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36 Cards in this Set
- Front
- Back
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What is synovial fluid, and what are its 3 functions?
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-Clear, viscous fluid in joint space.
Functions: -nourish/remove debris from cartilage. -Lubricate/cushion joints. |
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How would you describe synovial fluid re: its chem composition?
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A dialysate of plasma
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How does synovial fluid compare to plasma?
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-Glu/uric acid levels similar.
-Protein is only 1/3 |
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What substance makes synovial UNIQUE????
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HYALURONATE - mucopolysaccharide that thickens the fluid.
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What is normal synovial fluid?
-Color/clarity -Cells -Crystals -Glucose -Culture |
Color: yellow/clear to sl cloudy
Cells: 0-200 WBC/uL; < 25% PMNs Crystals: none Glucose only 0-10 different from blood glucose. |
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What are 5 classifications of Synovial fluid?
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-Normal
-Noninflammatory -Inflammatory -Septic -Hemorrhagic |
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What causes noninflammatory synovial fluid?
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Degenerative Joint Disease
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What are 4 types of Degenerative joint disease?
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1. Osteoarthritis
2. Osteochondritis 3. Osteochondromatitis 4. Traumatic arthritis |
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What are 2 causes of inflammatory synovial fluid?
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1. Immunologic (RA/SLE)
2. Crystal induced |
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What 3 things cause septic synovial fluid?
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1. Bacteria
2. Fungi 3. Mycobacteria |
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What are 2 causes of hemorrhagic synovial fluid?
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1. Traumatic arthritis
2. Coagulopathies |
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What is the collection procedure for synovial fluid?
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1. Use sterile syringe
2. Dispense into tubes for Heme, Micro, Chemistry 3. Note viscosity |
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What types of tubes are used for synovial fluid?
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Heme: Na heparin or EDTA
Micro: Sterile Chemistry: plain |
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How is viscosity noted?
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Normal = at least 4 cm long
Inflammatory = less than 4 cm |
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What is the normal color of synovial fluid?
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yellow
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What other types of synovial fluid can be yellow?
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-Normal
-noninflammatory -inflammatory -crystal induced |
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What colors can inflammatory be?
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yellow or bloody
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what color is septic synovial fluid?
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green or white
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what color is hemorrhagic synovial fluid?
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red to brown to xanthochromic
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what color is a faulty tap synovial fluid?
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it has bloody streaks; heterogenous.
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What makes synovial fluid:
-clear -cloudy -milky |
Clear = normal
Cloudy = cells/bacteria/crystals Milky = cholesterol crystals |
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When does synovial fluid clot?
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when it is inflammatory
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What would you use to dilute synovial fluid for a wbc cnt?
Why? |
Saline or Phosphate buffer with hyaluronidase.
Because acetic acid disrupts the hyaluronic acid. |
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What three methods should be used to examine crystals?
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-Wright's stain
-Polarized microscopy -Compensated polarized microsc. |
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What is the function of a polarizer?
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Restricts the bending of light rays at 90" from their path of light source to one plane.
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Where does a polarizer go?
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between the light source and condensor
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where does the analyzer go?
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between the eyepiece and condensor.
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How do the polarizer and analyzer work together?
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1. When they are at 90' to each other, no light passes; dark field.
2. When crystals present, plane of vibration changes and light passes. |
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What is the function of a compensator?
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It retards red light and separates light into slow/fast vibration
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What 5 crystals can be found in synovial fluid?
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1. Monosodium Urate
2. Calcium Pyrophosphate 3. Hydroxyapatite 4. Cholesterol 5. Corticosteroid |
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What are the features of MSU crystals?
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-Needley
-Intra/extracellular Yellow when parallel to slow vibration. |
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What disease are MSU crystals associated with?
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GOUT.
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what disease are calcium pyrophosphate crystals associated with?
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PSEUDOGOUT
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What is pseudogout associated with?
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Degenerative arthritis
Endocrine disorders |
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What other tests are done for chemical analysis of synovial fluid?
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GLUCOSE - bacterial infection alters it.
Protein Lactic acid Uric acid Hyaluronate |
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What are the most common bacteria found in
-16-50 yr olds? -over 50 yr olds? |
Young: gonococcal arthritis
Old: Staph aureus arthritis |
