Download Assisting with Highly Specialized Examinations

PowerPoint® to accompany
Medical Assisting
Chapter 41
Second Edition
Ramutkowski  Booth  Pugh  Thompson  Whicker
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1
Assisting with Highly Specialized
Examinations
Objectives:
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.
2
Assisting with Highly Specialized
Examinations
Objectives (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.
3
Assisting with Highly Specialized
Examinations
Objectives (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.
4
Introduction

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 .
5
Specialty 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.
6
Allergy

Allergist specializes
in diagnosing and
treating allergies.
The most severe kind
of allergic reaction is
anaphylaxis which is
life-threatening.


Substances that cause
allergic reactions are
called allergens.
Reaction may be local
or may manifest
themselves throughout
the body.
7
Allergy Examination


Involves a medical history and several
diagnostic tests.
You will need to understand the function of
the immune system and how allergies are
treated.



Allergen avoidance
Medications
Desensitization to a substance by means of
injections.
8
Allergy Testing
 Scratch test – tests the patient for
specific allergies
 Intradermal 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 allergen
 Radioallergosorbent test RAST
9
Cardiology



Cardiologist - 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:



Electrocardiography
Stress testing
Echocardiography
10
Cardiology Examination
 Begins with blood
pressure reading and
evaluation of overall
cardiac health
 Diagnostic tests are
used to reveal heart
diseases and disorders.
11
Cardiology 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
12
Radiography Techniques
Angiography – 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.
13
Dermatology
 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.
14
Dermatology Examinations

Whole-body skin
examination




Top layer of the entire
surface of the skin
Scalp
Genital area
Area between toes
15
Dermatologic Conditions and
Disorders




Acne vulgaris –
inflammation of the oil
glands of the skin
Contact dermatitis –
inflammation caused
by irritants
Ringworm –fungal
infection
Moles – raised black or
tan spots on the skin



Skin cancer –Basal
cell, squamous cell,
and malignant
melanomas.\
Warts – skin tumors
caused by viral skin
infection
Other conditions




Eczema
Impetigo
Psoriasis
Scabies.
16
Apply Your Knowledge
Which of the following is the most serious
type of skin cancer? Can you name each
type?
17
Apply Your Knowledge
Which of the following is the most serious
type of skin cancer? Can you name each
type?
Squamous Cell
Malignant Melanoma
Basal Cell
18
Endocrinology



Endocrinologists 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.
19
Endocrine Examinations




Thorough medical history
Assess the patient’s skin condition, weight
and cardiac functioning for clues to illness
Diagnostic urine and blood tests to measure
hormones are important
Ultrasound, X-rays, and iodine scans are used
to make diagnosis
20
Endocrine Disease and Disorders


Diabetes mellitus – hyperglycemia or
elevated level of glucose in the blood.
Thyroid gland dysfunctions




Hypothyroidism – low thyroid
Hyperthyroidism – high thyroid
Goiter – enlarged thyroid gland
Cushing’s syndrome – overproduction of
hormones in the adrenal cortex
21
Gastroenterology



Gastroenterologists 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.
22
Gastrointestinal Examinations




Gastric 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.
23
Gastrointestinal Examinations
(cont.)


Proctoscopy – examines the lower rectum
and anal canal.
Sigmoidoscopy – only the sigmoid area is
viewed with the scope.
24
GI Diagnostic Testing

Lab tests




Stomach contents
Urine
Feces
Radiologic examinations


Cholecystography –gallbladder function test
performed with X ray
Ultrasound – used for problems of gallbladder,
pancreas, spleen, or liver
25
GI Diagnostic Testing (cont.)


Barium swallow –
detect abnormalities in
the esophagus,
stomach, and small
intestine
Barium enema –
detect abnormalities of
the large intestine
26
Gastrointestinal Diseases and
Disorders




Level 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.
27
Neurology



Neurologists 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.
28
Neurological Examination
The neurologist evaluates
 Cognitive function (mental status)
 Cranial nerves
 Motor system
 Reflexes
 Sensory system
29
Diagnostic Tests


Electroencephalography – records the
electrical activity of the brain
Imaging 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.
30
Neurological Diseases and
Disorders




Trauma
Paralysis
AIDS
 Meningitis
 Encephalopathy
 Peripheral
neuropathies
Other common
diseases – see table 414
31
Apply Your Knowledge
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?
32
Apply Your Knowledge -Answer
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?
An 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.
33
Oncology
 Oncologist 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.
34
Diagnostic Testing







Blood specimens
X-rays
CT scan
MRI
CEA
Ultrasound
biopsy
35
Cancer Treatment
Surgery – removal of all or
part of the tumor
Radiation Therapy – uses
radiation to kill or stop the
growth of tumor cells
Chemotherapy – uses
anticancer drugs to kill
malignant cells
36
Ophthalmology


Ophthalmologists 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.
37
Ophthalmic Examinations
 Inspects 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 exam
38
Eye Diseases and Disorders




Blepharitis- chronic inflammation of the
edges of the eyelid
Ptosis – drooping of the upper eyelid
Sty – infection of the eyelash follicle
Conjunctivitis – pinkeye
39
Eye Diseases and Disorders
(cont.)



Cataracts – cloudy areas in the lens of the
eye
Glaucoma – fluid pressure builds up inside
the eye
Retinal detachment – retina separates from
the underlying choroid layer
40
Orthopedics


Orthopedics 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.
41
Orthopedic Examinations


Assesses the structure
and function of the
musculoskeletal
system.
You may have to help
drape, position, or
physically support the
patient during the
exam.
42
Orthopedic Diseases and
Disorders





Back pain
Muscle strain
Osteoarthritis
Tumors
Fractures
43
Otology


Otologist treats disease and disorders of the
ears.
You may assist with or perform auditory
screening
44
Common Diseases and
Disorders of the Ear







Cerumen impaction
Otitis externa or media
Pruritus
Mastoiditis
Meniere’s Disease
Tinnitus
Presbycusis
45
Surgery


Surgeons 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.
46
Urology


Urologist 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.
47
Urologic Examinations
Urine and blood tests,
Semen analysis and
smears
 Cystometry
 Cystoscopy
 Testicular biopsy

48
Urologic Diseases and
Disorders







Cystitis
Epididymitis
Hydrocele
Impotence
Kidney stone
Prostatic hypertrophy
Prostate cancer
49
Apply Your Knowledge
What examination should be done by a
27-year-old male patient to detect
cancer?
50
Apply Your Knowledge -Answer
What examination should be done by a
27-year-old male patient to detect
cancer?
Testicular Self-Examination
51
Summary
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.
52
End of Chapter
53