Diagnostic Procedures

Diagnostic Procedures

 

A

acid perfusion test: One test used to measure esophageal function. Test reproduces the pain of heartburn by placing a nasogastric tube into one nostril down into the esophagus. A dilute solution of hydrochloric acid is sent down the tube, followed by a saline solution.

ACTH stimulation test (cosyntropin or tetracosactide test): Test that determines adrenal gland function by measuring the adrenal response to adrenocorticotropic hormone (ACTH).

alanine aminotransferase (ALT): Test used to check for liver damage; it measures the amount of ALT enzyme in a blood sample taken via venipuncture.

allergy testing: Skin test for identifying allergens to confirm allergic contact sensitization. Types include: intradermal test: A small amount of allergen is injected into the skin; more sensitive than the skin prick test. skin patch test: The suspected substance is applied to an adhesive patch that is placed on the skin for 24 to 72 hours. skin prick test: A drop of solution containing a possible allergen is place on the skin where a series of scratches or needle pricks have been made.

amniocentesis: Surgical puncture of the amniotic sac, which surrounds the fetus in utero, to remove amniotic fluid; can detect genetic disorders and evaluate an adverse uterine environment.

Amsler chart: Grid that looks similar to graph paper with horizontal and vertical lines. The person with macular degeneration may notice distortion of the grid pattern, such as bent lines and irregular box shapes, or a gray-shaded area.

angiography: Radiographic visualization of blood vessels, with or without the injection of a radiopaque material. Common types include cerebral, coronary, renal, pulmonary, and abdominal angiography.

antibody titers: Measures the amount of antibody against a particular antigen in the blood taken via venipuncture.

anti-DNA antibodies: Measures antinative DNA antibody levels in a serum sample obtained by venipuncture.

antinuclear antibody (ANA): Diagnostic test to help screen for autoimmune disorders, especially of systemic lupus erythematosus (SLE) for which peripheral blood smears are taken and a fluoresceintagged antihuman gamma globulin is used. If the LE factor is present, the specimen will fluoresce.

antistreptolysin O (ASO) titer: Blood test to measure antibodies against antistreptolysin O that is produced by group A Streptococcus.

arterial blood gases (ABGs): Percutaneous arterial puncture is made to assess the gas exchanges of oxygen and carbon dioxide in the lungs by measuring the partial pressures of oxygen and carbon dioxide.

aspartate aminotransferase (AST): Venipuncture is performed to measure this cardiac enzyme. Aspartate aminotransferase is essential to energy production; used to detect recent myocardial infarction, to differentiate acute hepatic disease, and to monitor clients with cardiac and hepatic disease. May be performed at the same time as ALT.

audiogram: Record made by a delicate instrument, the audiometer, of the threshold of hearing; identifies a person’s hearing ability.

auscultation and percussion (A & P): Auscultation is listening to the sounds within the body, usually using a stethoscope. Percussion is using the fingertips to tap the body lightly to determine size, position, and consistency of body structures and fluids.

B

barium (contrast) enema: (Also called a lower GI.) Radiograph of the lower gastrointestinal tract; barium, given as an enema, is the contrast medium.

barium (contrast) swallow: (Also called an upper GI.) Radiograph of the upper gastrointestinal tract; barium, given by mouth, is the contrast medium.

bilirubin levels: Blood test to determine the level of bilirubin in the circulating blood; venipuncture is used to obtain the blood sample.

biopsy: Test that removes cells or tissues for examination to determine presence or extent of disease.

blood glucose testing: Measures the amount of glucose in the blood; common for detecting diabetes or prediabetes. Types of tests include:

  • fasting glucose (FBS): Done when the client has not eaten for 8 hours.
  • 2-hour postprandial blood sugar: Measures blood glucose 2 hours after a meal.
  • random blood sugar (RBS): A number of random blood glucose tests are taken throughout the day, regardless of when a meal was consumed.

blood pressure: Measures cardiac function; records the blood force on peripheral arteries during the cardiac cycle; stethoscope and sphygmomanometer are used.

blood serum for hormones: Radioimmunoassay (see radioimmunoassay) and competitive protein binding are two testing methods commonly used to measure serum hormone levels; blood samples are carefully drawn so as to correspond with or avoid times of peak secretions for the particular hormones being tested.

