You are here

Pratter Medical Terms Glossary

Blood Work

ACTH

Adrenocorticotropic Hormone is found in the pituitary gland. It results in the production and release of corticosteroids. ACTH is measured when Addison's disease or Cushing's syndrome are suspected.

Acute hepatitis panel

This panel is ordered for hepatitis. This panel tests for Hepatitis A, B and C. Symptoms of hepatitis can include fatigue and abdominal pain. A patient with hepatitis may notice his or her eyes or skin have turned slightly yellow, a medical condition termed jaundice.

Albumin

This panel is ordered for hepatitis. This panel tests for Hepatitis A, B and C. Symptoms of hepatitis can include fatigue and abdominal pain. A patient with hepatitis may notice his or her eyes or skin have turned slightly yellow, a medical condition termed jaundice.

Aldolase

Aldolase is an enzyme that can be elevated in cases in which there is muscle or liver damage. Therefore, it is ordered to assist in the evaluation of muscle and liver disease.

Alpha subunit pituitary hormones

This blood test is performed to help in the diagnosis of pituitary tumors in the brain.

Androstenedione

This test is performed to help diagnose medical conditions related to excess production of male hormones, which can include testosterone. This test can be ordered to assist in the diagnosis of congenital adrenal hyperplasia.

Anti-Cyclic Citrullinated peptide Antibodies (Anti-CCP)

This blood test can be ordered to help diagnose rheumatoid arthritis and assess its severity.

Anti-Diuretic hormone (ADH)

An ADH level is commonly ordered for the diagnosis of diabetes insipidus, a condition in which the kidneys are not able to conserve water. This can be associated with excessive thirst, referred to as polydipsia. It is also ordered for the Syndrome of Inappropriate ADH (SIADH), a condition in which there is excess secretion of SIADH. SIADH can occur after brain injury.

Anti-mitochondrial antibody

This test can be used to help evaluate for liver disease. It is used to assist in the diagnosis of primary biliary cirrhosis.

Anti-nuclear antibody (ANA)

This test is ordered to help evaluate for autoimmune disorders. This test is often abnormal in persons with systemic lupus erythematosus, more generically referred to as lupus, as well as Sjögren's syndrome and scleroderma.

Anti-thyroid peroxidase antibody (Anti-TPO)

Thyroid peroxidase is an enzyme found in a thyroid gland. It helps in the production of thyroid hormones. The presence of anti-TPO is noted in Hashimoto's disease or Graves' disease of the thyroid gland.

Basic Metabolic Panel (BMP)

This test measures sodium, potassium, calcium, chloride, carbon dioxide, glucose, blood urea nitrogen (BUN) and creatinine. BUN and creatinine serve as markers of kidney function.

C reactive protein

This blood test serves as a marker of inflammation. Therefore, it is elevated in various forms of infection, arthritis, vasculitis, lupus, and inflammatory bowel disease. It is also used as a screening tool for assessing risk of coronary artery disease.

C-peptide

C-Peptide is made by the pancreas. Therefore, it is used to help diagnose the most common problem of the pancreas, namely diabetes. It can help differentiate between Type I and Type II diabetes. A person with Type I diabetes has a low C-peptide, whereas a person with Type II diabetes can have a normal or high level of C-peptide.

C3 complement assay

The complement system is part of the immune system. Therefore, this test is abnormal in persons with autoimmune disorders such as rheumatoid arthritis or lupus. It is also ordered for some forms of autoimmune kidney disease, such as glomerulonephritis.

CA 125

Cancer antigen 125 is used to monitor cancer treatment. It can also be used to screen for ovarian cancer.

CA 19-9

Cancer antigen 19-9 serves as a blood test for pancreas cancer. It is used measure the effectiveness of pancreas cancer treatment.

Calcitonin

This hormone is made in the thyroid gland. Therefore, it is tested to evaluate for thyroid disease. The level of calcitonin is elevated with medullary thyroid carcinoma.

Calcium

Calcium is an important component for building bones. A high calcium level can be found in various forms of cancer that eat into the bone and then spill that extra calcium into the bloodstream. It can be low in forms of kidney and liver disease as well as in vitamin D deficiency.

Calcium, ionized

Calcium is an important component for building bones. Ionized calcium represents the calcium that is not attached to protein in the blood. Similar to calcium, its value is elevated in cancer that has spread to the bones and low in cases of low vitamin D level and kidney failure.

CarcinoEmbryonic Antigen (CEA)

This protein in the blood is often used as a colon and rectal cancer screening tool. It also can be used to evaluate the efficacy of treatment for cancer in these regions.

Chromogranin A

This test is used to help confirm the diagnosis of carcinoid tumors, including pheochromocytomas, medullary thyroid carcinomas and pituitary adenomas. It is also used to help determine the efficacy of treatment of such tumors.

Complete blood cell count (CBC)

A complete blood cell count assesses the levels of white blood cells, hemoglobin, hematocrit and platelet count. White blood cells are elevated in patients with infections. Hemoglobin and hematocrit are low in patients with anemia. Platelets are important for blood clotting, which means a low platelet count is a risk factor for excessive bleeding.

Complete blood cell count (CBC) with differential

In the medical world, this is often abbreviated or pronounced "CBC with diff." The differential refers to the different types of white blood cell counts which includes neutrophils, lymphocytes, monocytes, eosinophils and basophils. The levels of these different types of white blood cell counts have implications as to what is causing the infection. In a patient with a high clinical suspicion for an infection, a CBC with differential is ordered. A high neutrophil count points toward a bacterial infection. A high lymphocyte count points toward a viral infection. An elevated eosinophil count points toward an allergic process.

Complete Metabolic Panel (CMP)

This blood test measures the levels of glucose (sugar), sodium, potassium, calcium, chloride, carbon dioxide, blood urea nitrogen (BUN), creatinine, total protein, albumin, total bilirubin, alkaline phosphatase (ALP), aspartate aminotransferase (AST), and alanine aminotransferase (ALT). The BUN and creatinine assess kidney function. The total protein and albumin level assess nutritional status. The bilirubin level assesses liver and gallbladder function. The enzymes ALP, AST and ALT assess liver function.

Cortisol, free

This hormone is made in the adrenal glands. An abnormal cortisol level can indicate a medical condition adversely affecting the pituitary gland or the adrenal gland. An overactive adrenal gland is commonly associated with a medical condition known as Cushing's syndrome, which can cause weight gain with a rounded face appearance, high blood pressure and fatigue.

Creatinine

This is a blood test that evaluates the function of the kidney. The higher the lab value, the lower the kidney function.

Creatinine phosphokinase (CPK)

This is a muscle enzyme. It is elevated in muscle diseases that cause hip and shoulder girdle pain and weakness. It is also elevated in patients who are having a heart attack as the heart also is a muscle. The CPK level can be fractionated, which means it can be further subdivided to see how much of this enzyme is specifically related to heart damage.

DHEA

This is a male hormone test used to evaluate for diseases of the adrenal glands and testes. Patients with elevated DHEA levels have symptoms such as a deeper voice, acne, and muscularity. It can be elevated in patients with adrenal cancers and congenital adrenal hyperplasia.

Estradiol

This estrogen hormone test can be used to evaluate menstrual abnormalities and infertility. In addition, it can monitor anti-estrogen therapy for breast cancer and monitor/evaluate hormone replacement therapy for menopausal women. This test can also be used to detect estrogen-producing tumors.

Ferritin

Ferritin is a major iron storage protein in the human body. High levels are noted in a medical condition known as hemochromatosis. Low levels are noted in patients with iron deficiency anemia.

Folic acid

Folic acid is a type of vitamin B. It is needed to make red blood cells, white blood cells and platelets. It is important for the development of a fetus. It is commonly ordered as part of an anemia workup.

