BASIC INVESTIGATIONS: ENDOSCOPY, X-RAY, MRI, ECG

Doctors who
Where scope is
Type Area examined typically perform the
inserted
surgery

through a small
arthroscopy joints incision near the orthopaedic surgeon
examined joint

into the nose or pulmonologist or

bronchoscopy lungs
mouth thoracic surgeon

gastroenterologist or
colonoscopy colon through the anus
proctologist

cystoscopy bladder through the urethra urologist

through the mouth or

enteroscopy small intestine gastroenterologist
anus

gynaecologists or
hysteroscopy inside of the uterus through the vagina gynaecological
surgeons

through a small
various types of
laparoscopy abdominal or pelvic area incision near the
surgeons
examined area

otolaryngologist, also
through the mouth or known as an ear, nose,
laryngoscopy larynx
nostril and throat (ENT)
doctor

mediastinum, the area between through an incision

mediastinoscopy thoracic surgeon
the lungs above the breastbone

rectum and the lower part of the

gastroenterologist or
sigmoidoscopy large intestine, known as the into the anus
proctologist
sigmoid colon

thoracoscopy, also
area between the lungs and the through a small pulmonologist or
known as a
chest wall incision in the chest thoracic surgeon
pleuroscopy

upper
gastrointestinal
endoscopy, also esophagus and upper intestinal
through the mouth gastroenterologist
known as tract
an esophagogastro
duodenoscopy

ureteroscopy ureter through the urethra urologist

READING AND WRITING

 Basic investigations: Endoscopy, X-ray, MRI
Endoscopy is a procedure in which the doctor uses specialized instruments to view and operate on the internal
organs and vessels of the body. It allows surgeons to see problems within your body without making large
incisions. Endoscopy has a much lower risk of bleeding and infection than open surgery. Still, endoscopy is a
medical procedure, so it has some risk of bleeding, infection, chest pain, perforation, fever, persistent pain in the
area of the endoscopy, redness and swelling at the incision site. Endoscopies fall into categories, based on the area
of the body that they investigate. Here are some examples of the latest endoscopy technologies. A revolutionary
procedure known as a capsule endoscopy may be used when other tests aren’t conclusive. During a capsule
endoscopy, you swallow a small pill with a tiny camera inside. The capsule passes through your digestive tract,
without any discomfort to you, and creates thousands of images of the intestines as it moves through.
Chromoendoscopy is a technique that uses a specialized stain or dye on the lining of the intestine during an
endoscopy procedure. The dye helps the doctor better visualize if there’s anything abnormal on the intestinal
lining. Endoscopic ultrasound uses an ultrasound in conjunction with an endoscopy this allows doctors to see
organs and other structures that aren’t usually visible during a regular endoscopy, thin needle can then be inserted
into the organ or structure to retrieve some tissue for viewing under a microscope (this procedure is called fine
needle aspiration). Endoscopic mucosal resection (EMR) is a technique used to help doctors remove cancerous
tissue in the digestive tract. In EMR, a needle is passed through the endoscope to inject a liquid underneath the
abnormal tissue. This helps separate the cancerous tissue from the other layers so it can be more easily removed.
Gastroscopy is a nonsurgical procedure used to examine a person's digestive tract. Using an endoscope, a flexible
tube with a light and camera attached to it, your doctor can view pictures of your digestive tract on a colour TV
monitor. During an upper endoscopy, an endoscope is easily passed through the mouth and throat and into
the oesophagus, allowing the doctor to view the oesophagus, stomach, and upper part of the small intestine.
Doctors will often recommend endoscopy to evaluate: stomach pain, gastritis, difficulty swallowing, ulcers,
digestive tract bleeding, polyps or growths in the colon. Endoscopy may also be used to treat a digestive tract
problem. For example, the endoscope might not only detect active bleeding from an ulcer, but devices can be
passed through the endoscope that can stop the bleeding. In the colon, polyps can be removed through the scope to
prevent the development of colon cancer.
X-ray (type of radiation called electromagnetic waves) is a common imaging test used for decades to view the
body without making an incision. X-ray imaging creates pictures of the inside of the body. The images show the
parts of body in different shades of black and white this is because different tissues absorb different amounts of
radiation. Calcium in bones absorbs x-rays the most, so bones look white, fat and other soft tissues absorb less and
look gray, air absorbs the least, so lungs look black.