blood smear: A drop of blood is placed on a slide and examined microscopically; examination of blood cells is helpful in diagnosing many diseases.

bone marrow biopsy: Bone marrow fluid and cells can be removed through aspiration or needle biopsy of bone tissue; examination gives important data about blood disorders.

bone mineral density (BMD): Test that measures bone mineral density to diagnose osteoporosis. BMD determines the amount of mineralized tissue in grams per square centimeter in the area of bone scanned. (See dual-energy x-ray absorptiometry [DEXA]).

bronchial washings: A procedure in which saline is instilled through a bronchoscope as cells and microorganisms from the upper airways are aspirated into a trap; material is then centrifuged, stained, and examined by microscopy or cultured if infection is suspected.

bronchoscopy: Visualization of the larynx, trachea, and bronchi through a metal or fiberoptic scope with a light; also used for bronchial washings, removal of foreign bodies, and biopsy.

C

C-reactive protein (CRP) test: Nonspecific immunoassay serum blood test that determines the presence but not the cause of inflammation; used to monitor the therapy for autoimmune disorders such as rheumatoid arthritis.

carcinoembryonic antigen (CEA): Blood test used to monitor the effectiveness of cancer therapy; also helps determine how widespread the cancer (especially colon and rectal cancer) is.

cardiac catheterization: Catheter is passed into the right (veins to inferior vena cava) or left (arteries to the aorta) side of the heart; can determine blood pressure and blood flow in the heart.

cardiac enzymes: (See creatinine phosphokinase [CPK], and aspartate aminotransferase.)

cardiac stress test: Evaluates the heart and vascular system during physical exercise; helpful in identifying partial blockage to coronary arteries.

catheterization of ejaculatory ducts: Catheter is passed into the ejaculatory ducts to determine blockage or disease.

catheterization, urine: Introduction of a catheter through the urethra into the bladder for withdrawal of urine.

cerebral angiography: (See angiography.) Radiographic visualization of blood vessels of the brain after injection of radiopaque material into the arterial bloodstream. CT scan is a less hazardous procedure and is more commonly used.

cerebrospinal fluid (CSF) analysis: Lumbar puncture between the third and fifth lumbar vertebrae is commonly used to measure CSF pressure and to obtain CSF to diagnose viral or bacterial meningitis, brain tumor and hemorrhages, and chronic central nervous system infections.

chemistry screens: Tests performed on blood to determine values of any number of factors, such as calcium, phosphorus, creatinine, uric acid, cholesterol, total protein, alkaline phosphatase, glucose, blood urea nitrogen, and sodium.

cholecystogram: Used to detect biliary tract disease. A series of radiographs of the gallbladder is taken after the ingestion of contrast medium.

coccidiodin skin test: Delayed hypersensitivity skin test used to detect coccidioidomycosis, an acute self-limiting disease of the respiratory organs.

colonoscopy: Visual examination of the lower bowel with a colonoscope. Biopsy and surgical excision can be accomplished through the scope.

complement-fixation test: Common blood assay used to determine if antigen-antibody reactions have occurred; it can measure the severity of an infection.

complete blood cell count (CBC): Venipuncture usually is performed to give a complete picture of all the blood’s formed elements. A CBC usually includes hemoglobin, hematocrit, red and white blood cell counts, and a differential white blood cell count.

complete neurologic examination: Series of tests and procedures to assess functioning of cranial nerves, motor and sensory systems, and superficial and deep tendon reflexes.

computed tomography (CT) scan: Noninvasive radiographic technique more sensitive than conventional radiography; a scanner and detector circle the client while sending an array of focused x-rays through the body; allows a specialist to distinguish tumors, abscesses, hemorrhages, and white and gray brain tissue.

computed tomography angiogram (coronary): A technique that noninvasively determines if fatty deposits or calcium deposits have built up in the coronary arteries.

creatinine phosphokinase (CPK): Venipuncture is performed to measure CPK, an enzyme that speeds up the creatine-to-creatinine transformation in muscle cells and brain tissue. Its purpose is to detect acute myocardial infarction or reinfarction and evaluate chest pain and skeletal muscle disorders.

culture and sensitivity: Withdrawing of tissue or fluid, placing it on a suitable culture media, and determining whether or not bacteria grow. If bacteria do grow, they are identified by bacteriologic methods. Tests are then done to determine the susceptibility of the client’s bacterial infection to antibiotics. A viral culture will detect viral growth in a sample.

cystoscopy: Urinary bladder is distended with water or air while the client is sedated. Examination of the bladder with a fiberoptic scope is done to obtain biopsy samples and to remove polyps. (See voiding cystoscopy.)

cystourethrography: Radiographic examination of the bladder and urethra by use of contrast media cytology.

