Submitted by: Candice Smith, Wentzville High School

In participation with Mid Rivers Tech Prep Consortium, Krista Flowers

Materials Needed

Handouts, worksheets, references as listed below, markers for BINGO cards

Grade Level

High School

Show Me Standard

SC 8, H/PE 1, H/PE 3
GOAL 1.1, GOAL 1.2, GOAL 1.5, GOAL 2.1, GOAL 4.6

Description

In this lesson the students will learn the common diagnostic imaging modalities used in radiology to identify neurological disorders and the possible reasons for their use. Useful for anyone interested in a career in biology.

Suggested Time

70-80 minutes

Objectives

  1. The students will list six diagnostic imaging modalities used by a radiologist or other professional in a radiology department to identify neurological disorders and relate the possible reasons for their use.
  2. The students will explain the procedure used for each of the six diagnostic tests done in radiology for determining neurological disorders.
  3. The students will identify by picture the technological equipment used in radiology for diagnosing neurological disorders.
  4. The students will spell and define, using a glossary handout provided by the teacher, all words to know from this lesson.

Human biology lesson.

Background Information

  • The students will need instruction on the two main divisions of the nervous system.
  • The students will need instruction on the purpose of the automatic nervous system and explain the action of its two divisions.
  • The students will need instruction on the coverings of the brain and spinal cord and describe their purpose.
  • The students will need instruction on what happens at synapses when nerve impulses are passed from one neuron to another.

Determining Prior Knowledge

  • The teacher will question the students about the anatomy of the central nervous
  • The teacher will ask students the purpose of the peripheral nervous system.
  • The teacher will ask the students to explain the two responses of the autonomic nervous system.
  • The teacher will have students draw the three types of neurons found in nerve tissue.

Advance Preparation

  • Hang pictures in the front of the room on the various types of diagnostic equipment used in radiology.
  • Pull off the Internet the latest research on the six diagnostic modalities used in radiology for determining diseases and disorders of the nervous system.
  • Prepare a chart for students to complete during the six group presentations.
  • Prepare a vocabulary list for the students to refer to during group investigations and during group presentations.
  • Prepare flash cards with the terms used during the lesson.
  • Prepare Bingo cards for terms used during this lesson.
  • Bring in treats/rewards for students who win each round of “BINGO”.
  • Prepare a list of disease and disorders that affect the nervous system for the students to choose from for doing their investigative report at the close of the lesson. (Students during the next class session will be in groups of two and investigate their disease and give a brief
  • description of the disease, state which diagnostic test is used, and relate the cause, symptoms and treatment of the disease.)

Lesson Description

Teacher Activities

Question students and make a list of the various types of equipment that they are familiar with that are used in a radiology department. Point to each of the six pictures and see if the students can identify any of the equipment by name.

Divide the students into six groups of four and have the students read through the packets of information for the diagnostic test for which they have been assigned.

  • angiography
  • conventional x-rays (myelography, chest & skull films)
  • computerized tomography
  • magnetic resonance
  • nuclear medicine
  • ultrasound

Each group will choose a team spokesman for the group who will present on blackboard or overhead projector.

Each group will determine and report to the class why the test is done, what a person experiences during the examination, patient preparation, how the test works, and identify any associated vocabulary from the provided handout.

Have students fill in their “BINGO” cards with the related terms used during the lesson.

Students will be read a definition and they will try to guess which term was used and cover the term on their “BINGO” card. After completing their card or winning for that round the student and their partner from today’s group will be given a reward incentive and be given the opportunity to choose which disease they and would like to research during the next class session. (After choosing their disease the students may re-join in the “BINGO” game.)

