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Surg Tech Chapter 13
Diagnostic procedures
| Question | Answer |
|---|---|
| Important patient information. You should know these things about a patient: | -Medical -Social -Ethnic -Religion -Psychological -Patients family medical history |
| the study of all the factors that may be involved in the development of a disease | Etiology |
| indication of disease or condition perceived by the patient | Symptoms |
| indication of disease or condition perceived by the examiner | Signs |
| • H&P • Diagnostic Imaging • Laboratory Findings • Electrodiagnostic Studies • Endoscopic Studies • Pulmonary Diagnosis • Plethysmography and phleborheography? | Sources of patient data |
| measurement of changes in the volume of organs or other body parts, particularly those changes resulting from blood flow | Plethysmography |
| the radiographic examination of veins injected with a radiopaque contrast medium | Phleborheography |
| – Verify and identify signs of pathological conditions – Include all body systems – Height – Weight – Temperature – Pulse respiration – BP | H&P • Physical examination |
| Palpate | use the hands or fingers to examine |
| Auscultate | to listen and interpret sounds within the body |
| Techniques that produce images of the human body | Diagnostic Imaging |
| (radiography, roentgenography) | X-RAY |
| First observed and documented in 1895 – Wilhelm Conrad Roentgen – Discovered by accident | X-RAY |
| Radiography Uses | -Anesthesia: lung abnormalities -Required preoperatively –Abnormalities and foreign bodies –Retained sponges, sharps etc. –Fluid or air in body cavities – Bone alignment and prosthesis placement –Placement of indwelling catheters, tubes, and drains |
| an artificial device used to replace a body structure, aid bodily function, or give cosmetic appearance; may be permanent or removable | Prosthesis |
| a substance or item that remains in place either permanently or for a period of time | Indwelling |
| the insertion of an endoscope through the urethra and into the bladder for the purpose of viewing for treatment and diagnosis | Cystoscopy |
| • Anterior or posterior (AP) radiographic views require that the film be placed underneath the patient • Lateral views require placement next to the body – Presents problems in the O.R. – Protect the sterile field • Film must be processed | Portable X-ray machine |
| Mammography | Utilization of x-rays to locate tumors of the breast |
| an x-ray film of the soft tissues of the breast | Mammogram |
| first dedicated x-ray machine developed for breast imaging | 1960’s |
| Women age 40 and older should have a | screening mammogram every year, and should continue to do so for as long as they are in good health. |
| Women in their 20s and 30s should have a | clinical breast exam as part of a periodic health exam by a health professional, preferably every 3 years. After age 40, women should have a breast exam by a health professional every year. |
| (BSE) | Breast self-exam |
| a radiographic process by which the spinal cord and the spinal subarachnoid space are viewed and photographed after the induction of a contrast medium | Myelography |
| MRI has largely replaced this technique | Myelography |
| – Some patients not eligible for MRI (metallic implants) – Myelography clearly outlines bone tissue | remember that.. |
| Fluoroscopy | X-rays used to project images of body structures onto a monitor |
| Assess cause and severity of peripheral vascular disease | Angiography |
| The procedure is done to clear a major artery that may be blocked by plaque accumulation | Endartectomy |
| the reconstruction of blood vessels damaged by disease or injury | Angioplasty |
| any one of various surgical procedures to divert or shunt the flow of blood or other natural fluids from normal anatomic course. | Bypass grafting- |
| Embolectomy | a surgical incision in an artery for the removal of an embolus or clot |
| Videotape and subtraction of background allows visualization of most veins and arteries following the intravenous or intra-arterial injection of a contrast media | Angiography |
| Solution injected into arteries, veins, or ducts during a radiographic exam that is radiopaque and therefore stands out in contrast to the surrounding tissues – radiopaque: not permitting the passage of x-rays or other radiant energy | Contrast Media |
| Contrast Media: 3 Different Kinds | • Hypaque • Cystografin • Renografin • Remember contain iodine, sodium • In proper dosages they are safe – Unsafe in over dosages |
| • Evaluation of heart function • Visualization of coronary arteries and cardiac chambers – Especially the left ventricle • Measurement of pressures within the cardiac chambers • Diagnose coronary artery, valvular, pulmonary and congenital heart dis | Cardiac Catherization |
| PET SCAN | Positron Emission Tomography |
| A computerized radiographic technique that uses radiographic substances to examine the metabolic activity of various body structures | PET SCAN |
| MRI | Magnetic Resonance Imaging |