D

dehydration test: Shows if a person is able to reduce diuresis in the event of restricted water ingestion and achieve sufficient concentration of passed urine.

dilation and curettage (D & C): Involves widening of the cervical opening and scraping with a curet to remove the uterine lining.

DNA testing: This test allows determination of heritage through the examination of deoxyribonucleic acid in a person’s cells

Doppler ultrasonography: Noninvasive test evaluating blood flow in the major veins and arteries of arms, legs, and extracranial cerebrovascular system. A handheld transducer directs highfrequency sound waves to the area being tested. Transcranial Doppler (TCD) is a test to measure the velocity of blood flow through blood vessels in the brain.

dual-energy x-ray absorptiometry (DEXA): Test to measure bone mineral density at sites especially susceptible to fracture to diagnose osteoporosis before any fractures occur. (See bone mineral density test.)

dynamic infusion cavernosometry and cavernosography (DICC): Test that pumps fluid into the penis at a known rate and pressure. It measures the vascular pressure in the corpus cavernosum during an erection. Cavernosography injects a contrast material prior to x-ray to visualize any leakage.

E

echocardiography: Noninvasive diagnostic test using ultrasound to visualize internal cardiac structures. A special transducer is placed on the client’s chest, and it directs ultra-high-frequency sound waves toward cardiac structures, which reflect these waves. The echoes are converted to electrical impulses and displayed on an oscilloscope.

ejaculatory or semen analysis: Uses semen specimen to evaluate the volume of seminal fluid, sperm count, and sperm motility; also used to detect semen on a person who has been raped, identifying the blood group of an alleged rapist, or to prove sterility in a paternity suit.

electrocardiography (ECG): Recording of electric currents emanating from the heart muscle. Electrodes are placed on the client to obtain the reading.

electroencephalography (EEG): Recording of electric currents developed in the brain by placing electrodes on the skull.

electrolyte analysis: Analysis of electrolytes (sodium, potassium, chloride, and bicarbonate) to evaluate fluid and acid-base status.

electrooculography (EOG): Electrodes placed on the skin next to the eyes to measure changes between the front and back of the eyeball as the eye moves; can detect retinal pigment epithelium dysfunction.

electromyography (EMG): The process of creating a graphic recording of muscle contraction as a result of electrical stimulation.

ELISA (enzyme-linked immunosorbent assay): Rapid enzyme immunochemical assay method in which either an antibody or antigen can be coupled to an enzyme. Used to detect certain bacterial antigens and antibodies as well as hormones. One of the primary diagnostic tests for many infectious diseases, including HIV.

endomysium antibody (EMA): This test helps to determine how effective a gluten-free diet is for an individual with celiac disease.

endoscopic retrograde cholangiopancreatography (ERCP): Radiographic examination of the pancreatic ducts and hepatobiliary tree after injection of a contrast medium into the duodenal papilla. It is used to diagnose pancreatic disease.

endoscopy: Visual inspection of any cavity of the body by means of an endoscope.

Epstein-Barr virus (EBV) antibody test: A blood test to detect antibodies to the Epstein-Barr virus antigens; venipuncture is used to obtain the blood sample.