Student Activities

  • Identify by illustrated pictures the six types of diagnostic equipment used in radiology to diagnose diseases and disorders of the nervous system.
  • Count off into teams, join team at table and choose a recorder and spokesman.
  • Work together and determine why the test is done, what a person experiences during the examination, patient preparation, how the test works, and describe any associated vocabulary found on handout #3.
  • Each group spokesman will present to the class on blackboard or overhead projector and answer student questions.
  • Students will take notes as described on handout #2 during each of the six group presentations.
  • Students will randomly fill in their “BINGO” card (handout #1) with the important terms used as listed below during the lesson.
  • Students will participate in a game of Bingo (by covering the term they believe was used on their card after the definition is read by the instructor.)

Important Terms Used

Angiography Angioplasty
Angiographic Procedures Aneurysm
Arteriosclerosis Brain edema
Catheter Cerebral Spinal Fluid (CSF)
Cerebral Vascular Accident (CVA) or Transischemic attack (TIA) Chest x-rays
Clinical networks Contrast agents
Computer tomography (CT) Conventional x-ray imaging
Digital radiography Doppler ultrasound
Echo Planar Imaging Electron Beam Computer Tomography (EBCT)
Film cassettes or Bucky board Fluoroscopy
Functional MRI (f-MR) Hemorrhage
Image intensifier Lumbar puncture
Magnetic Resonance Imaging (MRI) MR Angiography
MR contrast media Myelography
Nuclear medicine or radionuclide scanning Open MRI
Positron emission tomography (PET scan) Radiologic technologist
Radiology Radio nuclide
Radioisotope Radiopaque dye
Spiral CT SPECT (Single positron emission tomography)
Three-dimension image processing Ultrasound scanning

Future Investigative Disease Projects

ALS (Lou Gehrig’s disease) Alcoholic neuritis
Bell’s Palsy Cerebral Palsy
Encephalitis Epilepsy
Herpes Zoster (Shingles) Hydrocephalus
Meningitis Migraine
Neuralgia Multiple Sclerosis (MS) Parkinson’s
Neuron and spinal cord damage Poliomyelitis or infantile paralysis
Reye’s Syndrome Sciatica
Spina bifida Subdural Hematoma
Subarachnoid Hemorrhage Transient Ischemic Attack (TIA)
Trigeminal Neuralgia (tic douloureux)

References

Anderson, Kenneth. Mosby’s Medical, Nursing, and Allied Health Dictionary. Fourth edition. Mosby Publishing, 1994.

Ehrlich, Ann. “Chapter 10-The Nervous System” and “Chapter 15-Diagnostic and Imaging Procedures”. Medical Terminology for Health Professions. Delmar Publishers, 1988. pg. 185-204 & pg. 289-308.

Fong, Elizabeth. “Unit 53-Representative Disorders of the Nervous System”. Body Structures & Functions. Delmar Publishers, 1989. pg. 396-400.

Imaginis Corporation. 1998. http://www.imaginiscorp.com/faqs. “Ultrasound Imaging” – 13.html, “Computer Tomography Imaging (CT)” -10.html, “Angiography” -9.html, “Heart Disease: Prevention, Diagnosis and Treatment” -heart.html, “Milestones in Medical Diagnosis and Diagnostic Imaging” -17.html, “History of medical diagnosis and diagnostic imaging” – 16.html, “The vital role of medical imaging in the prevention, diagnosis and treatment of stroke” – stroke.html, “What is medical diagnostic imaging and radiology” -3.html, “Magnetic Resonance Imaging” -11.html, “Nuclear Medicine Imaging (NM)” – nuc_why.html & nuc_pet.html, “Conventional X-ray Imaging” – xray.html.

Keir, Lucille. “Unit 2 Nervous System”. Medical Assisting Administrative and Clinical Competencies. Third Edition. Delmar Publishers, Inc., 1993. pg. 220-232.

Miller & Levine. “Chapter 37 Nervous System.” Biology. Third edition. Prentice Hall, Inc., 1995. pgs. 808-835.