Follicular Stimulating Hormone (FSH)

This hormone is produced by the pituitary gland of the brain. It helps regulate the menstrual cycle and the production of eggs by the ovaries. It can be ordered to aid in the diagnosis of pituitary conditions as well as infertility in both men and women.

Glucose, fasting

This measures blood glucose after a fasting period of approximately 10-12 hours. If the blood glucose is elevated, it is supportive of the diagnosis of diabetes mellitus.

Growth hormone

Growth hormone is produced by the pituitary gland of the brain. Excess growth hormone during childhood can result in gigantism, whereas deficiency can result in dwarfism.

Hemoglobin A1C

This blood test is used to determine how well diabetes is being controlled over a several week time frame. If the hemoglobin A1C level is elevated, this is objective evidence of poor control of diabetes. It helps doctors counsel and prescribe proper diabetic medication.

Hepatitis A antibody

The presence of hepatitis A antibodies means that a person is or has been infected with hepatitis A virus.

Hepatitis B surface antibody

The presence of hepatitis B surface antibodies indicates that a person has successfully generated antibodies to fight off the hepatitis B infection or that there has been a successful response to a hepatitis B vaccination. The presence of hepatitis B surface antibodies indicates that one is immune to future hepatitis B infections.

Hepatitis B surface antigen

The presence of a hepatitis B surface antigen indicates that a person is infected either acutely or chronically with the hepatitis B virus. A person who has evidence of the hepatitis B virus antigen without evidence of any immune system response (hepatitis B surface antibodies) is contagious.

Hepatitis C antibody

The presence of hepatitis C antibodies indicates the presence of a hepatitis C viral infection. These antibodies do not provide immunity against this virus. It can take a few months after a hepatitis C infection before this test becomes positive.

Hepatitis C genotype

The hepatitis C virus has six different genotypes. This information is used to provide a prognosis in regard to the effectiveness of treatment.

Hepatitis C PCR

This test helps identify an active hepatitis C infection. It can be found within a few weeks of exposure to the hepatitis C virus.

Hydroxyprogesterone, 17-d

This test is most often ordered for an infant to help determine adrenal function. If elevated, this blood test is supportive of congenital adrenal hyperplasia (CAH), which is a disorder of the adrenal gland located just above the kidney. Symptoms and signs of adrenal gland dysfunction in young women can include irregular periods, deep voice, ambiguous genitalia, excessive hair growth and infertility. Signs and symptoms of adrenal gland dysfunction in young boys and men can include early onset puberty, deep voices, well-defined muscles and also infertility.

IBD 7 panel (Inflammatory Bowel Disease)

This blood panel is used to help differentiate ulcerative colitis from Crohn's disease in patients with inflammatory bowel disease. Not all patients fit into a clear-cut diagnosis for one of these two diseases, so this blood work can help confirm the diagnosis.

IGF-1

This stands for Insulin-like Growth Factor 1. It is used to help diagnose growth disorders.

INR level/PT level

This stands for International Normalized Ratio and Prothrombin Time. These are measures of how well or poorly blood thinner medication is being managed to prevent cardiovascular disease. This blood test is used for patients who take warfarin (brand name Coumadin) as a blood thinner. Blood thinners such as warfarin are commonly used after a heart attack, heart valve replacement surgery, blood clots or a stroke to prevent additional heart attacks, blood clots or strokes.

Insulin

Insulin is a hormone made in the pancreas. It is important for regulating blood glucose. Blood glucose is our main source of energy. The most common reason to order the blood test insulin is for the evaluation of diabetes mellitus.

Iron (Fe) level

Iron is a mineral needed for hemoglobin. Hemoglobin is a part of the red blood cell that carries oxygen throughout the body. This test is ordered to check for iron deficiency anemia - a disease in which the iron level would be low. In hemochromatosis, in the iron level would be high.

Lipid panel (cholesterol and triglycerides)

This panel includes a cholesterol level, triglyceride level, HGL cholesterol level (good cholesterol), and LDL cholesterol level (bad cholesterol). This panel blood test helps assess risk factor and treatment protocols for the prevention of coronary artery disease and stroke.

Luteinizing Hormone (LH)

Luteinizing hormone is made by the pituitary gland of the brain. For men, luteinizing hormone is associated with the production of testosterone. For women, luteinizing hormone is associated with menstrual regularity. This test is ordered to help evaluate causes of infertility.

Lyme antibody titer

The presence of Lyme antibody in the blood indicates that a person either has or had Lyme disease. Lyme disease can present as fatigue, muscle pain and/or multiple joint pain after being bitten by a deer tick infected by the bacteria Borrelia burgdorferi. Classically, Lyme disease also has a red bulls eye rash.

Magnesium

Magnesium plays an important role in muscle function. Therefore, magnesium deficiency can be associated with muscle weakness, cramping, cardiac dysrhythmias and seizures. A magnesium level can be low in patients with kidney disorders, such as those associated with diabetes mellitus or any gastrointestinal disorder causing a lack of absorption of magnesium.

Norepinephrine/epinephrine (Catecholamines, fractionated)

These hormones are made in the brain and adrenal glands. Generically, they can be referred to as adrenaline. They are responsible for "fight or flight" reactions. Norepinephrine and epinephrine result in increased heart rate, blood pressure, and breathing rate. A tumor known as a pheochromocytoma can increase the amounts of these hormones in the bloodstream.

Prolactin

Prolactin is a hormone made by the pituitary gland of the brain. Prolactin helps make breast milk. It can be ordered to evaluate for pituitary tumors presenting as amenorrhea, infertility and erectile dysfunction associated with a low testosterone level.

Prostate specific antigen (PSA) total

Prostate specific antigen is a protein produced by the prostate gland. It is widely used to screen for prostate cancer. It can also be used to evaluate the efficacy of prostate cancer treatment or to see if prostate cancer has recurred. Sometimes, though, it can be elevated without cancer in medical conditions including prostatitis or benign prostatic hypertrophy (BPH).

PTT (Partial Thromboplastin Time)

Partial thromboplastin time measures the time it takes blood to clot. A PTT level is measured to evaluate the efficacy of the blood thinning property of heparin, an intravenous blood thinner used immediately after the diagnosis of a blood clot in the leg or lung. A properly elevated PTT level indicates that heparin is working properly to prevent the formation of additional blood clots.

Renin

Renin is an enzyme located in the kidneys. In patients with high blood pressure, renin can be ordered as part of a workup to identify the cause of high blood pressure, particularly when the patient has a low potassium level.

Sed rate (ESR)

Sed rate is the short term for erythrocyte sedimentation rate. This blood test evaluates the amount of inflammation in a person's body. A sed rate is elevated in a patient with an inflammatory process. It is a sensitive but not specific test. In other words, a sed rate is good at determining if there is inflammation in the body but not good at identifying the cause of the inflammation. Inflammation can be caused by infections, trauma or arthritis. If a sed rate is elevated, your doctor will look further into its cause. If a sed rate is normal, there is much less clinical concern for an inflammatory process. A sed rate can be used to monitor the efficacy of treatment of inflammatory conditions, such as rheumatoid arthritis or lupus. Effective treatment results in a lower sed rate.

SGPT/ALT

This is also known as Serum Glutamic Pyruvic Transaminase or Alanine Amino Transferase. It is an enzyme located in the liver and heart and will be elevated with liver and heart disease, including hepatitis and cirrhosis.

Smooth muscle antibody

This blood test is ordered to assist in the diagnosis of an autoimmune form of hepatitis, which is known to be much more common in women.

SPEP

This stands for Serum Protein Electrophoresis. Additional proteins found in the blood via this technique are often used to assist in the diagnosis and treatment of multiple myeloma.

Thyroglobulin

A thyroglobulin level is ordered to evaluate the presence versus absence of a residual thyroid cancer after thyroid treatment, such as a thyroidectomy.

