« Modern methods research on the psychophysiology of memory"

Introduction

Chapter 1. Modern methods of memory research

1.1 Microelectrode method

1.2 Electroencephalography (EEG)

1.3 Magnetoencephalography (MEG)

Chapter 2. Visual methods for studying memory

2.1 Positron emission tomography

2.2 Nuclear magnetic resonance introscopy

Conclusion

Sources and literature

Introduction

Memory is a psychophysiological process consisting of remembering, storing and reproducing information.

The founder of psychophysiology is the English doctor David Gargley. During the period of formation of psychophysiology as a science, special attention was paid to the study of the central nervous system and its physiological manifestations. One of the important directions (in the study of the central nervous system) is the search for brain structures responsible for memory. None of them physiological functions has not had such close and comprehensive study by biologists, physiologists, psychologists, neurologists and other sciences. The accumulated clinical and experimental material has made it possible to put forward a number of theories explaining memory processes.

1. Theory of associations by contiguity, similarity, contrast.

2. Gestalt psychology.

3. Behavioral theory.

4. Theory of psychoanalysis.

5. Semantic theory.

6. Biochemical theory.

7. Neural theory.

8. Wave theory memory units.

The listed theories allow us to trace the direction of the scientists’ thoughts and the limitations of the research methods used.

The development of technological progress and the introduction of new research methods allow us to rise to a qualitatively new level of research into mysteries. human memory.

The study of memory has not only scientific, but also practical interest: writing school textbooks, curriculum, scheduling school activities. The study of the volume of short-term memory, carried out in preschoolers using the formula KP = 7 + 2, is only from 5 to 9 pictures, numbers, words. Based on the volume of short-term memory, one can predict the success of learning or developmental delays. OKP=2+1 is academic credit. When studying preschoolers, it is necessary to reflect in the child’s chart: the type of central nervous system: sanguine, phlegmatic, choleric, melancholic; biorhythmic activity of the central nervous system: “lark”, “owl”, “pigeon”; the prevailing type of memory: auditory, auditory-musical, “auditory-motor”, or visual, visual-logical.

The collected information allows you to individually develop the child, using his or her own type of memory, and smoothly lead a group of children in cognitive process. In persons with an auditory type of memory for learning foreign languages, medical terms, formulas in physics and chemistry, the first phase of slow sleep, lasting 90-100 minutes, can be used. The biochemical and electrical activity of the brain during this phase of sleep still remains at the level of wakefulness, and auditory information can be assimilated. Young professionals who go on business trips abroad, having an auditory type of memory, can master spoken language in the shortest possible time. Memory reaches its maximum development by the age of 25 and is retained for high level up to 40-45 years, then begins to worsen. In this regard, there is age limit for accepting documents for full-time university and subsequent postgraduate education.

Electroencephalographic research methods and complementary tomographic and vascular biochemical methods made it possible to create maps of brain structures involved in remembering and reproducing information and to diagnose the causes of memory impairment. The first generation of devices, which allows one to see the subtle energy shell surrounding the human body - the aura, allows one to observe the emotional manifestations of memories. Reading information from the emotional and mental shells of the aura is not yet available. This secret side of human memory will also be revealed to the future generation of scientists.

Chapter 1. Modern methods of memory research

1.1 Microelectrode method

The study of man and the secrets of his memory keeps pace with technical progress. Graphic electrophysiological research methods using microelectrodes have appeared. They got their name because the diameter of their recording surface is about one micron. Microelectrodes are available in metal and glass. A metal microelectrode is a rod made of a special high-resistance insulated wire with a recording tip. A glass microelectrode with a diameter of about 1 mm is made of special glass - Pyrex, with a thin unsoldered tip filled with an electrolyte solution. Microelectrodes are applied to the parts of the brain being studied that are responsible for memory in animals, and a graphical recording of the impulse activity of neurons is observed.

1.2 Electroencephalography (EEG)

The first highly informative, non-invasive method for studying the central nervous system in humans was electroencephalography.

The scalp in the places where the electrodes are applied is wiped with alcohol, degreased, then a special electrically conductive paste-gel is applied.

There are two ways to record EEG: bipolar and monopolar. With a bipolar lead, the potential difference between two active electrodes is recorded. This method is used clinically to diagnose the localization of a pathological focus in the brain. In psychophysiology, the method of monopolar abduction is used. One electrode is placed over the area of ​​the brain being studied, the other on the earlobe or mastoid process, where electrical processes are minimal and can be taken as zero.

To compare EEG results obtained in laboratories around the world, it was necessary to create a single standard system application of electrodes, called the “10-20” system. In accordance with this system, psychophysiologists are required to take three measurements of the skull of the subject:

1. Longitudinal size of the skull - the distance from the bridge of the nose to the occipital protuberance.

2. The transverse size of the skull is the distance between the external auditory canals.

3. Head circumference, measured at the same points.

These dimensions are used to draw a grid, at the intersections of which electrodes are applied. Electrodes located along the midline are marked with the Z index; electrode leads from the left half of the head are numbered with odd indices, from right half heads are numbered with even indices.

Electrode leads in the “10-20” system:

1. frontal (frontal) F 1 ...

2. central C 1 ...

3. parietal (parietal) P 1 ...

4. temporal (temporal) T 1 ...

5. occipital (occipital) O 1 ...

U healthy people in a state of wakefulness, an alpha rhythm with a frequency of 8-13 Hz is recorded in the occipital areas of the brain responsible for visual memory and spatial orientation. This rhythm was first recorded and described by Hans Berger under the name alpha rhythm. It is very important to note that with optic nerve atrophy, long-term or congenital blindness, the alpha rhythm disappears. But in the parietal region, responsible for tactile memory, which is well developed in the blind - compensating for the loss of vision - a mu rhythm appears close in frequency to the alpha rhythm. In the experiment, we can observe a change in the alpha rhythm to the mu rhythm; the patient is blindfolded and asked to identify familiar objects by touch.

In persons suffering from the disorder visual memory and orientation in space, wandering and getting lost on the streets of the city, the alpha rhythm is barely visible due to inhibition in the occipital region. After a course of magnetic therapy on the occipital region, visual orientation in space and alpha rhythm are restored.

In persons with auditory, musical memory, musicians, composers in the left temporal region, responsible for this type memory, a frequency close to the alpha rhythm is recorded - the Kappa rhythm.

When tested, when performing piece of music From memory, we can easily track the change from the alpha rhythm to the Kappa rhythm.

Phenomenal auditory memory possessed by the composer Mozart. At the age of 14, he came to Rome, where he heard a piece of church music in St. Peter's Basilica. The notes were kept in the greatest secrecy and constituted a secret at the papal court. Young Mozart, coming home, reproduced the music he heard from memory. Many years later, it was possible to compare Mozart's recording with the original notes; as it turned out, there was not a single error in Mozart's notes.

What is the EEG of dancers and figure skaters who are overwhelmed with emotions and have excellent auditory, visual, motor memory? As soon as music starts to sound, the Betta rhythm appears in all areas of the brain, oscillations in the range from 14 to 30 Hz.

We observe the beta rhythm during the paradoxical phase of sleep with rapid movements of the eyeballs and spoken speech. Parents in this situation, alarmed by the violent manifestations of sleep, rush to wake up and calm the child, explaining that this is just a dream. We also observe the beta rhythm in the rare pathology of sleepwalking (somnambulism), which requires medical intervention and parental supervision of the child.

In persons with a verbal-logical, visual-logical type of memory, who are slow to work, and who are able to maintain concentration and attention for a long time without fatigue, a special Gamma rhythm with a frequency of more than 30 Hz is drawn on the EEG.

Drivers, pilots, military personnel, rescuers, doctors, whose work is often associated with significant emotional stress, requiring immediate decision-making, the Theta rhythm is recorded with a frequency of 4 to 8 Hz.

In a calmly sitting person, the Delta rhythm is recorded on the EEG. In the first phase of slow-wave sleep, which lasts 90-100 minutes, biochemical and electrical activity is close to wakefulness, and the person successfully assimilates auditory information. This allowed students with auditory memory to learn foreign languages ​​in a shorter time.

During the daytime, while awake, the Delta rhythm indicates a tumor of the cerebral cortex.

EEG allows you to monitor the activity of various parts of the brain when solving problems, counting in your head, performing short-term memory tasks, and identify the causes of forgetfulness or progressive memory deterioration.

1.3 Magnetoencephalography (MEG)

Another non-invasive method for studying memory in humans is magnetoencephalography. MEG is recorded using highly sensitive electromagnetic fields sensors MEG can be presented as profiles of magnetic fields on the surface of the skull, or as a curved line. MEG complements the information about brain activity obtained from EEG.

