diagnostic imaging and physical therapy

diagnostic radiology used for…

• screening 

• clinical diagnosis

x-rays

• electromagnetic waves that travel at the speed of light and penetrate solid objects

• requires shielding with lead aprons

• quick, painless procedure

• radiation during pregnancy may lead to birth defects

what is the medical assistant’s role in diagnostic imaging?

• assist with procedures

• schedule appointments

• provide preparation instructions

• explain the procedure

• ask pertinent questions

  • medication history

  • women – possibility of pregnancy

• pre- and post-procedure care

• insurance verification

• pre-authorization from insurance companies

  • MRI, CT, PET scans typically require

KUB radiography

• x-ray of abdomen

• assesses the size, shape, and position of kidney, ureter, and bladder

mammography

x-ray exam of internal breast tissues

contrast medium

• aids in making structures lighter and brighter

• easier to visualize

what are the different types of contrast medium?

• iodine (patients can have allergic reaction)

• barium

• air/Gases 

• elements (metals)

how is contrast medium administered?

• orally

• injection

• intravenously

oral contrast agents

• can take a week to be excreted from the body

• will interfere with visualization testing

  • endoscopy studies will need to be delayed until the dye clears the body

IV contrast / iodine

• dye clears the body in 24 hours

• caution with impaired renal function patients

  • can cause reduction in kidney function to those with an already existing kidney problem

• need to ask patients about possible shellfish allergy

• injected into a blood vessel

  • can show inside of vessel and give information on surrounding organs

what are the adverse effects to contrast medium?

• oral agents

  • mild to severe

  • abdominal cramping, constipation, nausea, vomiting, diarrhea 

• iodine

  • check for allergy to iodine or shellfish

  • monitor patient for signs of allergy or anaphylaxis (a serious, life-threatening allergic reaction)

computed tomography (CT)

• diagnostic imaging procedure

• uses a combination of x-rays and computer technology to produce images of the inside of the body

magnetic resonance imaging (MRI)

• medical imaging technique

• uses a magnetic field and computer-generated radio waves to create detailed images of organs and tissues

CT and MRI can be ordered…

• with or without contrast

• check order!

• patient instructions needed

fluoroscopy

• x-ray with video

• shows movements inside the body over time

hysterosalpingography

examination of uterus and fallopian tubes

arthrography

• contrast medium

• used to diagnose abnormalities or injuries in joints, cartilage, tendons, or ligaments

angiography

• contrast medium

• assess arteries or veins

angiocardiography

• contrast medium

• images of medium flowing through the heart, lungs, and major vessels

myelography

• contrast medium

• used to evaluate spinal abnormalities

cholecystography

• oral contrast medium

• detect gallstones or abnormalities of the gallbladder

barium swallow

• upper GI series

• contrast medium – barium (oral)

• diagnose and evaluate obstructions, ulcers, polyps, diverticulosis, tumor or motility problems in the esophagus, stomach, duodenum, and small intestine

• indicated for dysphagia (difficulty swallowing) 

barium enema

• lower GI

• contrast media (barium and/or air)

• diagnose and evaluate obstructions, ulcers, polyps, diverticulosis, tumors, or motility problems of the colon or rectum

intravenous pyelography (IVP)

• contrast media

• shows contrast medium moving through kidneys, ureters, and bladder

• caution with decreased renal function

retrograde pyelography

• contrast medium

• contrast medium injected through a urethral catheter

• caution with decreased renal function

ultrasound

• uses sound waves to produce pictures of the inside of the body

  • helps diagnose

    • causes of pain, swelling and infection

    • heart conditions

    • examine an unborn child (fetus) in pregnant women

    • helps guide biopsies

• safe, noninvasive, and does not use radiation

• requires little to no special preparation

nuclear medicine

use of radionuclides (radioactive) to evaluate internal organs

SPECT

access brain damage after stroke

PET

detect early signs of cancer, heart disease and brain disorders

MUGA scan

used to evaluate the condition of the heart muscle

what is the medical assistant’s role in physical therapy and rehabilitation?

• apply cold and heat

• assist with ambulation

• teach basic exercises

• demonstrate how to use a cane, walker, crutches, or wheelchair

• discuss with the patient specific therapies for home use

• coordinate the patient’s schedule

• make referrals

• document treatments and findings

• answer the patient’s questions

physical therapy

• medical specialty treating

  • musculoskeletal disorders

  • nervous disorders

  • cardiopulmonary disorders

what are the benefits of physical therapy?

