Medical Terminology: Chest, Abdominal, and Urinary Tract Tests

1. What are Chest, Abdominal, and Urinary Tract Tests?
When there are suspected disorders of the upper gastrointestinal tract, thyroid gland, liver, gallbladder, kidney, spleen, urinary tract, and other organs in the upper part of the body, the health care provider is likely to order a number of tests to uncover the underlying problem.
Some tests enable the health care provider to examine the esophagus, stomach, duodenum, bile, and pancreatic ducts and to take a biopsy, or, in some cases, remove an obstruction. Other tests enable the health care provider to scan the liver, spleen, gallbladder, and kidney by using contrast material to highlight the structure of the organ. Images of the organ are captured with a camera and studied to uncover diseases and disorders.
There are also procedures that the health care provider can perform to temporarily or permanently repair a problem. Some examples are the removal of a cancerous thyroid gland, a tumor from the bladder, or fixing urinary incontinence.

2. Lung Scan
The lung scan is used to assess blood flow to the lungs and identify a pulmonary embolism.

Understanding the Lung Scan
A lung scan is performed to detect a pulmonary embolism that impedes blood flow to the lungs. There are three types of lung scans:
. Perfusion: In a perfusion scan, the patient is injected with a radioactive tracer into a blood vessel. An image is taken of the lungs as the tracer circulates to the lungs. A pulmonary embolism is suspected in areas of the lung where the tracer is not seen.
. Ventilation: In a ventilation scan, the patient inhales gas that contains a radioactive tracer. An image is taken of the lungs. A pulmonary embolism is suspected in areas of the lung that are not receiving the tracer.
. V/Q: A V/Q scan consists of both the perfusion and the ventilation scan. The ventilation scan is performed first. This is the most commonly performed lung scan.

3. Pulmonary Function Tests
Pulmonary function tests are used to assess the function of the patient’s lungs and monitor progress of lung therapy.

Understanding the Pulmonary Function Tests
There are a number of pulmonary function tests used to assess how well the patient’s lungs perform. These tests are:
- Gas Diffusion: Measures the amount of gasses that cross the alveoli per minute. These include arterial blood gases and the carbon monoxide diffusing capacity.
- Spirometry: This measures the volume and capacity of the lungs. The patient breathes into a mouthpiece of the spirometer, and information measured by the spirometer is printed out in a chart called a spirogram. Common lung function values that are measured are:
Forced vital capacity (FVC): Amount of forced exhaled air
Forced expiratory volume (FEV): Amount of exhaled air with force in one breath measured in seconds
Forced expiratory flow 25. to 75%: Air flow halfway through an exhale
Peak expiratory flow (PEF): Air quickly exhaled
Maximum voluntary ventilation (MVV): amount of air the patient breathes in and out in 1. minute
Slow vital capacity (SVC): Amount of air slowly exhaled after inhaling as deeply as possible
Total lung capacity (TLC): Amount of air in lungs after inhaling as deeply as possible
Functional residual capacity (FRC): Amount of air in lungs at the end of a normal exhaled breath
Residual volume (RV): Amount of air in lungs after exhaled completely
Expiratory reserve volume (ERV): The difference between the amount of air in the lungs after a normal exhale (FRC) and the amount after exhaled with force (FVC)
- Exercise Stress: Measures the effect exercise has on the lungs
- Body Plethysmograph: Measures the volume and capacity of the lungs
- Inhalation Challenge: Assesses the patient’s airway responses to allergens

4. Upper Gastrointestinal (UGI) Test Series
The upper gastrointestinal (UGI) test is used to assess the underlying cause of stomach pain and indigestion and the underlying cause of malabsorption syndrome.

Understanding the Upper Gastrointestinal Test Series
The upper gastrointestinal test series consists of a group of tests that assess the esophagus, stomach, and duodenum. Prior to the series, the patient ingests barium contrast material and water. X-ray images of the esophagus, stomach, and duodenum are taken using a fluoroscope as the barium moves through the UGI tract. Images are displayed on a computer screen and stored for further review. If the health care provider sees anything suspicious, he or she might perform an endoscopy, in which an endoscope is inserted down the esophagus and into the stomach and duodenum to directly view the UGI tract.
The UGI series is also performed during a full gastrointestinal series, which also involves examination of the lower gastrointestinal tract.

5. Esophagus Test Series
The esophagus test series is used to assess the underlying cause of gastroesophageal reflux (GER) and chest pain.

Understanding the Esophagus Test Series
The esophagus test series consists of two tests that assess the esophagus and esophageal sphincters:
. Esophageal Manometry: Measures esophageal muscle contractions
. Esophageal Acidity Test: Measures the pH of the esophagus

6. Gallbladder Scan
The gallbladder scan is used to assess the structure of the gallbladder and the underlying cause of upper right abdominal pain.