Epworth sleepiness scale (ESS): Measures daytime sleepiness by use of a short questionnaire. (See multiple sleep latency test [MSLT].)

erythrocyte sedimentation rate (ESR): Blood specimen is obtained by venipuncture to measure the time required for erythrocytes in whole blood to settle to the bottom of a vertical tube; may be one of the earliest disease indicators.

esophageal acid testing: A test to determine the amount of acid in reflux. The 24-hour esophageal pH test is performed by passing a catheter through the nose into the esophagus. A sensor on the tip of the catheter senses acid and records over a 24-hour period; recorder is attached to the other end of the catheter, which is wrapped around the ear and attached to the recorder at the waist. (See acid perfusion test.)

esophageal manometry: A test to measure the pressure inside the lower part of the esophagus. A thin, pressure-sensitive tube or esophageal probe is passed through the mouth or nose into the stomach. The tube is pulled slowly back into the esophagus and measures the muscle contractions along the way.

excretory urography: (See intravenous pyelogram [IVP]).

exfoliative cytology: Microscopic examination of cells that have shredded or scaled off the surface epithelium. The cells are obtained from sputum, lesions, secretions, urine, aspirations, smears, or washings.

F

fetal karyotype: Diagnostic test in utero to detect abnormalities in chromosomes.

fluorescein angiography: This eye test uses special dye and a camera to visualize blood flow in the retina and choroid.

fluorescent Treponema antibody-absorption test (FTA-ABS): Serum or CSF test that provides the most sensitive treponemal antibodies in all stages of syphilis.

G

gastric analysis: Evaluates gastric function by measuring the contents of a fasting client’s stomach for acidity, appearance, and volume.

gastroscopy: Inspection of the stomach interior using a gastroscope.

Glasgow coma scale: The test provides a score in the range 3 to 15; the sum of the scores obtained from three categories measures consciousness.

glucose tolerance test: Checks to determine how the body metabolizes glucose. Blood is drawn before and after a glucose-containing liquid is swallowed.

glycated hemoglobin test (A1c): Measures the amount of sugar attached to the hemoglobin in red blood cells; results are given as a percentage. This test gives an indication of how well diabetes is controlled.

Gram stain: Staining procedure in which microorganisms are stained with crystal violet, followed by iodine solution; decolorized with alcohol; and counterstained with safranin. The retention of either the violet or pink color is a means to identify and classify bacteria. Gram-positive bacteria retain the violet color; gram-negative bacteria lose the violet color and are counterstained red.

H

heart catheterization: Percutaneous intravascular insertion of a catheter into any chamber of the heart or great vessels for diagnosis, assessment of abnormalities, interventional treatment, and evaluation of the effects of pathology on the heart and great vessels.

hematocrit: Used to measure the percentage of packed red cells in a whole blood sample obtained by finger stick or venipuncture.

hemoglobin: Venipuncture or finger stick is done to measure the amount of hemoglobin found in whole blood; used to measure the severity of anemia or polycythemia.

hemoglobin electrophoresis: Evaluates different types of hemoglobin in the blood.

histoplasmin skin test: Form of delayed hypersensitivity skin testing to detect a systemic fungal respiratory disease due to Histoplasma capsulatum.

Holter monitor: A machine to record the heart’s rhythms over a period of 24 to 48 hours during normal activity.

Huhner test: Postcoital examination of cervical mucus to assess characteristics of the mucus as correlated with the phase of the woman’s menstrual cycle and number, motility, and ability of the sperm to cross the cervical mucus.

hysterosalpingography: Radiography of the uterus and uterine tubes after the introduction of an opaque material through the cervix.

I

immunofluorescence microscopy: This test labels antigens or antibodies with a fluorescent dye.

immunoglobulin E (IgE): Test using either serum or urine that provides a detailed separation of the individual immunoglobulin (IgG, IgA, IgD, IgM, IgE) to identify the presence of monoclonal protein and its type.

immunohistochemical test: Test performed on a serum sample to detect the presence of an antibody directed against antigens in cells or tissue sections that are mounted on glass slides.

intravenous cholangiogram: Radioisotope is injected intravenously, and radiographs are taken of the bile ducts.

intravenous pyelogram (IVP): Contrast medium is injected intravenously, and radiographs are taken as the medium is cleared from the blood by glomerular filtration. The renal calyces, renal pelves, ureters, and urinary bladder are all visible on film.

in vitro lymphocyte transformation test: An in vitro test to detect lymphocyte function.

K

kidneys ureters bladder (KUB): Radiographs taken of the kidneys, ureters, and bladder.