Chapter 2. Visual methods for studying memory

2.1 Positron emission tomography

IN last years Positron emission tomography of the brain began to be used to study memory. The patient is intravenously injected with one of the isotopes: oxygen - 15, nitrogen - 13, fluorine - 18, or a glucose analogue - deoxygmonosis. In the brain, isotopes emit positrons, which collide with electrons to produce a pair of protons. There is a PET camera above the patient's head that detects protons; information from the camera is sent to a computer, which provides an image of the location of pain activity in brain slices. Thus, the researcher can obtain a layer-by-layer image of the brain structures involved in remembering and reproducing information.

2.2 Nuclear magnetic resonance imaging (NMR)

Nuclear magnetic resonance introscopy is used to study the processes of remembering and reproducing information. For the study, the patient is placed in a cylindrical tube with a constant magnetic field 30,000 times stronger than Earth's. The patient's body is exposed to radio waves, tissue protons absorb their energy. After the radio waves are turned off, the protons give off energy, which is recorded as a magnetic resonance signal. After processing the signal, an image appears on the computer, characterizing the activity of biochemical processes and the speed of blood flow in the tissues. NMR has become the most powerful visual research method in the psychophysiology of human memory.

For the first time, it was noted that when memorizing the information being studied, biochemical activity appears in the left hemisphere of the brain, and when remembering and reproducing information, biochemical activity appears in the right hemisphere of the brain. When the patient silently recalled episodes own life, activity was manifested in the anterior parts of the cerebral cortex. When remembering historical events, the activity of the posterior parts of the cerebral cortex was manifested. Remembering visual images leads to activation of the occipital regions, auditory information - to activation of the temporal auditory areas of the brain.

Thus, it was concluded that recollection reactivates those areas of the brain that were active when remembering. Visual research methods made it possible to create a map of the activated brain centers when remembering and reproducing information.

Conclusion

The study of human psychophysiology, which began in ancient times, has covered a long research path. In each era, with the introduction of new research methods, some aspect of human memory was revealed. In our enlightened 21st century, with the introduction of the microelectrode method, EEG, tomography, NMR, for the first time it was possible to create maps of brain structures involved in memory processes. The use of NMR allowed us to visually observe that the processes of memorizing and reproducing information occur in the auditory type of memory in the temporal region, the visual type of memory in the occipital regions of the brain, the musical and motor type of memory, additionally the parietal zones are activated, where the tactile and motor memory zones are located.

Psychophysiological research methods have found their practical application in studying the volume of short-term memory in preschoolers, in order to determine the success of a child’s education at school, as well as teaching foreign languages ​​to people with an auditory type of memory during the slow phase of sleep, lasting 90-100 minutes.

The future generation of scientists will have to study and use for practical purposes the information recorded on the emotional and mental shells of the human aura.

Sources and literature

1. Aleksandrov Yu.I. Psychophysiology. Peter, 2007.

2. Bekhtereva N.P. Neurophysiological aspects of mental activity. L.: Nauka, 1971.

3. Danilova N.N. Psychophysiology. M.: Aspect-Press, 2002.

4. Kuzin V.S. Psychology. M, 1999.

5. Luria A.R. A little book about big memories. M.: MSU, 1968.

6. Maklakov A.G. General psychology. Peter, 2005.

7. Stolyarenko L.D. Basics of psychology. Rostov-on-Don: “Phoenix”, 2003.

8. Sergeev B.F. Secrets of memory. M, 1974.

Contraindications are the patient's serious condition, acute liver and kidney diseases, and intolerance to iodine drugs, which are injected into the vascular bed through a special catheter. 1-2 days before the study, a test is performed to determine the patient’s tolerance to iodine preparations. During the examination, local anesthesia or general anesthesia is used.

The images are obtained using a conventional X-ray machine. When converters are used with a television device, the radiation exposure to the patient is significantly reduced.

Angiocardiography. X-ray examination cavities of the heart and large vessels after introducing a contrast agent into the bloodstream using a catheter.

Used to diagnose congenital and acquired heart defects and developmental anomalies of the great vessels. Allows you to identify the nature, localization of the defect, circulatory disorders. Contraindications: acute liver and kidney diseases, severe myocardial damage, hypersensitivity to iodine drugs.

The simplest and most accessible method is speech hearing testing. Its advantage is the ability to conduct an examination without special instruments; in addition, this method corresponds to the main role of the auditory function - to serve as a means verbal communication. Under normal conditions, hearing is considered normal when perceiving whispered speech at a distance of 6-7 meters.

When using equipment, the results of the study are recorded on a special form: this audiogram gives an idea of ​​the degree of hearing impairment and the location of the lesion.

In modern clinics and hospitals, a biopsy is performed on every third patient; the material for it can be taken from almost any organ with special instruments.

Bronchoscopy can be performed under local anesthesia and general anesthesia. With local anesthesia, the root of the tongue, pharynx, trachea and main bronchi are lubricated with a solution of dicaine. An anesthetic spray can also be used. Most often used for general anesthesia general anesthesia. The study is carried out in a sitting or supine position.

Research is carried out with the patient in the supine position, applying electrodes to the surface of the chest. The resulting potential difference is recorded on the screen of a cathode ray tube.

The study is carried out on days 18-20 of the menstrual cycle. The intestines and bladder must be emptied. In the X-ray room, a contrast agent is slowly injected into the uterine cavity with a syringe and an X-ray is taken; a control image is taken a day later.

Catheterization does not require any special preparation of the patient. It is usually carried out in the morning (on an empty stomach) in a cath lab (with special equipment) by professionally trained doctors. The technique is based on the introduction of catheters into the heart through the aorta by puncture of the right femoral artery. After the study, patients need bed rest for the first 24 hours.

Catheterization allows you to study the structure and function of all parts of the cardiovascular system. With its help, you can determine the exact location and size of individual cavities of the heart and large vessels, identify defects in the septa of the heart, and also detect abnormal discharge of blood vessels. Through the catheter, you can record blood pressure, electrocardiogram and phonocardiogram, and obtain blood samples from parts of the heart and great vessels.

It is also used for medicinal purposes for administering medications. In addition, using special catheters, heart surgery is performed (occlusion of the patent ductus arteriosus, elimination of valve stenosis). It is possible that as bloodless research methods (such as ultrasound, etc.) improve, cardiac catheterization will be used less frequently for diagnostic purposes, and more often for therapeutic purposes.

The study is carried out using a colposcope - a binocular equipped with a strong light source. Its optical system allows you to examine the mucous membrane at a magnification of up to 30 times. The examination is carried out under illumination with a quartz light source, since the cancerous tissue in this case acquires its characteristic glow.

Planned laparoscopy is performed after preliminary clinical, laboratory and x-ray examination and is the final stage of diagnosis. Emergency laparoscopy is performed for acutely developed pathology of the abdominal organs. Both are performed under local anesthesia in most cases. Diagnostic laparoscope is a special device with fiber optics, is intended for examination of organs only. The manipulation laparoscope has an additional special channel for introducing various devices that allow biopsy, coagulation, etc.

The first stage of a laparoscopic examination is the introduction of oxygen or air through a needle into the abdominal cavity to increase the viewing sector. The second stage is the introduction of an optical tube into the abdominal cavity. The third stage is examination of the abdominal cavity. Then the laparoscope is removed, the air is removed, and sutures are placed on the skin wound. The patient is prescribed bed rest, painkillers, and cold on the stomach for 24 hours.

Typically, monitoring is used:

1) for immediate detection of conditions that threaten the patient’s life and provision of emergency assistance;

2) to record changes over a given time, for example, to record extrasystoles.

In the first case, stationary monitors are used, equipped with an alarm that is automatically turned on when the values ​​of the indicators deviate beyond the limits set by the doctor. Such control is established over a patient with life-threatening complications - disturbances in heart rhythm, blood pressure, breathing, etc. In other cases, portable devices are used that allow long-term and continuous recording of an ECG on a slowly moving magnetic tape. The portable monitor is mounted on a belt thrown over the patient's shoulder, or on an elastic belt.

Determination of eye pressure. The purpose of the study is to identify pathological changes in the tone of the eyeball. Both increases and decreases in intraocular pressure can impair eye function and lead to severe, irreversible changes. The method serves to diagnose early glaucoma.

For precise definition intraocular pressure, tonometers and elastotonometers are used.

The study is carried out with the patient lying down. After anesthetizing the eye with dicaine solution, the doctor places a tonometer on the center of the cornea.

