Bài giảng Medical Assisting - Chapter 41: Assisting with Highly Specialized Examinations

ChapterPowerPoint® to accompany Second EditionRamutkowski  Booth  Pugh  Thompson  WhickerCopyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.Medical AssistingChapter 411Objectives:41-1 Briefly describe the medical specialties of allergy, cardiology, dermatology, endocrinology, gastroenterology, neurology, oncology, ophthalmology, orthopedics, otology, surgery, and urology. 41-2 Describe the types of examinations and diagnostic tests performed in each of these specialties and the medical assistant’s role in these examinations and tests.Assisting with Highly Specialized Examinations 2Objectives (cont.)41-3 Identify and describe the most common diseases and disorders seen in these medical specialties and typical treatments for them.41-4 Describe the medical assistant's duties in performing a scratch test.41-5 Describe the medical assistant’s role in assisting with a sigmoidoscopy.Assisting with Highly Specialized Examinations3Objectives (cont.) 41-6 Outline the medical assistant’s responsibilities in preparing the ophthalmoscope for use.41-7 Describe the medical assistant’s role in assisting with a needle biopsy.Assisting with Highly Specialized Examinations4Introduction You may be employed in a role to assist with specialized examinations.Many physicians choose to specialize within various fields You will be asked to assist with diagnostic testing and specialized examinations .5Specialty Examinations Physicians working in special areas that focus on one body system or even on a single type of disease or medical intervention.Be prepared to address concerns and questions from patients for the specialty of your employment.6AllergyAllergist specializes in diagnosing and treating allergies.Substances that cause allergic reactions are called allergens.Reaction may be local or may manifest themselves throughout the body. The most severe kind of allergic reaction is anaphylaxis which is life-threatening.7Allergy ExaminationInvolves a medical history and several diagnostic tests.You will need to understand the function of the immune system and how allergies are treated.Allergen avoidanceMedicationsDesensitization to a substance by means of injections.8Allergy TestingScratch test – tests the patient for specific allergiesIntradermal test – introduction of dilute solutions of allergens into the skin Patch test – placing a linen or paper patch on the skin and then dropping suspected allergenRadioallergosorbent test - RAST9CardiologyCardiologist - physician who specializes in heart disease and disorders.You must be familiar with the structure of the cardiovascular system and typical examination and measurements associated with it.Test performed include:ElectrocardiographyStress testingEchocardiography10Cardiology Examination Begins with blood pressure reading and evaluation of overall cardiac healthDiagnostic tests are used to reveal heart diseases and disorders. 11Cardiology Examination (cont.)Electrocardiogram (EKG or ECG) – provides a measurement of the electrical activity of the heart.Stress test – recording the EKG while the patient is exercising on a stationary bicycle or treadmill.Holter monitor – 24 hour recording of EKG 12Radiography TechniquesAngiography – X ray of blood vessels after the injection of contrast medium to evaluated function and structure of arteries.Echocardiography tests- uses sound waves to detect structural defects or fluid accumulations.Cardiac catheterization – catheter is inserted into a vein or artery of the arm or leg to the blood vessels of the heart to measure pressure of the heart’s chambers, and heart motions with the aid of fluoroscopy.13Dermatology Dermatologists diagnose and treat skin diseases and disorders. You must understand basic elements of the dermatologic exam and procedures. Assisting with positioning and draping during skin exams and taking skin scrapings or wound cultures may be your duties.14Dermatology ExaminationsWhole-body skin examination Top layer of the entire surface of the skinScalpGenital areaArea between toes 15Dermatologic Conditions and DisordersAcne vulgaris – inflammation of the oil glands of the skinContact dermatitis – inflammation caused by irritantsRingworm –fungal infection Moles – raised black or tan spots on the skinSkin cancer –Basal cell, squamous cell, and malignant melanomas.\Warts – skin tumors caused by viral skin infectionOther conditionsEczemaImpetigoPsoriasisScabies.16Apply Your KnowledgeWhich of the following is the most serious type of skin cancer? Can you name each type?17Apply Your KnowledgeWhich of the following is the most serious type of skin cancer? Can you name each type?Squamous Cell Malignant Melanoma Basal Cell 18EndocrinologyEndocrinologists treat diseases and disorders of the endocrine system.Hormonal imbalances can affect the basic process of growth, metabolism, and reproduction.You will assist with examinations as well as collect specimens for analysis.19Endocrine Examinations Thorough medical historyAssess the patient’s skin condition, weight and cardiac functioning for clues to illnessDiagnostic urine and blood tests to measure hormones are importantUltrasound, X-rays, and iodine scans are used to make diagnosis20Endocrine Disease and DisordersDiabetes mellitus – hyperglycemia or elevated level of glucose in the blood.Thyroid gland dysfunctionsHypothyroidism – low thyroidHyperthyroidism – high thyroidGoiter – enlarged thyroid glandCushing’s syndrome – overproduction of hormones in the adrenal cortex21GastroenterologyGastroenterologists diagnose and treat disorders of the entire gastrointestinal (GI) tract.You need to understand the basic elements of GI exam and procedures. You will show patients how to prepare for the exams and be prepared to answer patient questions.22Gastrointestinal ExaminationsGastric lavage – obtaining a sample of stomach content