Thyroglobulin antibody (anti-thyroglobulin antibody)

This test can be used to evaluate for autoimmune thyroid diseases, including Hashimoto's disease and Graves' disease.

Thyroid Stimulating Hormone (TSH)

A TSH level is ordered to help determine the cause of a person?s fast or slow body metabolism. TSH is produced in the brain. It makes the thyroid gland produce two additional hormones, including triiodothyronine (T3) and thyroxine (T4).

Thyroid stimulating immunoglobulin

This thyroid antibody test is ordered to evaluate for autoimmune thyroid disease, including Graves' disease and Hashimoto's disease.

Thyroxine binding globulin

Thyroxine binding globulin binds to the thyroid hormone in your bloodstream. This test is sometimes ordered to help determine the clinical reason for an elevated or lowered level of thyroid hormone.

Total Iron Binding Capacity (TIBC)

Total iron binding capacity is a test ordered to help evaluate patients who are suspected of either iron deficiency or iron overload. The medical diagnosis for a person with iron deficiency is termed anemia. Symptoms of anemia can include fatigue, weakness, and headaches. The medical diagnosis for a patient with an iron overload is termed hemachromatosis. Symptoms of iron overload include joint pain, abdominal pain, and fatigue.

Vitamin B12 level

A vitamin B12 level is ordered for medical conditions associated with Vitamin B12 deficiency including pernicious anemia, an autoimmune disease, alcoholism, Crohn?s disease, gastric bypass surgery, a peripheral neuropathy and delirium. Vitamin B12 is important to our central and peripheral nervous system.

Vitamin D level

A vitamin D level is ordered for patients who present with symptoms of a low Vitamin D level, such as fatigue or muscle aches. Vitamin D is also important for bone strength. It is also ordered as part of an osteoporosis work up. Sunlight exposure is necessary for the absorption of Vitamin D. Therefore, a low vitamin D level is more common in parts of the country where the majority of the days are cloudy.

Cardiology

Cardiac catheterization

A cardiac catheterization usually occurs via the insertion of a catheter through the femoral artery of a patient in the groin region. The catheter is threaded up through the aorta and into the heart where the coronary arteries and heart chambers can be visualized with dye placed through the catheter. Any narrowing or clogging of the arteries can be identified and subsequently treated with such procedures as balloon angioplasty, stent placement, or coronary artery bypass graft surgery.

Exercise or pharmacologic stress echocardiogram

There are two types of stress echocardiograms. The first type is an exercise stress echocardiogram that involves running on a treadmill and then performing the echocardiogram while the heart is pumping hard (under stress). For individuals not physically fit or for those with significant heart and/or lung disease, a medication, such as dobutamine, places some stress on the heart as if one physically exercised and then echocardiogram is performed. This is referred to as a pharmacologic stress echocardiogram. This is the second type of stress echo.

CT

Abdominal CT angiography

CT stands for computerized tomography. The term angiogram refers to the imaging of blood vessels. A CT angiogram therefore refers to CT imaging of blood vessels. For example, an abdominal CT angiogram can be used to evaluate for an abdominal aortic aneurysm, which is a ballooning of an artery that places it at risk for rupture.

Doctor's Visits

ER visit, level 2, low severity

Usually, the presenting problem is of low to moderate severity. This includes an ER physician taking a patient history, performing a focused examination and making a medical decision of low complexity.

ER visit, level 3, moderate severity

Usually, the presenting medical problem is of moderate severity. The ER physician evaluation and management includes taking an expanded clinical history, performing an expanded focused clinical examination and medical decision making of moderate complexity.

ER visit, level 4, high severity

Usually, the presenting problem is of high severity and requires the urgent evaluation by the emergency physician but it does not pose an immediate significant threat to life or physiologic function of the patient. This evaluation and management by the ER physician includes a taking a detailed clinical history, performing a detailed clinical examination and making a medical decision of moderate complexity.

Established patient follow up visit, Level 1, Medicare and Non-Medicare

A follow up office visit for an established patient that may not require the presence of a physician. Usually, the presenting clinical problem is minimal.

Established patient follow up visit, Level 2, Medicare and Non-Medicare

A follow up office visit for an established patient that may not require the presence of a physician. Usually, the presenting clinical problem is minimal.

Established patient follow up visit, Level 3, Medicare and Non-Medicare

A follow up office visit for an established patient that requires an expanded focused clinical history, an expanded focused clinical examination and medical decision making of low complexity. The presenting clinical problem is of low to moderate severity.

Established patient follow up visit, Level 4, Medicare and Non-Medicare

A follow up office visit for an established patient that requires a detailed clinical history, a detailed clinical examination and medical decision making of moderate complexity. The presenting clinical problem is of moderate to high severity.

Established patient follow up visit, Level 5, Medicare and Non-Medicare

A follow up office visit for an established patient that requires a comprehensive clinical history, a comprehensive clinical examination and medical decision making of high complexity. The presenting clinical problem is of moderate to high severity.

Medicare new doctor visit, Level 1

A new office visit for a patient with a Medicare insurance product that requires a focused clinical history, a focused physical examination and straightforward medical decision making. The presenting clinical problem is usually self-limited or minor.

Medicare new doctor visit, Level 2

A new office visit for a patient with a Medicare insurance product that requires an expanded focused clinical history, an expanded focused physical examination and straightforward medical decision making. The presenting clinical problem is of low to moderate severity.

Medicare new doctor visit, Level 3

A new office visit for a patient with a Medicare insurance product that requires a detailed clinical history, a detailed clinical examination and medical decision making of low complexity. Even though the decision making is of low complexity, the presenting clinical problem is of moderate severity.

Medicare new doctor visit, Level 4

A new office visit for a patient with a Medicare insurance product that requires a comprehensive clinical history, a comprehensive clinical examination and medical decision making of moderate complexity. The presenting clinical problem is of moderate to high severity.

Medicare new doctor visit, Level 5

A new office visit for a patient with a Medicare insurance product that requires a comprehensive clinical history, a comprehensive clinical examination and medical decision making of high complexity. The presenting clinical problem is of moderate to high severity.

Non-Medicare new doctor office visit, Level 1

A new office visit for a patient with a non-Medicare insurance product that requires a focused clinical history, a focused clinical examination and straightforward decision making. The presenting clinical problem is self-limited or minor.

Non-Medicare new doctor office visit, Level 2

A new office visit for a patient with a non-Medicare insurance product that requires an expanded focused clinical history, an expanded focused clinical examination and straightforward medical decision making. The presenting clinical problem is usually of low severity.

Non-Medicare new doctor office visit, Level 3

A new office visit for a patient with a non-Medicare insurance product that requires a detailed clinical history, a detailed clinical examination and medical decision making of low complexity. Even though the decision making is of low complexity, the presenting clinical problem is of moderate severity.

Non-Medicare new doctor office visit, Level 4

A new office visit for a patient with a non-Medicare insurance product that requires a comprehensive clinical history, a comprehensive clinical examination and medical decision making of moderate complexity. The presenting clinical problem is of moderate to high severity.

Non-Medicare new doctor office visit, Level 5

A new office visit for a patient with a non-Medicare insurance product that requires a comprehensive clinical history, a comprehensive clinical examination and medical decision making of high complexity. The presenting clinical problem is of moderate to high severity.

Ear, Nose and Throat (ENT)

Fine needle biopsy neck

A fine needle biopsy or fine needle aspiration are interchangeable terms. A fine needle aspiration occurs when a needle is inserted into an area of clinically suspected abnormal material, usually either the thyroid gland or a lymph node. A fine needle biopsy serves as a minimally invasive technique used to evaluate for cancer.

Flexible laryngoscopy

This involves examining the throat, including the vocal cords. A thin, flexible lit scope is placed through the nose and down the throat. This test can detect throat cancer, vocal cord polyps and irritation and swelling of the vocal cords due to acid reflux. Patients with throat pain, voice changes, chronic cough, or breathing problems may undergo this test.

