ALU book chapter 1 Flashcards
A procedure that uses high frequency sound waves to image soft tissue
Ultrasonography
What are invasive tests?
Techniques that involve the puncture or cutting of the skin, or entry into an orifice, for the purpose of introducing an instrument or catheter
What are the most common diagnostic imaging tests
X-rays, Ct, ultrasound, MRI, and radionuclide studies
A common imaging technique that uses a beam of radiation that is scatter or absorbed in differing amounts by different tissues.
x-ray
an imaging tool that allows the physician to view, in real time, moving parts of the body, such as barium moving through the intestine–it is used for both diagnosis and treatment
fluoroscopy
Name 3 contrast agents
barium, iodine, and gadolinium-based contrast
The use of small amounts of short-lived radioactive substance that is formulated to be absorbed by targeted tissues
nuclear medicine
a nuclear medicine that can be attached to a carrier substance that is injected intravenously, taken orally, or inhaled by the individual
radionuclide or radiopharmaceutical
What are the most common radionuclides?
radioactive iodine, technetium, thallium, gallium, and indium
What are nuclear studies most useful for
useful for imaging bone, for determination of thyroid and hepatobiliary function, and assess for coronary artery disease
A procedure that utilizes high-frequency sound waves to image soft tissue and procedure an image
ultrasonography
The types of waves for ultrasonography
scattered, refracted, and attenuated
On an ultra sound, how is an organ measured?
it is calculated by measuring the time it takes for the sound waved to travel to the transducer to the reflecting surface being studied and back to the transducer where they are amplified and displayed on a monitor
3 different tissues that reflect sound waves in varying degrees
hyperechoic tissues show white on the image, hypoechoic tissues show gray on the image, and anechoic being the total absence of reflected sound waves
Advantages of ultrasound over MRI and CT
- its ability to differentiate solid from fluid-filled structures
- lower cost
- portability
- accessibility
- no exposure to ionizing raditation
Limitations of ultrasonography
- the skill level of the ultrasonologist
- image resolution that is not as good as other techniques
- “noise” produced when US waves hit gas and bone
different ultrasound techniques
a-mode, b-mode, m-mode, grayscale, real-time, and doppler
allows scanning at a rate rapid enough to create a moving image of the heart, including the motion of the valves and walls
real-time ultrasound
What is a doppler ultrasound
used to measure the velocity and direction of blood flow within the heart and blood vessels by measuring change in pitch. It is useful in the valuation of venous insufficiency, blood clots, arterial occlusion, or stenosis
What is a duplex scan
using a combination of b-mode with the doppler ultrasound
What is computed tomography (CT)
created by passing a rotating beam of x-rays into the individual and obtaining thousands of point images at specific depths. It is compared to taking a loaf of sliced bread then examining it one slice at a time
Limitation of CT
exposes an individual to a significantly higher dose of iodizing radiation
What is an electronic-beam computed tomography (EBCT)
use electronic beam that allows such rapid acquisition of images that it can produce images of the coronary arteries despite the motion of the heart
What is a magnetic resonance imaging (MRI)
uses a magnetic field to induce changes in proton spin within tissues. Radioactive waves are emitted at specific frequencies that make atoms resonate and absorb the energy. The tissue them release a weak radio wave that can be measured by a scanner and amplifies
Who cannot have an MRI
Individuals with implanted metal, such as pacemakers, pin and plates, implanted defibrillators, cochlear implants, or artificial joints
When is an MRI preferred to a CT
when soft tissue resolution is needed
Why would contrast be helpful for an MRI
can be used to highlight vasculature, areas of inflammation, and tumors
What is a positron emission tomography (PET) scan
diagnostic images obtained from the decay of a positron emitting radionuclide agent. A donut-shaped machine records these energy emissions in in real time
What agent is used for PET scans
Fluorine-18 labeled deoxy glucose
What is a PET scan primarily used for?
