1 DIAGNOSTIC PROCEDURES ST 240

2 Etiology  The study of ALL factors that may be involved in the development of a disease

3 SOURCES OF PATIENT DATA  H & P  IMAGING  LAB FINDINGS  ELECTRODIAGNOSTIC STUDIES  ENDOSCOPIC  PULMONARY DX

4 HISTORY AND PHYSICAL  First step of Etiology  Medical, social, psychological, family  Physical examination – should include all body systems  Height, weight, temperature, pulse, respiration, blood pressure  All surgery patients must have an H&P in their records before taken into the O R

5 DIAGNOSTIC IMAGING  Radiography p. 372  Fluoroscopy p. 373  Angiography  Heart Catheterization  Cholangiography p. 376  Computed Axial Tomography ( CAT scan)  Magnetic Resonance Imaging ( MRI )  Ultrasonography  Doppler Ultrasonography  Isotope Scanning

6 Radiography  ID the location of abnormalities and F.B.  Locate retained sponges, sharps, or instruments  Discover fluid or air within the body  Verify the correct location for an operative procedure  Aid in bone reduction or prosthesis placement  Verify placement of indwelling catheters, tubes, and drains

7 ID the location of abnormalities and F.B.

8  Verify the correct location for an operative procedure

9 Aid in bone reduction or prosthesis placement  AP view  Lateral view

10 Verify placement of indwelling catheters, tubes, and drains

11 Locate retained sponges, sharps, or instruments

12 Discover fluid or air within the body

13 Mammography

14 Myelogram

15 Fluoroscopy

16 Cholangiogram

17 Angiogram – peripheral

18 Cardiac Catheterization

19 Computed Tomography (CT scan)

20 Magnetic Resonance Imaging (MRI)

21 Positron emission tomography

22 Ultrasonography

23 Doppler

24 Isotope scanning

25 Lab reports

26 H&H  Hemoglobin – protein-iron compound in the blood that carries oxygen to the cells from the lungs and carbon dioxide away from the cells to the lungs  Hematocrit – a measure of the packed cell volume of red cells

27 Hematological studies – Values p379 table 13-1  Hemoglobin - Male 13.5 to 18g/dL Female 11.5 to 15.5g/dL  Hematocrit – Male 40-52% Female 35-46%  Platelets – 130 to 400  WBC – 5,000 to 10,000  Coagulation – 5 to 15 minutes

28 Urinalysis -Values p 380 table 13-2  A clean-catch is used  Color – light straw to dark amber  pH – 4.5 to 8.0 (average 6)  Glucose – negative

29 Tissue specimens  Needle aspiration – needle and syringe  Incisional biopsy – partial of lesion  Excisional biopsy - entire tumor  Frozen Section – for immediate dx; no formalin  Permanent section – for final dx, 24 hrs; placed in formalin  Orientation and Margins are important

30 Bacteriologic tests  Culture and sensitivity – aerobic and anaerobic  Taken with cotton-tipped applicator  Special care should be used with the anaerobic culture  Taken under sterile conditions and before antibiotic therapy  Gram stain – a way to ID bacteria

31 Electrocardiography  Used to record and study the electrical activity of the heart  3 lead for typical surgeries; 5 lead for more extensive surgeries  Holter monitor is used to monitor a person’s heart for a 24 hour period

32 Electroencephalography  Used to record and study the electrical activity of the brain  Used during cranial, spinal, and vascular procedures for monitoring of neurological function  Can be used to determine the area of the brain affected by a tumor

33 Electromyography  Used to record and study the electrical activity of skeletal muscle

34 Pulmonary Diagnosis  Pulse oximetry – arterial saturation of hemoglobin with oxygen is measured by passing a light through the tissues  Capnography – used to estimate arterial levels of carbon dioxide (end- tidal CO 2 )  Spirometry – used to evaluate the patient’s respiratory status; lung capacity, resistance, and vent pressure

35 Plethysmography and Phleborheography  Used to record variations in the blood volume and variations of a body part or extremity  Can be used to diagnose DVT

36 ENDOSCOPY  Used for DX, BX, therapeutic purposes  Arthroscopy  Laparoscopy  Thoracoscopy  Bronchoscopy  Laryngoscopy  Colonoscopy

37 ENDOSCOPY cont.  Gastroscopy  Hysteroscopy  Sinusoscopy  Otoscopy  Cystoscopy – resectoscope  Choledochoscopy  Mediastinoscopy  Ureteroscopy  Angioscopy