Microlaryngoscopy

This is a microscopic (magnified) view of the vocal cords via a laryngoscope. A laryngoscope is a scope with a light used to evaluate medical conditions of the larynx (voice box).

Nosebleed (epistaxis) cauterization with rigid scope

The medical term for nosebleed is epistaxis. A recurrent or persistent nosebleed may require cauterization with a rigid scope. A scope is placed into the nose to permit the otolaryngologist to view the exact site of bleeding in order to stop its flow.

Otoacoustic emissions

This is a hearing test that measures responses produced by the inner ear, referred to as the cochlea. The test involves the placement of a probe into the ear with a microphone that picks up up a sound recording omitted from the cochlea. Some patients with hearing loss do not have this emission. Otoacoustic emissions can be used as a hearing test screen for infants.

Sinus endoscopy

An endoscope is inserted into the nose. The scope does not advance into the sinuses but permits a limited view of them. This test can detect blockage of nasal passages due to nasal polyps. It can also help identify foreign bodies.

Turbinate reduction, inferior

The goal of this surgery is to improve nasal breathing. The inferior turbinate bones are resected to enlarge the nasal passage. If the turbinates are enlarged, it is more difficult to breathe through the nose.

Tympanometry

Tympanometry is a test to help determine if there is fluid behind the eardrum or a perforation of the eardrum. This can be caused by an ear infection, referred to as otitis media. This test is performed by placing the instrument into the ear. The change in ear pressure induced by the instrument causes the eardrum to respond to both the pressure and the sound, which is then measured.

Tympanoplasty

Tympanoplasty refers to the surgical repair of an eardrum. A perforated eardrum surgery can be performed to reduce infection in the middle ear and to improve hearing.

Uvuloplasty for sleep apnea

A uvuloplasty is the term used for removal of part or all of the uvula in the top back portion of the mouth. The removal of this tissue opens up the air passageway. The purpose of performing a uvuloplasty is to alleviate or eliminate sleep apnea and snoring.

Videonystagmography (VNG) and 4 units caloric vestibular test

This test evaluates inner ear function, which is responsible for balance and dizziness. This test has four parts ? all of which assess eye movement. Two parts of this test include the eyes following an object or image movement. One part involves head and body movement which, in turn, is associated with observed eye movements. Fourth, caloric testing involves the placement of warm and cold air into the air canal and eye movements are observed.

Gastroenterology

Colonoscopy with polyp removal via cold biopsy

A polypectomy is the removal of a polyp. The removal of polyps reduces the risk of colon cancer. A small polyp is removed via cold forceps.

Colonoscopy with polyp removal via hot biopsy

A polypectomy is the removal of a polyp. The removal of polyps reduces the risk of colon cancer. Hot forceps are used to perform an electrocautery procedure in an effort to destroy residual polyp tissue during this type of polypectomy.

Colonoscopy with polyp removal via snare

A polypectomy is the removal of a polyp. The removal of polyps reduces the risk of colon cancer. A larger polyp is removed via a snare technique, which involves the application of a metal ring that is placed over the polyp and then closed around it before removing it.

Colonoscopy, dilation by balloon

A balloon is used to dilate or open up a stricture (narrowing) in the colon, which is a known complication in some patients with Crohn?s disease. A scope with a light and camera is placed through the anus and into the large intestine for this procedure.

Flexible sigmoidoscopy

This test involves inserting a scope into the rectum and into the last two feet of the large intestine referred to as the sigmoid colon. The large intestine is approximately 5 feet in total. A flexible sigmoidoscopy can help diagnose a cause of lower gastrointestinal tract bleeding and also screen for colon cancer. A scope with a light and camera is placed through the anus and into the sigmoid colon for this test.

Gastrostomy tube (G tube) with upper GI endoscopy

A gastrostomy tube is also known as a G tube or a feeding tube. For patients who cannot eat due to a stroke or some other medical condition leaving them with an inability to obtain adequate calories by mouth, a G tube is placed into the stomach. The G tube has an exit through the skin of the belly overlying the stomach. Bags of nutrition containing proper balances of carbohydrates, sugars and protein are then administered to the patients via the G tubes. A G tube can be placed either temporarily or permanently.

Hemorrhoid banding

A scope is placed into the anus and the hemorrhoid is tied off at its base with rubber bands. By doing this, the hemorrhoids no longer get blood flow. In several days to one week, the hemorrhoid then shrinks and falls off.

Small bowel capsule endoscopy

A capsule with a small camera inside it is swallowed. The camera takes several pictures as it is transmitted through the gastrointestinal tract. Capsule endoscopy permits visualization of the approximate 20 feet of small bowel that a gastroenterologist cannot reach via an upper GI endoscopy (EGD) or colonoscopy. This test is used to help evaluate for medical conditions adversely affecting the small bowel.

General Surgery

Abscess incision and drainage, head or neck

An abscess is an infection with a collection of pus. It cannot be treated with antibiotics by mouth or intravenously because a pus ball does not have blood supply. Antibiotics can only get to a site of infection via blood supply. Thus, an abscess must be drained. This means that the surgeon will place a cut in the area of the abscess and permit it to drain.

Anoscopy, diagnostic

An anoscopy is the viewing of the anus, anal canal and internal sphincter region with a scope usually for the purpose of detecting a source of bleeding or discomfort, such as internal hemorrhoids. It can also be used to identify and remove a foreign body or to assist in the diagnosis of cancer in this region.

Botox limb injection 5 or more muscles for spasticity with Botox A 300 units

Botulinum ("Botox") is a toxin that causes paralysis of muscle fibers by working at the neuromuscular junction. Botox is clinically for treating patients with spasticity of the upper limbs, most commonly from strokes. Spasticity is defined as the triad of hyperreflexia, pathologic reflexes and uni-directional velocity dependent resistance through a single plane of motion. In layman's terms, think of spasticity as tight muscles due to a brain or spinal cord injury or disease process. Botox injections help reduce the overall muscle tone which allows a limb to be more functional. This permits more motion at a joint to facilitate activities of daily living.

Botox neck injection for cervical dystonia with Botox A 100 units

Botulinum ("Botox") is a toxin that causes paralysis of muscle fibers by working at the neuromuscular junction. Botox is clinically for treating patients with cervical dystonia. In layman's terminology, tight and painful muscles are injected with Botox. This reduces muscle tone and pain and thereby also enhances neck range of motion.

Breast biopsy

A needle is placed, often with the assistance of imaging, such as ultrasound, into a suspicious breast lump. This is the least invasive way to obtain breast tissue for analysis in a pathology lab to be examined for cancer.

Breast mastectomy, partial with ID of sentinel lymph nodes

Mastectomy is the medical term used for removal of a breast. If only part of the breast is removed, it is termed a partial mastectomy. The sentinel lymph nodes are the first nodes that the breast tissue empties into and therefore are the lymph nodes most likely to have cancer. Therefore, a breast mastectomy often occurs with sentinel lymph node dissection and pathologic tissue analysis for cancer.

Cholecystectomy (gallbladder removal), laparoscopic technique

This is the term for the surgical removal of the gallbladder. Painful gallstones and/or resistant gallbladder infections can be treated with the removal of the gallbladder. This surgery is statistically more common in obese individuals.

Exploratory laparoscopy

A laparoscopy involves placing a scope with a camera in the abdomen through a small incision to look at the abdominal and/or pelvic structures for diagnostic and treatment purposes. The abdomen is usually artificially filled with air to create space to view the internal structures.

Gastric banding, laparoscopic, bariatric surgery

This is a form of bariatric surgery. Bands are placed on the outer portion of the stomach constricting it, and thereby limiting how much food and drink can go through the stomach. Thus, caloric content is limited.

