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Neuro Testing


Computed Tomography (CT Scan) *Efficiency = 1 ~X-Ray based (movable) ~Gathers visual 'slices' of the brain (tomas) ~Produces 3D images. X-rays through the body area being studied. Each rotation of scan provides a picture of a thin slice of the organ or area ~Used for all parts of the body
Magnetic Resonance Imaging (MRI) *Efficiency = 2 ~Uses magnetic radiology to image atoms of structures. Provides good contrast b/t soft tissues ~Extremely accurate disease detection. Ex: Brain trauma seen as bleeding & swelling. Also: Aneurysms, stroke, tumors, inflammation of brain & spine
Magnetic Resonance Angiography (MRA) *Efficiency = 3 ~To represent, describe, or 'paint' ~Atoms act like compasses exposed to a magnetic, radio signal turned on then off, which knocks out alignment ~Realignment emits High Resolution signals (white for blood flow images) ~HA, Brain Hemorrhage, etc
Functional Magnetic Resonance Imaging (fMRI) *Efficiency = 4 ~Measures brain activity by detecting changes in blood flow b/t oxygen-rich & oxygen-poor blood using Blood-Oxygen-Level-Dependent (BOLD) contrast ~Can produce activation maps & graphs showing areas of the brain involved in particular mental processes
Positron Emission Tomography (PET) (Radionuclide Imaging) *Efficiency = 6 ~Radioactive substance injected into blood & CT X-Ray used ~Measures decay pattern of gamma waves & lights up to O2/glucose levels (metabolism) by emissions from 2 gamma (better quality than SPECT, which uses 1) ~Primarily detects cancer
Single Photon Emission Computed Tomography (SPECT) (Radionuclide Imaging) *Efficiency = 5 ~Uses injection of a gamma-emitting radioisotope into bloodstream ~Uses gamma rays CT X-Ray to provide 3D cross-sectional slices ~ Uses only single photon ration, as opposed to simultaneous double like PET ~Primarily detects cancer
Magneto/encephalo/graphy (MEG) *Efficiency = 7 ~Maps brain activity of magnetic fields and electrical currents with magnetic meters ~Assesses both spatial and function of brain ~Tests cognitive function, determines various brain functions, localizes sz affected areas before brain surgery
EEG VS. MRI The first is usually more sensitive to focal pathology than the second.
Transcranial Doppler (TCD) ~Measures the velocity of blood flow through the brain's blood vessels ~Used to help in the diagnosis of emboli, stenosis, vasospasm from a subarachnoid hemorrhage ~Inexpensive
Cerebral Angiography ~Provides images of blood vessels in and around the brain, thereby allowing detection of abnormalities such as AVM and aneurysms ~A catheter is inserted into a large artery and threaded through the circulatory system to the carotid artery
Intracranial Pressure Monitoring ~Used in treating severe traumatic brain injury patients ~Invasive and uses various transducer systems (most used is insertion of a catheter into the cranium)
Evoked Potentials - What are Evoked Potentials? ~Used determine the amount of time it takes for the electrical signal to travel along the nerve to the brain ~Electrical activity is produced by stimulation of specific sensory nerve pathways
Evoked Potentials - Visual Evoked Potentials (VEP, VER): ~Requires observation of a flashing checkerboard pattern projected on a monitor ~Special eyeglasses are needed ~Children may need special goggles to help focus
Evoked Potentials - Auditory Evoked Potentials (AEP): ~Involves listening to clicking noises generated in a set of headphones ~Requires the application of a few electrodes to the scalp
Evoked Potentials - Median Nerve Sensory Evoked Potentials (MNSEP)(SSER): ~Requires stimulation of median nerve located near the wrist ~Requires application of electrodes on the scalp, neck, chest, and wrists ~Nerves of the arms and legs are stimulated by an electrical pulse
Evoked Potentials - Posterior Tibial Nerve Sensory Evoked Potentials (PTNSEP)(SSER): ~Requires stimulation of posterior tibial nerve located near ankle ~Requires application of electrodes on the scalp, back, hips, knees, and inner ankles ~Nerves of the arms and legs are stimulated by an electrical pulse
Evoked Potentials - Evoked Potential Back Averaging: ~Involves recording EEG and multiplying existing jerking movements (100-200) ~Requires the application of electrodes to the scalp and electrodes where the jerking movements occur
Evoked Potentials - Somatosensory Evoked Response (SSER) ~Nerves of the arms and legs are stimulated by an electrical pulse ~A mild electrical stimulus is applied through the electrodes ~Detects problems with the spinal cord as well as numbness and weakness of the extremities
Evoked Potentials - Brainstem Auditory Evoked Response (BAER): ~Can diagnose hearing ability and can indicate the presence of brain stem tumors and Multiple Sclerosis ~Electrodes are placed on the scalp and earlobes ~Auditory stimuli, such as clicking noises and tones, are delivered to one ear
Electromyogram (EMG) Measures the electrical activity of muscles at rest and during contraction.
