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MICROSCOPIC EXAMINATION OF SPUTUM.
Isaqova Nasiba Raxmatjonovna
Mamadjonova O’g’ilchaxon Xalimjon qizi
Fergana Medical Institute of Public Health
https://doi.org/10.5281/zenodo.12047327
Abstract.
Phlegm (sputum) is a pathological secretion released from the
respiratory tract by coughing. Examination of sputum helps to determine the
nature of the pathological process in the respiratory organs and its etiology.
Clinical examination of sputum includes examination, measurement of its
quantity, study of its physical and chemical composition, microscopic,
bacterioscopic and cytological examinations[1,2,3]. .Material collection rules:
after rinsing the mouth, it is taken in the morning into a dry glass jar or Petri
dish. Saprophytic flora increases in old sputum and destroys its shape elements.
If necessary, sputum is stored in a cold place, but not for more than 2-3 hours.
Sputum is always infected, so you should be careful when communicating with
it.
Key words:
Sputum, saprophytic flora, native preparation, epithelia,
Kurshman spirals, mycobacteria
INTRODUCTION
Microscopic examination of sputum. Technique of preparation of native
drug. Sputum is placed in a Petri dish and spread carefully with a spatula and
needle until a translucent layer remains. The translucent layer of sputum is
visible on white and black backgrounds, the difference in color, consistency,
shape The parts to be used are separated[4,5]. The found derivatives are
separated with a cutting characterizing instrument.
The separated material is transferred to the glass of the object, in which
the dense ones according to consistency are closer to the center of the
preparation, and the less dense ones are placed on the periphery. The material is
covered with glass. The drug is viewed in a small (objective x5, eyepiece x7)
volume for viewing Kurshman spirals and primary orientation, and in a large
volume for separating its shaped elements. Epithelium and other cell elements.
Flat epithelium is the epithelium of the mucous membrane of the oral cavity,
nasopharynx, larynx and vocal cords[6,7,8,9]. It consists of flat thin cells with a
small pycnotic nucleus and homogeneous cytoplasm. It can be determined in all
sputum samples.
There is no main diagnostic value.
Cylindrical or prismatic squamous epithelium can be of different shapes,
mainly poniform, less round, triangular, irregularly shaped, round or oval
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nucleus mainly eccentric, It is located closer to the basal part of the cell. When
the size of neutrophil granulocytes increases, they are rounded, sometimes
irregular in shape, with a granular cytoplasm and nucleus with a diameter of 10-
12 μm, consisting of several segments. It appears in various inflammatory
processes of respiratory organs.
Eosinophil granulocytes are found in sputum in the form of individual
cells, as well as groups and swarms. The cells are round, granular, of the same
size and shape. To clearly identify eosinophils, the blood smear is stained
according to Pappenheim (8-10 minutes). A large amount of eosinophils in
sputum in allergic conditions (bronchial asthma, eosinophilic bronchitis) in
helminthosis (pulmonary echinococcosis).
Erythrocytes in sputum are unchanged when lung tissue is damaged, in
pneumonia, lung infarction, etc[10,11]. Alveolar macrophages are large round-
shaped cells, 10 to 25 μm in size, derived from reticuloendothelial cells.
Elastic fibers are connective tissue elements that appear in sputum when
lung tissue is destroyed: pulmonary tuberculosis, cancer, abscess, gangrene and
echinococcosis. Coral fibers are elastic fibers coated with fatty acid salts. These
fibers are called sputum. detection in am indicates the presence of tuberculous
cavern[12,13,14]. Calcareous elastic fibers are rough, rod-like formations
saturated with calcium salts. Tuberculosis is detected in sputum when the focus
is broken.
Fibrin consists of parallel thin fibers arranged in a mesh. Fibrins are often
observed in sputum during inflammatory processes (fibrinous bronchitis,
tuberculosis, actinomycosis, croupous pneumonia).
Curshman spirals are mucus formations of various sizes. Kurshman's
spirals are composed of leukocytes and Sharko-Leyden crystals, which are
microscopic mucous spirals. Kurshman's spirals are often observed in bronchial
asthma and other pathological processes (various bronchitis, pneumonia,
abscess, lung cancer). Crystal derivatives[15]. Sharko-Leyden crystals of various
sizes are colorless, octahedral in shape, reminiscent of a compass arrow. These
crystals are characteristic of bronchial asthma, eosinophilic bronchitis, lung
damage by helminths. . These sharp-pointed rhomboid crystals are yellow in
color. In an abscess, it is sometimes found in sputum in lung gangrene.
Cholesterol crystals are colorless, rectangular in shape, formed as a result of the
breakdown of fat in closed spaces[16,17,18] (abscess, tuberculosis,
echinococcosis) Fatty acid crystals - occur as a result of sputum retention in
cavities (tuberculosis, abscess, bronchiectasis). Fungi, bacteria and parasites.
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Actinomycetes are macroscopically small, dense, yellow grains. A
structure with filaments radiating from the central set, with ends that are
widened like a flask.
When stained by the Gram method, the filaments are purple, and the
bumps are pink. Yeast fungi belonging to the genus Candida are budded cells and
pseudomycelial fibers with short buds[19,20]. They are found during long-term
treatment with antibiotics in very weak patients.
Echinococcus elements in the sputum of the lungs echinococcosis is
determined. During examination, small bubbles, parts of the bubble chitin layer,
as well as echinococcal hooks are detected[21].
Ascarid larvae, pneumocyst eggs, trichomonads can also be detected in the
sputum. Bacteria are detected in the stained smear: tuberculosis mycobacteria,
pneumococci, streptococci, staphylococci, Friedlander's diplobacilli.
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