Gastric bypass, laparoscopic, bariatric surgery

This is a form of bariatric surgery. A portion of the stomach is removed and sewn together making the stomach smaller. This results in fewer calories being absorbed. It is common for a person to lose about 100 pounds after this procedure.

Lumbar puncture (spinal fluid tap) with CerebroSpinal Fluid (CSF) analysis

A lumbar puncture can also be referred to as a lumbar spinal tap. The spinal fluid is analyzed to look for infection or elevated proteins. With an infection, there would be elevated white blood cell counts. The cerebrospinal fluid can be cultured for bacteria to determine the type of infection. Elevated protein levels in the cerebrospinal fluid can be used to support the diagnosis of multiple sclerosis or Guillain-Barre syndrome.

Muscle biopsy, surgery

There are several different types of muscle disease. A small scalpel is used to resect a piece of muscle that is adversely affected (often a thigh muscle). This muscle tissue is analyzed in a clinical pathology lab to determine the specific type of muscle disease for treatment and prognosis.

Umbilical hernia repair, laparoscopic

The umbilicus is the medical term for the belly button. A hernia is an outpouching or rupture through the abdominal muscle wall by some bowel. Thus, an umbilical hernia involves the separation of muscle near the umbilicus. In layman?s terminology, a bulge around the belly button is noted. Surgical treatment can include suturing the muscle together for smaller hernias, while larger hernias require a piece of mesh to be put in place to help hold the larger abdominal wall defect together.

Miscellaneous Imaging

Barium swallowing study

This study involves the swallowing of barium, a liquid contrast medium that helps light up the esophagus and stomach. After swallowing the dye, x-rays are taken that light up this part of the gastrointestinal tract. It is used for stroke patients to make certain that they are safe to swallow liquids and different types of food. A barium swallowing study can also help detect narrowing of the esophagus, ulcers, tumors and a hiatal hernia.

Gastric emptying study

This is a nuclear medicine study whereupon a person will have a small amount of tasteless radioactive material placed in either food or a liquid and over several hours repeat scans are performed to see how fast the food and drink is passing through one's gastrointestinal tract. There is no pain involved with this test. This test is performed for gastroparesis. Gastroparesis is the term referred to a medical condition in which there is a slow emptying through the digestive tract. Gastroparesis is associated with symptoms of abdominal pain and bloating.

MR cholangiogram (MRPI)

The MR stands for Magnetic Resonance. Therefore, this is a magnetic resonance imaging study of the biliary tract. Biliary tract refers to the region of the gallbladder. This MRI looks for an obstruction of the bile. It is used for cases of cancer, referred to as malignancy, where there is obstruction of bile without an obvious gallstone causing the obstruction. It is a non-invasive method of anatomically diagnosing a medical condition without requiring some type of needle or scope.

Neurosurgery

Carpal tunnel release surgery

Carpal is Latin for hand. Therefore, carpal tunnel syndrome means hand tunnel syndrome. This medical condition causes numbness and tingling in the hand, pain in the thumb muscles in the palm of the hand and can cause a permanent loss of thumb/grip strength. The number one risk factor for carpal tunnel syndrome is obesity. Furthermore, it is four times more common in women than men because women have smaller hands than men; hence women have smaller hand tunnels than men but they still have to have the same 10 tendons and one carpal tunnel nerve (median nerve) travel through a small space. A carpal tunnel release surgery involves cutting a transverse carpal ligament in half. This is analogous to raising a drawbridge. A ligament on the palmar surface of the hand is cut in half to create more space. In general, this surgery has an excellent success rate. Surgery sooner than later is associated with a better outcome on a permanent basis. Waiting too long for surgery in the order of years often means that the carpal tunnel nerve is permanently injured.

Obstetrics/Gynecology

Colposcopy of cervix

A colposcope is inserted into the vagina where it can be used to help evaluate and diagnose precancerous or cancerous areas, including the vulva, vagina and cervix. It also can be used to help diagnose and treat genital warts and inflammation of the cervix, known as cervicitis.

Dilitation and curettage (D & C)

A D&C removes tissue from the lining of the uterus. This cleaning of the uterine lining is performed for women with heavy menstrual periods or after a miscarriage or abortion.

Endometrial aspiration biopsy

The endometrium is the lining of the uterus. An endometrial biopsy involves a gynecologist taking a portion of the endometrium via a thin straw or a brushing to obtain endometrial cells. These endometrial cells are examined in a clinical pathology lab to determine the cause of abnormal bleeding or to check for cancer.

Pap smear, lab screening

A pap smear is performed to screen for cancer of the cervix. It is performed in the doctor?s office while the woman is lying on the physical examination table in stirrups. A speculum is inserted into the vagina, so that the gynecologist can identify the cervix and obtain cells with a soft brush or spatula. The cervix tissue sample is analyzed under a microscope to determine whether or not there is any evidence of cancer.

Tubal ligation

In layman?s terminology, a tubal ligation is referred to as a woman having her ?tubes tied.? The fallopian tubes can be cut or tied off so that a woman can no longer become pregnant. It can be performed conveniently at the time of a cesarean section. Otherwise, it can be done laparoscopically with small incisions.

Ophthalmology

Anterior vitrectomy

The vitreous is the clear fluid in the eye. Anterior means front, so this procedure is the removal of the vitreous humor from the front. This is done for removal of foreign bodies, floaters interfering with vision, bleeding, and dislocation of the intraocular lens.

B-scan ultrasound

A B-scan ultrasound is performed with the eyes closed. A water-based gel is placed on the eyelid and the ultrasound device looks through the eyelid and into the eye. This is performed to evaluate the anatomic location of a lens implant, glaucoma, cataracts, and tumors.

Capsulotomy

This ophthalmic procedure is performed if there is cloudiness on the back side of a lens. Clouding of a lens is a common complication of cataract surgery. If the cloudiness adversely affect a person?s vision enough, he or she may consider a capsulotomy to remove part of the capsule to eliminate cloudiness and improve vision.

Cataract surgery

A cataract results in cloudiness of the lens. Cataract surgery involves removal of the original lens and placement of an artificial lens.

Corneal topography

This is a mapping of the cornea, known as the surface of the eye. It is performed by projecting specific light patterns onto the corneal surface that are reflected, measured and stored to a computer. Corneal topography is most commonly performed on those about to undergo LASIK procedure. LASIK reduces or eliminates near-sightedness (myopia) so that one does not need glasses.

Fluorescein angiography

In this procedure, fluorescein, a dye, is injected into a vein, usually in the forearm. The dye circulates throughout the entire body. As it circulates through the eyes, pictures are taken to help determine the pattern of blood flow in the back of the eye. A disruption of blood flow could be due to retinal tears or diabetic retinopathy. This procedure helps pinpoint areas of the retina that need to be treated via laser surgery.

Fundus photo, bilateral

The fundus is the interior surface of the eye, which includes the retina, optic disc, macula, fovea and posterior pole. A patient looks into a low power microscope with a camera that takes pictures of the inside of the eye. This evaluates for diseases and injuries to the eye structures named.

Gonioscopy, bilateral

This is performed to look for glaucoma at the front of the eye. In this procedure, the eyes are numbed with anesthetic drops and a lens with mirrors is placed on the front of the eye. The eye doctor can then direct a beam of light to evaluate the angles of the eye affected by glaucoma.

Indocyanine Green Angiography (ICG)

In this test, the indocyanine green dye is injected into the vein of a forearm. It then quickly circulates through all the blood vessels, including those of the eyes. Thus, it is used to diagnose injury and disease processes of the eye blood vessels. It can facilitate the diagnosis of a retinal tear with bleeding as well as macular degeneration.

IntraOcular Lens (IOL) exchange

This is part of a procedure for a cataract removal. The lens a person is born with is removed and a new artificial lens is replaced (exchanged) to improve one?s vision.

