Basic Diagnostic Methods in Medicine Ján Jakuš

Classification A. Biochemical Methods-Blood tests, Enzyme tests, Mineral content tests, Test for evaluation of concentration -Na, K, Ca..., Glucose, Urea, in blood plasma, in liquor or in urine.... B. Physical Methods 1. Mechanical : e.g. Ausculta- tion, Percussion, Palpation, Blood pressure (non- direct) method, Body temperature measurement.. 2. Electric: ECG, EEG, EMG, ENG, ERG, Audiometry, Blood pressure (direct method,) Blood flow, and Air flow tests, Chronaxi- metry Electromechanical: Spiro- metry, Energymetry,Test for sceletal muscle con- tractions, the lenght and tonus evaluation...

4. Optic and Optoelectric methods: Light microscopy, Electron microscopy,Ophtalmoscopy, Otoscopy, Bronchoscopy, Fiber optics Ultrasound (Dopplers) methods:Blood flow test, Sonography, Echocardiography X- ray Imagine methods: Sciascopy, Sciagraphy, Classic Tomography, Computer tomo- graphy (CT) Methods of Nuclear Medicine: Radioi- sotopes, Gammagraphy, Pozitron Emmision Tomography (PET) Magnetic scanning methods- Nuclear Magnetic Resonance Tomography (NMRT) 9. Combination of methods: AB and -8

Mechanical Methods Palpation- is a kind of an old, and subjective meth- od for evaluation of size and shape of organs within a body (e.g. liver, kidney, spleen, lymphatic glands, appendix bowel... Percussion- this old and subjective method- It looks for size and shape of organs and their boundaries (e.g. lungs, heart).Doctor uses his 3 rd digit in order to strike the skin above the organ. As a result are different kinds of sounds Auscultation- old and subjective method looking for sounds and murmours determined by stethoscope Blood pressure and Temperature measurements(see practicals)

Electrical Methods - ECG,EEG,EMG,ENG Electrocardiography (ECG)-method for record of heart electric signal from the surface of the skin. (For explanation of ECG curve and technique of re- cording see Practicals and Biophysical elixir) Electroencphalography (EEG)- a method for record - ing of brain electric signal from the scalp.The po- int is evaluation of frequency (f) and amplitude(A) of waves e.g. in Epilepsy. Waves or Rhythms: Alpha are recorded at rest with closed eylids with f = 8-13 Hz and A = 50 μV. Beta –when eyelids are open,f =15-20Hz, A = 5-10 μV Theta –pathology in adults,f = 4-7 Hz, A = 50 μV Delta- at REM Sleep f = 1- 4 Hz, A = 100 μV

Electrocardiography ECG leads Bipolar: I.II.III, CR, Cl, CF Unipolar: VR,VL,VF, aVR, aVL, aVF, V 1 -V 6 ) ECG curve ECG curve

Optic and Optoelectric Methods Light Microscopy- uses visible light. Microscop consists of ocular, objective,condenser, lateral and angular drift. Microscop increases the angle between two dots, thereby to percieve them as a two. Resolution : m (1/10 mm- 1/10 nm. Electron Microscopy- uses flow of electrons. Their source is „electron gun“., then pass through very thin layer of explored tissue and finally reach the projective. Picture is displayed on monitor. Reso- lution10 -6 – m (from μm to ηm) Fiber optics- consists of 130 cm long tube, with ca- nals: canal for image formation, canal for light,, working canal, rinsing canal.Doctor looks through an ocular in order to see the image of failured organ (e.g.stomach ulcer, tumors, etc).

Light Microscopes

Electron Microscope Electron Microscope

Fiber Optics

Ultrasound - Dopplers methods The ultrasound (US) is a sound with f >20kHz (MHz) Sources: piesoelectric crystals, generators of US Point: US targets body, one part of it is absorbed by tissues and another part is refracted back to the probe of of the piesocrystal (Dopplers effect) Refracted US is named ECHOE The higher is US frequency (Mhz), the lower is it penetration, but better is a resolution of the org- an and vice versa Rule: The higher is US frequency (Mhz), the lower is it penetration, but better is a resolution of the org- an and vice versa. ECHOES are detected by spe- cial sensors and processed and displayed on black - white or colour monitor. US methods (So- nography, Echocardiography, Angiography) US is harmless,safe and very useful non-invasive methods. (use in pregnant women )

Ultrasound methods