Basic Diagnostic Methods in Medicine Ján Jakuš Ján Jakuš.

Basic Diagnostic Methods in Basic Diagnostic Methods in MedicineMedicine

Ján JakušJán Jakuš

ClassificationClassificationA. 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

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

Mechanical Methods

Palpation- 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)

Electrical Methods - ECG,EEG,EMG,ENGElectrical 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 μVTheta –pathology in adults,f = 4-7 Hz, A = 50 μVDelta- at REM Sleep f = 1- 4 Hz, A = 100 μV

Electrocardiography

ECG leads ECG leads BipolarBipolar: Standard I.II.III, CR, Cl, CF : Standard I.II.III, CR, Cl, CF

UnipolarUnipolar: VR,VL,VF, aVR, aVL, aVF, V: VR,VL,VF, aVR, aVL, aVF, V11-V-V66))

ECG curveECG curve

Optic and Optoelectric MethodsOptic 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).

Light MicroscopesLight Microscopes

Electron MicroscopeElectron Microscope

Endoscopy and Fiber Optics

Ultrasound - Dopplers methodsUltrasound - 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 USPoint: 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 (MHzThe higher is US frequency (MHz)), the lower is , the lower is its penetration, but better is a resolution of the its penetration, but better is a resolution of the organs and vice versaorgans 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 )

Ultrasound methods

Ultrasonography-Ultrasonography- detection of size and shape of foetus in uterus

X-Ray Imaging methodsX-Ray Imaging methods:: Sciascopy,Sciagraphy, Sciascopy,Sciagraphy, Classical and Computer Tomography Classical and Computer Tomography

X-raysX-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

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

Sciascopy, Sciagraphy, Comp. TomographyTomography

Classical Tomography Computer Tomogr.Classical Tomography Computer Tomogr.

Computer Tomography scan (CTComputer Tomography scan (CT))

CT scanning - tumor in lungsCT scanning - tumor in lungs

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...of the atoms (C,P,Ca, Na,K...)) that compose a that compose a body.The interaction of both the body.The interaction of both the low and high mag-low and high mag-netic fields netic fields are involved.are involved.

Patient is putted into a tunel .Then - Patient is putted into a tunel .Then - a low frequency a low frequency magnetic fieldmagnetic field affects his body. In affects his body. In turn- the high turn- the high freq. magnetic fieldfreq. magnetic field is applied. Finally- both types of is applied. Finally- both types of magnetic fields are magnetic fields are suddenly switched off.suddenly switched off. Hence, Hence, protons obtain their original energy ( protons obtain their original energy ( deexcitation)deexcitation) and the magnetic signal is emmited , and passes and the magnetic signal is emmited , and passes the body...the body structures are displayed on the body...the body structures are displayed on screen with very high resolution.screen with very high resolution.

NMRSNMRS

Nuclear Magnetic Resonancy Nuclear Magnetic Resonancy ScanningScanning

Benefits:Benefits: non-invasive and safe methodnon-invasive and safe method ( no x- ( no x-

ray radiation)ray radiation) short time for scanshort time for scan (10-20 minutes (10-20 minutes)) high resolution of picturehigh resolution of picture

Obstacles: Obstacles: kind of an expensive test claustrophobia (a fear of patient (a fear of patient inside a tunelinside a tunel)) extreme noise (from coils)) scan is not permitted in patients with metals inside the body (pacemakers, (pacemakers, artifficial joints,etc.artifficial joints,etc.

NMRS- device NMRS- device && equipment equipment

SEMINAR

Notice!Notice!For more details of this and another For more details of this and another

diagnostic methods look diagnostic methods look Nave Nave && Nave, Nave, and/or WEBand/or WEB

For seminars prepare a semestral papers For seminars prepare a semestral papers (obligatory). Also a speech (not obligatory) (obligatory). Also a speech (not obligatory) with description of 1 of the Diagnostic or with description of 1 of the Diagnostic or Therapeutic methods (Max. 7 minutes / 1 Therapeutic methods (Max. 7 minutes / 1 contributioncontribution)) of Power point. of Power point.

Thanks for Your Attention !Thanks for Your Attention !