used to evaluate pulmonary nodules to determine if they are metabolically active
used to evaluate lung cancer, colorectal cancer, esophageal cancer, head and neck cancer, lymphoma and melanoma
useful adjunct in diagnosis of Alzheimer’s, Parkinson’s, epilepsy, and hibernating myocardium
Limitations of PET scan
- cost
- accessibility
- the nature of the radionuclide agent
- the fact that elevated serum glucose or insulin levels can adversely affect the results
- limited sensitivity for defining tumors smaller then 10 mm
- the high degree of expertise required for proper interpretation
What is an imaging study used to visualize the major blood vessels in the body, including those of the heart, carotids, brain, kidneys, lungs and legs
traditional angiography
Why would contrast be used for an angiography?
allows identification of obstruction, aneurysms, arteriovenous malformations, pulmonary emboli, and deep vein thrombosis
Why are CTA and MRA are preferred to angiography?
less invasive, less risk, and produce reasonably accurate images
what allows the physician to investigate the body and inspect cavities or hallow organs
endoscopy
what is an invasive procedure that employs the optical qualities of fiberoptic technology and power lens system that allows light to travel and images to be transmitted through curved structures
endoscopy
Why does the endoscopic instrument have a port?
- installation of drugs, air, or fluid
- suction, irrigation and cauterization
- equipment needed to perform biopsies
Diagnostic test for acute head trauma
ct without contrast
diagnostic test for TIA
CT/CTA, MRI/MRA carotid ultrasound
diagnostic test for acute hemorrhage, acute hemorrhagic stroke
CT/CTA, MRO/MRA
diagnostic test for brain abscess
ct or mri with contrast
diagnostic test for sinus disease
ct, mri
diagnostic test for hydrocephalus
ct, mri, cisternography
diagnostic test for aneurysm, arteriovenous malformation
MR angiogram, CT angiogram
diagnostic testing for acute non-hemorrhagic stroke
ct/cta, mri/mra
diagnostic testing for tumor or metastasis
ct/mri
diagnostic testing for multiple sclerosis
mri
diagnostic testing for Alzheimer’s
MRI, PET/CT scan
The radiographic imaging of the subarachnoid spaces that contain spinal fluid. It is used to diagnose cerebral fluid problems
cisternography
What is a tilt table test?
a test used to evaluate syncope, particularly when cardiac testing and seizure evaluation have not provided a diagnosis
What is an electroencephalography?
measures and records the low voltage electrical activity produced by the brain. Electrodes are placed at defined points on the scalp and 16-20 electrode pairs are evaluated
What is an electromyography?
an invasive procedure that involves the insertion of a needle electrode into a muscle and the recording of electrical activity of muscle fibers individually and collectively
The measured electrical response of the brain to stimulation of specific sensory pathways. Wires are placed onto the scalp overlying areas to be stimulated and electrical impulses are recorded on a graph
Evoked potentials
used in the diagnosis of MS. They detect slowing of electrical conduction due to demyelination
Visual evoked potentials (VEPs)
an electrical response to a click or noise made in each ear. Helps in the diagnosis of deafness, particularly in infants, and the response is delayed in MS.
Brainstem auditory evoked response (BAER)
detects sequential activation of nerves along a pathway
Somatosensory evoked potentials (SSEPS)
a biopsy used for skin lesions that are considered suspicious for malignancy and to confirm a clinical diagnosis. Shave and punch biopsies remove small pieces of tissue.
Skin biopsy
What is a nailfold microscopy?
the use of an optical microscope to visualize, and a computer to quantify, changes in size, shape and number of capillaries.
What tests are used for testing of the eyes?
fluorescein angiography, Snellen test, tonometry, and Schirmer tear test
What is the test that involves the intravenous injection of fluorescein dye into an arm vein to image the retina and choroid vasculature of the eye? A special camera is used to take pictures before and after the dye is injected.