Intravitreal injection with Ozurdex

Ozurdex injections are approved for macular edema (swelling) due to retinal vein occlusion or diabetes. It is also indicated to treat non-infectious inflammation of the uvea affecting the back portion of the eye. The eye is numbed with drops and a small needle is inserted into the eyeball to deliver the medication.

Intravitreal injection with Lucentis

Lucentis injections are approved for macular degeneration, macular edema (swelling) following retinal vein occlusion as well as diabetic macular edema. The eye is numbed with drops and a small needle is inserted into the eyeball to deliver this medication.

Iridotomy/iridectomy laser

This procedure is performed on patients with acute closed-angle glaucoma. A beam of light is directed at the edge of the iris to create a hole that allows fluid to flow more freely between the front and back parts of the eye. The goal is to decrease pressure buildup within the eye that is associated with glaucoma.

Laceration/puncture closure

Direct trauma to the eye can require an ophthalmologist to surgically close the wound to facilitate healing and prevent infection.

Laser, focal

Focal laser is used to treat macular edema. The macula is the back center part of the eye. It is located within the retina. Edema refers to swelling. Therefore, this procedure treats swelling in the center of the retina with a laser. This is performed for diabetic macular edema.

PAN retinal laser

Pan retinal laser surgery treats diabetic retinopathy. This disease can cause multiple small blood vessels to bleed, causing permanent eye damage and loss of vision. The laser treatments help stop the bleeding and hopefully also prevent retinal detachment. Hundreds of very small, brief, focused points of laser are placed into the retina.

Pars plana vitrectomy

The vitreous is the clear fluid in the eye. A pars plana vitrectomy is done for removal of foreign bodies, floaters interfering with vision, bleeding and dislocation of the intraocular lens.

Pneumatic retinopexy

This is performed on patients with a retinal detachment. A retinal detachment can cause permanent loss of vision. If the retinal tear and subsequent detachment are in the top half of the eye, a gas bubble is injected into the eyeball. This bubble then floats to the top half of the eye and pushes the retina against the back of the eyeball where is belongs. The patient may have to keep his or her head in the same position 24 hours a day for multiple days in order to keep the gas bubble in proper position while the retina heals back in place. The gas bubble will spontaneously resorb and go away.

Retinal break laser

A laser is used to ?spot weld? a retina that has broken or torn away from the back of the eyeball. The retina is responsible for vision. A retinal tear does not cause loss of vision, but if the retinal tear would detach from the back of the eye, blindness will ensue. The purpose of lasering a retinal tear is to prevent blindness. If there is a retinal tear with detachment, laser treatment is used to help restore vision. During this procedure, the eye is first numbed with a lubricant. Then, a needle is inserted for further anesthesia inside the eyeball. The laser device shoots short, quick repetitive bursts of laser to the back of the eyeball to help hold the retina in place.

Retinal detachment prophylaxis via cryo

Cryotherapy is used to ?spot weld? a retina that has broken or torn away from the back of the eyeball. The retina is responsible for vision. A retinal tear does not cause loss of vision, but if the retinal tear would detach from the back of the eye, blindness will ensue. The purpose of using cryotherapy on a retinal tear is to prevent blindness. If there is a retinal tear with detachment, cryotherapy treatment is used to help restore vision. During this procedure, the eye is first numbed with a lubricant. Then, a needle is inserted for further anesthesia inside the eyeball. The cryotherapy device shoots short, quick repetitive bursts of cold to the back of the eyeball to help hold/freeze the retina in place.

Tear duct probe

A tear duct probe treats a blocked tear duct. This procedure can be done under local or general anesthesia. It is most commonly performed on babies.

Trabeculoplasty laser

Laser trabeculoplasty is a medical procedure used to treat glaucoma. The laser treatment helps permit fluid to flow out of the front part of the eye and thereby decreasing pressure in the eye.

Vitrectomy

The vitreous is the clear fluid in the eye. A vitrectomy is done for removal of foreign bodies, floaters interfering with vision, bleeding and dislocation of the intraocular lens.

Vitrectomy and PanRetinal Photocoagulation (PRP)

This procedure is performed for patients with diabetic retinopathy. The vitreous is the clear fluid in the eye. A vitrectomy is done for removal of foreign bodies, floaters interfering with vision, bleeding and dislocation of the intraocular lens. In other words, the vitreous was no longer clear and therefore it was removed. The term ?pan? refers to all over. The laser treatments help stop the bleeding and hopefully also prevent retinal detachment. Hundreds of very small, brief, focused points of laser are placed into the retina.

Vitrectomy epiretinal peel

A vitrectomy indicates the removal of the fluid inside the eyeball. It is removed when it becomes cloudy and impairs vision, such as with significant bleeding or floaters. Sometimes, an epiretinal membrane peeling, also known as a membranectomy, can be performed at the same time. This is done to restore some vision in the area of the macula ? the center of the eye. At times, the epiretinal membrane, known as the macular pucker, develops scar tissue. As the macula scars, central vision can be distorted and objects can appear wavy. Removing the epiretinal membrane via a procedure called a peel can help reduce this distortion.

Orthopedic Surgery

Arthroscopic Anterior Cruciate Ligament (ACL) reconstruction Surgery

The anterior cruciate ligament is responsible for stabilizing the knee, especially in sports that require ?cutting?, such as basketball, soccer and tennis. This ligament connects the femur and tibia bones. The torn ACL ligament is removed completely. One of three sources of a tendon graft are used to make the new ACL ligament: 1) the patient?s own patella tendon, 2) a cadaver ACL graft, or 3) a portion of the patient?s hamstring tendon. This procedure is performed arthroscopically via three small incisions around the knee. An arthroscope with a light and a camera projects an image onto a screen to facilitate the orthopedic procedure.

DeQuervain tenosynovectomy

This involves the removal of synovium (a covering on top of the tendon) on the thumb side of the wrist near the larger of the two forearm bones, referred to as the radius. A chronic inflammation of the tendon can be cured of a tenosynovitis if there is no longer a synovium to become inflamed (synovitis).

Ganglion cyst excision

A ganglion cyst involves the formation of a gelatinous substance on the surface of a tendon, most often at the wrist. There is no known cause for its development. The orthopedic surgeon can remove this benign structure in an outpatient setting.

Rotator cuff repair, arthroscopic

The rotator cuff is made up of four muscles, each of which has its own tendon. Most of the time, with a rotator cuff tear, the supraspinatus tendon is the one that gets torn. This tendon can be sutured back together in most instances. Often, the orthopedist will also shave away any arthritis in the area of this tendon so that there is more space in the shoulder joint to prevent any future fraying of this tendon by bone spurs.

Shoulder impingement syndrome arthroscopic acromioplasty decompression

Shoulder impingement syndrome is often caused by the formation of osteoarthritis at the shoulder. As bone spurs (osteophytes) form as a result of the aging process, there is less shoulder joint space that results in an impingement of bone on the rotator cuff and biceps tendon with overhead activities. In this case, the orthopedic surgeon shaves the undersurface of the acromion (one of the bones at the shoulder joint) to create a ?new and improved? larger shoulder joint space. This procedure is performed arthroscopically via three small incisions around the shoulder. An arthroscope with a light and a camera projects an image onto a screen to facilitate the orthopedic procedure.

Trigger finger release

A trigger finger is diagnosed when there is thickening of a tendon that causes it to catch or trigger as it travels through a tunnel through on the palm side of the hand. The tendon becomes too large for its tunnel. This condition is more common in diabetics and alcoholics, although the majority of cases have no known cause. An orthopedic surgeon can perform a simple outpatient procedure to help the affected tendon glide better through the arch or pulley system at the metacarpophalangeal (MCP) joint.

Ulnar nerve decompression

The ulnar nerve at the elbow is also referred to as the funny bone nerve. This nerve is most often injured at the elbow. The ulnar nerve is one of two nerves that provide strength to the hand. If injured, the ulnar nerve most often causes numbness and tingling in the small and ring fingers. It can also cause weakness in the hand. This injury can be caused by either overuse or direct trauma. An ulnar nerve decompression surgery is performed to alleviate any pressure on the ulnar nerve that occurs with motion at the elbow, particularly with elbow flexion (bent).

