Table of contents
Suitable diagnostic study.
Application of diagnostics and considerations.
Multiple Choice Questions from the Report
Diagnostic tests are defined as an approach used for clinical information about the health of an individual (Tamil Selvan et al., 2019). This report will provide details of the suitable diagnostic tests associated with the screening of the central nervous system and the peripheral nervous system based on the case study of James (65 years) who has been diagnosed with stroke and has developed blurred vision and partial left side paralysis. This report will provide a detailed explanation of the suitable diagnostic studies and their application and underline their importance in these assessments. Further, special considerations or requirements to be considered while performing these diagnostics will also are evaluated.
The central nervous system (CNS) of an individual is constituent of brain and the spinal cord whereas, the peripheral nervous system (PNS) includes the extended nerves that branch out from the CNS and function together as a system (Kapoor et al., 2019) The nervous system is built of neurons that provide the requisite information through sensory neurons, translocate the signals through motor neurons and allow its processing in the CNS to guide action and neuromotor response to stimuli. To perform the neurological and nervous system assessment of the patient, the following diagnostic tests can be conducted:
The computed tomography scan also known as the CAT uses the X rays to produce axial or horizontal images of the body. The X rays can penetrate the skin and allow imaging. A detailed image of the entire body is produced in this test and can be performed without the need for sedation (Tamil Selvan et al., 2019). This test is suitable and useful as it helps in the determination of body anomalies by providing a distinct picture of blockages by using a contrasting dye for a detailed image (Singh & Esmende, 2018).
An angiogram is a diagnostic test that provides images of the blood vessels through the brain. The test is also known as the arteriogram (Ohno et al., 2017). The technique uses the X rays to take pictures of the blood vessels using a contrasting agent or a dye to show blockages or any constriction. This test is suitable and useful as it also helps in the identification of the site of inflammation and stroke in the patient and thus helps in the application of a targeted intervention. A cerebral angiogram is thus performed to find regions of aneurysm, blockage, stroke, or bleeding in the brain (Demchuk et al., 2016).
A magnetic resonance imaging scan is one of the most popular diagnostic methods associated with the screening of the Central nervous system and the Peripheral nervous system. The test uses a combination of apparatus to produce body images. (Werden et al., 2017) These include magnets, radio frequencies and a compted interpreter. Sedation may be required for the patients undergoing an MRI scan. MRI is most commonly used for the diagnosis of health conditions associated with the central nervous system. Nerve compression and mass lesions are the two common peripheral nervous system problems that require the deployment of MRI scans for diagnosis (Daniels et al., 2017). This technique of diagnosis will be suitable as it will help in the identification of tissue and organ impact of the stroke and apply suitable interventions to prevent further damage and adopt management strategies to minimize the loss (Quenardelle et al., 2016).
James should be advised to not to be wearing any metal objects as they can interfere with the imaging through the CT scan. If the CT scan is ordered without a contrast the patient can eat and drink and also consume the prescribed medications (Tamil Selvan et al., 2019). However, if a CT scan with a contrast dye is being performed, the patient is advised to not consume anything before three hours if the scan and is encouraged to drink only clear liquids. The patient is also encouraged to increase the fluid intake after the scan has been performed if the contrast is given for the test. Consideration of claustrophobia is also important while conducting this scan (Singh & Esmende, 2018).
There are multiple risks associated with the conduct of angiogram that must be informed to the patient, James and his carers, an informed consent must be obtained to continue the procedure (Demchuk et al., 2016). James should be kept flat and lying for several hours after the procedure to minimise the chances of any serious bleeding and promote the healing of the artery. With the diagnostic catheterization, the patient is advised to rest for about four hours and the diagnosis through the interventional catheterization the patient is requested to rest for about six hours (Ohno et al., 2017).
The primary consideration that is associated with the MRI Scan is to not have any metallic objects on the body of the patient as they can affect the magnetic field of the MRI scan. Internal implants like a heart pacemaker, medication pump, and metal pins that should be informed to the clinician by James (Werden et al., 2017). Earplugs or headphones are suggested for James to counter the loud noise of the MRI scanning procedures. However, these noises are normal and should not be considered as a worry (Daniels et al., 2017). Information regarding the same should be shared with James to ensure minimizing the panic in the patient during the procedure. Consideration of claustrophobia is also important while conducting this scan (Quenardelle et al., 2016).
This report provides a brief detail of the suitable diagnostic methods that can be used for the screening of the central as well as the peripheral nervous system. The three diagnostic tests that have been included in this report include the computed tomography scan, angiography, and magnetic resonance scan. This report provides the details of the mode of function of these diagnostics and also explains the usefulness of their application. Special considerations that must be noted while performing these diagnostics have also been included in this report to provide a complete detail about the application and utility of these diagnostic techniques for screening of anomalies in the central nervous system and the peripheral nervous system.
Question 1: A CT scan provides images of the body in which orientation?
Question 2: X-rays are used in which of the following diagnostics?
Question 3: Brain is part of which system?
Question 4: A diagnostic test can be defined as:
Question 5: X-rays are used in diagnostics as:
Daniels, S. K., Pathak, S., Mukhi, S. V., Stach, C. B., Morgan, R. O., & Anderson, J. A. (2017). The relationship between lesion localization and dysphagia in acute stroke. Dysphagia, 32(6), 777-784. https://link.springer.com/article/10.1007/s00455-017-9824-0
Demchuk, A. M., Menon, B. K., & Goyal, M. (2016). Comparing vessel imaging: Non-contrast computed tomography/computed tomographic angiography should be the new minimum standard in acute disabling stroke. Stroke, 47(1), 273-281. https://www.ahajournals.org/doi/abs/10.1161/strokeaha.115.009171
Kapoor, I., Mahajan, C., & Prabhakar, H. (2019). Basics of neuroanesthesia: Anatomy, Physiology, and Pharmacology. In Co-existing Diseases and Neuroanesthesia (pp. 5-14). Singapore.: Springer https://link.springer.com/chapter/10.1007/978-981-13-2086-6_2
Ohno, Y., Yoshikawa, T., Kishida, Y., Seki, S., & Karabulut, N. (2017). Unenhanced and contrast-enhanced MR angiography and perfusion imaging for suspected pulmonary thromboembolism. American Journal of Roentgenology, 208(3), 517-530. https://www.ajronline.org/doi/abs/10.2214/AJR.16.17415
Quenardelle, V., Lauer-Ober, V., Zinchenko, I., Bataillard, M., Rouyer, O., Beaujeux, R., ... & Marescaux, C. (2016). Stroke mimics in a stroke care pathway based on MRI screening. Cerebrovascular Diseases, 42(3-4), 205-212. https://www.karger.com/Article/Abstract/445956
Singh, H., & Esmende, S. (2018). Radiology: The Basics. In Essential Orthopedic Review (pp. 5-6). Singapore.: Springer, Cham. https://link.springer.com/article/10.1007/s00330-002-1505-0
Tamil Selvan, S., Padmanabhan, P., & Zoltán Gulyás, B. (2019). Nanotechnology-based diagnostics and therapy for infections in the CNS. ACS Chemical Neuroscience. 208(3), 517-530. https://europepmc.org/article/med/31726008
Werden, E., Cumming, T., Li, Q., Bird, L., Veldsman, M., Pardoe, H. R., ... & Brodtmann, A. (2017). Structural MRI markers of brain aging early after ischemic stroke. Neurology, 89(2), 116-124. https://n.neurology.org/content/89/2/116.short
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