Body fluid analysis

1. Salale University
College of Health Sciences
Department of Adult health nursing
Seminar presentation on
Body Fluid Analysis and their importance
Presented by Group 3
Presented to Mr Dase A.
Fitche , Oromia, Ethiopia, 2023
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2. Participants
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SN Name ID
1 Mekonnen Urgessa 183/15
2 Mesfin Shifera 185/15
3 Mesfin Assefa 186/15
4 Yordanos Lamma 195/15

3. Course Outline
 Introduction
 CSF Fluid Analysis
 Synovial Fluid Analysis
 Amniotic fluid analysis
 Serous Fluid Analysis
 Semen Fluid Analysis
 Reference
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4. Course Objectives
 After completing the presentation, the audiences should
identify:-
 Type of body fluids and its analysis
 What is the clinical importance of its analysis
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5. Introduction
 Body fluids are one of the unique specimens received in
the lab that require multidisciplinary testing.
 The types of fluids most commonly examined are
cerebrospinal (CSF), serous (pleural, peritoneal and
pericardial), synovial, Semen and Amniotic.
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6. 1. Cerebrospinal Fluid Analysis
 Cerebrospinal fluid (CSF) bathes the brain and spinal
cord.
 CSF is produced primarily (70%) from secretions into the
four ventricles of the brain by the highly vascular choroid
plexus (vascular fringe–like folds in the pia mater).
 The formation of CSF can be described as a selective
secretion from plasma, not as an ultrafiltrate.
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7. Cerebrospinal Fluid Analysis…
 This is evidenced by higher CSF concentrations of some
solutes (e.G., Sodium, chloride, magnesium)
 Lower CSF concentrations of other solutes (e.G.,
Potassium, total calcium) compared with plasma.
 If simple ultrafiltration were responsible for csf
production, these solute concentration differences would
not exist.
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8. Specimen Collection
 Cerebrospinal fluid specimens are collected specifically
for the diagnosis or treatment of disease.
 Although the lumbar puncture principally used to obtain
CSF specimens is fairly routine, it involves significant
patient discomfort and can cause complications
 Therefore once a CSF specimen has been collected,
 it is imperative that it is properly labeled
 handled at the bedside and in the laboratory.
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9. Specimen Collection…
 As CSF is collected, it is dispensed into three (or more)
sequentially labeled sterile collection tubes.
 The first tube is used for chemical and immunologic
testing, because any minimal blood contamination
resulting from vessel injury during the initial tap normally
does not affect these results.
 The second tube is used for microbial testing.
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10. Specimen Collection…
 Third tube is reserved for the microscopic examination of
cellular components (i.E., Red and white blood cell
counts and cytologic studies).
 If only a small amount of csf is obtained and a single
collection tube must be used, the ordering physician
prioritizes the tests desired.
 With these low-volume specimens, the microbiology
laboratory receives the specimen first, to ensure
culturing of a sterile specimen.
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11. Specimen Collection…
 Cell counts, followed by chemical and immunologic
testing, should immediately follow the microbiological
examination.
 The examination and testing of CSF should take place
as soon as possible after collection.
 Delay in testing can cause inaccurate results, such as
falsely low cell counts caused by the lysis of white blood
cells or falsely high lactate levels caused by glycolysis.
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12. Specimen Collection….
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13. CSF Fluid Reference Range
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14. Clinical importance of analysis
Inflammation
Tumors
Barrier dysfunctions
Infection
Bleeding
Multiple sclerosis
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15. Clinical importance…
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17. Clinical importance of CSF analysis..
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18. 2. Synovial Fluid Analysis
 Synovial Fluid
 Is present in the skeleton where friction could develop
such as the joints, bursae, and tendon sheaths, viscous
synovial fluid is present.
 The resultant viscous fluid serves as a lubricant for the
joint;
 is the sole nutrient source for the metabolically active
articular cartilage, which lacks blood vessels, lymphatics,
and nerves.
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19. Synovial Fluid Analysis…
 The composition of synovial fluid is unique:
 Its glucose and uric acid concentrations are equivalent to
blood plasma levels
 its total protein and immunoglobulin concentrations can
vary from one-fourth to one-half those of plasma.