by inserting an orogastric tube.Endoscopy – scope used to visually inspect a canal or cavity of the body.Peroral endoscopy – viewing with a scope of the esophagus, stomach, and/or duodenum.Colonoscopy – use of scope introduced through the rectum to view large intestine.23Gastrointestinal Examinations (cont.)Proctoscopy – examines the lower rectum and anal canal.Sigmoidoscopy – only the sigmoid area is viewed with the scope.24GI Diagnostic TestingLab testsStomach contentsUrineFecesRadiologic examinationsCholecystography –gallbladder function test performed with X rayUltrasound – used for problems of gallbladder, pancreas, spleen, or liver25GI Diagnostic Testing (cont.)Barium swallow – detect abnormalities in the esophagus, stomach, and small intestineBarium enema – detect abnormalities of the large intestine26Gastrointestinal Diseases and DisordersLevel of discomfort may be misleading in relation to severity.Keep your notes accurate and complete when a patient reports GI symptoms.Note the level of patient’s pain.Have basic knowledge of diseases and disorders – See table 40-3.27NeurologyNeurologists diagnose and treat diseases and disorders of the central nervous system.Your duties include assisting with examination by readying equipment for use, positioning the patient, and handling the doctors tools and other items.You may be asked to perform parts of these examinations.28Neurological ExaminationThe neurologist evaluates Cognitive function (mental status)Cranial nervesMotor systemReflexes Sensory system29Diagnostic Tests Electroencephalography – records the electrical activity of the brainImaging procedures – angiograms, brain scans, CT, MRI, myelography, skull x-rays, and electromyography(PET) Positron emission tomography studies the blood flow and metabolic activity of the brain.30Neurological Diseases and Disorders TraumaParalysisAIDSMeningitisEncephalopathyPeripheral neuropathiesOther common diseases – see table 41-431Apply Your KnowledgeA patient has a seizure disorder and will be going for a EEG. He asks, “What is a EEG? What should I expect?” How should you answer this patient? 32Apply Your Knowledge -AnswerAn EEG records the electrical activity of your brain. They will place electrodes on your scalp and have you rest quietly or engage in other activities.A patient has a seizure disorder and will be going for a EEG. He asks, “What is a EEG? What should I expect?” How should you answer this patient? 33OncologyOncologist specializes in the detention and treatment of tumors and cancerous growths.A tumor is a lump of abnormal cells.You must be aware of various types of cancer. You will prepare patients for the side effects from cancer treatment and help patient deal with them. Metastasis is the transference of abnormal cells to body sites far removed from the original tumor.34Diagnostic TestingBlood specimensX-raysCT scanMRICEAUltrasoundbiopsy35Cancer TreatmentSurgery – removal of all or part of the tumorRadiation Therapy – uses radiation to kill or stop the growth of tumor cellsChemotherapy – uses anticancer drugs to kill malignant cells36OphthalmologyOphthalmologists treat the eyes and related tissues.You may perform some of the procedures that involve measuring various aspects and function of the eye such as visual acuity, color vision, and intraocular pressure.37Ophthalmic ExaminationsInspects the interior of the patient’s eyes, including the retina, optic nerve, blood vessels, and visual fields. Test for Glaucoma with the aid of a tonometer.Refraction exam38Eye Diseases and DisordersBlepharitis- chronic inflammation of the edges of the eyelidPtosis – drooping of the upper eyelidSty – infection of the eyelash follicleConjunctivitis – pinkeye39Eye Diseases and Disorders (cont.)Cataracts – cloudy areas in the lens of the eyeGlaucoma – fluid pressure builds up inside the eyeRetinal detachment – retina separates from the underlying choroid layer40OrthopedicsOrthopedics focuses on disorders, injuries, and disease of the muscular and skeletal system.You may perform some of the procedures that involve X rays, helping with casting, applying hot or cold treatments, and educating patients about therapy regimens.41Orthopedic ExaminationsAssesses the structure and function of the musculoskeletal system.You may have to help drape, position, or physically support the patient during the exam.42Orthopedic Diseases and DisordersBack painMuscle strainOsteoarthritisTumorsFractures43OtologyOtologist treats disease and disorders of the ears.You may assist with or perform auditory screening 44Common Diseases and Disorders of the EarCerumen impactionOtitis externa or mediaPruritusMastoiditisMeniere’s DiseaseTinnitusPresbycusis45SurgerySurgeons treat a variety of diseases and disorders by repairing wounds or diseased organs or removing diseased organs, limbs, or tissues.You should understand presurgical procedures, surgical assisting procedures, and post surgical care.46UrologyUrologist diagnose and treat disorders and diseases of the urinary system.You would assist with general exam; collection and processing of urine, blood, and other specimens; and participate in patient education.47Urologic ExaminationsUrine and blood tests, Semen analysis and smearsCystometryCystoscopyTesticular biopsy 48Urologic Diseases and Disorders CystitisEpididymitisHydroceleImpotenceKidney stoneProstatic hypertrophyProstate cancer49Apply Your KnowledgeWhat examination should be done by a 27-year-old male patient to detect cancer?50Apply Your Knowledge -AnswerTesticular Self-ExaminationWhat examination should be done by a 27-year-old male patient to detect cancer?51Summary Medical Assistant You will need to familiarize yourself with the anatomy and physiology relevant to the specialty in which you work. By working to understand the diseases and disorders, you will develop the ability to better educate patients and respond to their concerns.52End of ChapterEnd of Chapter53