This method is used to measure pressure in large vessels, parts of the heart and examine organs using special instruments. Necessary for administering medications for local anesthesia and novocaine blockades. Serves for infusion of blood, its components, blood substitutes and for obtaining blood from donors.

Using a needle, it is possible to remove pathological contents from the cavities, such as gas, pus, ascitic fluid, as well as empty the bladder if it is impossible to catheterize it.

In the area of ​​the intended puncture, the patient’s skin is treated with an antiseptic. The puncture of superficial tissues is carried out without anesthesia, deep tissues are punctured under local anesthesia, and sometimes under anesthesia. Needles of various lengths and diameters are used. After the puncture, the patient is under the supervision of a doctor.

In radioisotope diagnostics, two methods are used:

1) The patient is administered a radiopharmaceutical drug, followed by a study of its movement or unequal concentration in organs and tissues.

2) Labeled substances are added to the test tube with the blood being tested, assessing their interaction. This is etc. a screening test for the early detection of various diseases in an unlimited number of people.

Indications for radioisotope research are diseases of the endocrine glands, digestive organs, as well as bone, cardiovascular, hematopoietic systems, brain and spinal cord, lungs, excretory organs, lymphatic system. It is carried out not only if some pathology is suspected or if there is a known disease, but also to clarify the extent of the lesion and assess the effectiveness of treatment. There are no contraindications to radioisotope research; there are only some restrictions. Comparison of radioisotope, X-ray and ultrasound data is of great importance.

There are six main methods of radioisotope diagnostics: clinical radiometry, radiography, whole body radiometry, scanning and scintigraphy, determination of radioactivity of biological samples, radioisotope study of biological samples in vitro.

Clinical radiometry determines the concentration of radiopharmaceuticals in organs and tissues of the body by measuring radioactivity over a time interval. Intended for the diagnosis of tumors located on the surface of the skin, eyes, mucous membrane of the larynx, esophagus, stomach, uterus and other organs.

Radiography - registration of the dynamics of accumulation and redistribution of the administered organ radioactive drug. It is used to study rapidly occurring processes, such as blood circulation, ventilation, etc.

Radiometry of the whole body is carried out using a special counter. The method is intended to study the metabolism of proteins, vitamins, the function of the gastrointestinal tract, as well as to study the natural radioactivity of the body and its contamination with radioactive decay products.

Scanning and scintigraphy are designed to obtain images of organs that selectively concentrate the drug. The resulting picture of the distribution and accumulation of the radionuclide gives an idea of ​​the topography, shape and size of the organ, as well as the presence of pathological foci in it.

Determination of radioactivity in biological samples - intended to study organ function. The absolute or relative radioactivity of urine, blood serum, saliva, etc. is considered.

Radioisotope research in vitro - determination of the concentration of hormones and other biological active substances in blood. In this case, radionuclides and labeled compounds are not introduced into the body; All analysis is based on in vitro data.

Each diagnostic test is based on the participation of radionuclides in the physiological processes of the body. Circulating along with blood and lymph, drugs are temporarily retained in certain organs, their speed and direction are recorded, on the basis of which a clinical opinion is made.

In gastroenterology, this makes it possible to study the function, position and size of the salivary glands, spleen, and the condition of the gastrointestinal tract. Various aspects of liver activity and the state of its blood circulation are determined: scanning and scintigraphy give an idea of ​​focal and diffuse changes in chronic hepatitis, cirrhosis, echinococcosis and malignant neoplasms. When scintigraphy of the pancreas, obtaining its image, inflammatory and volumetric changes are analyzed. With the help of labeled food, the functions of the stomach and duodenum are studied in chronic gastroenteritis and peptic ulcers.

In hematology, radioisotope diagnostics helps to establish the life expectancy of red blood cells and determine anemia. In cardiology, the movement of blood through the vessels and cavities of the heart is traced: based on the nature of the distribution of the drug in its healthy and affected areas, a reasonable conclusion is made about the state of the myocardium. Sciptigraphy provides important data for the diagnosis of myocardial infarction - an image of the heart with areas of necrosis. Radiocardiography plays a great role in recognizing congenital and acquired heart defects. Using a special device - a gamma camera, it helps to see the heart and large vessels at work.

In neurology, radioisotope techniques are used to identify brain tumors, their nature, location and prevalence. Renography is the most physiological test for kidney diseases: an image of the organ, its location, function.

The advent of radioisotope technology has opened up new opportunities for oncology. Radionuclides selectively accumulating in tumors have made it possible to diagnose primary cancers of the lungs, intestines, pancreas, lymphatic and central nervous systems, since even small tumors are detected. This allows you to evaluate the effectiveness of treatment and identify relapses. Moreover, scintigraphic signs of bone metastases are detected 3-12 months earlier than x-rays.

In pulmonology, these methods “hear” external respiration and pulmonary blood flow; in endocrinology, they “see” the consequences of disorders of iodine and other metabolism, calculating the concentration of hormones - the result of the activity of the endocrine glands.

All studies are carried out only in radioisotope diagnostic laboratories by specially trained personnel. Radiation safety is ensured by calculating the optimal activity of the administered radionuclide. Patient radiation doses are clearly regulated.

In this study, the beam x-rays, passing through organs and tissues, is absorbed by them to an unequal extent and at the exit becomes heterogeneous. Therefore, when it then hits the screen or film, it causes the effect of shadow exposure, consisting of light and darker areas of the body.

At the dawn of radiology, its area of ​​application was only the respiratory organs and skeleton. Today the range is much wider: the gastrointestinal, biliary and urinary tracts, kidneys, blood and lymphatic vessels, etc.

The main tasks of x-ray diagnostics: to determine whether the patient has any disease and to identify it features to differentiate with other pathological processes; accurately determine the location and extent of the lesion, the presence of complications; assess the general condition of the patient.

Organs and tissues of the body differ from each other in density and ability to be x-rayed. So, well, bones and joints, lungs, heart are visible. When X-raying the gastrointestinal tract, liver, kidneys, bronchi, and blood vessels, the natural contrast of which is insufficient, they resort to artificial contrast, specially introducing harmless radiopaque substances into the body. These include barium sulfate and organic iodide compounds. They are taken orally (when the stomach is examined), injected into the bloodstream intravenously (for urography of the kidneys and urinary tract) or directly into the organ cavity (for example, for bronchography).

Indications for x-ray examination are extremely wide. The choice of the optimal method is determined by the diagnostic task in each specific case. They usually start with fluoroscopy or radiography.

Fluoroscopy is the process of obtaining an X-ray image on a screen, not at all)" - but can be used wherever there is an X-ray diagnostic apparatus. Allows you to examine organs in the process of their work - respiratory movements of the diaphragm, heart contraction, peristalsis of the esophagus, stomach, intestines. It can also be done visually determine the relative position of organs, localization and displacement of pathological formations. Many diagnostic and therapeutic procedures are performed under fluoroscopy control, for example, vascular catheterization.

However, lower resolution than radiography and the inability to objectively document the results reduce the value of the method.

Radiography is the production of a fixed image of any part of the body using x-rays on a material sensitive to it, usually photographic film. It is the leading method for studying the osteoarticular apparatus, lungs, heart, and diaphragm. The advantages include the detail of the image, the presence of an x-ray that can be stored for a long time for comparison with previous and subsequent x-rays. The radiation exposure to the patient is less than with fluoroscopy.

To obtain additional information about the organ under study, they resort to special x-ray methods, such as fluorography, tomography, electroradiography, etc., based on their technical means.

Electroradiography is the principle of obtaining an x-ray image on plain paper.

Fluorography is the photographing of an X-ray image from a screen onto smaller photographic film, carried out using special devices. It is used for mass examinations of the chest organs, mammary glands, paranasal sinuses, etc.

Tomography - layer-by-layer x-ray imaging. A tomogram produces a clear cross-sectional image of a body part or organ. It is very important in the study of lungs, bones and joints, liver, kidneys, etc.

Methods such as cholegraphy, urography, angiography, etc. are intended for studying a system or organ after artificial contrasting. They are used according to strict indications only in cases where simpler methods do not provide the necessary diagnostic results.

In some cases, an X-ray examination requires preliminary preparation of the patient in order to ensure the quality of the examination and reduce the associated discomfort or prevent the development of complications. So, the rectum is always freed from feces by prescribing. laxatives, cleansing enemas. Before puncture of a vessel or duct, local anesthesia is required. To reduce the body's sensitivity to certain radiocontrast agents, they are taken in combination with desensitizing agents. Sometimes medications are used to identify the functional state of a particular organ. For example, morphine, prozerin to stimulate gastric motility. Secretin, cholecystokinin for accelerated emptying of the gallbladder and contrasting of the bile ducts.

