Diagnostic tests

A
acid perfusion test: One test used to measure esophageal function. This 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.

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 in-

jected 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 pos-

sible 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 ves- sels, with or without the injection of a radiopaque
material. Common types include cerebral, coronary, renal, pulmonary, and abdominal angiography.

ankle-brachial index (ABI): Used to check for periph- eral arterial disease of the legs; it predicts the
severity of the disease.

anorectal function test: Evaluates bowel muscle function.

anorectal manometry: Test to measure anal sphincter muscles, rectal sensation, and neural reflexes
neces- sary for normal bowel movement.
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 sys-
temic lupus erythematosus (SLE) for which periph- eral blood smears are taken and a fluorescein-tagged
antihuman gamma globulin is used. If the LE factor is present, the specimen will fluoresce.

antistreptolysin O (ASO) titer: Blood test to meas- ure 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. Aspar-
tate aminotransferase is essential to energy produc- tion; 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 finger- tips to tap the body lightly to determine size, posi-
tion, 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 examina- tion to determine presence or extent of disease.

Appendix 1
Diagnostic Procedures

2
457

3
4
458 Diagnostic Procedures

blood glucose testing: Measures the amount of glu- cose 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.

oral glucose tolerance test: Measures blood glu-

cose after a person fasts for at least 8 hours and 2 hours after drinking a liquid containing 75 grams of
glucose dissolved in water.

random blood sugar (RBS): A number of random blood glucose tests are taken throughout the day,
regardless of when a meal was consumed.

2-hour postprandial blood sugar: Measures blood glucose 2 hours after a meal.

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 meas- ure serum hormone levels; blood samples are
care- fully 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.

blood urea nitrogen (BUN): Measures nitrogen in the blood coming from urea; performed to deter- mine
how well kidneys are functioning.

body mass index (BMI): Measures body fat based on height and weight as applied to adults.

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]).

bone scintiscan: Nuclear imaging test (using radioac- tive materials injected into a vein) to help diagnose
bone disease or detect bone cancer.

bronchial washings: A procedure in which saline is instilled through a bronchoscope as cells and
microorganisms from the upper airways are aspi- rated 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 fiber-optic scope with
a light; also used for bronchial washings, removal of foreign bodies, and biopsy.

5
C
caloric test: This test uses water temperature differences to diagnose acoustic nerve damage.

carbon 13 (13C) urea breath test: Breath test for detecting bacteria in persons with dyspepsia and ulcer-
like symptoms.

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 identify-
ing partial blockage to coronary arteries.

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

cerebral angiography: (See angiography.) Radi- ographic 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.

chorionic villus sampling (CVS): Prenatal test of chorionic villi sample removed from the placenta to
provide information about the genetic makeup of the fetus.

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

colorectal transit study: A test to evaluate colon function and motility; helps in diagnosis of patho-
logical constipation.

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

6
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 neurological 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 con-
ventional 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.

cryoablation: Destruction of tissue.

culture and sensitivity: Withdrawing of tissue or

fluid, placing it on a suitable culture media, and de- termining whether or not bacteria grow. If bacteria do
grow, they are identified by bacteriologic meth- ods. Tests are then done to determine the suscepti- bility
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 fiber-optic 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 during urination.

D
DNA testing: This test allows determination of her- itage through the examination of deoxyribonucleic
acid in a person’s cells.

Doppler ultrasonography: Noninvasive test evaluat- ing blood flow in the major veins and arteries of
arms, legs, and extracranial cerebrovascular system. A handheld transducer directs high-frequency 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 cavernosog- raphy (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.

7
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 elec- tric currents developed in the brain by placing elec-
trodes 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 anti- gens 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

Diagnostic Procedures 459

8
9
10
460 Diagnostic Procedures

pancreatic ducts and hepatobiliary tree after injec- tion 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.

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

erythrocyte sedimentation rate (ESR): Blood speci- men 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 pres- sure 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.

esophagogastroduodenoscopy: Upper barium swallow.

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

F
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 measur- ing 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

11
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 microor- ganisms 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.

hepatobiliary iminodiacetic acid (HIDA) scan: A scan to track production and flow of bile through the
small intestine to show any blockage.

histoplasmin skin test: Form of delayed hypersensi- tivity skin testing to detect a systemic fungal respi-
ratory 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 cor-
related 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.

hysterosonography: A transvaginal ultrasound to capture inside the uterus; evaluate uterine

abnormalities.

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

12
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.

interferon-gamma release assays (IGRAs): Blood tests to identify individuals at increased risk for
developing tuberculosis.

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 glomeru- lar 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.

isotope scanning: A small amount of radioactivity is injected into the body’s vein in order to obtain a
series of pictures of different organs.

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.

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 adreno-
corticotropic hormone (ACTH) stimulation is monitored to determine pathology.

low-dose helical CT scan: This spiral CT scan con- tinually rotates to take several 3-dimensional x-rays
of the lungs.