| High-frequency sound waves are directed into the body and reflected from the tissues to a recording device | Ultrasonography |
| • Noninvasive study that provides a twodimensional image of the heart • Ultrasonic waves • Transesophageal echocardiography (TEE) – Brings the probe closer to the heart | Echocardiography |
| (TEE) | Transesophageal echocardiography |
| • Ultrasonic waves • Measure the blood flow and transmits the sound of moving red blood cells • Used to determine patency of an arterial anastomsis – Probe may be covered with sterile drape or may be sterile | Doppler Ultrasonography |
| (UA) | Urinalysis |
| Voided specimen- | collected as the patient urinates into a clean container |
| Clean-catch sample- | involves cleaning the urinary meatus prior to voiding and catching the sample in midstream into a sterile container |
| Catheterized specimens- | obtained under sterile conditions |
| BIOPSY | – Excision of tissue (specimen) – Aspiration of fluid (specimen) – Used to determine the nature of a disease or for treatment of a condition |
| Specimens are sent to the : | Pathology department |
| Cytologic examination | study of cells |
| Histologic examination | study of tissue |
| All tissue and objects removed from a patient are considered specimens and sent to pathology for examination | sdf |
| Loss of specimen | – Second procedure – Delay postoperative treatment |
| Correct labeling | – Specimens must be correctly labeled • Identity of specimen • Origin of specimen • Orientation of specimen • Patient label |
| – Patient may be subjected to unnecessary surgery if... | Incorrect labeling |
| Foreign bodies | • Cared for according to health care facility policy • May have legal value |
| Specimen handling | - Containers need to be right size - pass specimen in proper manner - Place small specimens on telfa pad - Large specimens may be handed off in a container - Never use counted sponges - Circulator should wear gloves - Label container |
| If unable to hand of specimen right away: | – Place in safe location – Keep from drying out |
| Most common type of preservative is: | formalin |
| Fluid with cells can be smeared and fixed on a microscopic slide | Smear or Brush Biopsy |
| Removal of fluid through a needle attached to a syringe | Aspiration Biopsy |
| – Fluid taken from a cyst – Fluid from a joint – Fluid from a cavity – Solid lesion (breast, thyroid, or lymph node) – Cells are then examined | Aspiration Biopsy |
| • Removal of a portion of tissue mass or lesion for pathological study • Frozen sections (FS) • Permanent sections | Incisional Biopsy |
| – Must be sent to pathology dry – Preservative will dissolve the stones or permanently alter them | calculi (stones) |
| – Sent dry – Bagged and wrapped for transfer – Sometimes the limb must be returned for burial with patient | Amputated limbs |
| – Handle carefully • Do not use forceps or clamps – Could scratch the bullet – Handle with gloved hands | Bullets |
| Removed Prostheses | • Kept dry and sent to pathology |
| Tissue or fluid that is suspected of being infected may be cultured | Bacteriologic Tests |
| – Identification – Treatment – Called culture and sensitivity – Sterile cotton-tipped swabs – Aerobic – anaerobic | Bacteriologic Tests |
| • 1844 • Identifies bacteria • Exposed to crystal violet and iodine | Gram Stain |
| gram positive | Retain dye (purple): |
| gram negative | Fade (pink) |
| CSF | (cerebrospinal fluid) |
| – Drawn from the lumbar area of the spinal cord for analysis • Usually clear • Preliminary diagnosis can be made if the fluid is cloudy or bloody • Final diagnosis can be made after laboratory analysis | (cerebrospinal fluid) SPINAL TAP |
| Thoracentesis | Placement of a needle into the posterior portion of the pleural space for analysis of pleural effusion |
| Pleural effusion: | an abnormal accumulation of fluid in the intrapleural spaces of the lungs |
| ECG | Electrocardiography |
| Dysrhythmias | Abnormality in a normal rhythmic pattern |
| EEG | Electroencephalography |
| SEIZURE | a hyperexcitation of the neurons in the brain leading to a sudden, violent involuntary series of contractions of a group of muscles |
| EPILEPSY | a group of neurologic disorders characterized by recurrent episodes of convulsive seizures, sensory disturbances, abnormal behavior, loss of consciousness, or all of these. |
| EMG | Electromyography |
| The study and recording of the electrical activity of skeletal muscle • Muscles are electrically stimulated via a probe • Provides information about muscle contractility and innervation | EMG |
| Capnography | Estimates the arterial levels of carbon dioxide – Measures the amount of carbon dioxide that is exhaled |
| Spirometry | • Evaluates the patient’s respiratory status • Noninvasive • Detects: – Leaks in ventilatory system – Chronic obstructive pulmonary disease |
| chronic an irreversible condition characterized by diminished inspiratory and expiratory capacity of the lungs | COPD |
| ENDOSCOPY | Direct visualization of internal structures for diagnostic purposes – Preoperatively – intraoperatively |
Created by:
Dmercer