1.
Basic Diagnostic Methods in
Medicine
Ján Jakuš

2.
Classification
A. Biochemical Methods-Blood tests, Enzyme
tests, Mineral content tests, Test for evaluation of
concentration - Na, K, Ca..., Glucose, Urea in blood
plasma, in liquor or in urine....
B. Physical Methods 1. Mechanical : e.g. Ausculta-
tion, Percussion, Palpation, Blood pressure (non-
direct) method, Body temperature measurement..
2. Electric: ECG, EEG, EMG,
ENG, ERG, Audiometry, Blood pressure (direct
method,) Blood flow, and Air flow tests, Chronaxi-
metry ...
3. Electromechanical: Spiro-
metry, Energymetry,Test for Sceletal muscle con-
tractions, or the Evaluation of the lenght and
muscle tonus

3.
4. Optic and Optoelectric methods: Light
microscopy, Electron microscopy,Ophtalmoscopy,
Otoscopy, Bronchoscopy, Fiber optics...
5. Ultrasound (Dopplers) methods:Blood
flow test, Sonography, Echocardiography...
6. X- ray Imagine methods: Sciascopy,
Sciagraphy, Classic Tomography, Computer
Tomography (CT)...
7. Methods of Nuclear Medicine: Radioi-
sotopes , Gammagraphy, Pozitron Emmision
Tomography (PET)....
8. Magnetic Scanning Methods- Nuclear
Magnetic Resonance Tomography (NMRT)
9. Combination of methods: AB and 1-8

4.
Mechanical Methods
Palpation- is a kind of an old, and subjective meth-
od for evaluation of size and shape of organs
within a body (e.g. liver, kidney, spleen, lymphatic
glands, appendix bowel...
Percussion- this old and subjective method- It looks
for size and shape of organs and their boundaries
(e.g. lungs, heart).Doctor uses his 3rd digit in order
to strike the skin above the organ. As a result
there are different kinds of sounds (tissue vibra-
tions)
Auscultation- old and subjective method looking for
sounds and murmours determined by stethoscope
Blood pressure and Temperature measurements(see
practicals)

5.
Electrical Methods - ECG,EEG,EMG,ENG
Electrocardiography (ECG)-method for record of
heart electric signal from the surface of the skin.
(For explanation of ECG curve and technique of re-
cording see Practicals )
Electroencephalography (EEG)- a method for record
of brain electric signal from the scalp.The point is
evaluation both the frequency (f) and amplitude(A)
of waves e.g. in Epilepsy.
Waves or Rhythms:
Alpha are recorded at rest with closed eylids with
f = 8-13 Hz and A = 50 μV.
Beta –when eyelids are open,f =15-20Hz, A = 5-10 μV
Theta –pathology in adults,f = 4-7 Hz, A = 50 μV
Delta- at REM Sleep f = 1- 4 Hz, A = 100 μV

6.
Electrocardiography
ECG leads Bipolar: Standard I.II.III, CR, Cl, CF
Unipolar: VR,VL,VF, aVR, aVL, aVF, V1-V6
)
ECG curve

7.
Optic and Optoelectric Methods
Light Microscopy- uses visible light. Microscop
consists of ocular, objective,condenser, lateral
and angular drifts. Microscop increases the angle
between two dots, thereby to percieve them as a
two. Resolution :10-4-10-7 m (1/10 mm- 1/10 nm.
Electron Microscopy- uses flow of electrons. Their
source is „electron gun“., then they pass through
very thin layer of explored tissue and finally reach
the projective (instead of an ocular). Picture is
displayed by videosystem on a screen of monitor.
Resolution10-6 – 10-9m (from μm - to ηm)
Fiber optics- consists of 130 cm long tube, with ca-
nals: canal for image formation, canal for light,
working canal, rinsing canal. Doctor looks through
an ocular in order to see the image of failured

8.
Light Microscopes

9.
Electron Microscope

10.
Endoscopy and Fiber Optics

11.
Ultrasound - Dopplers methods
The ultrasound (US) is a sound with f >20kHz (in
medicine is used US with f= hundreds of MHz)
Sources: piesoelectric crystals, generators of US
Point: US targets body, one part of it is absorbed by
tissues and another part is refracted back to the
probe of the piesocrystal (Dopplers effect)
Refracted part of US is named ECHOE.
Rule: The higher is US frequency (MHz), the lower is
its penetration, but better is a resolution of the
organs and vice versa. ECHOES are detected by
special sensors and processed and displayed on
screen of black - white or colour monitors. US
methods (Ultrasonography, Echocardiography,
Angiography). US is harmless,safe and very
useful non-invasive methods, used with
advantage e.g.in pregnant women )

12.
Ultrasound methods

13.
Ultrasonography- detection of size
and shape of foetus in uterus

14.
X-Ray Imaging methods: Sciascopy,Sciagraphy,
Classical and Computer Tomography
X-rays: kind of ionizing, non-visible radiation. It is
danger for living body. Max. harmless exposure is
5 mSv/ year -adults
Definition: is elmg. waving of photoelectrons (as a
visible ligh), but with very short λ = 0.05 ηm
Source: X-ray tube (diode with - Cathode and + Ano-
de ). Electrons are emitted from Cathode and flight
in vacuum targeting Anode. Thus, only 1-2% X- ra-
ys is produced, 98% is taken away of diode as a
heat. There are “hard“ and “soft“types of X-rays.
The higher is an anodal voltage (50-150 kV) the har-
der (more penetrable) is X-ray radiation and vice
versa. X-ray photo is black-white.The bones and
air have best contrast, soft tissues have worse or
no contrast. The contrast matters must be injected

15.
X-Ray Tube (DIODE)- for details also look Nave
and Nave

16.
Sciascopy, Sciagraphy, Comp. Tomography

17.
Classical Tomography Computer Tomogr.

18.
Computer Tomography scan (CT)

19.
CT scanning - tumor in lungs

20.
Nuclear Magnetic Resonancy Scanning (NMR)
This method does use X-rays, but a magnetic energy
obtained from vibration of protons placed within the
core of the atoms (C,P,Ca, Na,K...) that compose a
body.The interaction of both the low and high mag-
netic fields are involved.
Patient is putted into a tunel .Then - a low frequency
magnetic field affects his body. In turn- the high
freq. magnetic field is applied. Finally- both types of
magnetic fields are suddenly switched off. Hence,
protons obtain their original energy ( deexcitation)
and the magnetic signal is emmited , and passes
the body...the body structures are displayed on
screen with very high resolution.

21.
NMRS

22.
Nuclear Magnetic Resonancy
Scanning
Benefits: non-invasive and safe method ( no x-
ray radiation)
short time for scan (10-20 minutes)
high resolution of picture
Obstacles: kind of an expensive test
claustrophobia (a fear of patient
inside a tunel)
extreme noise (from coils)
scan is not permitted in patients with
metals inside the body (pacemakers,
artifficial joints,etc.

23.
NMRS- device & equipment

24.
SEMINAR
Notice!
For more details of this and another
diagnostic methods look Nave & Nave,
and/or WEB
For seminars prepare a semestral papers
(obligatory). Also a speech (not obligatory)
with description of 1 of the Diagnostic or
Therapeutic methods (Max. 7 minutes / 1
contribution) of Power point.

25.
Thanks for Your Attention !