Wrist fracture surgery, open reduction and internal fixation

An orthopedic surgeon uses a scalpel, exposes the fractured bone and uses some type of metal device to stabilize the broken bone.

Pain Anesthesiology

Caudal epidural corticosteroid injection with fluoroscopy (x-ray guidance)

A caudal epidural corticosteroid injection is used to help treat an inflamed nerve root in the back causing pain down a patient?s lower limb. The medical term for this is a lumbosacral radiculopathy. The layman?s term for this is ?sciatica,? although the sciatic nerve is not the site of pathology. This injection occurs in the area of the tailbone, medically termed the sacrum. This injection is performed under fluoroscopic (x-ray) guidance. The goal of this procedure is to place the anti-inflammatory steroid medication into the cerebrospinal fluid surrounding the inflamed low back nerve root to reduce inflammation, promote healing and alleviate pain.

Cervical epidural corticosteroid injection with fluoroscopy (x-ray guidance)

This injection is performed under fluoroscopic (x-ray) guidance into the cervical spine canal. This injection into the back of the neck places anti-inflammatory steroids into the cerebrospinal fluid (CSF). The goal of this procedure is to place the anti-inflammatory steroid medication into the cerebrospinal fluid surrounding the inflamed cervical nerve root to reduce inflammation, promote healing and alleviate pain.

Lumbar epidural corticosteroid injection with fluoroscopy (x-ray guidance)

This injection is performed under fluoroscopic (x-ray) guidance into the lumbar spine canal. A lumbar epidural corticosteroid injection is used to treat an inflamed or injured lumbar or proximal sacral nerve root. The medical term for this is a lumbosacral radiculopathy. The layman?s term for this is ?sciatica,? although the sciatic nerve is not the site of pathology. This injection occurs in the area of the tailbone, medically termed the sacrum. The goal of this procedure is to place the anti-inflammatory steroid medication into the cerebrospinal fluid surrounding the inflamed low back nerve root to reduce inflammation, promote healing and alleviate pain.

Sacroiliac (SI) joint injection with ultrasound

Sacrum is the medical term for the tailbone. Ilium is the medical term for part of the hip bone. Thus, the sacroiliac joint is the tailbone - hip bone joint. In a thin person from behind, these joints are represented by a set of dimples in the low back. SI joint pain is more common in women since the ligaments holding this joint together weaken during pregnancy to accommodate the descending fetus for childbirth. An anti-inflammatory steroid injection into this joint can both alleviate pain and help diagnose the SI joint as a cause of low back pain. An SI joint injection is performed under fluoroscopic or ultrasound guidance since it is not an easy joint to inject due to its shape and angle.

Physical Medicine and Rehabilitation

Carpal tunnel injection

In cases where there is a known cause for carpal tunnel syndrome, a low dose, concentrated corticosteroid injection can be helpful. A carpal tunnel injection occurs at the juncture of the wrist and the hand on the palm side of the hand. If a woman had carpal tunnel syndrome due to pregnancy and she is no longer pregnant, a single corticosteroid carpal tunnel injection may be the only treatment needed.

Greater occipital nerve block

The occiput refers to the back of the head. There is a left and right greater occipital nerve in the back of the head. They can be the cause of headaches in the back of the head. This is referred to as greater occipital neuralgia. Greater occipital neuralgia can occur after a whiplash injury. A combination of an anti-inflammatory corticosteroid medication and numbing medication is usually utilized to reduce inflammation and pain.

Podiatry

Avulsion of toenail

This is the term for the surgical removal of part or all of a toenail. This is most commonly done for patients with infected, ingrown toenails.

Bunionectomy/Bunion removal

A bunion is the formation of extra bone, most commonly at the joint at the base of the big toe. A bunionectomy is performed to remove an osteoarthritic or degenerative change at that joint. A bunionectomy procedure also straightens out the big toe.

Cheilectomy (bone spur removal) from big toe

This is the removal of a bone spur or bump from the first metatarsal head (base of the big toe). A bone spur can also be referred to as an osteophyte or osteoarthritis, which is arthritis from the aging process.

Distal metaphyseal osteotomy

This procedure treats a hallux valgus deformity. In layman?s terminology, this is a crooked, painful big toe. The term osteotomy refers to the removal of bone. Therefore, during this surgery, the podiatrist will remove bone and also adjust the joint angle to straighten the big toe and fix it in place with a plate, pin or screw.

Ganglion injection

A ganglion is the formation of a gelatinous substance around a tendon. By placing a needle into a ganglion and puncturing it, the injection alone can adequately drain the painful ganglion in some cases. Most often, a corticosteroid agent (anti-inflammatory medication) is injected to help reduce the inflammation associated with a ganglion.

Incision and Drainage (I&D) of bone for osteomyelitis

This procedure is performed after a patient is diagnosed with osteomyelitis. Osteomyelitis is an infection of bone. In order to properly diagnose and treat the infection, the podiatrist surgically removes some bone to have it analyzed in a laboratory for the type of bacteria. The infected bone specimen is cultured to determine the type of bacteria and to also determine the antibiotic sensitivity and resistance for proper treatment.

Mass removal from under skin

This is a procedure name for the removal of a ganglion cyst from a tendon sheath or for the removal of a lipoma, a benign fatty tumor, underneath the skin that appears as a soft, movable lump.

Neuroma excision (including Morton neuroma)

A neuroma is an onion bulb-like, thickened formation of a small nerve on the ball of the foot, medically termed the metatarsal pad. This procedure surgically removes this painful, swollen nerve to reduce pain. A neuroma is a cause of metatarsalgia.

Ostectomy (bone removal) from 2nd, 3rd or 4th metatarsal bones

This is the removal of a bone spur from metatarsal bones. The metatarsal bones are the long, straight bones of the foot. A bone spur may also be referred to as an osteophyte or an osteoarthritic change, which occurs from the aging process.

Plantar fascia injection

The plantar fascia is soft tissue that helps support the foot?s arch. The plantar fascia is injected with an anti-inflammatory corticosteroid to reduce swelling and pain. Patients with plantar fasciitis suffer from pain on the inside front of the heel.

Plantar fascia release

In persistent cases of plantar fasciitis, a plantar fascia release is performed by cutting or releasing the plantar fascia in the front of the heel. The plantar fascia at this point will no longer be tight and painful. An open release is the term for a larger surgical cut (although this is still relatively small), whereas an endoscopic release is the term used for a plantar fascia release surgery associated with a smaller cut or scar. This leads to a shorter healing time of the surgical wound.

Sharp excision

Sharp excision is the surgical removal of a toenail and its accompanying nail bed. The common reasons for performing this procedure include a recurrent infected, ingrown big toenail as well as a thick, deformed fungus-infected toenail.

Tarsal tunnel release

Tarsal is the Latin word for foot. Therefore, tarsal tunnel syndrome means foot tunnel syndrome. A short stature and obesity are risk factors for foot tunnel syndrome because there is less space in the tunnel for the nerve. Tarsal tunnel syndrome symptoms include pain in the bottom of the foot beyond the heel and numbness and tingling in the toes. A tarsal tunnel release cuts the laciniate ligament in half along the inner ankle to create a larger tunnel space for the nerve.

Toe arthrodesis/Toe fusion

Toes are fused for either a hammer toe deformity or an advanced, painful arthritic toe joint. The term arthrodesis and fusion medically may be used interchangeably. During this procedure, the podiatrist surgically eliminates the joint by using pins or implants to fuse the joint together.

Toe arthroplasty

The term arthro refers to joint and plasty refers to removal. Therefore, this is the removal of a bone spur at a toe joint. With the removal of bone, the joint space becomes larger and less painful.

