Diagnostic ProceduresANES 1502

Anesthesia Technology Fundamentals ICollege of DuPage

Sources of Patient Data▪ Obtained several ways

▪ History and physical examination

▪ Diagnostic imaging

▪ Laboratory findings

▪ Electrodiagnostic studies

▪ Endoscopic studies

▪ Pulmonary diagnosis

History and Physical Examination▪ First step in determining the etiology of a patient’s condition

▪ Gathering medical, social, and psychological information about the patient and, if applicable, the patient’s family

▪ Physical examination should be performed

▪ Symptoms and signs

▪ Several tools and methods are available

Diagnostic Imaging▪ Various techniques

▪ Now available for producing images of the human body

▪ Radiography (roentgenography)

▪ X-rays▪ Mammography

▪ Myelography

Diagnostic Imaging (cont’d)▪ Fluoroscopy

▪ Utilizes X-rays to project images of body structures onto a monitor

▪ Many intraoperative applications▪ Angiography and cholangiography

▪ Retrograde urography

▪ Aid in bone realignment and prosthesis placement

▪ Verification of catheter placement and lead introduction

▪ To direct instrumentation

Diagnostic imaging (cont’d)▪ Computed axial tomography (CT or CAT scan)

▪ Use of a specialized X-ray machine that produces pictures of a body part in “slices” for evaluation by a radiologist

▪ CT scanner is adjustable to make the slices as thick or thin as desired

Diagnostic Imaging (cont’d)▪ Positron emission tomography (PET scanning)

▪ Combines CT and radioisotope brain scanning

▪ Helps to identify how different areas of the brain function by highlighting chemical or metabolic activity

Diagnostic Imaging (cont’d)▪ Magnetic resonance imaging (MRI)

▪ Uses two different forms of energy▪ Spinning hydrogen atom is placed into a magnetic field, forcing the atoms to line

up and “spin”

▪ Applied radio waves force the hydrogen atoms to cycle in phase

▪ Atoms release a radio wave of the characteristic frequency that is measured and transformed into an image

▪ MRI uses these radio waves in a strong magnetic field to form pictures of parts of the body

Diagnostic Imaging (cont’d)▪ Ultrasonography

▪ High-frequency sound waves are directed into the body and reflected from the tissues to a recording device for diagnostic purposes

▪ Echocardiography

▪ Provides a two-dimensional image of the heart by directing beams of ultrasonic waves from a sonar-like device through the chest wall

Diagnostic Imaging (cont’d)▪ Doppler ultrasonography

▪ Doppler monitor measures blood flow that transmits the sound of moving red blood cells to the transducer

▪ Used in the OR to determine the patency of arterial anastomosis

Diagnostic Imaging (cont’d)▪ Isotope scanning

▪ Involves intravenous injection of a radioactive isotope into the patient prior to the imaging study

▪ Radiation therapy

▪ Use of radiation to kill cells by interfering with metabolic activity

Laboratory Reports▪ Laboratory or pathology department

▪ Responsible for countless types of examinations on every type of body fluid and tissue that exists

▪ Findings are extremely valuable in sorting out what may be normal for one patient and abnormal for another

Laboratory Reports (cont’d)▪ Important studies and tests

▪ Hematologic studies: See Module 14 Resources

▪ Urinalysis: See Module 14 Resources

Electrodiagnostic Studies▪ Body consists of cells that contain polarized molecules

▪ Communication systems of the body are bioelectrical or biochemical

▪ Microelectrical impulses can be measured and provide useful diagnostic information

Electrodiagnostic Studies (cont’d)▪ Electrocardiography

▪ Electrocardiogram (ECG) is a valuable tool for detection and evaluation of all forms of heart disease

▪ Electrocardiography is performed by placing a number of electrodes in predetermined locations on the skin of the arms, legs, and torso to record the electrical activity of the heart

Electrodiagnostic Studies (cont’d)▪ Electroencephalography (EEG)

▪ Display and recording of the electrical activity of the brain by measurement of changes in electric potentials

▪ Electromyography (EMG)

▪ Study and recording of the electrical activity of skeletal muscle

Pulmonary Diagnosis▪ Respiratory status and severity of pulmonary conditions is evaluated

in several ways

▪ Pulse oximetry: measures oxygen saturation in percentages

▪ Capnography: estimates arterial levels of carbon dioxide

▪ Spirometry: provides information about lung capacity, resistance, and ventilatory pressure

Endoscopy▪ Endoscopes

▪ Can be used preoperatively or intraoperatively to directly visualize internal structures for diagnostic purposes

▪ Refer to individual procedural chapters for specific endoscopic procedures

Plethysmography and Phleborheography▪ Plethysmography

▪ Useful in patients with diffuse small vessel arterial disease, especially diabetics

▪ Plethysmograph

▪ Instrument for determining and registering variations in the volume of an extremity and in the amount of blood present in the extremity or passing through it

Plethysmography and Phleborheography (cont’d.)▪ Phleborheography

▪ Plethysmographic technique

▪ Rhythmic changes in venous volume in the legs associated with respiration are recorded