Nerve Conduction Studies Measure how well and how fast the nerves can send electrical signals.
What does an EMG look for? ~Finds diseases that damage muscle tissue, nerves, or junctions between nerve and muscle ~These problems may include a herniated disc, Amyotrophic Lateral Sclerosis (ALS), or Myasthenia Gravis (MG), cause of weakness, paralysis, or muscle twitching
What does a Nerve Conduction Study look for? ~Finds damage to the PNS ~Includes all nerves leading away from CNS and the smaller nerves that branch out ~This test is often used to help find nerve problems such as Carpal Tunnel Syndrome or Guillain-Barré Syndrome
How is a Nerve Conduction Study done? ~Usually done with EMG ~A shock-emitting electrode placed directly over studied nerve ~A recording electrode is placed over muscles supplied by nerve ~Several brief electrical pulses are sent to nerve ~Brief burning, tingling, twitching
Neuro-Otological Help differentiate causes of impaired hearing.
Wada Test - 'Intracarotid Sodium Amobarbital Procedure' (ISAP) Used to establish cerebral language and memory representation of each hemisphere. Conducted with the pt awake. A barbiturate (usually sodium amobarbital) is introduced into arteries one hemisphere at a time to shut down language/memory in each hemisphere.
Fluoroscopy An imaging technique that uses X-rays to obtain real-time moving images of the internal structures of a pt. Consists of an X-ray source and fluorescent screen b/t a pt is placed. Modern technology allows the images to be recorded and played on a monitor.
Polysomnography (PSG) A multi-parametric test used in the study of sleep and as a diagnostic tool in sleep medicine.
Electronystagmogram (ENG) Measures normal EM and involuntary rapid EMs called nystagmus. Also checks the muscles that control EM and how well the eyes, inner ears, and brain help you keep your balance and position (such as when you change from lying down to standing).
What is an fMRI used for? The most basic use is spotting injured or diseased tissue. Can be used to monitor growth of brain tumors, determine brain functioning after a stroke or diagnosis of Alzheimer's disease and find out where in the brain seizures are originating.
What is an MRA used for? Can find problems with the blood vessels that may be causing reduced blood flow. Both the blood flow and the condition of the blood vessel walls can be seen. The test is often used to look at the blood vessels that go to the brain, kidneys, and legs.
What is a PET Scan used for? Create images which show where cells are particularly active in the body. It is most commonly used to diagnose cancer.
What is a SPECT Scan used for? Primarily used to view how blood flows through arteries and veins in the brain. It may be more sensitive to brain injury. The scanner can show a cross-section slice of the organ. This comes in handy for uses such as staging thyroid and other cancers.
What is a MEG used for? An imaging technique used to measure the magnetic fields produced by electrical activity in the brain, for research and clinical. Can assist surgeons in localizing epilepsy, sensory mapping, autism, and determining function of various parts of the brain.
What is a TCD used for? Can be used at bedside to assess the cerebral vasculature noninvasively. Useful for the evaluation of occlusive intracranial vascular lesions with many emerging indications in the management of ischemic stroke.
What is a Fluoroscopy used for? Used in many types of procedures, such as barium X-rays, cardiac catheterization, arthrography (joints), lumbar puncture, placement of intravenous (IV). Shows many body systems, including the skeletal, digestive, urinary, respiratory, and reproductive.
Created by: kmburg5840