Fluorescein Angiography
What is the Snellen Test
it is a common test for visual acuity. It involves the reading of block letters of graduated sizes at a specific distance
A test that measures intraocular pressure.
tonometry
What is a Schirmer tear test?
It is used to determine if the eye is producing sufficient tears to keep it moist. A strip of filter paper is paced under the lower lid and the number of tears is absorbed over a five-minute period is measured
What tests are used for hormonal/glandular disorder?
Thyroid update and scans, fine needle aspirate, and parotid sialography
What are the 3 classifications of nodules found on a thyroid scan?
cold, functional, and hot
What is a procedure where a needle is inserted into the thyroid nodule and obtaining cells and/or fluid for pathological diagnosis?
fine needle aspirate (FNA)
What is a parotid dialogrpahy
used in the diagnosis and management of parotid lesions. It involves the injection of a contrast material into the parotid duct. Pa and lateral x-rays are performed.
What is a MIBG scan
useful for diagnosing pheochromocytoma and neuroblastomas. It involves the injection of MIGB and a specialist scanner is used.
diagnostic test for placement of tubes and in-dwelling lines
ultrasound, x-ray
diagnostic test for pneumonia, atelectasis
x-ray
diagnostic test for shortness of breath, asthma, COPD, interstitial lung disease, chronic cough
x-ray, pulmonary function test (PFTs), CT
diagnostic test for Bronchiectasis
x-ray, ct
diagnostic test for pneumothorax
x-ray, ct
diagnostic test for blebs and bullae
x-ray, ct
diagnostic test for foreign body, aspiration
x-ray, ct and bronchoscopy
diagnostic test for trauma
x-ray, ct
diagnostic test for asbestosis
x-ray, ct
diagnostic test for hemoptysis
x-ray, ct, bronchoscopy
diagnostic test for mediastinal mass
ct with contrast
diagnostic test for pulmonary nodules
ct, x-ray
diagnostic test for lung tumor
x-ray, ct, bronchoscopy
diagnostic test for localization of pleural effusion before thoacentisis
x-ray, ultrasound
diagnostic test for interstitial lung disease
ct, PFTs
diagnostic test for pulmonary embolus
CTA, V/Q scan
What is a laryngoscopy
a specialized instrument inserted through the nose or mouth to visualize the pharynx, larynx, and vocal cords. This is a way to get a biopsy.
Uses a fiberoptic endoscope to examine the structures in the chest between and in front of the lungs. It requires a small incision for insertion of the endoscope and is used when CT guided biopsy cannot be done.
mediastinoscopy
What is a transbronchial needle biopsy?
done during bronchoscopy for accessible lung lesions. allows the physician to remove foreign objects or provide laser and other treatments
What is a thoracentesis?
an invasive procedure performed when fluid accumulates between the visceral and parenteral pleura. a needle attached to a syringe is inserted into the pleural space to remove the fluid
What is a procedure that utilizes fluoroscopy and intravenous contrast injected into a catheter inserted into the femoral vein and guided into the pulmonary artery to visualize or to exclude pulmonary embolus, to identify vascular anomalies or to delineate vessels before surgery.
pulmonary angiogrpahy
what is oxygen saturation
it measures the percentage of red blood cells “saturated” with oxygen. It is measured with a pulse oximeter that is attached to the index finger and measures oxygen based on hwo red blood cells absorb and reflect light.
What are the measurements for the pulmonary function tests?
- forced vital capacity (FVC)
- forced expiratory volume at 1 second (FEV1)
- FEV1/FVC ratio
- diffusing capacity (DLCO)
What is the item that measures the maximum volume of air exhaled after deep inspiration
forced vital capacity (FVC)
Define pulmonary function tests
record the movement of air into and out of lungs and plot it against time.
What is the diffusing capacity (DLCO)?
a measure of the ability of inhaled carbon monoxide to move out of the lungs and into the blood. It gives important information about the gas exchanging capacity of the lungs
What is a polysomnography?