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

lupus erythematosus (LE) test: Blood sample is mixed with laboratory-treated antigens. If the sample
con- tains 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.

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

13
lymphoscintigraphy: A special type of nuclear medi- cine imaging that provides pictures called scinti-
grams 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 gall- stones
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 fash- ion. 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.

mental status examination (MSE): Observations a mental health specialist uses to understand a client’s
presentation to help in a diagnosis.

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 situa-
tions 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
National Institutes of Health (NIH) Chronic Pro- statitis Symptom Index: Using a questionnaire,
provides a method of evaluating symptoms and quality of life in men with chronic prostatitis.

Diagnostic Procedures 461

14
15
16
462 Diagnostic Procedures

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 (electrooculogram), 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 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 manipu- lated, 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.

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

17
the lungs.
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.

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.

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

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

portable cardiorespiratory monitoring: A compact, portable monitor to acquire, classify, record, and
display cardiorespiratory data in an online manner; detects apnea, blood oxygen saturation, and heart rate.

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; in-
volves placing the hair or scales of the lesion on a microscopic slide with a few drops of KOH solu- tion.
The KOH dissolves the keratinous material for better visualization.

PPD tuberculin test: Intradermal injection of a puri- fied protein derivative (PPD) tuberculin antigen. A
delayed reaction occurs in clients infected with tubercle bacillus, whether 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.

prostatic acid phosphatase (PAP): Formally a major tumor marker for prostate cancer that has been
replaced with the PSA; can be used to predict recurrence in men undergoing radical prostatectomy for
localized prostate 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 spirome-
ter 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.

18
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 blood test for methicillin-resistant
Staphylococ-

cus aureus: This test can detect MRSA and less dangerous strains of the staph bacterium in just 2 hours.

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 avail- able to offer faster and easier response to
determine if the virus is present. The following website pro- vides a detail of the four tests currently
approved by the FDA http://www.cdc.gov/hiv/basics/ testing.html

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 condi-
tions, 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 of 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.

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

rheumatoid factor blood test: Blood test to detect rheumatoid arthritis; present in about 80% of adults
with rheumatoid arthritis.

19
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 CT,
ultrasound, or 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, phos- phorus, and protein in the blood. (See chemistry
screens.)

serum creatinine (serum creatinine kinase): Creati- nine in blood serum provides a sensitive measure
of tissue damage, especially renal damage. Creati- nine 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, meas- ures 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 meas-

ures 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): Pro- duction of hCG begins very quickly after the fertil-
ized ovum is implanted into the uterine wall; the

Diagnostic Procedures 463

20
21
22
464 Diagnostic Procedures

blood test reveals the presence of hCG if pregnancy

has occurred.
serum protein electrophoresis: Measures serum albu-

min 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 flex- ure 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 ani- mals 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.

StaphSR assay: Rapid blood test to detect Staphylococcus aureus (SA) and methicillin-resistant
Staphylococcus aureus (MRSA).

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.
straight-leg raising test: The leg is raised with the

knee straight to determine low back and leg pain. If pain radiates down the back of the leg below the
knee, the test is positive, indicating that one or more nerve roots leading to the sciatic nerve may be
compressed or irritated.

sweat test: Measures sodium and chloride in sweat to diagnose cystic fibrosis; people with cystic fibrosis
have 2 to 5 times the normal amount of sodium and chloride in their sweat.

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

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

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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 anti- body 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 ultra- sound 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.
transillumination test: Uses a light shining through

a body area or organ to check for abnormalities; often used on the head, scrotum, or chest of newborn or
breast of adult female.

transthoracic echocardiogram (TTE): The echocar- diogram probe is placed on the chest wall to get
heart images through the chest wall.

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.

“triple screen” blood test—alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), and
estriol: Tests maternal blood for three specific substances—AFP, hCG, and estriol; often helps

in estimating a person’s chances of having an

abnormality.
tumor markers in blood (CEA, PSA): See carci-

noembryonic antigen (CEA) and prostate-specific antigen (PSA).

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

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

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ureteroscopy: Process of examining the inside of the urinary tract (specifically the urethra and bladder)
with an endoscope.

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 immunochro- matographic 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 essen-
tial 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 is 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.

vasography: Used when ultrasound is uncertain; radioactive dye is injected into the vas deferens and
ejaculatory ducts; the X-ray is taken as the dye flows through the ducts to detect blockage.

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

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

vesiculography: X-ray of the seminal vesicles follow- ing injection of radiopaque medium.

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

videoplethysmography: A relatively new method to detect atrial fibrillation via facial feature recordings
that illustrate a subtle change in skin color and uneven blood flow.

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vision-field test: Eye test to detect dysfunction in central and peripheral vision.

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. In those with equal hearing ability in the ears, the sound is perceived as being located at the top of
the head; to a person with unilateral conduc- tive 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: Di- agnostic test detects the levels of a particular type of
antibody, IgM, in a client’s serum. IgM anti- bodies 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.

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

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