A promising combination of X-ray examination with radioisotope, endoscopic, ultrasound, thermographic and other methods.

Complications, such as consequences of x-ray examination, are observed relatively rarely. These include allergic reactions, acute respiratory distress, drop in blood pressure, cardiac dysfunction, etc. This usually occurs during the study or within the first 30 minutes after its completion. Continuous medical monitoring of the patient’s condition is important, as well as providing emergency medical care if necessary.

Rheography of the extremities is used for diseases of peripheral vessels, accompanied by changes in their tone, elasticity, narrowing or complete blockage of the arteries. The rheogram is recorded from symmetrical areas of both limbs, onto which electrodes of the same area, 1020 mm wide, are applied. To find out the adaptive capabilities of the vascular system, tests with nitroglycerin, physical activity, and cold are used.

Rheohepatography is a study of liver blood flow. By recording fluctuations in the electrical resistance of its tissues, it makes it possible to judge the processes occurring in vascular system liver: blood supply, lesions, especially in acute and chronic hepatitis and cirrhosis.

It is carried out on an empty stomach, with the patient lying on his back, in some cases after a pharmacological load (papaverine, aminophylline, nosh-pa).

Rheocardiography is a study of cardiac activity, the dynamics of blood filling of large vessels during the cardiac cycle.

Rheopulmonography - involves recording the electrical resistance of lung tissue and is used for bronchopulmonary pathology. It is of particular importance in surgery, since a rheopulmonogram can be taken from any part of the lung directly during surgery. This is necessary in cases where preoperative examination does not allow us to provide a sufficiently accurate conclusion about the condition of the lung segments bordering the affected ones, and it is necessary to clarify the expected extent of resection.

Rheoencephalography - determines the tone and elasticity of brain vessels, measuring their resistance to current high frequency, weak in strength and tension. It also allows you to determine the blood supply to parts of the brain, diagnose the nature and location of its lesions, and gives a good result when vascular diseases, especially in cerebral atherosclerosis. In the acute period of stroke, it helps to establish the ischemic nature of the circulatory disorder or thromboembolic cerebral infarction. Rheoencephalography is promising for brain injuries, brain tumors, epilepsy, migraine, etc. This method is used in the study of fetal hemodynamics during childbirth.

Thermography. Registration method infrared radiation from the surface of the human body. It is used in oncology for the differential diagnosis of tumors of the mammary, salivary and thyroid glands, bone diseases, cancer metastases in bones and soft tissues.

Physiological basis thermography is an increase in the intensity of thermal radiation over pathological foci due to increased blood supply and metabolic processes in them. A decrease in blood flow in tissues and organs is reflected by the “fading” of their thermal field.

Preparing the patient includes avoiding taking hormonal medications, medications that affect vascular tone, and applying any ointments for ten days. Thermography of the abdominal organs is carried out on an empty stomach, and the mammary glands - on the 8-10th day of the menstrual cycle. There are no contraindications, the study can be repeated many times. As an independent diagnostic method, it is rarely used; comparison with the data of the clinical and radiological examination of the patient is mandatory.

This is done using special devices - computed tomographs with a rotating X-ray tube that moves around a stationary object, examining the entire body or part of it “line by line.” Since human organs and tissues absorb X-ray radiation to an unequal extent, their image appears in the form of “strokes” - a computer-set absorption coefficient for each point of the scanned layer. Computer tomographs make it possible to isolate layers from 2 to 10 mm at a scanning speed of one layer of 2-5 seconds, with instant image reproduction in black and white or color.

Computer examination is usually carried out with the patient lying on his back. There are no contraindications, it is easily tolerated, so it can be performed on an outpatient basis, as well as for seriously ill patients. Makes it possible to examine all parts of the body: head, neck, chest organs, abdominal cavity, spinal cord, mammary glands, spine, bones and joints.

A CT scan of the head is performed after a complete clinical examination of a patient with suspected damage to the central nervous system. In case of traumatic brain injury, fractures of the skull bones, hemorrhages, bruises and swelling of the brain are detected. Using the method, it is possible to detect vascular malformations - aneurysms. For brain tumors, their location is determined, the source of growth and the extent of the tumor are identified.

When examining the chest organs, the mediastinum, great vessels, heart, as well as the lungs and lymph nodes are clearly visible.

When examining the abdominal organs and retroperitoneal space, you can obtain an image of the spleen, liver, pancreas and kidneys (the study of the kidneys is more informative with artificial contrast).

Computed tomography is safe and does not cause complications. By supplementing clinical and x-ray data, it allows you to obtain more complete information about the organs.

It is used to recognize the disease, to monitor the dynamics of the process and evaluate the results of treatment. Due to its safety (the possibility of multiple examinations), ultrasound diagnostics has become widespread.

Usually does not require any special preparation of the patient. The examination of the abdominal organs is mainly carried out in the morning on an empty stomach, the female genital organs, prostate gland and bladder - with a full bladder. For better contact of the ultrasonic sensor with the surface of the body, the skin is lubricated with a special gel.

Ultrasound diagnostics allows you to obtain important information about the condition of various organs - liver, pancreas, spleen, kidneys, bladder, prostate, adrenal glands, thyroid gland, etc. In an obstetric clinic, determine the gestational age and location of the fetus, delays in its development and congenital defects, establish a non-developing pregnancy, complete or incomplete miscarriage.

It is also possible to diagnose gynecological diseases: fibroids and uterine tumors, cysts and ovarian tumors.

Ultrasound examination is indicated in all cases if any formation is palpated in the abdominal cavity; it is of particular importance in recognizing malignant tumors of the digestive organs. Some acute diseases that require urgent surgical intervention are easily diagnosed, such as acute cholecystitis, acute pancreatitis, vascular thrombosis, etc. Sonography almost always allows you to quickly identify the mechanical nature of jaundice and accurately determine its cause.

When examining the heart, information is obtained about the features of its structure and the dynamics of contractions, about congenital and acquired defects, myocardial lesions, coronary disease, pericarditis and other diseases of the cardiovascular system. Ultrasound is used to assess the pumping function of the heart, to monitor the action medicines, for studying coronary circulation and is the same reliable method of bloodless diagnostics as electrocardiography and x-ray examination of the heart.

Pulse Doppler devices record the speed of blood flow in deep-lying great vessels (aorta, inferior vena cava, renal vessels, etc.), detect obstruction of peripheral vessels - zones of thrombosis or compression, as well as obliterating endarteritis.

Ultrasound diagnostics makes it possible to visually represent the internal structures of the eyeball, even in cases of opacity of its media, allows you to measure the thickness of the lens, the length of the axes of the eye, detect retinal and choroidal detachment, opacification in the vitreous body, and foreign bodies. Used to calculate the optical power of an artificial lens and to monitor the development of myopia.

The ultrasound method is simple and accessible, has no contraindications and can be used repeatedly, even during the day, if the patient’s condition requires it. The information obtained complements the data of computed tomography, X-ray and radioisotope diagnostics, and must be compared with the clinical condition of the patient.

They are performed if diseases of the urinary system are suspected, usually after a survey image and, if possible, after an ultrasound or radioisotope scan. Contraindicated in acute liver and kidney damage, myocardial infarction.

To obtain a good image, preparation of the patient is necessary, which consists of following a diet and emptying the intestines. A cleansing enema is given the evening before, a second enema is given 10-20 minutes before the examination, then a survey photograph is taken. It is used to assess the readiness of the intestines and the patient is administered radiocontrast agents. The number of images and the time they take depend on the nature of the disease and the purpose of the study.

Urography has great diagnostic value in case of urolithiasis: localization of the stone, functional state of the affected and healthy kidney, and urinary tract. The method is quite informative for kidney injuries, inflammatory diseases, and tuberculosis of the urinary system. In addition, it allows us to judge changes in the lower urinary tract due to tumors, bladder diverticula, and identify prostate adenoma.

During urography, complications associated with increased sensitivity to radiocontrast agents are possible.

The phonocardiogram is recorded in a specially equipped isolated room where complete silence can be created. The doctor identifies points on the chest, from which recording is then made using a microphone. The patient's position during recording is horizontal. The use of phonocardiography for dynamic monitoring of the patient’s condition increases the reliability of diagnostic conclusions and makes it possible to evaluate the effectiveness of treatment.

Absolute contraindications to cholegraphy are acute liver and kidney diseases, intolerance to iodine drugs. During the preparation period, patients should follow a diet that limits foods that contribute to gas formation. Persons prone to allergic reactions are prescribed antihistamines for three days. On the morning of the study, eating, smoking and taking medications is prohibited. With slow intravenous administration of the radiocontrast agent, the possibility of side effects is reduced.