Aka sleep study–is used to confirm a diagnosis of obstructive sleep apnea hypopnea syndrome.
What is recorded during a sleep study?
- EEG to observe sleep stages
- electro-oculogram (EOG) to record eye movement
- respiratory effort
- airflow
- oxygen saturation
- electrocardiogram
- body position
- submental and anterior tibialis movements
- noises, including snoring
Information the sleep study provides
- total sleep time and efficiency
- the percentage of time in each sleep stage
- time it takes to get to sleep (sleep latency)
- arousals from sleep
- the number of obstructive apneas, hypopneas, and central apneas
What is the test that is used to diagnose TB?
purified protein derivative
What is sputum for analysis?
collected after a deep cough or suctioned from bronchial tubes and placed in a sterile container. It is observed for the presence of blood and color and is sent for culture.
What is a routine screening test for breast cancer?
mammography
What are the limitations of a mammogram?
dense breast tissue, implants, skill of the radiologist, and misses 10-20% of clinically palpable breast cancer
What are the biopsy techniques for breast cancer?
Fine needle aspirate, stereotactic biopsy, and open surgical biopsy/excisional biopsy
diagnostic test of most cardiac problems
chest x-ray, EKG, stress test, echocardiography
diagnostic test of left ventricular ejection fraction
echocardiography, myocardial perfusion imaging (MPI)
diagnostic test of congestive heart failure
chest x-ray, echocardiography
diagnostic test for thoracic aneurysm
CTA, echocardiography
diagnostic test for aortic aneurysm
CTA, ultrasound
diagnostic test for coronary artery ischemia
EKG, cardiac catheterization, MRA, CTA
diagnostic test for Arrhythmias
EKG, holter/event monitor, stress test, EP testing
diagnostic test for congenital heart disease
chest x-ray, echocardiography, cardiac catheterization
diagnostic test for endocarditis/pericarditis
echocardiography
diagnostic test for valvular disease
echocardiography
diagnostic test for PVD/ claudication
doppler ultrasonography, ankle-brachial index
diagnostic test for carotid bruit
doppler ultrasonography, CTA
diagnostic test for deep vein thrombosis
doppler venous ultrasonography
What is stress testing?
They are performed to test for coronary heart disease–uses exercise EKG testing
What is an echocardiograms?
a transducer send the sound waves across the chest wall.
What is a transesophageal echo (TEE)?
allows imaging of the heart in all planes without the interference of the chest wall. The transducer is positioned in the esophagus to allow better visualization.
a study that is done to assess significant arrhythmias
Electrophysiological (EP) mapping
What is a Holter monitor
an ambulatory electrocardiogram (EKG)
The leads are applied to the chest and continual or periodic EKGs are recorded for 24 hours or longer. An event monitor is used when patients can detect the onset of their symptoms. Clients keep a journal of what they are doing and the EKG results are compared to the journal
What is an endomyocardial biopsy?
a rare procedure done by catheterization of the right or left heart. An instrument is added tot he catheter that excises small samples of tissue, which are sent for pathology
What is the most common x-ray for the abdomen?
flat plate of the abdomen or KUB
3 types of radionuclide scans for the analysis of abdominal organs
gastric emptying, reflux testing and cholescintigraphy
Endoscopic exams for the diagnosis and treatment of the abdominal pathology
laparoscopy, gastroscopy, colonoscopy, endoscopic retrograde cholangiopancreatography (ERCP), and video capsule endoscopy
What is a laparoscopy
a small incision is made near the navel and carbon dioxide is pumped in to move the abdominal wall and separate the surrounding structures. The scope is then inserted and the structures of the abdomen can be examined.