L

laparoscopy: Small incision is made in the abdominal wall to visualize the interior of the abdomen using a laparoscope. It is used to examine the ovaries or fallopian tubes and as a gynecologic sterilization technique.

laparotomy (exploratory): An incision into the abdominal wall to provide access to the abdominal cavity.

laryngoscopy: Visual examination of the interior of the larynx using a laryngoscope.

low-dose dexamethasone suppression test: This test may be performed whenever there is unexplained excessive glucocorticoid secretion. Dexamethasone is given orally every 6 hours for 2 days, and adrenocorticotropic hormone (ACTH) stimulation is monitored to determine pathology.

lumbar puncture: (Also called a spinal tap.) (See cerebrospinal fluid [CSF] analysis.)

lupus erythematosus (LE) test: Blood sample is mixed with laboratory-treated antigens. If the sample contains antinuclear antibody, the LE factor will react with the antigen, causing swelling and rupture of the nuclear material. Phagocytes from the serum engulf the foreign particles and form LE cells, which are then detected by microscopic examination.

lymphangiography: Radiograph of the lymphatic vessels following injection of oil-based contrast medium into a lymphatic vessel in each foot.

lymph node biopsy: Lymph node tissue is removed and examined under a microscope for signs of infection or a disease.

lymphoscintigraphy: A special type of nuclear medicine imaging that provides pictures called scintigrams of the lymphatic system; used to identify the first node to receive lymph drainage from a tumor, to detect blockage in the lymph system, and to assess the stage of cancer.

M

magnetic resonance angiogram (MRA): Type of MRI using a magnetic field and pulses of radio wave energy to provide pictures of blood vessels inside the body

magnetic resonance cholangiopancreatography (MRCP): MRI using a magnetic field and pulses of radio wave energy to visualize the biliary and pancreatic ducts; can be used to determine if gallstones are lodged in any of the ducts surrounding the gallbladder.

magnetic resonance imaging (MRI): A radiological technique using magnetism, radio waves, and a computer to produce images of body structures. An individual is surrounded by a magnetic field, which causes hydrogen atoms to line up in a certain fashion. A signal is released when the atoms move back to their original places and is processed by the computer. Ionizing radiation is not required.

mammogram: Radiograph of the mammary gland or breast.

Mantoux test: A skin test to determine if there has been exposure to Mycobacterium tuberculosis that causes tuberculosis.

microscopic urine: Urine sample is centrifuged; then the cells, casts, and crystals are viewed to detect infection, obstruction, inflammation, trauma, or tumors.

multiple sleep latency test (MSLT): A nap study to see how quickly a client falls asleep in quiet situations during the day; the MSLT is a standard way to measure the level of daytime sleepiness.

myelography: Radiograph of the spinal cord after the injection of a contrast medium; used to identify and study spinal lesions caused by trauma and disease. It has been largely replaced by CT scan or MRI.

N

neurological assessment: Several examinations, tests, and procedures are performed to help make a diagnosis of nervous system diseases. Tests likely include CT and MRI scans, cerebral angiogram, electroencephalogram, electromyogram, and a nerve conduction study.

nocturnal polysomnography: Test of sleep cycles and stages using continuous EEG recordings of brain waves, electrical activity of muscles, eye movement (electro-oculogram), breathing rate, blood pressure, blood oxygen level, heart rhythm, and direct observation of a person during sleep.

noncontrast spiral CT: (Also called helical CT.) X-rays are used to scan an entire area while the person lies still on a table. The table passes through the donut-shaped CT scanner. The scanner rotates around the client while a computer creates images from the scan and assembles them into a three-dimensional model.

O

ophthalmologic examination: (Also called a refraction examination.) An examination that includes a series of tests to check vision and eye health.

ophthalmoscopy: Allows magnified examination of inner structures of the eye; the ophthalmoscope used has a light source and a special viewing device.

Ortolani sign: Procedure to evaluate the stability of the hip joints in newborns and infants. With the infant on his or her back, the joints are manipulated, and if a clicking or popping sensation (Ortolani sign) is felt or heard, the joint is unstable.

otologic examination: Ear examination; may include the use of an otoscope, a tuning fork, and an audiometer.

otoscopy: Direct visualization of the external auditory canal and the tympanic membrane through an otoscope.

P

palpation: The health-care provider touches and feels the client’s body to examine the size, consistency, texture, location, and tenderness of an organ or body part.