When analyzing cholegrams, the position, shape, contours, size and structure of the shadow of the bile ducts and gallbladder are determined, paying special attention to the presence of filling defects in them, most often caused by stones. To study the motor function of the gallbladder, the patient is given two raw egg yolks to eat and the duration of contraction of the gallbladder and the time of its relaxation are recorded.

An electrocardiogram is used to determine the frequency and rhythm of cardiac activity (duration, length, shape of waves and intervals). Some pathological conditions are also analyzed, such as thickening of the walls of one or another part of the heart, heart rhythm disturbances. It is possible to diagnose angina pectoris, coronary heart disease, myocardial infarction, myocarditis, and pericarditis.

Some medications (cardiac glycosides, diuretics, cordarone, etc.) affect the electrocardiogram readings, which makes it possible to individually select medications for the treatment of the patient.

The advantages of the method - harmlessness and the possibility of application in any conditions - contributed to its widespread introduction into practical medicine.

While recording electroencephalography, the subject sits reclining in a special comfortable chair or, in severe cases, lies on a couch with a slightly raised headboard. Before the examination, the patient is warned that the recording procedure is harmless, painless, lasts no more than 20-25 minutes, and that it is necessary to close your eyes and relax your muscles. Tests are used with opening and closing the eyes, with irritation by light and sound. Electroencephalogram readings for any disease must be correlated with clinical examination data.

The method has important For early diagnosis precancerous diseases and tumors of various localizations in the early stages of their development, as well as to differentiate them from diseases of an inflammatory nature.

Fiber optics has opened up broad prospects for endoscopy. The flexibility of fiber light guides and the ability to transmit images and light along a curved path made the fiberscope flexible and easy to control. This reduced the danger of the study and included the intestines, female genital organs, and blood vessels in the scope of its objects.

Endoscopic methods are also used for medicinal purposes: removal of polyps, local administration of drugs, dissection of cicatricial stenoses, stopping internal bleeding, removal of stones and foreign bodies.

The advantage of the method is its high sensitivity in the image of soft tissues, as well as high resolution, down to fractions of a millimeter. Allows you to obtain an image of the organ under study in any section and reconstruct their three-dimensional images.

Chronology of the development of astronomy from the end of the 19th century - throughout the 20th centuries - and the beginning of the 21st century
1860 the book “ Chemical analysis by spectral observations" by Kirchhoff and Bunsen, which described methods of spectral analysis. The beginning of astrophysics was made.
1862 The satellite of Sirius was discovered, which Bessel spoke about in his research.
1872 American G. Dreper took the first photograph of the spectrum of a star.
1873 J.C. Maxwell publishes A Treatise on Electricity and Magnetism, in which he outlined the so-called Maxwell's equations, thereby predicting the existence of electromagnetic waves and the "Pressure of Light" effect.
1877 A. Hall discovered the satellites of Mars - Deimos, Phobos. In the same year, Martian canals were discovered by the Italian G. Schiaparelli.
1879 English astronomer J. H. Darwin published a hypothesis about tidal origin Moons. S. Fleming proposes dividing the Earth into time zones.
1884 26 countries introduced standard time, proposed by Fleming. Greenwich was chosen by international agreement as the prime meridian.
1896 A satellite was discovered near Procyon, predicted by Bessel.
1898 W. G. Pickering discovered Saturn's moon Phoebe with its ability to rotate in the opposite direction relative to its planet.
Beginning XX century scientists G. von Zeipel and G. K. Plummer built the first models of stellar systems.
1908 George Hale first discovered a magnetic field in an extraterrestrial object, which became the Sun.
1915-1916 Einstein deduced general theory relativity, defining new theory gravity. The scientist concluded that a change in speed acts on bodies like the force of gravity. If Newton at one time called the orbits of the planets fixed around the Sun, then Einstein argued that the Sun has a gravitational field, as a result of which the orbits of the planets make a slow additional rotation.
1918 American Harlow Shapley, based on observations, developed a model of the structure of the Galaxy, during which the real location of the Sun was revealed - the edge of the Galaxy.
1926-1927 - B. Lindblad and Jan Oort, analyzing the movement of stars, come to the conclusion about the rotation of the Galaxy.
In 1931, radio astronomy began with the experiments of K. Jansky.
1932 Jansky discovered radio emission cosmic origin. The first radio source of continuous radiation was identified as a source in the center of the Milky Way.
1937 American G. Reber designed the first parabolic radio telescope, the diameter of which was 9.5 m.
1950s X-rays emanating from the Sun have been detected. The beginning of X-ray astronomy was laid.
1950s formation of modern infrared astronomy. Study of information in the range between visible radiation.
1953 J. de Vaucouleurs discovered the first supercluster of galaxies, also called the Local.
1957 begins space age launching artificial earth satellites.
1961 First human launch into space. Yuri Gagarin became the first cosmonaut.
1962 Orbital launched solar observatory, with the help of which it became possible to systematically carry out observations regarding ultraviolet radiation, which gave rise to the development of ultraviolet astronomy.
1962 The first X-ray source outside the solar system is discovered - Scorpius X-
1965 the first human exit in open space, perfected by Alexey Leonov. The duration of the exit was 23 minutes. 41 sec.
1969 Man's foot set foot on the surface of the Moon. The first astronaut on the surface of the Moon was Neil Armstrong.
1991 launch of the Compton Gamma-ray Observatory, which gave a powerful impetus to the development of gamma-ray astronomy.

Contraindications are the patient's serious condition, acute liver and kidney diseases, and intolerance to iodine drugs, which are injected into the vascular bed through a special catheter. 1-2 days before the study, a test is performed to determine the patient’s tolerance to iodine preparations. During the examination, local anesthesia or general anesthesia is used.

The images are obtained using a conventional X-ray machine. When converters are used with a television device, the radiation exposure to the patient is significantly reduced.

AUDIOMETRY. - Measurement of hearing acuity, i.e. sensitivity of the auditory organ to sounds of different pitches. It consists mainly in maintaining the lowest sound intensity at which it is still audible. Three main methods are used: hearing testing with speech, tuning forks, and audiometer.

The simplest and most accessible method is speech hearing testing. Its advantage is the ability to conduct an examination without special instruments; in addition, this method corresponds to the main role of the auditory function - to serve as a means of speech communication. Under normal conditions, hearing is considered normal when perceiving whispered speech at a distance of 6-7 meters.

When using equipment, the results of the study are recorded on a special form: this audiogram gives an idea of ​​the degree of hearing impairment and the location of the lesion.

BIOPSY. - Intravital excision of tissues or organs for examination under a microscope. It allows you to accurately determine the existing pathology, as well as diagnose clinically unclear and initial stages of neoplasms, and recognize various inflammatory phenomena. Repeated biopsy traces the dynamics of the pathological process and the influence of therapeutic measures on it.

In modern clinics and hospitals, a biopsy is performed on every third patient; the material for it can be taken from almost any organ with special instruments.

BRONCHOSCOPY. - A diagnostic and therapeutic procedure consisting of a visual assessment of the condition of the bronchial tree using a special device - a bronchoscope. It is carried out to diagnose tumors of the trachea and bronchi (taking a biopsy), to remove foreign bodies from the respiratory tract, to straighten sleeping areas of lung tissue (atelectasis), to wash the bronchi and introduce medications into them.

Bronchoscopy can be performed under local anesthesia and general anesthesia. With local anesthesia, the root of the tongue, pharynx, trachea and main bronchi are lubricated with a solution of dicaine. An anesthetic spray can also be used. For general anesthesia, general anesthesia is most often used. The study is carried out in a sitting or supine position.

VECTORCARDIOGRAPHY. - Registration of the electrical activity of the heart using special devices - vector electrocardioscopes. Allows you to determine changes in the magnitude and direction of the electrical field of the heart during the cardiac cycle. The method is a further development of electrocardiography. In the clinic, it is used to diagnose focal myocardial lesions, ventricular hypertrophy (especially in the early stages) and rhythm disturbances.

Research is carried out with the patient in the supine position, applying electrodes to the surface of the chest. The resulting potential difference is recorded on the screen of a cathode ray tube.

CARDIAC CATHETERIZATION.- Introduction of special catheters into the cavities of the heart through peripheral veins and arteries. Used to diagnose complex heart defects, clarify indications and contraindications for surgical treatment of a number of diseases of the heart, blood vessels and lungs, to identify and evaluate cardiac, coronary and pulmonary insufficiency.

Catheterization does not require any special preparation of the patient. It is usually carried out in the morning (on an empty stomach) in a cath lab (with special equipment) by professionally trained doctors. The technique is based on the introduction of catheters into the heart through the aorta by puncture of the right femoral artery. After the study, patients need bed rest for the first 24 hours.