What is a video capsule enoscopy
a wireless imaging device that is swallowed and sensors are placed at various points on the abdomen wall that receive jpeg images that are stored in a recorder for later viewing
What is the ERCP
A long endoscope that enters from the mouth into the stomach and duodenum. A tube is passed through the endoscope that allows for injection of dye into the binary ducts and pancreas.
procedure where a radiologist inserts a needle through the skin and liver into the hepatic duct and injecting dye. The biliary tree is then visualized by x-ray.
percutaneous transhepatic cholangiography
What is a peroral pneumocolon
an x-ray of the terminal ileum and right colon done by insufflating air through a small catheter inserted into the rectum just as orally ingested barium reaches the right colon.
What is the fecal occult blood (FOB)
Aka guaiac test
a screening test fone to detect blood in tool.
what are the ways to complete blood imaging
indium scan
bone marrow biopsy
aspiration
diagnostic test for calculus
KUB, CT
diagnostic test for hematuria
intravenous pyelogram (IVP), cystoscopy, CT
diagnostic test for renal trauma
CT with contrast
diagnostic test for hydronephrosis/obstruction
ultrasound, CT, IVP
diagnosis test for renal vein thrombosis
CTA, MRI
diagnosis test for probable cyst as incidental finding on IVP or CT
ultrasound
diagnostic test for probable mass found on IVP
CT, MRI
diagnostic test for polycystic kidney disease
CT, US
diagnostic test for bladder tumor
cystoscopy, CT with contrast
diagnostic test for renal artery stenosis
captopril renal scan, CTA, MRA
What is an intravenous pyelogram (IVP)
a contrast agent to provide detailed images of the collecting system, calyces, and renal pelvis of the kidneys, and images the ureters
What is a scan done to evaluate blood flow to the kidneys, to image the kidneys and to observe renal function
radionuclide renal scan
What is a cystoscopy
the insertion of a flexible cystoscope into the bladder to look for causes of bladder dysfunction or inflammatory or malignant causes of hematuria
diagnostic test for fracture, subluxation of the spine
x-ray, CT
diagnostic test for occult fracture
CT
diagnostic test for stress fracture, occult hip fracture
CT
diagnostic test for bone/mineral loss
DEXA scan
diagnostic test for metastases
x-ray, ct, bone scan,PET
diagnostic test for osteomyelitis
x-ray, ct bone scna, MRI
diagnostic test for back pain with radiculopathy, herniated disc
x-ray, mri, myelography, CT
diagnostic test for arthritis
x-ray
diagnostic test for spinal tumor
MRI
diagnostic test for shoulder pain
x-ray, MRI
diagnostic test for neurogenic claudication
MRI, CT
diagnostic test for temporal bone, cholesteatoma
CT
diagnostic test for myelopathy
MRI
diagnostic test for carpal tunnel syndrome
nerve conduction tests
what is a dual x-ray absorptiometry (DEXA) scan?
a painless screening test done to evaluate bone mass and monitor therapeutic intervention–it is reported as a T score
diagnostic test for pelvic or scrotal pain
ultrasound
diagnostic test for uterine fibroids
pelvic ultrasound
diagnostic test for cervical, uterine, ovarian cancer
ultrasound, CT, MRI
diagnostic test for follow up for abnormal pap smear
colposcopy
diagnostic test for abnormal uterine bleeding
ultrasound
diagnostic test for enometriosis
ultrasound, laparoscopy
diagnostic test for prostate
ultrasound
diagnostic test for testicular/scrotal masses
doppler ultrasound
diagnostic test for postvoid residual urine
catheter insertion after voiding, ultrasound
what is a hysterosonography?
an ultrasound done after saline is infused into the uterus via a catheter. The saline acts to distend the uterus and provide contrast to outline the uterus
involves the insertion of a small, lighted tube through the vagina and into the uterus to allow visualization of the uterine lining. Endometrial biopsy can be done during this procedure
hysteroscopy
What is a transrectal ultrasound?
a probe is inserted into the rectum
allows for measurement of prostate volume, detection of prostate masses, and to guide prostate biopsy
What is a uroflowmetry
the individual urinates into a special toilet equipped with an uroflow meter. It measures the flow or urine per second that is then graphed.