This can help to diagnose, monitor, and treat many medical conditions. Different types of X-rays are used for
different purposes e.g. mammogram, barium enema. Conditions that may call for an X-ray include: bone cancer,
breast tumours, enlarged heart, blocked blood vessels, conditions affecting lungs, digestive problems, fractures,
infections, osteoporosis, arthritis and tooth decay.

It’s important to stay still while the images are taken. This will provide the clearest images possible. X-rays use
small amounts of radiation to create images of your body. The level of radiation exposure is considered safe for
most adults, but not for a developing baby.
Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to form pictures of
the anatomy and the physiological processes of the body. MRI scanners use strong magnetic fields, magnetic field
gradients, and radio waves to generate images of the organs in the body. MRI scan uses a large magnet, radio
waves, and a computer to create a detailed, cross-sectional image of internal organs and structures.
The scanner itself typically resembles a large tube with a table in the middle, allowing the patient to slide in.
Doctors, scientists, and researchers are now able to examine the inside of the human body in high detail using a
non-invasive tool.
The following are examples in which an MRI scanner would be used: anomalies of the brain and spinal cord;
tumours, cysts, and other anomalies in various parts of the body; breast cancer screening for women who face a
high risk of breast cancer; injuries or abnormalities of the joints, such as the back and knee; certain types of heart
problems; diseases of the liver and other abdominal organs.
Once in the scanner, the MRI technician will communicate with the patient via the intercom to make sure that
they are comfortable. They will not start the scan until the patient is ready. During the scan, it is vital to stay still.
Any movement will disrupt the images, much like a camera trying to take a picture of a moving object. Depending
on the images, at times it may be necessary for the person to hold their breath. If the patient feels uncomfortable
during the procedure, they can speak to the MRI technician via the intercom and request that the scan be stopped.
An MRI scanner contains two powerful magnets. These are the most important parts of the equipment. Functional
1. Answer the following questions:
1. How does the MRI technician communicate with the patient?
2. When is MRI scanner used?
3. Why is endoscopy used?
2. Derivatives. Complete the text bellow with the correct form of the words in brackets
A surgeon inserts an endoscope through a small cut or an........ (to open) in the body such as the mouth. An
endoscope is a......... (flexion) tube with an attached camera that allows your doctor to see. Doctor can use
forceps and scissors on the endoscope to operate or remove tissue for biopsy. Endoscopy allows doctor to
visually examine an organ without having to make a large .......(to incise), help doctor determine the cause
of any abnormal symptoms you’re having, remove a small sample of tissue, which can then be sent to a lab
for ......(far) testing; this is called an endoscopic biopsy, help doctor see inside the body during a surgical
procedure, such as repairing a stomach ulcer, or removing gallstones or tumours. Like most technologies,
endoscopy is constantly ......(to advance). Newer generations of endoscopes use high-definition imaging to
create images in incredible detail. (To innovate) ........techniques also combine endoscopy with imaging
technology or...... (surgery) procedures.

