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85 Cards in this Set

  • Front
  • Back
Effusion classifications
-(general contents)
-Pure transudate (low protein, low TNCC)
-Modified transudate
-Exudate, Septic (high protein, high TNCC, bacteria)
-Exudate, nonseptic (high protein, high TNCC, no bacteria)
Pleural & Peritoneal fluid formation in health
-formed by
-returned how
-formed by processes involving Starling's Law

-returned to blood via lymphatic vessels
Animals with enough pleural and peritoneal fluid in health to collect a sample
-horses
-cattle
Pleural & Peritoneal fluid composition in health
Plasma constituents (most)
-H2O
-Electrolytes
-"Other" solutes (glucose, urea, creatinine)

Proteins
-low [albumin]
-small proteins
Refractive index
-depends on
-# of particles/volume
-type of particles
Refractive index
-used to measure
-[TP]
-SGref
Refractive index of urine
-mostly determined by
-electrolytes
-urea
-creatinine
Refractive index of plasma
-mostly determined by
-electrolytes
-proteins
Effusion
-define
-accumulation of fluid in a body space or cavity

-rate of fluid formation >> rate of fluid removal
Ascites
-define
-accumulated fluid in a serous cavity (peritoneal)

-transudate, exudate, or "other" type
Transudation
-define
-passage of fluid or solute through a membrane due to changes in hydraulic or oncotic pressure gradients
Transudate
-define
-effusion produced by changes in mechanical factors
Hydrostatic pressure
-define
-energy/pressure of a fluid at rest

-pressure due to gravity
Hydraulic pressure
-define
-energy/pressure of a fluid in motion

-pressure due to pump (heart)
Exudation
-define
-the act of oozing out through pores
Exudate
-define
-an effusion produced by increasing permeability to plasma proteins because of inflammation
Hemorrhage
-define
-the escape of loss of blood from blood vessels/heart
Lymphorrhage
-define
-the escape or loss of lymph from lymph vessels
Starlings law
Net filtration = LpS [chg. hydraulic pressure - chg. oncotic pressure]

Net filtration = LpS [(Pcap - Pif) - s(Picap - Piif)]
Capillaries
-normally permeable to
-not permeable to
Permeable to:
-water
-electrolytes
-small solutes (urea, glucose water)

Not Permeable to:
-most protein (excpet for in the liver and lungs)
-blood cells
Osmolality
-define
-total solute concentration
2 major factors causing inc. fluid movement into extravascular space
-inc. hydraulic pressure
-dec. oncotic pressure gradient
Dec. change in oncotic pressure
-due to
-inc. in oncotic pressure of interstitial fluid from capillary permeability to proteins

-large dec. in plasma [TP] resulting in large dec. of capillary oncotic pressure with slight decrease in interstitial oncotic pressure
Reasons for a "safe zone" resulting in no fluid accumulation
-dec. [TP]plasma & dec. [TP]if --> no change in oncotic pressure

-inc. lymphatic drainage
Pathogeneses of cavitary effusions
-transudation
-exudation
-hemorrhage
-lymphorrhage
-rupture of hollow organ
-mixed
Transudate
-causes of formation
-inc. vascular hydraulic pressure --> congestion
-dec. plasma oncotic pressure ---> hypoproteinemia
-both

can't be due to hypoalbunemia by itself
Composition of transudates depends on
-permeability of capillaries to proteins
Protein poor transudate
-form where
-contents
Most tissue
-H2O
-electrolytes
-glucose
-urea
-...
Protein rich transudates
-form where
-contents
Liver
-same as protein poor transudate but with plasma proteins too
Protein Poor Transudate
-causes
-hepatic cirrhosis
-protein-losing nephropathy
-non-cirrhotic portal hypertension
Protein Poor Transudate
-what causes water to accumulate in cavities?
-inc. blood hydraulic pressure (Na+ & H2O retention)
-dec. plasma oncotic pressure (dec. [TP] & dec. [albumin]
Protein Poor Transudate
-what causes cells to accumulate in the effusion?
-they don't
Protein Poor Transudate
-what causes plasma proteins to enter effusion?
-they don't
Protein Rich Transudate
-causes
Congestive heart failure
-Right side -- >hepatic congestion --> hepatic sinuses permeable to protein
-Left side --> pulmonary congestion --> pulmonary capillaries slightly permeable to protein
Transudate formation due to liver congestion where
-protein poor
-protein rich
Poor:
-Presinusoidal: portal vein
-Sinusoidal: early in sinus

