Faculty of allied medical sciences

1. Faculty of allied medical sciences Clinical chemistry (MLCC-203)

2. Pleural, Pericardial and Peritoneal Fluids. MLC-203 Dr. Eman El-Attar

3. Outcomes: By the end of this lectur the student will be able to: Types and examination of biological fluids.

4. Pleural, Pericardial and Peritoneal Fluids. Pleural, Pericardial and Peritoneal fluids , are fluids contained within closed cavities of the body. • The fluid fills the space between layers of cells to lubricate the surfaces as they move against each other , these fluids are an ultrafiltrate of the plasma formed by the membranes surrounding these cavities and then reabsorbed by lymph vessels Continuously thus the volume is very small. 1-Pleural fluid; Volume is about 1-10ml moistening the Pleural surfaces. 2-Pericardial fluid; it is the fluid that fills the space around the heart. Volume is 25-50ml . It has clear straw colored appearance. Abnormal accumulation fluid accumulation can inhibit heart action

5. Pleural, Pericardial and Peritoneal Fluids. • 3-Peritoneal fluid ; It is the fluid that fills the abdominal and pelvic cavities . Volume usually less than 100ml. Abnormal accumulation causes severe pain , and occurs in cases of ; • Hemorrhage. • Ruptured organ. • Post operative complications. • Fluid accumulation causes swelling and/or pain. Symptomatic treatment involves removal of fluid, by aspiration. When necessary, a portion of the fluid is submitted to the laboratory for analysis.

7. Analysis of Pleural, Pericardial and Peritoneal Fluids. • Accumulation of these fluids is called effusion which could be an accumulation of transudate or exudate fluid. • Transudate: A fluid that passes through a membrane which filters out much of the protein and cellular elements to yield a watery solution. A transudate is due to increased pressure in the veins and capillaries pressure forcing fluid through the vessel walls or low levels of protein the blood serum. It is a filtrate of blood. It accumulates in tissues outside the blood vessels and can cause edema (swelling). • Exudate: is a fluid rich in protein and cellular elements that oozes out of blood vessels due to inflammation and is deposited nearby. The altered permeability of blood vessels permits the passage of large molecules and solid matter through their walls.

8. Transudate vs Exudate

9. Analysis of Pleural, Pericardial and Peritoneal Fluids. Sample collection: Percardiocentis; is a procedure used to remove the pericardial fluid from the pericardial cavity. It is performed using a needle and under the guidance of an ultrasound.It can be used to relieve pressure from pericardial effusions or to diagnose the cause of abnormalities such as: Cancer, Cardiac perforation, Cardiac trauma, Congestive heart failure, Pericarditis .

10. Pleurocentesis

12. Paracentesis

14. Pericardiocentesis

15. Analysis of Pleural, Pericardial and Peritoneal Fluids. 1- Gross Examination; • Normal serous fluid has a clear straw colored appearance with low viscosity. Turbid (cloudy) fluid indicates a high leukocyte count and occurs in cases of infection. • Bloody fluid maybe a result of the collection procedure itself or bleeding caused by trauma or malignancy . 2-MicroscopicExamination; WBC and RBC counts are performed on an anti-coagulated undiluted specimen by a Hemacytometer. Normal WBC count < 500 / µL , a higher WBC count indicates infection or inflammation. Normal RBC count < 10,000/µL , a higher RBC count indicates hemorrhage.

16. Analysis of Pleural, Pericardial and Peritoneal Fluids. 3- Microbiological: The specimen is cultured for microganism investigation when infection is suspected. 4- Chemical analysis: -Protein examination to distinguish between transudate andexudate fluid. -Glucose estimation ; low levels is can indicate infection -LDH estimation ; high levels is can indicate malignancy.

17. Questions: Explain the different types of biological fluids.

18. Assignment: Write about an example of biological fluids By: Nadia dessouki Sabry El-Sayed

19. THANK YOU