Understanding the Gallbladder Scan
A gallbladder scan assesses the function of the gallbladder and is used to identify blockages in the bile ducts. A radioactive tracer is injected into the patient’s vein. The tracer is removed from the blood by the liver, which places the tracer into bile that flows into the gallbladder and then the duodenum. A camera takes an image of the tracer as the tracer flows through the liver to the duodenum.

7. Kidney Scan
The kidney scan is used to assess blood flow through the kidneys and kidney function.

Understanding the Kidney Scan
A kidney scan assesses the function of the kidney. A radioactive tracer is injected into the patient’s vein. The tracer moves through the blood vessels into the kidneys. A camera takes an image of the tracer as the tracer flows through the kidney, illustrating where blood flows unobstructed and where blood flow is blocked. There are two types of kidney scans:
. Function Study: This measures the time that the tracer takes to pass through the kidneys and enter the bladder as part of urine.
. Perfusion Study: This assesses blood flow through the kidneys.
A kidney scan is an alternative to the intravenous pyelogram (IVP) test.

8. Liver and Spleen Scan
The liver and spleen scan assesses blood flow through the liver and spleen. This scan also assesses the spleen following an injury and the liver to determine if cancer has metastasized to the liver. The liver and spleen scan is also used to assess cancer treatment.

Understanding the Liver and Spleen Scan
A liver and spleen scan assesses the function of the liver and spleen. A radioactive tracer is injected into the patient’s vein. The tracer moves through the blood vessels in the liver and spleen. A camera takes an image of the tracer as the tracer flows through the liver and spleen, illustrating where blood flows unobstructed and where blood flow is blocked.

9. Urinalysis
Urinalysis is performed to assess kidney function and other disorders.

Understanding Urinalysis
Waste material carried by blood is filtered by kidneys and excreted as urine. A urinalysis is performed to determine the characteristics of the urine and the existence and amount of substances in the urine. Urine characteristics are:
- Clarity: How clear is the urine?
- Color: What color is the urine?
- Specific Gravity: The balance between water and substances in the urine
- Odor: The aroma of urine
- pH: How acidic or alkaline is the urine?
There are several methods used to capture the urine sample:
- Clean-Catch Midstream One-Time Urine Collection: Urine is collected after the patient begins to urinate.
- Double-Voided Urine Collection: Urine is collected the second time that the patient voids.
- 24-Hour Urine Collection: Urine is collected over a 24-hour period.

10. Urine Culture and Sensitivity Test
The urine culture and sensitivity test is performed to assess the existence and type of microorganism in a patient with a urinary tract infection (UTI), as well as the proper medication to prescribe treatment.

Understanding the Urine Culture and Sensitivity Test
A urine culture is ordered when the patient is suspected of having a UTI. A urine collection is placed in an environment conducive to the growth of microorganisms for 3. days. The urine is examined to identify the presence and type of microorganism. Once the microorganism is identified, a sensitivity test is performed to determine the medication that kills the microorganism.

11. Renin Assay Test
The renin assay test is ordered to determine the underlying cause of hypertension.

Understanding the Renin Assay Test
The renin assay test is performed with the aldosterone test to determine the underlying cause of hypertension. Renin is an enzyme produced by the kidneys. Aldosterone is a hormone produced by the adrenal glands. Together, these work to balance the sodium and potassium levels within the patient. A high renin level might indicate a kidney disorder. A low renin level might indicate Conn’s syndrome. A low renin level and a high aldosterone level might indicate an adrenal gland tumor.

12. Thyroid Scan
The thyroid scan is used to assess thyroid function and the treatment for thyroid disease.

Understanding the Thyroid Scan Test
A thyroid scan assesses the function of the thyroid gland. There are two types of thyroid scans:
. Radioactive Iodine Uptake (RAIU) Test: This assesses the absorption of a radioactive tracer by the thyroid gland.
. Whole-Body Thyroid Scan: This test assesses whether or not thyroid cancer metastasized.

13. Thyroid and Parathyroid Ultrasound
The thyroid and parathyroid ultrasound assesses the size and shape of the thyroid and parathyroid glands.

Understanding the Thyroid and Parathyroid Ultrasound
The thyroid and parathyroid ultrasound is used to assess the size and shape of the thyroid gland and the parathyroid glands, which are located behind the thyroid gland. This test is not used to assess the function of these glands.

14. Thyroid Hormone Tests
The thyroid hormone tests are used to assess for hyper-and hypothyroidism, and the underlying cause of abnormal thyroid-stimulating hormone (TSH) test results. It is also used to assess treatment of hyper- and hypothyroidism.