Catheterization allows you to study the structure and function of all parts of the cardiovascular system. With its help, you can determine the exact location and size of individual cavities of the heart and large vessels, identify defects in the septa of the heart, and also detect abnormal discharge of blood vessels. Through the catheter, you can record blood pressure, electrocardiogram and phonocardiogram, and obtain blood samples from parts of the heart and great vessels.

It is also used for medicinal purposes for administering medications. In addition, using special catheters, heart surgery is performed (occlusion of the patent ductus arteriosus, elimination of valve stenosis). It is possible that as bloodless research methods (such as ultrasound, etc.) improve, cardiac catheterization will be used less frequently for diagnostic purposes, and more often for therapeutic purposes.

LAPAROSCOPY. - A method for diagnosing diseases of the abdominal cavity using a special optical instrument, which is inserted through a puncture of the anterior abdominal wall or posterior vaginal fornix. Provides instrumental palpation and obtaining biopsy material for more accurate histological studies; if the clinical diagnosis is unclear, it helps to establish the form or stage of the disease. If necessary, serves for therapeutic measures: installation of drainage, removal of foreign bodies, electrocoagulation, organ puncture.

Planned laparoscopy is performed after preliminary clinical, laboratory and x-ray examination and is the final stage of diagnosis. Emergency laparoscopy is performed for acutely developed pathology of the abdominal organs. Both are performed under local anesthesia in most cases. A diagnostic laparoscope is a special device with fiber optics, intended only for examining organs. The manipulation laparoscope has an additional special channel for introducing various devices that allow biopsy, coagulation, etc.

The first stage of a laparoscopic examination is the introduction of oxygen or air through a needle into the abdominal cavity to increase the viewing sector. The second stage is the introduction of an optical tube into the abdominal cavity. The third stage is examination of the abdominal cavity. Then the laparoscope is removed, the air is removed, and sutures are placed on the skin wound. The patient is prescribed bed rest, painkillers, and cold on the stomach for 24 hours.

MONITOR SURVEILLANCE. - It is carried out over several hours or days with continuous recording of the body’s condition. Monitoring is carried out over pulse and respiration rates, arterial and venous pressure, body temperature, electrocardiogram, etc.

Typically, monitoring is used: 1) for immediate detection of conditions that threaten the patient’s life and provision of emergency assistance; 2) to record changes over a given time, for example, to record extrasystoles. In the first case, stationary monitors are used, equipped with an alarm that is automatically turned on when the values ​​of the indicators deviate beyond the limits set by the doctor. Such control is established over a patient with life-threatening complications - disturbances in heart rhythm, blood pressure, breathing, etc. In other cases, portable devices are used that allow long-term and continuous recording of an ECG on a slowly moving magnetic tape. The portable monitor is mounted on a belt thrown over the patient's shoulder, or on an elastic belt.

RADIOISOTOPIC DIAGNOSTICS.- Recognition of pathological changes in the human body using radioactive compounds. It is based on recording and measuring radiation from drugs introduced into the body. With their help, they study the functioning of organs and systems, metabolism, blood flow speed and other processes.

In radioisotope diagnostics, two methods are used: 1) The patient is injected with a radiopharmaceutical drug, followed by a study of its movement or unequal concentration in organs and tissues. 2) Labeled substances are added to the test tube with the blood being tested, assessing their interaction. This is etc. a screening test for the early detection of various diseases in an unlimited number of people.

Indications for radioisotope research are diseases of the endocrine glands, digestive organs, as well as the bone, cardiovascular, hematopoietic systems, brain and spinal cord, lungs, excretory organs, and lymphatic system. It is carried out not only if some pathology is suspected or if there is a known disease, but also to clarify the extent of the lesion and assess the effectiveness of treatment. There are no contraindications to radioisotope research; there are only some restrictions. Comparison of radioisotope, X-ray and ultrasound data is of great importance.

There are six main methods of radioisotope diagnostics: clinical radiometry, radiography, whole body radiometry, scanning and scintigraphy, determination of radioactivity of biological samples, radioisotope study of biological samples in vitro.

Clinical radiometry determines the concentration of radiopharmaceuticals in organs and tissues of the body by measuring radioactivity over a time interval. Intended for the diagnosis of tumors located on the surface of the skin, eyes, mucous membrane of the larynx, esophagus, stomach, uterus and other organs.

Radiography – registration of the dynamics of accumulation and redistribution of the administered radioactive drug by the organ. It is used to study rapidly occurring processes, such as blood circulation, ventilation, etc.

Radiometry - the whole body - is carried out using a special counter. The method is intended to study the metabolism of proteins, vitamins, the function of the gastrointestinal tract, as well as to study the natural radioactivity of the body and its contamination with radioactive decay products.

Scanning and scintigraphy

Determination of radioactivity of biological samples - intended to study the function of an organ. The absolute or relative radioactivity of urine, blood serum, saliva, etc. is considered.

Radioisotope research in vitro - determination of the concentration of hormones and other biologically active substances in the blood. In this case, radionuclides and labeled compounds are not introduced into the body; All analysis is based on in vitro data.

Each diagnostic test is based on the participation of radionuclides in physiological processes body. Circulating along with blood and lymph, drugs are temporarily retained in certain organs, their speed and direction are recorded, on the basis of which a clinical opinion is made.

In gastroenterology, this makes it possible to study the function, position and size of the salivary glands, spleen, and the condition of the gastrointestinal tract. Various aspects of liver activity and the state of its blood circulation are determined: scanning and scintigraphy give an idea of ​​focal and diffuse changes for chronic hepatitis, cirrhosis, echinococcosis and malignant neoplasms. When scintigraphy of the pancreas, obtaining its image, inflammatory and volumetric changes are analyzed. With the help of labeled food, the functions of the stomach and duodenum are studied in chronic gastroenteritis and peptic ulcers.

In hematology, radioisotope diagnostics helps to establish the life expectancy of red blood cells and determine anemia. In cardiology, the movement of blood through the vessels and cavities of the heart is traced: based on the nature of the distribution of the drug in its healthy and affected areas, a reasonable conclusion is made about the state of the myocardium. Sciptigraphy provides important data for the diagnosis of myocardial infarction - an image of the heart with areas of necrosis. Radiocardiography plays a great role in recognizing congenital and acquired heart defects. Using a special device - a gamma camera, it helps to see the heart and large vessels at work.

In neurology, radioisotope techniques are used to identify brain tumors, their nature, location and prevalence. Renography is the most physiological test for kidney diseases: an image of the organ, its location, function.

The advent of radioisotope technology has opened up new opportunities for oncology. Radionuclides selectively accumulating in tumors have made it possible to diagnose primary cancers of the lungs, intestines, pancreas, lymphatic and central nervous systems, since even small tumors are detected. This allows you to evaluate the effectiveness of treatment and identify relapses. Moreover, scintigraphic signs of bone metastases are detected 3-12 months earlier than x-rays.

In pulmonology, these methods “hear” external respiration and pulmonary blood flow; in endocrinology, they “see” the consequences of disorders of iodine and other metabolism, calculating the concentration of hormones - the result of the activity of the endocrine glands.

All studies are carried out only in radioisotope diagnostic laboratories by specially trained personnel. Radiation safety is ensured by calculating the optimal activity of the administered radionuclide. Patient radiation doses are clearly regulated.

RHEOGRAPHY- (literal Translation: "reo" - flow, flow and its graphic representation). A method for studying blood circulation based on measuring the pulse wave caused by the resistance of the vessel wall when an electric current is passed. It is used in the diagnosis of various types of vascular disorders of the brain, limbs, lungs, heart, liver, etc.

Rheography of the extremities is used for diseases of peripheral vessels, accompanied by changes in their tone, elasticity, narrowing or complete blockage of the arteries. The rheogram is recorded from symmetrical areas of both limbs, onto which electrodes of the same area, 1020 mm wide, are applied. To find out the adaptive capabilities of the vascular system, tests with nitroglycerin, physical activity, and cold are used.

RHEOGEPATOGRAPHY– study of liver blood flow. By recording fluctuations in the electrical resistance of its tissues, it allows us to judge the processes occurring in the vascular system of the liver: blood supply, lesions, especially in acute and chronic hepatitis and cirrhosis.

It is carried out on an empty stomach, with the patient lying on his back, in some cases after a pharmacological load (papaverine, euphyllia, nosh-pa).

RHEOCARDIOGRAPHY– study of cardiac activity, the dynamics of blood filling of large vessels during the cardiac cycle.