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20. Specimen Collection
 Synovial fluid is removed by arthrocentesis, which is the
percutaneous aspiration of fluid from a joint using aseptic
technique.
 The volume of synovial fluid in a joint varies with the size
of the joint cavity and is normally small—about 0.1 to 3.5
mL.
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21. Synovial Reference Range
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22. Classification based on Lab. exam
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23. Classification…
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24. Clinical importance Synovial…
 For diagnosis of arthritis and other joint diseases
 Laboratory examination enables classification of the
disease process into one of four principal categories:
 non inflammatory,
 inflammatory,
 septic, or
 hemorrhagic.
 These general classifications aid in differential diagnosis
of joint diseases.
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25. 3. Serous Fluid Analysis
• The lungs, heart, and abdominal organs are surrounded
by a thin, continuous, serous membrane, as well as by
the internal surfaces of the body cavity wall.
• A space or cavity filled with fluid lies between the
membrane that covers the organ (visceral membrane)
and the membrane that lines the body wall (parietal
membrane).
• Each cavity is separate and is named for the organ or
organs it encloses
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26. Serous Fluid Analysis…
 The lungs are individually surrounded by a pleural
cavity,
 the heart by the pericardial cavity, and
 the abdominal organs by the peritoneal cavity.
 The serous membranes that line these cavities consist of
a thin layer of connective tissue covered by a single
layer of flat mesothelial cells
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27. Specimen Collection
 The term paracentesis refers to the percutaneous
puncture of a body cavity for the aspiration of fluid.
 Thoracentesis, for example, refers to the surgical
puncture of the chest wall into the pleural cavity to collect
pleural fluid,
 Pericardiocentesis into the pericardial cavity, and
 peritoneocentesis (or abdominal paracentesis) into the
peritoneal cavity
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28. Specimen Collection…
 Collection of effusions from a body cavity is an invasive
surgical procedure performed by a physician using
sterile technique.
 Unlike cerebrospinal fluid and synovial fluid collections,
serous fluid collections from effusions in the pleural,
pericardial, and peritoneal cavities often yield large
volumes of fluid.
 Consequently, the amount of fluid obtained often
exceeds that needed for diagnostic testing.
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29. Specimen Collection…
 Normally, serous fluids do not contain blood or
fibrinogen,
 A traumatic puncture procedure, a hemorrhagic effusion,
or an active bleed (e.G., From a ruptured blood vessel)
 can result in serous fluid that appears bloody and clots
spontaneously.
 Therefore to prevent clot formation, which entraps cells
and microorganisms,
• sterile tubes coated with an anticoagulant such as
 sodium heparin or liquid ethylenediaminetetra acetic acid
(EDTA) are used to collect fluid specimens for the
microscopic examination and microbiological studies.
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30. Specimen Collection…
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31. Clinical Importance Serous analysis…
 An effusion, particularly in the pleural or peritoneal
cavity, is classified as a transudate or an exudate.
 Classifying an effusion as a transudate or exudate is
important because this information assists the physician
in identifying its cause.
 Transudates primarily result from a systemic disease that
causes
 an increase in hydrostatic pressure or
 a decrease in plasma oncotic pressure in the parietal
membrane capillaries
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32. Clinical Importance…
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33. Clinical Importance…
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34. 4. Seminal Fluid Analysis
Seminal fluid or semen is a complex body fluid used to
transport sperm or spermatozoa.
Prostatic fluid secretions account for approximately 25%
of the ejaculate volume.
Familiarity with the male reproductive tract
 its various functions facilitates understanding of the
physical, microscopic,
 biochemical abnormalities that can occur in semen.
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35. Seminal Fluid Analysis…
The principal components of this milky, slightly acidic fluid are
citric acid; enzymes, particularly acid phosphatase and
proteolytic enzymes; proteins; and zinc.
Semen is unique in its high concentration of the enzyme acid
phosphatase.
Hence acid phosphatase activity can be used to positively
identify the presence of this body fluid.
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36. Seminal Fluid Analysis…
Proteins and some enzymes in prostatic secretions play
a role in coagulation of the ejaculate, whereas the
proteolytic enzymes are responsible for its liquefaction.
Zinc is primarily added to semen by the prostate gland
however, the testes and sperm also contribute zinc.