Handout #1

BINGO FOR DIAGNOSTIC TESTS & TERMS USED IN RADIOLOGY

FOR DETERMINING NEUROLOGICAL DISORDERS

B I N G O

Handout #2

SIX DIAGNOSTIC IMAGING MODALITIES USED IN RADIOLOGY

TO DETERMINE NEUROLOGICAL DISORDERS

Diagnostic Tests

  • Why the test is done
  • What a person experiences during the exam
  • Patient preparation
  • How the test works

ARTERIOGRAPHY OR ANGIOGRAPHY

COMPUTED TOMOGRAPHY IMAGING (CT)

MAGNETIC RESONANCE IMAGING (MRI)

NUCLEAR MEDICINE PET SCANNING AND SPECT SCANNING

ULTRASOUND IMAGING (US)

CONVENTIONAL X-RAYS:
MYELOGRAPHY
CHEST FILMS
SKULL FILMS

Handout #3

VOCABULARY LIST FOR DIAGNOSTIC IMAGING OF NEUROLOGICAL DISORDERS

Angiography: To image and diagnose diseases of the blood vessels of the body, including the brain and heart. Designed to diagnose pathology of these vessels such as blockage caused by plaque build up.

Angioplasty: This technique uses fluoroscopy to guide the compression of plaques and minimize the dangerous constriction of the heart vessels.

Angiographic Procedures Therapeutic (Interventional): Physicians inject streams of contrast agents into the area of interest using catheters to create detailed images of the blood vessels on x-ray “movies” in real time. Physicians can remove stenoses (blockages of blood vessels).

Aneurysm: Localized dilation of the wall of a blood vessel, usually caused by atheroschlerosis and hypertension, or less frequently by trauma, infection or a gengenital weakness in the vessel wall.

Brain edema: A swelling in the layer of meninges surrounding the brain.

Catheter: A small hollow tube that is inserted into arteries and used for diagnostic purpose and invasive-procedures.

Cerebral Spinal Fluid (CSF): The fluid that flows through and protects the four ventricles of the brain, the subarachnoid space, and the spinal canal.

Chest x-ray: The simplest and fastest way to image the heart and surrounding thoracic anatomy. It can show heart size and shape and reveal if the heart is misshapen or enlarged due to disease, reveal abnormal calcification (hardened or blockage due to cholesterol build up) is present in the main blood vessels, fluid in the lungs, image pacemakers and artificial heart valves.

Clinical networks: Were first implemented to allow digital diagnostic images to be shared between physicians via computer network, allowing a doctor in Boston to review a CT examination from a patient in Beijing, China if desired.

Contrast agents: A type of dye injected into the patient to intensify the surrounding organs. Patients allergic to shellfish may have difficulty with the contrast.

Computer tomography (CT): Combines the use of the digital computer together with a rotating x-ray device to create detailed cross section images of “slices” of the brain, spine and body. CT has the unique ability to image selectively by “windows” the digital image on the screen to look at soft tissue, bone and blood vessels.

Convention x-ray imaging: Shows the dense bone structure of the skull and spine.

Digital radiography: The TV signal from the x-ray system is converted to a digital picture which can then be enhanced for clearer diagnosis and stored digitally for future review.

Doppler ultrasound: Used to measure blood flow across a heart valve.

Echo Planar Imaging (EPI): An image that can show brain function, thus making the early detection of deadly stroke more possible.

Electron Beam Compute Tomography (EBCT): Uses a sweeping electron beam to create the rotating x-ray effect needed to make a computed tomography image. The EBCT is a very fast, non-invasive means to image the heart and coronary arteries. It eliminates the need for catheterization and contrast injection which is required in conventional cardia angiography. (An EBCT system can acquire at a rate of 10 to 20 images per second versus a slip-ring CT scanner that acquires one to two images per second.)

Film cassettes: To create an image by focusing x-rays through the body part of interest and directly onto a single piece of film inside a special cassette.

Fluoroscopy: Fluoroscopic imaging yields a moving x-ray picture or movie. It consists of an x-ray system and a fluorescent screen which registers x-rays and emitted glowing light. The doctor can watch the fluorescent screen and see moving images of the patient’s body.