Understanding the Thyroid Hormone Tests
The thyroid produces two hormones: thyroxine (T4) and triiodothyronine (T3). The thyroid hormone tests measure the levels of thyroid hormones in the patient’s blood. There are three thyroid hormone tests:
. Free Thyroxine (FT4): This test determines the amount of thyroxine that is not bound to globulin.
. Total Thyroxine (T4): This test determines the total amount of thyroxine that is attached to globulin and not bound to globulin.
. Triiodothyronine (T3): This test determines the total amount of triiodothyronine that is attached to globulin and not bound to globulin.

15. Thyroid-Stimulating Hormone (TSH) Test
The thyroid-stimulating hormone (TSH) test is ordered to assess the underlying cause of hyper- and hypothyroidism.

Understanding the Thyroid-Stimulating Hormone Test
The hypothalamus produces thyrotropin-releasing hormone (TRH), which causes the pituitary gland to produce the TSH. This causes the thyroid to produce thyroid hormones.

16. Salivary Gland Scan
The salivary gland scan assesses the function of the salivary glands and the underlying cause of swollen salivary glands and dry mouth.

Understanding the Salivary Gland Scan
A small amount of radioactive tracer is injected into the patient’s vein. Every few minutes an image is taken with a camera that detects the tracer in the bloodstream of the salivary gland. The patient is requested to suck on a lemon to cause the salivary glands to release saliva and increase the image of the salivary gland. Any blockage appears on the image.

17. D-Xylose Absorption Test
The D-xylose absorption test assesses the intestine’s ability to absorb D-xylose.

Understanding the D-Xylose Absorption Test
Patients with malabsorption syndrome are unable to absorb certain nutrients into their blood from the intestinal tract. This can result in malnutrition and chronic diarrhea. The D-xylose absorption test assesses whether or not these signs are a result of malabsorption syndrome by asking the patient to drink a solution of D-xylose and then measuring the amount of D-xylose in the patient’s blood and urine.

18. Stool Culture
A stool culture is ordered to identify microorganism in a stool sample.

Understanding the Stool Culture
A patient may exhibit diarrhea and other signs of an infection. The health care provider orders a stool culture to determine if the underlying cause is a microorganism. A sample of the patient’s stool is sent to the laboratory where it is placed in an environment that encourages the microorganism to grow. After 3. days, laboratory technicians determine if a microorganism is present and, if so, which microorganism.
The health care provider typically orders a sensitivity test of the sample along with the stool culture. The sensitivity test determines the medication that kills the microorganism.

19. Entero-Test (Giardiasis String Test)
The Entero-Test is used to detect the presence of Giardia intestinalis.

Understanding the Entero-Test
A patient who has severe diarrhea might have giardiasis. Giardiasis is caused by an intestinal parasite called Giardia intestinalis that is found in water, food, or soil that is contaminated with feces. The Entero-Test determines if the patient has giardiasis by sampling fluid in the duodenum. The patient swallows a gelatin capsule that is attached to a string. The string is taped to the outside of the patient’s mouth while the capsule dissolves in the stomach and the duodenum. The string is then removed and examined under a microscope.

20. Stool Analysis
The stool analysis is used to assess:
- Digestive tract disorder
- Liver disorder
- Pancreas disorder
- Colon cancer
- Absorption disorder

Understanding Stool Analysis
A stool analysis is the examination of the patient’s feces to identify digestive tract disorders. The patient’s stool sample is examined for color, volume, consistency, odor, and the presence of blood, fat, mucus, fiber, bile, and glucose.

21. Fecal Occult Blood Test (FOBT)
The fecal occult blood test (FOBT) is used to identify blood in the stool.

Understanding the Fecal Occult Blood Test
Blood in stool is not always visible. The FOBT examines the stool for blood that is not visible to the naked eye. This is referred to as occult blood. Although the presence of occult blood is linked to colon cancer, there are many other causes of occult blood in stool.

22. Overnight Dexamethasone Suppression Test
The overnight dexamethasone suppression test is used to screen for Cushing’s syndrome.

Understanding the Overnight Dexamethasone Suppression Test
The pituitary glands secrete adrenocorticotropic hormone (ACTH) based on the amount of cortisol in the patient’s blood. ACTH signals the adrenal glands to secrete cortisol. In Cushing’s syndrome, cortisol is secreted regardless of the secretion of the ACTH level. The overnight dexamethasone suppression test requires the patient to take dexamethasone, which is a corticosteroid. This increases the cortisol level in the patient’s blood and therefore signals the pituitary glands not to secrete ACTH and, as a result, the adrenal glands should not secrete cortisol. In the morning, the patient’s cortisol level should be relatively low. If not, then the patient might have Cushing’s syndrome.

