Pleural, Pericardial, and Peritoneal Fluid Analysis

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1

serous membrane

covers lungs, heart, and abdominal organs (visceral membrane) and internal surfaces of body cavity wall (parietal membrane)

2

pleural

fluid of the lungs

3

pericardial

fluid of the heart

4

peritoneal

fluid of the abdominal organs

5

mesothelial cells

single layer covering the thin layer of connective tissue lining the cavities

6

permeability, hydrostatic pressure, oncotic pressure, and absorption by lymphatic system

four factors that control formation and absorption of fluid

7

oncotic pressure

colloid osmotic pressure that opposes ultrafiltration

8

hydrostatic pressure

forces plasma ultrafiltrate to form in cavity

9

permeability of capillary endothelium

regulates rate of ultrafiltrate formation and its protein composition; increase causes increased movement of protein

10

protein-rich fluid

causes further movement of fluid into cavity

11

effusion

accumulation of fluid in a body cavity indicating an abnormal or pathologic process

12

paracentesis

percutaneous puncture of a body cavity for aspiration of fluid

13

thoracentesis

to obtain pleural fluid

14

pericardiocentesis

for pericardial fluid

15

peritoneocentesis (abdominal paracentesis)

for peritoneal fluid

16

ascites

an effusion in peritoneal cavity

17

ascitic fluid

same as peritoneal fluid

18

blood sample

collected for comparison purposes against body fluid

19

transudate

results from systemic disease that causes an increase in hydrostatic pressure or a decrease in plasma oncotic pressure; noninflammatory; pleural and peritoneal

20

exudate

results from inflammatory processes that increase permeability of capillary endothelium or a decrease in absorption by lymphatic system; infections, neoplasm, trauma, inflammatory; pleural and peritoneal

21

transudates

clear, pale yellow; viscosity similar to serum; do not clot

22

exudates

usually cloudy; various colors: yellow, green, or pink to red, may have shimmer or sheen; can form clots

23

cloudy paracentesis fluid

large numbers of white blood cells, other cells, chyle, and/or lipids; milky after centrifugation indicates chyle

24

chylous effusions

caused by obstruction or damage to lymphatic system

25

pseudochylous effusions

chronic effusions can be differentiated by lipid content

26

chylous

high triglycerides and chylomicrons present

27

pseudochylous

low triglycerides and no chylomicrons

28

traumatic taps

RBC's decrease later in collection; small clots may form

29

hemorrhagic effusion

blood homogeneously distributed; no clotting

30

neutrophils

predominate in most exudates of pleural and peritoneal fluid

31

lymphocytes

predominate in pleural effusions from TB, neoplasms, and systemic diseases

32

congestive heart failure, hepatic cirrhosis, and nephrotic syndrome

conditions that cause increase in hydrostatic pressure and decreased oncotic pressure of pleural and peritoneal transudates

33

infection, tumors, systemic disease (SLE and RA), and GI disease

conditions that cause increased capillary permeability in pleural and peritoneal exudates

34

tumors, neoplasms, and trauma or surgery

conditions that cause decreased lymphatic absorption in pleural and peritoneal exudates

35

infections, cardiovascular disease, tumors/neoplasms, hemorrhage, and systemic disease (RA SLE)

conditions that cause increased capillary permeability due to changes in parietal membrane of pericardial fluid not categorized as transudates or exudates

36

chemistry tets

assist in differentiating fluid as transudate or exudate, which aids in establishing cause of fluid accumulation

37

total protein, pH, LD, CEA, glucose, lipids, and amylase

possible chemistry tests of body fluids

38

less than 0.5

fluid/serum protein ratio of transudate

39

greater than 0.5

fluid/serum protein ratio of exudate

40

less than 0.6

fluid/serum lactate dehydrogenase ratio of transudate

41

greater than 0.6

fluid/serum lactate dehydrogenase ratio of exudate

42

glucose

only low-fluid amount is significant

43

amylase

high pleural or peritoneal fluid amylase associates with pancreatitis, esophageal rupture, gastric duodenal perforation, and metastatic disease

44

lipids

use to identify chylous effusions

45

pH

abnormally low helps identify pleural exudates caused by pneumonia or lung abscess

46

carcinoembryonic antigen

a tumor marker