Papanicolaou (Pap) test: Diagnostic test for early detection of cancer cells by a simple smear method. The sample is usually taken from the cervix through a vaginal speculum.

patch test: (See allergy testing.)

pelvic examination: Includes both an inspection of the vulva, vagina, and cervix for abnormalities and a bimanual palpation of the uterus, fallopian tubes, and ovaries. A Pap smear often is done at the same time.

penlight examination: Performed with a lighted instrument to check pupil reactivity.

perfusion lung scan: Client receives IV injection with radioactive particles that pass through the larger blood vessels but are temporarily trapped in small blood vessels. The images show blood perfusion in the lungs

pericardiocentesis: Surgical puncture of the pericardium to remove purulent pericardial effusion.

pH studies: Determines the acidity or alkalinity level of gastrointestinal secretions. The pH electrode to be used is swallowed by the client. Studies also can be done on blood and urine.

phenylketonuria (PKU) test: (Also called the Guthrie screening test.) Heel stick on an infant is done to collect three drops of blood for screening to check for elevation of serum phenylalanine; performed about 4 days after milk feeding has begun.

phlebography: Radiography of the veins after the injection of a radiopaque contrast medium.

phonocardiography: Indirect cardiac function measurement; the sounds of blood flowing through the heart and great vessels are recorded from sites on the chest by a microphone containing a transducer that converts the sound into electrical impulses; selected high- and low-frequency events are recorded on a graph.

polymerase chain-reaction test: Process that permits making, in a laboratory, unlimited numbers of copies of genes, beginning with a single molecule of the genetic material DNA to investigate and diagnose numerous bacterial diseases, viruses associated with cancer, and genetic diseases.

positron emission tomography (PET): Indirect visualization using an intravenous injection of a radionuclide contrast substance, which becomes concentrated in the organ being studied. Then the scanning transmits the findings to the computer, where analysis can take place. It is used to diagnose and evaluate certain disease conditions and tumors.

postvoid residual (PVR): Measures urine volume in women with overactive bladder.

potassium hydroxide (KOH) examination: Most sensitive test for superficial fungal infections; involves placing the hair or scales of the lesion on a microscopic slide with a few drops of KOH solution. The KOH dissolves the keratinous material for better visualization.

PPD tuberculin test: Intradermal injection of a purified protein derivative (PPD) tuberculin antigen. A delayed reaction occurs in clients infected with tubercle bacillus, whether or not there are clinical manifestations of disease.

proctoscopy: Visual examination of the rectum using a proctoscope.

prostate-specific antigen (PSA): Serology test to detect, classify, and stage prostatic cancer.

pulmonary angiography: A procedure using contrast media and x-rays to show blood flow through the lungs.

pulmonary artery catheterization (PAC): Permits evaluation of ventilation function through spirometer measurements; performed on clients with pulmonary dysfunction.

pulmonary function studies: Number of different tests to determine the ability of the lungs to exchange oxygen and carbon dioxide.

pulse oximetry: Widely used procedure to measure oxygen saturation of arterial blood during breathing.

R

radiography: Process of obtaining an image for diagnosing a radiologic modality.

radioimmunoassay: Technique in radiology used to determine the concentration of an antigen, antibody, or other protein in the serum. (See blood serum for hormones.)

random blood glucose test: (See blood glucose testing.)

rapid diagnostic tests (RDT): Developed to make accurate malaria diagnoses in locations where microscopy services are not available; finger-stick or venous blood is used, and the result is known in 10 to 15 minutes; a laboratory is not required.

rapid HIV antibody test: A number of tests are available to offer faster and easier response to determine if the virus is present. The following website provides a detail of the four tests currently approved by the FDA: http://www.cdc.gov/hiv/topics/testing/resources/journal_article/pdf/rapid_review.pdf.

rapid plasma reagin (RPR) test: Substitute for the venereal disease research laboratory (VDRL) test to detect syphilis. It uses a cardiolipin antigen to detect reagin, which is the antibody relatively specific to the causative agent for syphilis.

real-time RT-PCR (reverse transcription-polymerase chain reaction): The most sensitive test available to detect RNA in a single cell; quantitates gene expression.

rectal examination: Digital examination to detect polyps, early cancer, lesions, inflammatory conditions, and hemorrhoids. It also can show how far the uterus is displaced in the female and reveals the texture and size of the male prostate.

rectal manometry: Measures rectal sphincter function and peristaltic contractions.

red blood cell (erythrocyte) count: Usually performed with a CBC; measures the number red blood cells in a liter of blood.

