hsci unit 3: Diagnostic, Surgical, and Therapeutic Procedures

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arthrography

Series of radiographs taken after injection of contrast material into a joint cavity, especially the knee or shoulder, to outline the contour of the joint

bone density test (bone densitometry)

Noninvasive procedure that uses low-energy x-ray absorption to measure bone mineral density (BMD) and usually measures bones of the spine, hip, and forearm; also called dual-energy x-ray absorptiometry (DEXA)

discography

Radiological examination of the intervertebral disk structures with injection of a contrast medium

lumbosacral spinal radiography

Radiography of the five lumbar vertebrae and the fused sacral vertebrae, including anteroposterior, lateral, and oblique views of the lower spine

myelography

Radiography of the spinal cord after injection of a contrast medium to identify and study spinal distortions caused by tumors, cysts, herniated intervertebral disks, or other lesions

bone scintigraphy

Nuclear medicine procedure that involves intravenous injection of a radionuclide taken up into the bone

amputation

Partial or complete removal of an extremity as a result of disease, trauma, or a circulatory disorder

arthrocentesis

Puncture of a joint space using a needle to remove accumulated fluid or inject medications

arthroclasia

Surgical breaking of an ankylosed joint to provide movement

arthroscopy

Visual examination of the interior of a joint and its structures using a thin, flexible fiberoptic scope called an arthroscope (See Fig. 10-16.)

bone grafting

Implantation or transplantation of bone tissue from another part of the body or from another person to serve as replacement for damaged or missing bone tissue

bursectomy

Excision of a bursa (padlike sac or cavity found in connective tissue, usually in the vicinity of joints)

laminectomy

Excision of the posterior arch of a vertebra

sequestrectomy

Excision of a sequestrum (segment of necrosed bone)

total hip replacement (THR)

Surgical procedure to replace a hip joint damaged by a degenerative disease, commonly arthritis (See Fig. 10-17.)

bone immobilization

Procedure used to restrict movement, stabilize and protect a fracture, and facilitate the healing process

casting

Bone immobilization by application of a solid, stiff dressing formed with plaster of Paris or similar material

splinting

Bone immobilization by application of an orthopedic device to the injured body part

traction

Set of mechanisms for straightening broken bones or relieving pressure on the spine and skeletal system

electromyography (EMG)

Measures the contraction of muscles that control urination using electrodes placed in the rectum and urethra

cystoscopy (cysto)

Examination of the urinary bladder for evidence of pathology, to obtain biopsies of tumors or other growths, or to remove polyps

blood urea nitrogen (BUN)

Test that determines the amount of nitrogen in blood that comes from urea, a waste product of protein metabolism

culture and sensitivity (C&S)

Test that determines the causative organism of an infection and identifies how the organism responds to various antibiotics

bladder ultrasound

A noninvasive painless test that uses high-frequency soundwaves to produce images of the bladder before and after urination to check for urinary retention

intravenous pyelography (IVP)

Imaging of the urinary tract after IV injection of a contrast medium; also called excretory urography

renal nuclear scan

Nuclear imaging test using a radioactive substance (tracer) injected intravenously to produce images of the kidneys

voiding cystourethrography (VCUG)

X-ray of the bladder and urethra performed before, during, and after voiding using a contrast medium to enhance imaging

kidney transplant

Replacement of a diseased kidney with one that is supplied by a compatible donor (usually a family member or a cadaver who has donated the kidney before death)

nephrostomy

Opening created between the skin and kidney to drain urine through a tube to a collecting receptacle outside the body when the ureters are unable to do so

ureteral stent placement

Insertion of a thin, narrow tube into the ureter to prevent or treat obstruction of urine flow from the kidney

dialysis

Filtering procedure used to remove fluid and waste products from the blood and correct for electrolyte imbalances

hemodialysis

Dialysis in which an artificial kidney machine receives waste-filled blood, filters it using a solution called a dialysate, and then returns the dialyzed (clean) blood to the patient’s bloodstream (See Fig. 11-12.)