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37. Specimen Collection
 Because seminal fluid can contain infectious agents
such as hepatitis virus, human immunodeficiency virus,
herpes virus, and others.
 The specimen should be fully ejaculated.
 Condom ejaculated doesn’t represent the sample,
because condom lubricant kill the cells in sperm.
 The specimen analyzed early as much as possible.
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38. Semen examination
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39. Clinical Importance
Semen zinc levels can be used to evaluate prostate
function; a decreased level is associated with prostate
gland disorders.
In summary, semen is a highly complex transport
medium for sperm.
The paired seminal vesicles and the single prostate
gland are the major fluid contributors to semen.
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40. Clinical Importance…
It is analyzed routinely to evaluate infertility and to follow
up after a vasectomy to ensure its effectiveness.
For the evaluation of semen quality for donation
purposes and forensic applications (e.g., DNA analysis,
detection of semen).
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41. 5. Amniotic Fluid Analysis
 Amniotic fluid is the liquid medium that bathes a fetus
throughout its gestation.
 The amnion, a membrane composed of a single layer of
cuboidal epithelial cells, surrounds the fetus and is filled
with this fluid.
 Amniotic fluid protects the fetus while enabling fetal
movement.
 plays an important role in numerous biochemical
processes.
 Fetal cells and many biochemical compounds, such as
electrolytes, nitrogenous compounds, proteins, enzymes,
lipids, and hormones, are present in the amniotic fluid.
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42. Amniotic Fluid Analysis…
 Volume
 The volume increases from approximately 25 to 50 mL at 12
weeks’ gestation to 800 to 1200 mL at 37 weeks’ gestation.
 Abnormally increased amounts of amniotic fluid (>1200 mL)
is polyhydramnios.
 Abnormally decreased amounts of amniotic fluid (<800 mL),
is oligohydramnios,
 occur with congenital malformations and PROM
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43. Physical Examination
 Color
 Normally, amniotic fluid is colorless or pale yellow
 Distinctive yellow or amber coloration is associated with the
presence of bilirubin;
 a green color indicates the presence of meconium
 Turbidity
 All amniotic fluid is turbid to some degree depending on the stage
of pregnancy.
 Early in pregnancy,the fluid is not very turbid.
 As pregnancy progresses, increased amounts of fetal cells, hair,
and vernix are sloughed and remain suspended in the amniotic
fluid.
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44. Indications for Amniocentesis
 Amniotic fluid is collected trans-abdominally or vaginally with
simultaneous ultrasonic examination.
 Use of real time ultrasonography allows the clinician to
 identify a maternal tapping site that will yield amniotic fluid
 avoid injury to the fetus or the placenta.
 Trans-abdominal amniocentesis is preferred because
vaginal amniocentesis is associated with an increased risk
of infection.
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45. Clinical Importance
 Because contamination of the fluid with vaginal cells and
bacteria.
 Typically, amniocentesis is performed after 14 weeks’
gestation;
 an amniocentesis to detect neural tube defects or
genetic abnormalities is usually performed at 15 to 18
weeks’ gestation.
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46. Clinical Importance…
 This allows sufficient time for the performance of
chromosomal and biochemical studies,
 which may include culturing of fetal cells, as well as time
for consideration of pregnancy termination if the fetus is
determined to be abnormal.
 Amniocentesis later in pregnancy is primarily used to
assess the pulmonary and overall health status of the
fetus.
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47. Clinical Importance…
 Tests can determine the maturity of the fetal pulmonary
system by analyzing surfactants in the amniotic fluid.
 attempts made to suppress premature labor.
 If results indicate an immature fetal pulmonary system,
 elective delivery can be postponed
 corticosteroids (betamethasone) that promote lung
development can be given.
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48. Clinical Importance…
 In late pregnancy, amniocentesis may be performed to
assess fetal status owing to toxemia, diabetes mellitus,
or isoimmunization by Rhesus (Rh) factor.
 At times, these conditions necessitate early termination
of a pregnancy and the delivery of a premature infant.
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49. Clinical Importance…
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50. Reference
Nanncy A, Brunzel, Fundamental of Urine and Body Fluid
analysis
Dr. mehrdad vanaki, Diagnostic Challenges in Body Fluid
Analysis
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51. 51
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