Reed-Sternberg cells: These giant multinucleated cells seen under light microscopy are an indication of Hodgkin lymphoma.

refraction test: Defines any vision or refractive error and determines any correction necessary.

renal function test: (See urine creatinine tests.)

reticulocyte count: Venipuncture is performed and the number of immature erythrocytes in the blood is determined; important in diagnosing certain blood disorders, especially anemia.

Rinne test: Hearing test to evaluate air and bone conduction. A tuning fork is placed on the mastoid process.

S

scan: Image obtained from a system that compiles information in a sequence pattern, such as computed tomography (CT), ultrasound, or magnetic resonance imaging (MRI); scintiscan.

scintiscan: Produces a map of scintillations observed when a radioactive substance is introduced into the body. The intensity of the record indicates the differential accumulation of the substance in the various body parts.

sensitivity test: (See allergy testing.)

serum B12: Venipuncture is done for a quantitative analysis of serum vitamin B12 levels. Usually done concurrently with a serum folic acid because deficiencies of the two are common causes of megaloblastic anemia.

serum bilirubin: Measures serum levels of bilirubin; helps evaluate liver function, jaundice, biliary obstruction, and hemolytic anemia.

serum calcium, phosphorus, total protein, or serum electrolytes: This series of tests performed on a blood sample determines levels of calcium, phosphorus, and protein in the blood. (See chemistry screens.)

serum creatinine (serum creatinine kinase): Creatinine in blood serum provides a sensitive measure of tissue damage, especially renal damage. Creatinine levels are directly related to the glomerular filtration rate. (See chemistry screens.)

serum ferritin: Serum ferritin levels are related to the amount of available iron stored in the body. This test screens for iron deficiency and overload, measures iron storage, and can distinguish between iron deficiency and chronic inflammation.

serum folate: (See serum folic acid.)

serum folic acid: This test on a blood sample measures the levels of folic acid; helps to diagnose megaloblastic anemia and to determine folate stores in pregnancy.

serum gonadotropin: (See serum human chorionic gonadotropin [hCG].)

serum human chorionic gonadotropin (hCG): Production of hCG begins very quickly after the fertilized ovum is implanted into the uterine wall; the blood test reveals the presence of hCG if pregnancy has occurred.

serum protein electrophoresis: Measures serum albumin and globulins in an electric field by separating the proteins on the basis of size, shape, and electric charge at pH 8.6; helps to diagnose hepatic disease, protein deficiency, blood and renal disorders, and gastrointestinal and neoplastic diseases.

sigmoidoscopy: Visual inspection of the sigmoid flexure of the large intestine using a sigmoidoscope.

skin (intradermal or scratch) test: (See allergy testing.)

slit-lamp examination: Allows an ophthalmologist to visualize the anterior portion of the eye. The slit lamp is an instrument with a special lighting system and a binocular microscope.

Snellen chart: Visual screening using a standardized chart with block letters arranged in rows of decreasing size. A large E chart or one with animals and familiar objects may be used for children.

sputum culture: Examination of the material raised from the lungs and bronchi during deep coughing to determine pathogens.

stool culture: Feces will be examined to determine pathogens that cause gastrointestinal disease; a chemical test may also be done on the stool specimen to detect occult blood.

stool occult blood: Chemical test performed on a stool specimen to detect occult or hidden blood.

synovial fluid analysis: Sterile needle is inserted into a joint space to obtain a fluid specimen; aids in arthritis diagnosis, relieving pain and distention, and administering local drug therapy.

T

thoracentesis: Surgical puncture of the pleural space to remove fluid for analysis or treatment.

thyroid function tests: Tests of thyroid function, including physical examination; some tests include determination of thyroid hormone levels.