Toenail excision (cut toe nails)

This is the chemical introduction of phenol along one edge of a toenail, usually performed to treat a recurrent infected, ingrown toenail. This will dissolve or chemically remove the portion of the nail bed that is associated with the cause of the recurring infection.

Toenail trimming

This is for the trimming of toenails with toenail clippers. A podiatrist may be asked to do this for a diabetic person or some other elderly, debilitated person who cannot do this for himself or herself.

Pulmonary Medicine

Bronchoscopy

A bronchoscopy is a procedure where a scope with a light and a camera is passed either through the nose or mouth and down the throat far enough that it reaches the trachea (windpipe). It then goes into the lungs by way of the bronchi; hence the name bronchoscopy. This procedure is used to help identify cancer (a biopsy of tissue can be obtained during a bronchoscopy), remove excess mucus from the airways, determine a site of bleeding and remove a blockage, such as a piece of food, from the airway.

Pulmonary function test (PFT)

A pulmonary function test is also referred to as spirometry. This test determines how much air a person can move in and out of his or her lungs. It also reveals how well the lungs oxygenate. This test is commonly performed to assist in the diagnosis, evaluation and treatment of medical conditions including chronic obstructive pulmonary disease (COPD or emphysema), asthma, pulmonary fibrosis, and asthma. For this test, a person is asked to perform a series of breathing in and out of a tube to measure air volumes and lung capacity.

Ultrasound

Arterial doppler study of lower limbs

Doppler is another name for ultrasound. An ultrasound is a painless, non-invasive imaging study. An arterial Doppler study helps evaluate for peripheral vascular disease where there is a loss of blood flow in a limb, most commonly in a lower limb.

Echocardiogram

An echocardiogram is an ultrasound of the heart. A conductive gel is placed over the chest wall where the heart is located. An ultrasound transducer device is placed in the same area to permit the cardiologist to anatomically evaluate the heart valves to see if they are working properly or if they are leaking. An echocardiogram also permits the cardiologist to see how well the heart is or is not contracting. Furthermore, an echocardiogram also provides information in regard heart size.

Urine Tests

5HIAA

5-HIAA is known as 5-hydroxyindoleacetic acid, which can detected in urine for the purpose of evaluating for carcinoid tumors of the gastrointestinal tract. 5-HIAA is a metabolite of the hormone serotonin.

Calcium clearance 24 hour

Urine calcium is elevated in patients with parathyroid disease. It is often elevated in patients with a medical history of kidney stones, medically termed nephrolithiasis.

Catecholamines, free

Catecholamines include epinephrine and norepinephrine. These are the chemicals that are responsible for our ?fight or flight? response. These are also generically termed adrenaline. Catecholamines are responsible for increasing blood pressure and heart rate. A patient with an unusually high and persistent blood pressure, particularly one not responding to blood pressure medication, may be ordered this test to evaluate for a pheochromocytoma, a rare tumor of the adrenal gland that increases catecholamines.

Cortisol clearance 24 hour

A urine cortisol level can be used to help diagnosis problems involving an elevated cortisol level, such as Cushing syndrome, which can include findings associated with weight gain, obesity, high blood pressure and generalized muscle weakness. This test is useful to help diagnose problems with a low cortisol level, such as with adrenal insufficiency or Addison?s disease. Symptoms of a low cortisol level can include weight loss, fatigue and low blood pressure.

Creatinine clearance 24 hour

A urine creatinine test is ordered to evaluate kidney function. Creatinine is a byproduct of skeletal muscle breakdown and dietary meat intake. A urine creatinine test can also evaluate the efficacy of medical treatment for kidney disease.

Metanephrines, total

A metanephrine test is ordered to evaluate for a pheochromocytoma, which can clinically present as a persistent, elevated blood pressure. Metanephrines are the breakdown metabolites of epinephrine and norepinephrine, which are the chemicals in our bodies known for a ?fight or flight? response.

Osmolality

A urine osmolality is ordered to evaluate for an increased or decreased urine output. It can be ordered for a diabetic patient with increased urinary frequency, medically termed polyuria. Disease processes adversely affecting the level of anti-diuretic hormone (ADH) can also affect the urine osmolality.

Potassium clearance 24 hour

Potassium is an important electrolyte. This test is ordered to determine if the low potassium level in the blood is due to abnormal kidney function. A low potassium level can cause a cardiac dysrhythmias.

UPEP (Urine Protein ElectroPhoresis)

This urine test detects the levels of various proteins in the urine and helps diagnose kidney protein wasting diseases. This test is also ordered when multiple myeloma, a type of blood cancer, is suspected.

Urinalysis with microscopy

The urinalysis analyzes specific gravity, PH, protein, glucose, ketones, blood, leukocyte esterase, nitrite, bilirubin, and urobilinogen. Elevated protein in the urine can indicate kidney disease. Elevated glucose in the urine can indicate diabetes mellitus. The presence of ketones in the urine can indicate an insufficient amount of insulin in a diabetic patient. Blood in the urine can indicate kidney stones or a urinary tract infection. Leukocyte esterase in the urine can indicate a urinary tract infection. Leukocyte esterase is a white blood cell enzyme. The presence of white blood cells or its metabolites is supportive of a urinary tract infection. A microscopy can evaluate the number of red blood cells, white blood cells and bacteria in the urine sample. This can lead to diagnoses such as urinary tract infections, diabetes, nephrolithiasis (kidney stones) or other kidney diseases in conjunction with the urinalysis.

VMA

VMA stands for Vanillylmandelic Acid, which is a metabolite of epinephrine and norepinephrine. An excess of VMA is present in uncommon medical conditions, including neuroblastomas and pheochromocytomas.

Urology

Green light laser prostatectomy

Green light laser prostatectomy is performed for men with benign prostatic hypertrophy (BPH), which is an enlarging of the prostate associated with aging. This can also be performed to help prevent recurrent urinary tract infections. The symptoms associated with BPH can include frequent urination, the sensation of the bladder not being emptied and the urge to urinate frequently. During this procedure, a small scope is inserted through the tip of the penis into the urethra. Then, it is advanced to the area of the prostate. It is at this point that some form of laser can be used to open up the narrowed area of the urethra due to the enlarged prostate. The goal of this procedure is to increase urine flow, reduce the frequency of urination and eliminate the urge to urinate frequently.

Lithotripsy of kidney stone - Extracorporal Shock Wave Lithotripsy( ESWL)

The lithotripsy of a kidney stone is also referred to as extracorporal shock wave lithotripsy or ESWL. This is a non-surgical procedure where a patient with a kidney stone lays on a water-filled device. High energy sound waves are passed through the device into the body in order to break up the kidney stone into smaller pieces. They can be excreted through the urinary tract. This process can take up to an hour. In general, lithotripsy works better on smaller kidney stones.

Spermatocele repair

A spermatocele is a cyst that forms in the epididymis, which is located on the top and upper back portion of the testicles. In general, it is not painful, but if large enough, it can cause some discomfort. In this case, it can be surgically removed. Although sperm are stored in the epididymis, a spermatocelectomy is not believed to improve fertility.

Ureteroscopy

A ureteroscopy is used to evaluate and treat medical conditions of the ureter, such as kidney stones or urethral strictures. For this procedure, a ureteroscope is placed through the tip of the penis, through the urethra, through the urinary bladder and into a portion of the ureter.

Urethral cystoscopy

A cystoscope is placed into the urethra. It is a lighted instrument with a camera that permits the urologist to evaluate the urethra for disease. It can identify an enlarged prostate or kidney stones. Tissues can be removed for biopsy for the diagnosis of cancer.

Vasectomy x 4

A vasectomy involves the ligation (cutting) of the vas deferens of each testicle. It is a form of birth control. There is still fluid from the ejaculate but it does not contain sperm.