cavities. These aspiration
procedures are referred to as thoracentesis (pleural),
pericardiocentesis (pericardial), and paracentesis.
 SEROUS FLUID
SPECIMEN COLLECTION
An ethylenediaminetetraacetic acid (EDTA)
tube is used for cell counts and the
differential.

Sterile heparinized evacuated tubes are used

for microbiology and cytology

Chemistry tests can be run on clotted

specimens in plain tubes or on heparinized
tubes.

 SPECIMEN
COLLECTION
Fluids for laboratory examination are collected by needle aspiration
from the respective cavities.

THORACENTESIS PERICARDIOCENTESIS PARACENTESIS

PLEURAL FLUID PERICARDIAL FLUID PERIOTNEAL FLUID
clear and pale yellow clear and pale yellow clear and pale yellow
HEMOTHORAX turbid
Green or dark-brown
color
 SYNOVIAL FLUID
PHYSIOLOGY
Acts as a lubricant and adhesive
Provides nutrients for avascular articular cartilage

SPECIMEN COLLECTION AND

HANDLING

•Synovial fluid is collected by needle aspiration

called arthrocentesis.
•The amount of fluid present varies with the size of
the joint and the extent of fluid buildup in the joint.
Acts as a lubricant and adhesive
SPECIMEN COLLECTION AND HANDLING

Tube 1: 5-10mL into heparizied tube for

microbiological studies

Tube 2: 2-5mL in an anticoagulant tube for

microscopic

Tube 3: 5mL in a plain tube and allowed to clot,

normal SF does not clot.
SYNOVIAL FLUID ANALYSIS
A synovial fluid analysis is
performed when pain,
inflammation, or swelling
occurs in a joint, or when
there’s an accumulation of
fluid with an unknown
cause

Some potential diagnoses

include infection, gout,
arthritis, and bleeding.
SPECIMEN COLLECTION
Abnormal synovial fluid may be cloudy and thicker or thinner than normal fluid.
Cloudiness could mean there are crystals, excess white blood cells, or microorganisms in
the fluid.
Blood in the fluid could point to a bleeding injury in the joint or a more serious bleeding
problem throughout the body, such as hemophilia. Absent or ineffective clotting factors
cause hemophilia

Cloudy fluid, blood in the fluid, or excess fluid are all signs of a
problem in or around the joint, such as:
arthritis
gout
infection
autoimmune disorder
injury to the joint
SPECIMEN COLLECTION
Normal synovial fluid does not clot; however, fluid from a
diseased joint may contain fibrinogen and will clot.

The syringe that has been moistened with heparin

Powdered anticoagulants should not be used because

they may produce artifacts that interfere with crystal
analysis. The non-anticoagulated tube for other tests
must be centrifuged and separated to prevent cellular
elements from interfering with chemical and serologic
analyses.
SPECIMEN COLLECTION

Gram Stain and culture Heparinized or SPS

Cell counts Heparin or liquid EDTA

Glucose analysis Sodium flouride

All other tests Nonanticoagulated
specimen collection
•Normal synovial fluid appears colorless to pale
yellow. The word “synovial” comes from the Latin
word for egg, ovum.

•Normal viscous synovial fluid resembles egg

white.

•Turbidity is frequently associated with the

presence of WBCs; however, synovial cell debris
and fibrin also produce turbidity. The fluid may
appear milky when crystals are present.
 SYNOVIAL FLUID
VISCOSITY
Synovial fluid viscosity comes from polymerization of the
hyaluronic acid and is essential for the proper joints
lubrication.

CELL COUNTS
•The total leukocyte count is the most frequently performed cell count on synovial fluid. Red
blood cell (RBC) counts are seldom requested.

PROBLEM RESOLUTION
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut
labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco
laboris nisi ut aliquip ex ea commodo consequat.