peritoneal dialysis

Dialysis in which toxic substances are removed from the body by using the peritoneal membrane as the filter by perfusing (flushing) the peritoneal cavity with a warm, sterile chemical solution

exophthalmometry

Measures the degree of forward displacement of the eyeball (exophthalmos) as seen in Graves disease

A1c test

Blood test used to diagnose and manage type 1 and type 2 diabetes; also called glycated hemoglobin, hemoglobin A1c, and HbA1c.

fasting blood sugar (FBS)

Test that measures glucose levels in a blood sample following a fast of at least 8 hours

glucose tolerance test (GTT)

Screening test in which a dose of glucose is administered and blood samples are taken at regular intervals following the dose to determine how quickly glucose is cleared from the blood

insulin tolerance test (ITT)

Diagnostic test in which insulin is injected into the vein, causing severe hypoglycemia to assess growth hormone (GH) and cortisol reserve

thyroid function test (TFT)

Test that detects an increase or decrease in thyroid function

total calcium test

Test that measures blood calcium levels to detect bone and parathyroid disorders, malabsorption, or an overactive thyroid

radioactive iodine uptake (RAIU) and scan

Nuclear imaging procedure that combines a thyroid scan with an RAIU procedure to evaluate the structure and physiological functioning of the thyroid gland

parathyroidectomy

Excision of one or more of the parathyroid glands, usually to control hyperparathyroidism

thyroidectomy

Excision of the entire thyroid gland (thyroidectomy), a part of it (subtotal thyroidectomy), or a single lobe (thyroid lobectomy)

transsphenoidal hypophysectomy

Endoscopic surgery to remove a pituitary tumor through an incision in the sphenoid sinus (transsphenoidal) without disturbing brain tissue (See Fig. 14-9.)

insulin injection therapy

Lifelong therapy using a fine needle and syringe to inject insulin for controlling type 1 diabetes

insulin pump therapy

Treatment for type 1 diabetes that uses a device that continuously delivers insulin through a catheter placed under the skin (See Fig. 14-10.)

amniocentesis

Transabdominal puncture of the amniotic sac under ultrasound guidance using a needle (with the needle’s position verified by US on a monitor screen) and syringe to remove amniotic fluid (See Fig. 12-8.)

chorionic villus sampling (CVS)

Sampling of placental tissues for prenatal diagnosis of potential genetic defects

colposcopy

Visual examination of the vagina and cervix with an optical magnifying instrument (colposcope)

cordocentesis

Diagnostic prenatal test in which a sample of the baby’s blood is removed from the umbilical cord for testing; also called percutaneous umbilical blood sampling (PUBS)

endometrial biopsy

Removal of a sample of uterine endometrium for microscopic study

insufflation

Delivery of pressurized air or gas into a cavity, chamber, or organ to allow visual examination, remove an obstruction, or apply medication

Papanicolaou (Pap) test

An exfoliative cytology test to detect abnormal cells that are scraped from the cervix, usually obtained during routine pelvic examination (See Fig. 12-9.)

pelvimetry

Measurement of pelvic dimensions to determine whether the head of the fetus will be able to pass through the bony pelvis to allow vaginal delivery

hysterosalpingography (HSG)

Radiography and, usually, fluoroscopy of the uterus and uterine tubes (oviducts) following injection of a contrast medium

mammography

Radiographic examination of the breast to screen for breast cancer

transvaginal ultrasonography (TVUS)

Ultrasonography of the pelvic area performed with a probe inserted into the vagina, which provides sharper images of pathological and normal structures within the pelvis

cerclage

Suturing of the cervix to prevent it from dilating prematurely during pregnancy, thus decreasing the chance of a spontaneous abortion or preterm birth

cesarean section (C-section)

Incision of the abdomen and uterus to remove the fetus; also called C-section

colpocleisis

Surgical closure of the vaginal canal

conization

Excision of a cone-shaped piece of tissue, such as mucosa of the cervix, for histological examination

cryosurgery

Process of freezing tissue to destroy cells; also called cryocautery

dilation and curettage (D&C)

Widening of the cervical canal with a dilator and scraping of the uterine endometrium with a curette

hysterectomy

Excision of the uterus (See Fig. 12-11.)