3. Gap fill
equipment, electrical, heart, health, lightheadedness, attack, diagnose

An electrocardiogram records the (1)___________signals in your heart. It's a common and painless test
used to quickly detect heart problems and monitor your heart's(2)___________. Electrocardiograms, also
called ECGs or EKGs are often done in a doctor's office, a clinic or a hospital room. ECG machines are
standard (3)_________in operating rooms and ambulances. Some personal devices, such as smart watches,
offer ECG monitoring. An electrocardiogram is a painless, noninvasive way to help (4)__________many
common heart problems in people of all ages. The doctor may use an electrocardiogram to determine or
detect: abnormal (5)_________rhythm (arrhythmias), if blocked or narrowed arteries in your heart (coronary
artery disease) are causing chest pain or a heart attack, whether you have had a previous heart(6)________,
how well certain heart disease treatments, such as a pacemaker, are working. One may need an ECG if you
have any of the following signs and symptoms: chest pain, dizziness, (7)___________or confusion, heart
palpitations, rapid pulse, shortness of breath, weakness, fatigue or a decline in ability to exercise.
Vocabulary:

retrieve /rɪˈtriːv/- to bring or get something back, especially from a place where it should not be;

orthopaedic /ˌɔːθəˈpiːdɪk/- connected with the branch of medicine that deals with injuries and diseases of the
bones or muscles;

signal /ˈsɪɡnəl/- a series of electrical waves that carry sounds, pictures or messages; a movement or sound that
you make to give somebody information, instructions, a warning;

pacemaker /ˈpeɪsmeɪkə(r)/- an electronic device that is put inside a person’s body to help their heart beat
regularly;

underneath /ˌʌndəˈniːθ/- under or below something else, especially when it is hidden or covered by the thing
on top;

enema /ˈenəmə/- a liquid that is put into a person’s rectum (= the opening through which solid waste leaves
the body) in order to clean out the bowels, especially before a medical operation; the act of cleaning out
the bowels in this way;

gradient /ˈɡreɪdiənt/- the rate at which temperature, pressure, etc. changes, or increases and decreases,
between one region and another

intercom /ˈɪntəkɒm/- a system of communication by phone or radio inside an office, plane, etc.; the device
you press or switch on to start using this system;

celiac disease /ˈsiːliæk dɪziːz/- a disease in which somebody cannot digest food (= break it down in their
body) because their body is very sensitive to gluten (= a protein that is found in wheat);

Helicobacter pylori [ˈhelɪkəbæktɪər paɪˈlɔːraɪ] -  a common bacteria that may sometimes cause pain and may
lead to ulcers or stomach cancer;

LISTENING

I. Video: Gastroscopy: What is a gastroscopy procedure

https://youtu.be/jw5sKLRRBzA
Listening: Listening for the Main Idea: 
What is the talk mainly about?
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Listening for Details: Take notes of the ideas about Gastroscopy

Be ready to answer the questions.
1. What is gastroscopy?
2. How is the procedure done?
3. What is the aim of gastroscopy?
4. What is biopsy taken
5. What does the procedure involve?
6.
 Finish the sentences
1. An endoscope is a ...
2. A biopsy is a ...
3. Gastroscopy is recommended to find ... to diagnose... the presence of...
4. The synonym for oesophagus is...
5. Celiac disease is the ...
II. What happens in an X-ray scan?
https://youtu.be/fdwI5AzTDQQ
Be ready to answer the questions.
1. What is the name of the patient?
2. Why are X-Rays done?
3. What steps should be respected?

III. Magnetic Resonance Imaging (MRI)

https://youtu.be/E44W54z_Ykw
Be ready to answer the questions.
1. What is the aim for MRI?
2. What does MRI use?
3. What are the reasons to have MRI?
4. What should the technologist know?
5. What happens during the scan?
6. How long may MRI take?

Finish the sentences

1. Magnetic Resonance Imaging commonly known as ... helps...
2. MRI uses...
3. Before MRI you will remove...
4. It is not safe to have MRI with some...
5. To prepare for MRI you will...
6. In some cases you may get contrast ...

IV. How to record an ECG

https://youtu.be/1k4B_fIX_t0
1. What is ECG?
2. How is it done?

Post-listening: Discussion
Share your notes and discuss the main idea/details. 
Write one critical thinking question and discuss it in your group. 
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