neurological investigations Flashcards
why do physios need to know about neurological investigations?
-interpretation of diagnostic tests
-impact of diagnostic tests on patients ability to engage in physiotherapy Rx
-if wanting to go to a advanced practice role
what are skull xrays?
plain radiographs that provide information about bone, joint and limited soft tissue
-can be AP, lateral or PA
what can be an indication for a skull x-ray?
head trauma
however, limited use in detecting depressed or comminuted fractures
what is a CT scan?
an xray source rotated around patient
what could be indications for a CT brain, including advantages ?
-most efficient method of triage for acute trauma
advantages:
-fast and accurate at detecting acute haemorrhage
-excellent for assessing facial and skull fractures
-can visualise bleeding including extradural haematomas EDHs, subdural haematomas SDHs etc
what is a cerebral angiography?
a procedure that visualises blood vessels in the brain
- the pt is under local anaesthetic, a catheter is inserted into the femoral artery and manoeuvred up to the carotid or vertebral origin
what are indications for cerebral angiography?
-disorders of the cerebrovascular circulation
-aneurysm
-TIA
-vascular tumour etc
what is an MRI?
-magnetic resonance imaging
-unlike X-rays and CT’s- there is no radiation used
what is the important role of MRI
-MRI distinguishes the molecular composition of tissues , especially fat and water
-more sensitive in detecting soft tissue abnormalities compared to CT or xray
for what reasons can certain people not have MRI’s?
-ferrous metallic foreign bodies
-implanted electrical medical devices eg cochlear implant, pacemaker etc
-pregnancy
-claustrophobia
what is PET?
a type of imaging technique that allows doctors to observe the function and metabolism of organs and tissues in the body.
what is a lumbar puncture/ spinal tap?
medical procedure used to collect a sample of cerebrospinal fluid (CSF) from around the spinal cord.
what position is the pt in for a lumbar puncture, how many samples are needed and where is the needle inserted?
position: side lying, knees to chest
needle: into L4-L5 interspace
3 samples are needed
what are some precautions of a lumbar puncture?
-raised CSF
-tentorial herniation-coning (when tonsils of cerebellum are displaced through foramen magnum)
what is the role of lumbar punctures in diagnosis?
-meningitis
-encephalitis
-metastatic tumour (WCC’s)
-MS
what are examples of complications of a lumbar puncture?
-headache
-radicular pain
tonsils herniation
what is a muscle biopsy?
medical procedure in which a small sample of muscle tissue is removed for examination under a microscope
what conditions is muscle biopsy essential for diagnosing?
-inflammatory myopathies
-metabolic myopathies
what is electro-encephalography (EEG)?
a diagnostic test that measures the electrical activity of the brain
What are examples of some uses of an EEG?
-epilepsy
-states of altered consciousness
-parasomnias
-dementias
-cerebral infections
what is electromyography?
recording of electrical activity within a muscle
what does diagnostic EMG involve?
insertion of needles into muscle to record and observe motor action potentials
what kind of abnormalities could be seen on EMG?
-spontaneous activity at rest eg fibrillation
-abnormalities of recruitment
-abnormalities of motor unit potential
what are nerve conduction studies?
diagnostic tests that measure how well and how fast electrical signals travel through your nerves. This procedure helps doctors assess the function of the nerves, particularly in cases of suspected nerve damage or dysfunction
what factors can affect nerve conduction studies?
-age
-body temp
-pathology eg delay can occur with nerve entrapments etc
what are evoked responses?
electrical signals produced by the nervous system in response to a stimulus
what is electronystagmography?
It measures involuntary eye movements (called nystagmus) that occur when the inner ear or the brain is stimulated, typically by changes in head position or specific tests that affect the balance system.