RHEOPULMONOGRAPHY– consists of recording the electrical resistance of lung tissue, used for bronchopulmonary pathology. It is of particular importance in surgery, since a rheopulmonogram can be taken from any part of the lung directly during surgery. This is necessary in cases where preoperative examination does not allow us to provide a sufficiently accurate conclusion about the condition of the lung segments bordering the affected ones, and it is necessary to clarify the expected extent of resection.

RHEOENCEPHALOGRAPHY– determines the tone and elasticity of brain vessels, measuring their resistance to high-frequency current, weak in strength and voltage. It also allows you to determine the blood supply to parts of the brain, diagnose the nature and localization of its lesions, and gives good results in vascular diseases, especially in cerebral atherosclerosis. In the acute period of stroke, it helps to establish the ischemic nature of the circulatory disorder or thromboembolic cerebral infarction. Rheoencephalography is promising for brain injuries, brain tumors, epilepsy, migraine, etc. This method is used in the study of fetal hemodynamics during childbirth.

X-RAY DIAGNOSTICS.- Recognition of injuries and diseases of various human organs and systems based on obtaining and analyzing their X-ray images.

In this study, a beam of X-rays, passing through an organ and tissue, is absorbed by them to an unequal extent and becomes inhomogeneous at the output. Therefore, when it then hits the screen or film, it causes the effect of shadow exposure, consisting of light and darker areas of the body.

At the dawn of radiology, its area of ​​application was only the respiratory organs and skeleton. Today the range is much wider: the gastrointestinal, biliary and urinary tracts, kidneys, blood and lymphatic vessels, etc.

The main tasks of X-ray diagnostics are: to establish whether the patient has any disease and to identify its distinctive signs in order to differentiate it from other pathological processes; accurately determine the location and extent of the lesion, the presence of complications; rate general condition sick.

Organs and tissues of the body differ from each other in density and ability to be x-rayed. So, well, bones and joints, lungs, heart are visible. When X-raying the gastrointestinal tract, liver, kidneys, bronchi, and blood vessels, the natural contrast of which is insufficient, they resort to artificial contrast, specially introducing harmless radiopaque substances into the body. These include barium sulfate and organic iodide compounds. They are taken orally (when the stomach is examined), injected into the bloodstream intravenously (for urography of the kidneys and urinary tract) or directly into the organ cavity (for example, for bronchography).

Indications for x-ray examination are extremely wide. The choice of the optimal method is determined by the diagnostic task in each specific case. They usually start with fluoroscopy or radiography.

X-RAY SCOPE- This is the acquisition of an x-ray image on a screen. Can be used anywhere there is an X-ray diagnostic machine. Allows you to examine organs in the process of their work - respiratory movements of the diaphragm, heart contraction, peristalsis of the esophagus, stomach, intestines. You can also visually determine the relative position of organs, the localization and displacement of pathological formations. Under fluoroscopy control, many diagnostic and therapeutic procedures are performed, for example, vascular catheterization.

However, lower resolution than radiography and the inability to objectively document the results reduce the value of the method.

Radiography is the production of a fixed image of any part of the body using x-rays on a material sensitive to it, usually photographic film. It is the leading method for studying the osteoarticular apparatus, lungs, heart, and diaphragm. The advantages include the detail of the image, the presence of an x-ray that can be stored for a long time for comparison with previous and subsequent x-rays. The radiation exposure to the patient is less than with fluoroscopy.

To obtain additional information about the organ under study, they resort to special x-ray methods, such as fluorography, tomography, electroradiography, etc., based on their technical means.

THERMOGRAPHY– a method for recording infrared radiation from the surface of the human body. It is used in oncology for the differential diagnosis of tumors of the mammary, salivary and thyroid glands, bone diseases, cancer metastases in bones and soft tissues.

The physiological basis of thermography is an increase in the intensity of thermal radiation over pathological foci due to increased blood supply and metabolic processes in them. A decrease in blood flow in tissues and organs is reflected by the “fading” of their thermal field.

Preparing the patient includes avoiding taking hormonal medications, medications that affect vascular tone, and applying any ointments for ten days. Thermography of the abdominal organs is carried out on an empty stomach, and the mammary glands - on the 8-10th day of the menstrual cycle. There are no contraindications, the study can be repeated many times. As an independent diagnostic method, it is rarely used; comparison with the data of the clinical and radiological examination of the patient is mandatory.

TOMOGRAPHY(Greek tomos piece, layer + graphō write, depict) - a method of layer-by-layer examination of the organs of the human body using radiation diagnostics. There are methods of T. using ionizing radiation, i.e. with irradiation of patients (conventional X-ray, or so-called classical, computer X-ray and radionuclide, or emission computer, T.), and not related to it (ultrasound and magnetic resonance T.). With the exception of conventional X-ray, for all types of tomography, images are obtained using computers (computers) built into the devices.

Conventional X-ray tomography - the most common method of layer-by-layer research; is based on the synchronous movement in space of the emitter and the X-ray cassette during the X-ray shooting process. X-ray diagnostic devices for conventional X-ray T. consist of a movable emitter-X-ray cassette system, a mechanism for moving it, a device for placing the patient, mechanical supports, and electrical and electronic control devices. Tomographs are divided into longitudinal (the selected layer is parallel to the longitudinal axis of the human body), transverse (the selected layer is perpendicular to the axis of the human body) and panoramic (the selected layer has the shape of a curved surface).

Computer X-ray tomography (or computer T.) is based on obtaining a layer-by-layer X-ray image of an organ using a computer. The patient’s body is illuminated with an X-ray around its longitudinal axis, resulting in transverse “slices”. The image of the transverse layer of the object under study on the screen of a grayscale display is provided using mathematical processing of multiple X-ray images of the same transverse layer taken under different angles in the plane of the layer.

Computer examination is usually carried out with the patient lying on his back. There are no contraindications, it is easily tolerated, so it can be performed on an outpatient basis, as well as for seriously ill patients. Makes it possible to examine all parts of the body: head, neck, chest organs, abdominal cavity, spinal cord, mammary glands, spine, bones and joints.

A CT scan of the head is performed after a complete clinical examination of a patient with suspected damage to the central nervous system. In case of traumatic brain injury, fractures of the skull bones, hemorrhages, bruises and swelling of the brain are detected. Using the method, it is possible to detect vascular malformations - aneurysms. For brain tumors, their location is determined, the source of growth and the extent of the tumor are identified.

When examining the chest organs, the mediastinum, great vessels, heart, as well as the lungs and lymph nodes are clearly visible.

When examining the organs of the abdominal cavity and retroperitoneal space, you can obtain an image of the spleen, liver, pancreas and kidneys (the study of the kidneys is more informative with artificial contrast).

Computed tomography is safe and does not cause complications. By supplementing clinical and x-ray data, it allows you to obtain more complete information about the organs.

Radionuclide tomography (single-photon and two-photon) allows you to obtain a layer-by-layer image of the distribution of the radionuclide located in the organ. Indications for radionuclide T. are basically the same as for scintigraphy. However, compared to scintigraphy, radionuclide T. has better resolution. In single-photon radiation, medium- and short-lived radionuclides are used (99m Tc, 201 Tl, etc.). It is performed using special gamma cameras with one or two scintillation detectors rotating around the patient.

Two-photon, or positron-emission, T. is performed with ultra-short-lived radionuclides that emit positrons (15 O 2, 18 F, etc.). These radionuclides are produced in charged particle accelerators (cyclotrons) installed directly at the institution. For two-photon radiation, special gamma cameras are used that are capable of recording gamma rays that arise during the annihilation (collision) of a positron with an electron. Two-photon T. is of the greatest scientific interest, however, due to the high cost and complexity of application, its use in medical practice is limited.

Scanning and scintigraphy - designed to obtain images of organs that selectively concentrate the drug. The resulting picture of the distribution and accumulation of the radionuclide gives an idea of ​​the topography, shape and size of the organ, as well as the presence of pathological foci in it.

Ultrasonic tomography - a method of obtaining a layer-by-layer image by analyzing the echo signal reflected from the internal structures of the human body. Layer-by-layer ultrasound images are obtained by scanning an ultrasound beam, and therefore this method is sometimes called ultrasound scanning. Ultrasound T. is a common and accessible type of research, characterized by high information content, cost-effectiveness, and the absence of radiation exposure to the patient.

Magnetic resonance tomography (MRI) - a method of obtaining images of the internal structures of the human body (introscopy) through the use of the phenomenon nuclear magnetic resonance. MRI is most effective in studying the brain, intervertebral discs, and soft tissues. Peter Mansfield and Paul Lauterbur received the Nobel Prize for the invention of MRI in 2003. Raymond Damadian, one of the first researchers of the principles of MRI, holder of an MRI patent and creator of the first commercial MRI scanner, also made a famous contribution to the creation of magnetic resonance imaging.

