Glossary of Synovial fluid

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What is synovial fluid, and what are its 3 functions?
-Clear, viscous fluid in joint space.
-nourish/remove debris from cartilage.
-Lubricate/cushion joints.
How would you describe synovial fluid re: its chem composition?
A dialysate of plasma
How does synovial fluid compare to plasma?
-Glu/uric acid levels similar.
-Protein is only 1/3
What substance makes synovial UNIQUE????
HYALURONATE - mucopolysaccharide that thickens the fluid.
What is normal synovial fluid?
Color: yellow/clear to sl cloudy
Cells: 0-200 WBC/uL; < 25% PMNs
Crystals: none
Glucose only 0-10 different from blood glucose.
What are 5 classifications of Synovial fluid?
What causes noninflammatory synovial fluid?
Degenerative Joint Disease
What are 4 types of Degenerative joint disease?
1. Osteoarthritis
2. Osteochondritis
3. Osteochondromatitis
4. Traumatic arthritis
What are 2 causes of inflammatory synovial fluid?
1. Immunologic (RA/SLE)
2. Crystal induced
What 3 things cause septic synovial fluid?
1. Bacteria
2. Fungi
3. Mycobacteria
What are 2 causes of hemorrhagic synovial fluid?
1. Traumatic arthritis
2. Coagulopathies
What is the collection procedure for synovial fluid?
1. Use sterile syringe
2. Dispense into tubes for Heme, Micro, Chemistry
3. Note viscosity
What types of tubes are used for synovial fluid?
Heme: Na heparin or EDTA
Micro: Sterile
Chemistry: plain
How is viscosity noted?
Normal = at least 4 cm long
Inflammatory = less than 4 cm
What is the normal color of synovial fluid?
What other types of synovial fluid can be yellow?
-crystal induced
What colors can inflammatory be?
yellow or bloody
what color is septic synovial fluid?
green or white
what color is hemorrhagic synovial fluid?
red to brown to xanthochromic
what color is a faulty tap synovial fluid?
it has bloody streaks; heterogenous.
What makes synovial fluid:
Clear = normal
Cloudy = cells/bacteria/crystals
Milky = cholesterol crystals
When does synovial fluid clot?
when it is inflammatory
What would you use to dilute synovial fluid for a wbc cnt?
Saline or Phosphate buffer with hyaluronidase.
Because acetic acid disrupts the hyaluronic acid.
What three methods should be used to examine crystals?
-Wright's stain
-Polarized microscopy
-Compensated polarized microsc.
What is the function of a polarizer?
Restricts the bending of light rays at 90" from their path of light source to one plane.
Where does a polarizer go?
between the light source and condensor
where does the analyzer go?
between the eyepiece and condensor.
How do the polarizer and analyzer work together?
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.
What is the function of a compensator?
It retards red light and separates light into slow/fast vibration
What 5 crystals can be found in synovial fluid?
1. Monosodium Urate
2. Calcium Pyrophosphate
3. Hydroxyapatite
4. Cholesterol
5. Corticosteroid
What are the features of MSU crystals?
Yellow when parallel to slow vibration.
What disease are MSU crystals associated with?
what disease are calcium pyrophosphate crystals associated with?
What is pseudogout associated with?
Degenerative arthritis
Endocrine disorders
What other tests are done for chemical analysis of synovial fluid?
GLUCOSE - bacterial infection alters it.
Lactic acid
Uric acid
What are the most common bacteria found in
-16-50 yr olds?
-over 50 yr olds?
Young: gonococcal arthritis
Old: Staph aureus arthritis

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