Functional MRI (f-MRI): An image that can be used to glimpse at the neural activity of the brain along with showing the function of the cardiac muscle (myocardium).

Image intensifier: Television units used to allow dynamic x-ray imaging of moving scenes. These fluoroscopic movies provide new information of the beating heart and its blood vessels.

Magnetic Resonance Imaging (MRI): Uses magnetic energy and radio waves to create cross-section images or “slices” of the human body. The main component of most MR systems is a large tube shaped or cylindrical magnet. The three cross sectional images used are the axial orientation, sagittal orientation and the coronal orientation. Benefits include; it doesn’t use x-ray radiation, it gives better contrast definition then a CT can provide, can create detailed image of blood vessels without the use of contrast media.

MR Angiography: Developed and clinically available to allow non-invasive imaging of the blood vessels without radiation or contrast injection.

MR contrast media: A contrast called Gadolinium is used when imaging the vessels as well as soft tissue like the brain.

Myelography: A radiographic process by which the spinal cord and the spinal subarachnoid space are viewed and photographed after the introduction of a contrast medium. It is used to identify and study spinal lesions caused by trauma or disease.

Nuclear medicine or radionuclide scanning: Show the structure and function of an organ or body part thus showing if the organ is working properly. Low-level radio nuclides or radioactive chemicals are absorbed by or taking up at varying rates or taken up at varying rates or concentrations by different tissue types. The amount of radiation taken up and emitted by a specific body part is linked to metabolic activity (cellular function) of an organ or tissue. Cells dividing rapidly will show as “hot spots” of metabolic activity since they absorb more of the radio nuclide. A poorly functioning tissue will emit a different signal than healthy tissue, thus giving the physician an indication of how the tissue o organ is functioning.

Positron Emission Tomography (PET) scanning: A type of nuclear medicine scanning that involves cross sectional data acquisition and reconstruction much like computer tomography (CT) scanning. It has specific potential in imaging for showing hot spots of certain diseases and disorder of the brain (for example brain tumors) and the heart.

Radiology: A branch of medicine concerned with radioactive substances and, using various techniques of visualization, with the diagnosis and treatment of disease using any of the various sources of radiant energy.

Radiologic technologist: A person who, under the supervision of a physician (radiologist), operated radiologic equipment and assists radiologists and other health professionals, and whose competence has been tested and approved by the American Registry of Radiologic Technologists. (Also called x-ray technician.)

Radio nuclide: An isotope (or nuclide) that undergoes radioactive decay. Any of the radioactive isotopes of cobalt, iodine, phosphorus, stronitium, and other elements, used in nuclear medicine for imaging internal parts of the body.

Radioisotope: A radioisotope element, used for therapeutic and diagnostic purposes.

Radiopaque dye: A chemical substance that does not permit the passage of x-rays. Various radiopaque compounds are used to outline the interior of hollow organs such as heart chamber, blood vessels, respiratory passages, and the urinary tract in x-ray or fluoroscopic pictures.

Spiral CT: Allows a fast volume scanning of an entire organ during a single, short patient breath hold of 20 to 30 seconds.

SPECT (single positron emission computed tomography): Another type of nuclear medicine examination. It uses a gamma camera which can rotate, and has computer reconstruction similar to PET scanners.

Three-dimension image processing: Uses digital computer and CT or MR data, three dimensional images of bones and organs.

Tranischemic attacks (TIA): AN episode of cerebrovascular insufficiency, usually associated with a partial occlusion of an artery by an atherosclerotic plaque or an embolism.

Ultrasound scanning: This process involves placing a small device called a transducer with gel, against the skin of the patient near the region of interest. The transducer produces a stream of inaudible, high frequency sound waves which penetrate into the body and bounce off the organs inside and detects sound waves as they bounce off or echo back from the internal structures and contours of the organs. These waves are received by the ultrasound machine and turned into live pictures with the use of computers and reconstruction software.