Basic Diagnostics Method in Medicine

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Basic Diagnostic Methods in Medicine Ján Jakuš

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ClassificationA. Biochemical Methods-Blood tests, Enzyme tests, Mineral content tests, Test for evaluation of concentration - Na, K, Ca..., Glucose, Urea in blood plasma, in liquor or in urine.... B. Physical Methods 1. Mechanical : e.g. Ausculta-tion, Percussion, Palpation, Blood pressure (non-direct) method, Body temperature measurement.. 2. Electric: ECG, EEG, EMG, ENG, ERG, Audiometry, Blood pressure (direct method,) Blood flow, and Air flow tests, Chronaxi-metry ... 3. Electromechanical: Spiro-metry, Energymetry,Test for Sceletal muscle con-tractions, or the Evaluation of the lenght and muscle tonus

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4. Optic and Optoelectric methods: Light microscopy, Electron microscopy,Ophtalmoscopy, Otoscopy, Bronchoscopy, Fiber optics... 5. Ultrasound (Dopplers) methods:Blood flow test, Sonography, Echocardiography... 6. X- ray Imagine methods: Sciascopy, Sciagraphy, Classic Tomography, Computer Tomography (CT)... 7. Methods of Nuclear Medicine: Radioi-sotopes , Gammagraphy, Pozitron Emmision Tomography (PET).... 8. Magnetic Scanning Methods- Nuclear Magnetic Resonance Tomography (NMRT) 9. Combination of methods: AB and 1-8

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Mechanical MethodsPalpation- is a kind of an old, and subjective meth-od for evaluation of size and shape of organs within a body (e.g. liver, kidney, spleen, lymphatic glands, appendix bowel... Percussion- this old and subjective method- It looks for size and shape of organs and their boundaries (e.g. lungs, heart).Doctor uses his 3rd digit in order to strike the skin above the organ. As a result there are different kinds of sounds (tissue vibra-tions) Auscultation- old and subjective method looking for sounds and murmours determined by stethoscope Blood pressure and Temperature measurements(see practicals)

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Electrical Methods - ECG,EEG,EMG,ENG Electrocardiography (ECG)-method for record of heart electric signal from the surface of the skin. (For explanation of ECG curve and technique of re-cording see Practicals ) Electroencephalography (EEG)- a method for record of brain electric signal from the scalp.The point is evaluation both the frequency (f) and amplitude(A) of waves e.g. in Epilepsy. Waves or Rhythms: Alpha are recorded at rest with closed eylids with f = 8-13 Hz and A = 50 μV. Beta –when eyelids are open,f =15-20Hz, A = 5-10 μV Theta –pathology in adults,f = 4-7 Hz, A = 50 μV Delta- at REM Sleep f = 1- 4 Hz, A = 100 μV

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ElectrocardiographyECG leads Bipolar: Standard I.II.III, CR, Cl, CF Unipolar: VR,VL,VF, aVR, aVL, aVF, V1-V6) ECG curve

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Optic and Optoelectric MethodsLight Microscopy- uses visible light. Microscop consists of ocular, objective,condenser, lateral and angular drifts. Microscop increases the angle between two dots, thereby to percieve them as a two. Resolution :10-4-10-7 m (1/10 mm- 1/10 nm. Electron Microscopy- uses flow of electrons. Their source is „electron gun“., then they pass through very thin layer of explored tissue and finally reach the projective (instead of an ocular). Picture is displayed by videosystem on a screen of monitor. Resolution10-6 – 10-9m (from μm - to ηm) Fiber optics- consists of 130 cm long tube, with ca-nals: canal for image formation, canal for light, working canal, rinsing canal. Doctor looks through an ocular in order to see the image of failured organ (e.g. stomach ulcer, tumors, etc).

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Light Microscopes

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Electron Microscope

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Endoscopy and Fiber Optics

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Ultrasound - Dopplers methodsThe ultrasound (US) is a sound with f >20kHz (in medicine is used US with f= hundreds of MHz) Sources: piesoelectric crystals, generators of US Point: US targets body, one part of it is absorbed by tissues and another part is refracted back to the probe of the piesocrystal (Dopplers effect) Refracted part of US is named ECHOE. Rule: The higher is US frequency (MHz), the lower is its penetration, but better is a resolution of the organs and vice versa. ECHOES are detected by special sensors and processed and displayed on screen of black - white or colour monitors. US methods (Ultrasonography, Echocardiography, Angiography). US is harmless,safe and very useful non-invasive methods, used with advantage e.g.in pregnant women )

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Ultrasound methods

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Ultrasonography- detection of size and shape of foetus in uterus

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X-Ray Imaging methods: Sciascopy,Sciagraphy, Classical and Computer Tomography X-rays: kind of ionizing, non-visible radiation. It is danger for living body. Max. harmless exposure is 5 mSv/ year -adults Definition: is elmg. waving of photoelectrons (as a visible ligh), but with very short λ = 0.05 ηm Source: X-ray tube (diode with - Cathode and + Ano-de ). Electrons are emitted from Cathode and flight in vacuum targeting Anode. Thus, only 1-2% X- ra-ys is produced, 98% is taken away of diode as a heat. There are “hard“ and “soft“types of X-rays. The higher is an anodal voltage (50-150 kV) the har-der (more penetrable) is X-ray radiation and vice versa. X-ray photo is black-white.The bones and air have best contrast, soft tissues have worse or no contrast. The contrast matters must be injected

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X-Ray Tube (DIODE)- for details also look Nave and Nave

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Sciascopy, Sciagraphy, Comp. Tomography

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Classical Tomography Computer Tomogr.

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Computer Tomography scan (CT)

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CT scanning - tumor in lungs

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Nuclear Magnetic Resonancy Scanning (NMR) This method does use X-rays, but a magnetic energy obtained from vibration of protons placed within the core of the atoms (C,P,Ca, Na,K...) that compose a body.The interaction of both the low and high mag-netic fields are involved. Patient is putted into a tunel .Then - a low frequency magnetic field affects his body. In turn- the high freq. magnetic field is applied. Finally- both types of magnetic fields are suddenly switched off. Hence, protons obtain their original energy ( deexcitation) and the magnetic signal is emmited , and passes the body...the body structures are displayed on screen with very high resolution.

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NMRS

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Nuclear Magnetic Resonancy ScanningBenefits: non-invasive and safe method ( no x- ray radiation) short time for scan (10-20 minutes) high resolution of picture Obstacles: kind of an expensive test claustrophobia (a fear of patient inside a tunel) extreme noise (from coils) scan is not permitted in patients with metals inside the body (pacemakers, artifficial joints,etc.

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NMRS- device & equipment

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SEMINARNotice! For more details of this and another diagnostic methods look Nave & Nave, and/or WEB For seminars prepare a semestral papers (obligatory). Also a speech (not obligatory) with description of 1 of the Diagnostic or Therapeutic methods (Max. 7 minutes / 1 contribution) of Power point.

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Thanks for Your Attention !

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Last Updated: 8th March 2018

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