• restores and improves muscle function

• builds strength

• increases joint mobility

• relieves pain

• increases circulation

what is physical therapy used to treat?

• arthritis

• stroke

• lower back pain

• muscle spasms

• muscle injuries or diseases

• pressure sores

• skin disorders

• burns

joint mobility testing

range of motion (ROM) – degree to which a joint is able to move

muscle strength testing 

compares each side of body

gait - ambulation testing

• assessment of how a patient walks

• length of stride, balance, coordination

posture testing

• body position and alignment

• checks spinal curves

• symmetry of alignment

cryotherapy

• applying cold for therapeutic reasons

• types 

  • wet or dry

  • chemical or natural

• constricts blood vessels

• prevents swelling 

• controls bleeding

• anesthetic effect 

• reduces pus formation 

• lowers body temperature

thermotherapy

• applying heat for therapeutic reasons

• types 

  • dry

  • moist 

• dilates blood vessels – erythema

• relieves pain and congestion

• reduces muscle spasms

• relaxes muscles

• reduces inflammation and swelling

what are the factors affecting the use of cryotherapy and thermotherapy?

• therapy's purpose

• location and condition of affected area

• patient’s age and general health

what do you need to monitor when doing cryotherapy and thermotherapy?

• monitor patient for signs of tissue damage

  • be aware of contraindications

    • circulation or sensation impairment

    • temperature tolerance

    • elderly’s sensitivity to cold and heat

hydrotherapy

• use of water for soothing pains and treating certain medical conditions

• equipment:

  • pools, whirlpools, whirlpool spas, hot tubs, and physiotherapy tanks

• relaxes muscles 

• decreases pain

• increases circulation

exercise therapy

• primary treatment for some disorders and sports injuries

• used to increase:

  • flexibility

  • mobility

  • muscle tone

  • strength

mobility aids

• devices to improve patients’ ability to ambulate or move

  • DME (durable medical equipment)

    • canes, wheelchair, crutches, walker

    • requires a provider’s order

canes

• standard – provide small amount of support

• tripod and quad-base 

  • check for correct height

    • elbow bent 20-25 degrees

    • should not lean on cane for support

walkers

• used by patients who cannot walk unassisted

• have balance problems 

• provides a sense of stability

• adjust to proper height for patient

crutches

• transfers weight to the arms

• types 

  • axillary 

    • ground to axilla

    • short-term use

  • lofstrand, or canadian

    • ground to forearm

    • long-term use

which diagnostic procedure is an x-ray examination of the internal breast tissue?

• hysterosalpingography

• angiography

• mammogram

• PET scan

mammogram

which diagnostic procedure is an x-ray examination of the abdomen?

• hysterosalpingography

• angiography

• KUB radiography

• PET scan

KUB radiography

which is a radiologic procedure that uses a magnetic field and computer-generated radio waves to create detailed images of organs and tissues?

• ultrasound

• computed tomography (CT)

• x-ray

• magnetic resonance imaging (MRI)

magnetic resonance imaging (MRI)

which radiology test can diagnose motility problems in the esophagus, stomach, duodenum, and small intestine?

• barium enema

• hysterosalpingography

• arthrography

• barium swallow

barium swallow

which of the following statements is true about ultrasound?

• ultrasound uses radiation to produce images of the inside of the body

• ultrasound is invasive and requires extensive preparation

• ultrasound is commonly used to diagnose heart conditions

• ultrasound is not suitable for examining unborn children (fetuses) in pregnant women

ultrasound is commonly used to diagnose heart conditions

which is an assessment of how a patient walks, length of stride, balance, coordination?

• muscle strength

• gait

• posture

• range of motion

gait

when using cryotherapy on a patient what is the limit of time the application should be left on the patient?

• 10 minutes

• 20 minutes

• 30 minutes

• 1 hour

20 minutes

which physical therapy equipment uses water to soothe pains and treat medical conditions?

• fluoroscopy

• thermotherapy

• cryotherapy

• hydrotherapy

hydrotherapy

what does the abbreviation DME mean in relation to physical therapy?

• during medical exam

• durable medical equipment

• diagnostic medical exam

• diagnostic medical equipment

diagnostic medical equipment