Nuclear magnetic resonance (NMR) - selective absorption of electromagnetic radiation by a substance due to reorientation of magnetic moments atomic nuclei, located in a constant magnetic field. The NMR phenomenon is the basis for the method of studying the structure and molecular motion in various substances, incl. in biological objects.

Optical coherence tomography (OCT) is a medical imaging method that allows you to obtain images of the near-surface tissues of the human body in vivo with high spatial resolution. Physical principle of operation OCT similar to ultrasonic with the only difference that in OCT to probe biological tissue, optical radiation of the near-infrared (IR) wavelength range is used, rather than acoustic waves. The radiation of the probing beam is focused on the tissue, and the echo delay of the probing radiation reflected from the internal microstructure of the biological tissue at various depths is measured interferometrically. In parallel with depth scanning, a probe beam is scanned across the tissue surface, which provides a transverse scan of the OCT image. The resulting data (OCT image) forms a two-dimensional map of backscattering (or reflection) from microscopic optical inhomogeneities (cellular tissue structures) of biological tissue; Thus, OCT images essentially contain information about the morphological structure of superficial tissues.

OCT is of interest for clinical use for a number of reasons. The resolution of OCT is 10-15 microns, which is 10 times higher than the resolution of other diagnostic methods used in practice and involves studying an object at the level of microscopic tissue architecture. Information about tissue obtained using OCT is intravital, i.e. reflects not only the structure, but also the characteristics of the functional state of tissues. The OCT method is non-invasive because it uses radiation in the near-infrared range with a power of about 5 mW, which does not have a damaging effect on the body. In addition, the OCT method eliminates trauma and does not have the limitations of traditional biopsy.

Positron emission tomography (PAT) - a method of medical imaging (radioisotope diagnostics), based on the use of radiopharmaceuticals (RP) labeled with isotopes - positron emitters, which enter the body of the subjects by injection of an aqueous solution. After emission from the nucleus of an atom, the positron travels a distance of 1-3 mm in the surrounding tissues, losing energy upon collision with other molecules. At the moment of stopping, the positron combines with the electron, annihilation occurs: the mass of both particles turns into energy - two high-energy gamma quanta are emitted, scattering in opposite directions. In a positron emission tomograph, these gamma rays are recorded using several rings of detectors surrounding the patient.

ULTRASOUND DIAGNOSTICS– based on the principle of echolocation: ultrasonic signals reflected from acoustically inhomogeneous structures are converted on the display screen into luminous points that form a spatial two-dimensional image.

It is used to recognize the disease, to monitor the dynamics of the process and evaluate the results of treatment. Due to its safety (the possibility of multiple examinations), ultrasound diagnostics has become widespread.

Usually does not require any special preparation of the patient. The examination of the abdominal organs is mainly carried out in the morning on an empty stomach, the female genital organs, prostate gland and bladder - with a full bladder. For better contact of the ultrasonic sensor with the surface of the body, the skin is lubricated with a special gel.

Ultrasound diagnostics allows you to obtain important information about the condition of various organs - liver, pancreas, spleen, kidneys, bladder, prostate, adrenal glands, thyroid gland, etc. In an obstetric clinic, determine the gestational age and location of the fetus, delays in its development and congenital defects, establish a non-developing pregnancy, complete or incomplete miscarriage.

It is also possible to diagnose gynecological diseases: fibroids and uterine tumors, cysts and ovarian tumors.

Ultrasound examination is indicated in all cases if any formation is palpated in the abdominal cavity; it is of particular importance in recognizing malignant tumors of the digestive organs. Some acute diseases that require urgent surgical intervention are easily diagnosed, such as acute cholecystitis, acute pancreatitis, vascular thrombosis, etc. Sonography almost always allows you to quickly identify the mechanical nature of jaundice and accurately determine its cause.

When examining the heart, information is obtained about the features of its structure and the dynamics of contractions, about congenital and acquired defects, myocardial lesions, coronary artery disease, pericarditis and other diseases of the cardiovascular system. Ultrasound is used to assess the pumping function of the heart, to monitor the effect of medications, to study coronary circulation and is the same reliable method of bloodless diagnostics as electrocardiography and x-ray examination of the heart.

Pulse Doppler devices record the speed of blood flow in deep-lying great vessels (aorta, inferior vena cava, renal vessels, etc.), detect obstruction of peripheral vessels - zones of thrombosis or compression, as well as obliterating endarteritis.

Ultrasound diagnostics makes it possible to visually represent the internal structures of the eyeball, even in cases of opacity of its media, allows you to measure the thickness of the lens, the length of the axes of the eye, detect retinal and choroidal detachment, opacification in the vitreous body, and foreign bodies. Used to calculate the optical power of an artificial lens and to monitor the development of myopia.

The ultrasound method is simple and accessible, has no contraindications and can be used repeatedly, even during the day, if the patient’s condition requires it. The information obtained complements the data of computed tomography, X-ray and radioisotope diagnostics, and must be compared with the clinical condition of the patient.

FLUOROGRAPHY– photographing an X-ray image from a screen onto smaller photographic film, carried out using special devices. It is used for mass examinations of the chest organs, mammary glands, paranasal sinuses, etc.

PHONOCARDIOGRAPHY– a method of recording sounds (tones and noises) arising from the activity of the heart and is used to assess its work and recognize disorders, including valve defects.

The phonocardiogram is recorded in a specially equipped isolated room where complete silence can be created. The doctor identifies points on the chest, from which recording is then made using a microphone. The patient's position during recording is horizontal. The use of phonocardiography for dynamic monitoring of the patient’s condition increases the reliability of diagnostic conclusions and makes it possible to evaluate the effectiveness of treatment.

ELECTROCARDIOGRAPHY– registration of electrical phenomena occurring in the heart muscle when it is excited. Their graphic representation is called an electrocardiogram. To record an ECG, electrodes, which are metal plates with sockets for connecting wire plugs, are placed on the limbs and chest.

An electrocardiogram is used to determine the frequency and rhythm of cardiac activity (duration, length, shape of waves and intervals). Some pathological conditions are also analyzed, such as thickening of the walls of one or another part of the heart, heart rhythm disturbances. It is possible to diagnose angina pectoris, coronary heart disease, myocardial infarction, myocarditis, and pericarditis.

Some medications (cardiac glycosides, diuretics, cordarone, etc.) affect the electrocardiogram readings, which makes it possible to individually select medications for the treatment of the patient.

The advantages of the method - harmlessness and the possibility of application in any conditions - contributed to its widespread introduction into practical medicine.

ELECTROENCEPHALOGRAPHY– a method of electroencephalographic objective study of the functional state of the brain, based on graphic registration of its biopotentials. They are most widely used in solving the following problems: to establish the localization of a pathological focus in the brain, differential diagnosis of diseases of the central nervous system, study the mechanisms of epilepsy and identify it in the early stages; to determine the effectiveness of the therapy and assess reversible and irreversible changes in the brain.

While recording electroencephalography, the subject sits reclining in a special comfortable chair or, in severe cases, lies on a couch with a slightly raised headboard. Before the examination, the patient is warned that the recording procedure is harmless, painless, lasts no more than 20-25 minutes, and that it is necessary to close your eyes and relax your muscles. Tests are used with opening and closing the eyes, with irritation by light and sound. Electroencephalogram readings for any disease must be correlated with clinical examination data.

ELECTRO-RADIOGRAPHY– the principle of obtaining an x-ray image on plain paper.

ENDOSCOPIC EXAMINATION METHODS. - Visual examination of hollow organs and body cavities using optical instruments equipped with a lighting device. If necessary, endoscopy is combined with targeted biopsy, as well as X-ray and ultrasound examination. The results obtained from endoscopy can be documented using photography, film and video.

The method is important for the early diagnosis of precancerous diseases and tumors of various localizations in the early stages of their development, as well as for differentiating them from diseases of an inflammatory nature.

Fiber optics has opened up broad prospects for endoscopy. The flexibility of fiber light guides and the ability to transmit images and light along a curved path made the fiberscope flexible and easy to control. This reduced the danger of the study and included the intestines, female genital organs, and blood vessels in the scope of its objects.

Endoscopic methods are also used for medicinal purposes: removal of polyps, local administration of drugs, dissection of cicatricial stenoses, stopping internal bleeding, removal of stones and foreign bodies.

TABLE OF STUDENT CRITERION (T-CRITERION) VALUES