subtotal

Hysterectomy in which the cervix, ovaries, and fallopian tubes remain

total

Hysterectomy in which the cervix is removed but the ovaries and fallopian tubes remain; also called complete hysterectomy

total plus bilateral salpingo-oophorectomy

Total (complete) hysterectomy, including removal of the uterus, cervix, fallopian tubes, and ovaries

laparoscopy

Visual examination of the abdominal cavity with a laparoscope through one or more small incisions in the abdominal wall, usually at the umbilicus (See Fig. 12-12, page 418.)

lumpectomy

Excision of a small primary breast tumor (or “lump”) and some of the normal tissue that surrounds it (See Fig. 12-13.)

mammoplasty

Surgical reconstruction of the breast(s) to change the size, shape, or position

augmentation

Insertion of a breast prosthesis (filled with silicone gel or saline) beneath the skin or beneath the pectoralis major muscle

reduction

Breast reduction to reduce the size of a large, pendulous breast

mastectomy

Removal of the breast

total (simple) mastectomy

Excision of the entire breast, nipple, areola, and the involved overlying skin

modified radical mastectomy

Excision of the entire breast, including the lymph nodes in the underarm (axillary dissection) but with the chest muscles left intact (See Fig. 12-13B.)

radical

Excision of the entire breast, all underarm lymph nodes, and the chest wall muscles under the breast

reconstructive breast surgery

Creation of a breast-shaped mound to replace a breast that has been removed as a result of cancer or other disease

tissue (skin) expansion

Common breast reconstruction technique in which a balloon expander is inserted beneath the skin and chest muscle, saline solution is gradually injected to increase size, and the expander is then replaced with a more permanent implant (See Fig. 12-14, page 420.)

transverse rectus abdominis muscle (TRAM) flap

Surgical creation of a skin flap using skin and fat from the lower half of the abdomen, which is passed under the skin to the breast area; the abdominal tissue (flap) is then shaped into a natural-looking breast and sutured into place (See Fig. 12-15.)

tubal ligation

Procedure that ties (ligates) the fallopian tubes to prevent pregnancy

intrauterine device (IUD)

Small, T-shaped device inserted by a physician inside the uterus to prevent pregnancy

digital rectal examination (DRE)

Screening test in males that evaluates the size and consistency of the prostate (See Fig. 13-4.)

prostate-specific antigen (PSA)

Blood test used to detect prostatic disorders, especially prostate cancer; also called tumor marker test

semen analysis

Test that analyzes a semen sample for volume, sperm count, motility, and morphology to evaluate fertility or verify sterilization after a vasectomy

scrotal ultrasound (US)

Imaging procedure using sound waves to assess the contents of the scrotum, including the testicles, epididymis, and vas deferens; also called testicular ultrasound

transrectal ultrasound (TRUS) biopsy of the prostate

Imaging procedure using soundwaves emitted by a probe inserted through the rectum to serve as a guide for biopsy of the prostate when PSA and DRE are abnormal (See Fig. 13-5.)

circumcision

Removal of the foreskin, or fold of skin covering the tip (glans) of the penis

orchiopexy

Fixation of the testes in the scrotum

prostatectomy

Removal of all or part of the prostate

transurethral resection of the prostate (TURP)

Excision of prostate tissue by inserting a special endoscope (resectoscope) through the urethra and into the bladder to remove small pieces of tissue from the prostate gland (See Fig. 13-6.)

urethroplasty

Reconstruction of the urethra to relieve stricture or narrowing

vasectomy

Removal of all or a segment of the vas deferens for male sterilization

brachytherapy of the prostate

Radiation oncology procedure where radioactive “seeds” are placed directly within or near a tumor in the prostate to destroy malignant cells (See Fig. 13-8.)

cryotherapy of the prostate

Freezing of the prostate, causing cancer cells to die (See Fig. 13-9.)

external beam radiation therapy (EBRT)

Procedure in which the patient is positioned at a distance from the radiation source, which is then directed at the prostate; also called external beam radiation (EBT) or teletherapy