Rich
-Post-sinusoidal: central vein congestion, hepatic vein congestion
Protein rich transudate
-what causes the water to accumulate in cavities?
-inc. hydraulic pressure
Protein rich transudate
-what causes the cells to accumulate in the effusion?
-?????
-inflammation????
Protein rich transudate
-what causes the plasma proteins to enter the effusion?
-inc. hydraulic pressure in vessels permeable to plasma proteins
Exudate formation
-causes
-inc. vascular permeability to protein --> lower oncotic pressure gradient to bring fluid back in
Exudate
-fluid composition
-similar to plasma w/ concurrent migration of inflammatory cells
Exudate
-types
-infectious (septic)
-noninfectious (nonseptic)
Septic exudate
-causes
-Bacteria
-Viral
-Fungal
-Protozoan
-Parasitic
Nonseptic exudate
-causes
-Neoplasia, foreign body, necrotic tissue (spleen, pancrease)
-urine & bile
Exudate
-what causes water to accumulate in cavities?
-dec. oncotic pressure gradient from proteins leaking into interstitial fluid

-possible slight due to inc. in blood hydraulic pressure
Exudate
-what causes the cells to accumulate in the effusion?
-chemokines cause migration of cells to fluid (neuts, monocytes, others)
Exudates
-what causes the plasma proteins to enter the effusion?
-cytokines inc. vascular permeability to plasma proteins
Hemorrhagic effusions
-cause
-blood vessel damage
Hemorrhagic effusion
-composition
Initial:
-same as peripheral blood

Later:
-RBC resorption
-altered oncotic pressure gradient
Acute hemorrhagic effusion vs. Chronic hemorrhagic effusion
Acute
-mimics peripheral blood

Chronic
-fewer RBCs
-mild inflammation
-erythrophages, siderophages
Hemorrhagic Effusion
-causes of blood vessel damage
-trauma to blood vessels
-neoplasia
-hemostasis defects (warfarin)
Hemorrhagic effusion
-what causes the water to accumulate in cavities?
-H2O in blood

-possibly slightly due to dec. in oncotic pressure
Hemorrhagic effusion
-what causes the cells to accumulate in the effusion?
-cells in blood
-secondary inflammation
Hemorrhagic effusion
-what causes the plasma proteins to enter the effusion?
-plasma proteins in blood
Lymphatic effusion
-due to
-Lymphorrhage (vessel damage/trauma)
-Impaired lymph drainage
Lymphatic effusion
-composition of fluid
Thoracic duct (chylothorax):
-lymphocytes
-chylomicrons

Afferent vessels
-lymphocyte poor

Efferent vessels
-lymphocyte rich
Chylous effusions
-due to
leakage of lymph containing chylomicrons
-throacic duct damage (cardiac disease in Cats)
Nonchylous effusions
-due to
lymphatic obstruction
-lymphangiectasia
-LN disease
Lymphorrhagic effusions
-what causes the water to accumulate in cavities?
-H2O in lymph


-possibly slightly due to dec. oncotic pressure gradient
Lymphorrhagic effusions
-what causes the cells to accumulate in the effusion?
-lymphocyte-rich lymph
-secondary inflammation
Lymphorrhagic effusions
-what causes the proteins to enter the effusion?
-proteins in lymph (lipids--> inc. TP)
-secondary inflammation --> permeability
Fluids (w/ composition) that accumulate due to the rupture of hollow organs
-urine (composition + inflammatory change)
-bile (composition + inflammatory change)
-ingesta + inflammatory change
Uroperitoneum
-causes
-urinary bladder rupture
-damage to ureters or urethra
Bile leakage
-causes
-obstructed bile ducts
-neoplasia of bile ducts
-trauma to bile ducts
Leakage of gastric or intestinal contents
-causes
-de-vitalized tissues (vascular lesion)
-trauma (functure, FB)
-neoplasia
Neoplasia causing effusion from multiple processes
-necrosis --> inflammation --> exudate
-damaged vessels --> hemorrhage
-block lymphatic vessels --> lymphorrhage
Heart failure causing effusion from multiple processes
-protein-rich transudate --> inflammation --> exudate
Ruptured urinary bladder causing effusion from multiple processes
-uroperitoneum --> exudate
Effusion Tube to use for collection for possible culturing
-red top
Something to be aware of when collecting effusion sample in a tube for evaluation
-some tubes contain additive that falsely increase [TP]
Effusion tube to use to prevent fibrin clot formation
-Purple top --> EDTA
Effusion PCV
-measure when
-if collected effusion is pink to red
Effusion PCV
-interpretation
-compared to blood Hct
-indication of the amount of blood in the effusion
Effusion PCV
-considerations
-blood is resorbed
-bloody effusion diluted due to fluid shifts
Effusion PCV
-post centrifugation supernantant color
--colorless =
--red =
-colorless = fresh blood

-red = hemolyzed blood
Identify
Identify
-small lymphocytes
Identify
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-medium reactive lymphocytes
Identify
Identify
-mesothelial cells, sheet
Identify
Identify
-mesothelial cells, reactive
Identify
Identify
-macrophages
Identify
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-erythrophages
Identify
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-carcinoma cells (epithelial)
Identify
Identify
-squamous cells (epithelial)
Identify
Identify
-fungi
Identify
Identify
-bile pigment
Identify
Identify
-microfilaria