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Chap 18 cont 7

Arthrocentesis and bone marrow aspiration

what is arthrocentesis the aspiration of fluid from a joint
symptomes of arthrocentesis are fever of unknown origin, stiffness, limb lameness, leukocytosis, neutrophilia, malaise and anorexia
aspiration of the joint is contraindicated in patients with skin issues, trauma with hemorrhage from movement
materials needed for arthrocentesis sterile gloves, clippers, aseptic scrub, slides, syringes and needles
common sites for arthrocentesis are distal joints, including carpus, tarsus and stifle
for aspiration of the carpus hold the joint in flexion and use the medial radiocarpal joint to avoid cephalic vein
aspiration of the tarsus the jock is held in partial flexion at 90 degrees with the metatarsals and the tibia. the joint in approached medial or laterally
the stifle joint is aspirated in partially flexed during the procedure
normal synovial fluid contains a mixture of small and large mononuclear cells
elevations ted to occur with traumatized or degenerative joints, chronically inflamed joints and joints with osteochondrosis
Polymorphonuclear Neutrophils PMN's generally account for less than 10% of the nucleated cell count.
more severly inflammed joints will have a greater concentration of WBC's with a greater percentage of PMN's
Common sites for bone marrow aspiration are iliac wing, femur and humerus
Bone marrow aspiration is performed to evaluate the cells in the bone marrow
Indications of bone marrow aspiration patients with nonresponsive anemia, thrombocytopenia, neutropenia(w/o spesis), pancytopenia, leukemia, polycythemia and inappropriate RBC response, patients with lymphonma, multiple myeloma.
contraindications of bone marrow aspiration are as follows clotting factor abnormalities, severe thrombocytopenia
Complications of bone marrow aspiration include infection at the site of injection, damage to soft tissue structures, hematoma formation
Materials needed to perform a bone marrow aspiration are aspiration needle, scaple, steril gloves, 12 to 20 syringe, sterile drape, lidocaine, slides and collection tubes
what factors determine the site used age, size and conformation of the patient. Bone marrow of aged patients is less active in long bones than in flat bones
Iliac aspiration involves the patient in sternal or lateral recumbency
bone marrow is usually more viscous than blood and contains bony spicules, is a deeper red and contains fat globules
Humeral aspiration best site because of less tissue, fat and muscle overlying the bone
what is the positioning of the aspiration of the humerus the needle is placed perpendicular to the humeral shaft as the elbow is flexed. the shoulder is rotated externally
femoral aspiration is the same as aspiration from the ilium
femoral aspiration is acheieved by placing the patient is lateral recumbency, the needle is placed within the trochanteric fossa of the femur on the medial aspect of the greater trochanter of the proximal femur
fine needle aspiration is a quick procedure performed to acquire a sample of fluid or tissue cells from an accessible mass in the dermis, viscera or lymph node
FNA aid in the differentiation of inflammation and hyperplasia of the skin or other masses, neoplasia
Complications of FNA include minor hemotoma, tissue damage, and infection
Created by: tnewhouse