Basic Questions
Chest, Abdominal, and Urinary Tract Tests

1. What is the purpose of a lung scan?
The lung scan is used to assess blood flow to the lungs and identify a pulmonary embolism.

2. What is a perfusion scan?
In a perfusion scan, the patient is injected with a radioactive tracer into a blood vessel. An image is taken of the lungs as the tracer circulates to the lungs. A pulmonary embolism is suspected in areas of the lung where the tracer is not seen.

3. What is a ventilation scan?
In a ventilation scan, the patient inhales gas that contains a radioactive tracer. An image is taken of the lungs. A pulmonary embolism is suspected in areas of the lung that are not receiving the tracer.

4. What is a V/Q scan?
A V/Q scan consists of both the perfusion scan and the ventilation scan. The ventilation scan is performed first. This is the most commonly performed lung scan.

5. What are gas diffusion tests?
Gas diffusion tests measure the amount of gases that cross the alveoli per minute. These include arterial blood gases and the carbon monoxide diffusing capacity.

6. What is the body plethysmograph test?
The body plethysmograph test measures the volume and capacity of the lungs.

7. Why is an upper gastrointestinal (UGI) series ordered?
The upper gastrointestinal (UGI) test series is used to assess the underlying cause of stomach pain and indigestion and the underlying cause of malabsorption syndrome.

8. How is a UGI series performed?
The UGI series consists of a group of tests that assess the esophagus, stomach, and duodenum. Prior to the series, the patient ingests barium contrast material and water. X-ray images of the esophagus, stomach, and duodenum are taken using a fluoroscope as the barium moves through the UGI tract. Images are displayed on a computer screen and stored for further review. If the health care provider sees anything suspicious, he or she might perform an endoscopy, in which an endoscope is inserted down the esophagus and into the stomach and duodenum to directly view the UGI tract.

9. What is the purpose of the esophagus test series?
The esophagus test series is used to assess the underlying cause of gastroesophageal reflux (GER) and chest pain.

10. What is the purpose of the esophageal manometry?
Esophageal manometry measures esophageal muscle contractions.

11. How is a gallbladder scan performed?
A gallbladder scan assesses the function of the gallbladder and is used to identify blockages in the bile ducts. A radioactive tracer is injected into the patient’s vein. The tracer is removed from the blood by the liver, which places the tracer into bile that flows into the gallbladder and duodenum. A camera takes an image of the tracer as the tracer flows through the liver to the duodenum.

12. What is the purpose of a urinalysis?
Waste material carried by blood is filtered by kidneys and excreted as urine. A urinalysis is performed to determine the characteristics of the urine and the existence and amount of substances in the urine.

13. What are the characteristics of urine?
- Clarity: How clear is the urine?
- Color: What is the color of the urine?
- Specific Gravity: The balance between water and substances in the urine
- Odor: The aroma of urine
- pH: How acidic or alkaline is the urine?

14. What is a double-voided urine collection?
The double-voided urine collection is urine collected the second time the patient voids.

15. What is a clean-catch midstream one-time urine collection?
The clean-catch midstream one-time urine collection is urine is collected after the patient begins to urinate.

16. What would you expect a health care provider to order if he or she suspects a urinary tract infection (UTI)?
The urine culture and sensitivity test is performed to assess the existence and type of microorganism in a patient with a UTI and is also used to assess the proper medication to prescribe to treat the UTI.

17. What is the purpose of the renin assay test?
The renin assay test is ordered to determine the underlying cause of hypertension.

18. How is the renin assay test performed?
The renin assay test is performed with the aldosterone test to determine the underlying cause of hypertension. Renin is an enzyme produced by the kidneys. Aldosterone is a hormone produced by the adrenal glands. Together, these work to balance the sodium and potassium levels in the patient.

19. What is the radioactive iodine uptake (RAIU) test?
The RAIU test assesses the absorption of a radioactive tracer by the thyroid gland.

20. Why might the whole-body thyroid scan be ordered?
This test assesses whether or not thyroid cancer metastasized.

21. Why are thyroid hormone tests ordered?
Thyroid hormone tests are used to assess for hyper- and hypothyroidism and for the underlying cause of abnormal thyroid-stimulating hormone (TSH) test results. They are also used to assess treatment of hyper- and hypothyroidism.

22. What is the free thyroxine test?
The free thyroxine (FT4) test determines the amount of thyroxine that is not bound to globulin.

23. What is the total thyroxine test?
The total thyroxine (T4) test determines the total amount of thyroxine that is attached to globulin and not bound to globulin.

24. What is the purpose of the thyroid-stimulating hormone (TSH) test?
The thyroid-stimulating hormone (TSH) test determines the underlying cause of thyroid disorder.

25. What is the purpose of the D-xylose absorption test?
The D-xylose absorption test assesses the intestine’s ability to absorb D-xylose.