Tinel sign: Cutaneous tingling sensation produced by pressing on or tapping the nerve trunk that has been damaged or is regenerating following trauma.

tissue transglutaminase (tTG) antibody: This antibody is important in diagnosing celiac disease; the value of this antibody in long-term follow-up is controversial.

tonometry: Measurement of tension or pressure, especially of the eye for detection of glaucoma.

toxicology screen: Tests used on blood or urine to detect toxic substances.

transesophageal echocardiogram (TEE): An ultrasound transducer that uses high-frequency sound waves to produce a graphic outline of the heart’s movement. It is positioned on an endoscope, inserted down the throat into the esophagus; it provides a close look at the heart’s valves and chambers without interference from the ribs or lungs.

transvaginal sonography (transvaginal ultrasound, or TVS): Test that examines the vagina, uterus, fallopian tubes, ovaries, and bladder through an instrument that is inserted into the vagina and causes sound waves to bounce off pelvic organs. The echoes created are sent to a computer to produce a sonogram.

tumor markers in blood (CEA, PSA): (See carcinoembryonic antigen [CEA] and prostatespecific antigen [PSA].)

U

ultrasonography: Use of ultrasound to produce an image or photograph of an organ or tissue. Ultrasound echoes are recorded as the sound waves strike tissues of different densities.

upper gastrointestinal endoscopy: Allows visualization of the upper gastrointestinal tract to diagnose inflammatory, ulcerative, and infectious disease, neoplasms, and other lesions.

urinalysis: Voided specimen in a clean container is obtained to test for color, appearance, formed elements, casts, odor, transparency, and specific gravity.

urinary antigen test: This test is an immunochromatographic membrane assay that detects cell wall C-polysaccharide common to all types of pneumonia.

urine calcium and phosphates: Measures the urine levels of calcium and phosphates, which are essential for formation and resorption of bone; requires a 24-hour urine specimen.

urine catch, 24-hour: Urine is collected over a 24-hour period to measure quantity as well as physical and chemical characteristics.

urine creatinine: Measures the levels of creatinine in urine; used to help assess glomerular filtration and to check the accuracy of 24-hour urine collection based on relative contrast levels of creatinine excretion.

urine culture: Clean-voided midstream sample is collected for evaluation of urinary tract infections; the specimen is studied under a microscope, and a colony count made to determine the presence of infection.

urine flowmetry (uroflowmetry): Test to measure the volume of urine excreted, the speed it is excreted, and how long excretion takes; helps in evaluating urinary tract function.

urodynamic tests: Measures bladder function and efficiency.

V

vaginal smear: With a cotton-tipped applicator or wooden spatula, vaginal secretions are collected for microscopic examination.

Venereal Disease Research Laboratory test (VDRL): This test is used to screen for primary and secondary syphilis. A serum sample usually is used, but a specimen of cerebrospinal fluid may be used, also.

venography: Test performed to view the veins (usually in leg); dye is used, and x-rays are viewed as the dye flows through the veins.

vestibular testing: A number of tests to help determine problems with the vestibular portion of the inner ear; helps isolate dizziness symptoms to a specific cause that can often be treated.

visual acuity test: Part of an eye examination; evaluates the client’s ability to distinguish the form and detail of an object.

voiding cystoscopy: Examination of the bladder to determine urine excretion. (See urine flowmetry.)

W Weber test: Test for unilateral deafness. A vibrating tuning fork held against the midline of the top of the head is perceived as being so located by those with equal hearing ability in the ears; to person with unilateral conductive deafness, the sound is perceived as being more pronounced on the diseased side; in persons with unilateral nerve deafness, the sound is perceived as being louder in the good ear.

Western blot test, ELISA/Western blot: A set of blood tests to diagnose chronic HIV infection.

West Nile virus (WNV) IgM capture ELISA: Diagnostic test detects the levels of a particular type of antibody, IgM, in a client’s serum. IgM antibodies can be detected within the first few days of the onset of illness and can assist in diagnosis of WNV.

white blood cell count (WBC): Test made on whole blood to report the number of leukocytes in a cubic millimeter. The WBC may rise or fall in disease and is diagnostically useful only when interpreted in light of the client’s clinical status.

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x-ray of kidneys, ureters, and bladder (KUB): Provides radiographs of the kidneys, ureters, and bladder to evaluate the urinary tract and kidney structure, size, and position.