1. Presented by Nasser Alatawi Saud Alqahtani Mazen almohammadi
SPUTUM
Presented by
Nasser Alatawi
Saud Alqahtani
Mazen almohammadi

2. Sputum
Sputum is a mucusey substance secreted into the airways of the respiratory tract. It can be coughed, spit out or swallowed.
produced by surface epithelial cells and sub-mucous glands.
It is a 5 µm thick that covers the airways and protects bronchial epithelium against inhaled noxious substances.

3. Sputum
Mucus is transported by the respiratory cilia towards the oropharynx.
Normally it is colorless, odorless .
overnight sputum is more viscose than day sputum.
Normal amount of secretion is 100ml per day.
Sputum production is increased by injury of the bronchial tree or lung parenchyma, caused by inhaled noxious substances or by inflammation.

4. Chemical composition 95% water 5 % organic components:
Carbohydrates ( such as sialic acid which contribute to its high viscosity)
Proteins ( enzymes, immunoglobulin) which also contributes to the viscosity of sputum.
Lipids
DNA from broken WBC
Macrophages
Bronchial epithelial cells

5. Clinical features Normal sputum is either white or colorless.
Yellow to green sputum (Purulent : increased WBC or abscesses fluid or fibers ) can be an indication of pus or infection such as pneumonia.
Blood in sputum is called hemoptysis which could be due to lung cancer, tuberculosis, lung abscess , hemorrhage.
Rust color is due to decomposed Hemoglobin.
Very thick (viscose) sputum is a characteristic of cystic fibrosis .
Ascaris can be seen in sputum (because of its life cycle).

6. Sputum VS Saliva Saliva Sputum Criteria colorless White/colorless
Less but can`t roll out
Densest
Density
Viscose
Appearance
More than 25/LPF
Less than 5/LPF
Many/LPF
(abundant/many)/HPF
Less than 25/LPF
More than 5/LPF
(None/few)/LPF
(Few/moderate)/HPF
Microscopy:
Epithelial cells
WBCs
Food particles
Bacteria

7. Collecting Sputum Samples

8. Smear preparation

9. Fix the smear by passing it through a Bunsen flame several times
Smear preparation
Fix the smear by passing it through a Bunsen flame several times

10. Sputum test
A sputum test can include a culture (gram stain) and / or a cytology test on a sample of sputum.
Stained by (cytology)
Hematoxylin stain
Leishman stain
Giemsa stain

11. Sputum test PMNs in a sample of sputum Sputum cytology ;
Examines a sample of sputum (mucus) under a microscope to determine whether abnormal cells are present , such as tumor cells.

12. Collecting Sputum Samples
Bronchoscope; . An instrument (bronchoscope) is inserted into the airways, usually through the nose or mouth, or occasionally through a tracheotomy. It can be used to collect samples of tissue or sputum for analysis.

13. Type of specimen few blood stained flecks Normal
saliva with a small amount of material
Normal
few blood stained flecks
heavily stained with blood

14. Report form Macroscopic Microscopic Report notes Volume Color
Viscosity
Microscopic
WBCs
RBCs
Epithelial cells
Blood
Any other abnormality
Report notes
Describe any abnormal result
Describe any conclusion and recommendation
For example
- Cystic fibrosis test indicated
- No abnormal findings seen