ABI-Ankle/Brachial Index - Non-Invasive Physiologic Studies
Immigration Physicals (Full Physicals, Immunizations, Blood Draws, etc. )
ABI- Ankle/Brachial Index
A Non-Invasive Physiological Study of the upper and lower extremity arteries. The ankle brachial pressure is the ratio of the blood pressure in the lower legs to the blood pressure in the arms. Compared to the arm, lower blood pressure in the leg is a symptom of blocked arteries (peripheral vascular disease). The ABI is calculated by dividing the systolic blood pressure in the arteries at the ankles and foot by the higher of the tow systolic blood pressures in the arms.
A Doppler ultrasound blood flow detector, commonly called Doppler Wand or Doppler probe, is used to register the peripheral pulse while the sphygmomanometer (blood pressure cuff) is inflated over the artery until the pulse ceases, proximal to the Doppler probe.
The cuff is slowly defltaed, and the corresponding spygmomanometer pressure at the instant the pulse returns provides the systolic blood pressure reading, for the given artery. The ABI test is a popular tool for the non-invasive assessment of PVD. Studies have shown the sensitivity of the ABI is 90% with the corresponding 98% specificity for detecting hemodynamically significant (Serious) stenosis.
A Holter monitor is a machine that continuously records the heart's rhythms. The monitor is usually worn for 24 - 48 hours during normal activity.
Electrodes (small conducting patches) are stuck onto your chest and attached to a small recording monitor. You carry the Holter monitor in a pocket or small pouch worn around your neck or waist. The monitor is battery operated. While you wear the monitor, it records your heart's electrical activity. You should keep a diary of what activities you do while wearing the monitor. After 24 - 48 hours, you return the monitor to your doctor's office. The doctor will look at the records and see if there have been any irregular heart rhythms. It is very important that you accurately record your symptoms and activities so that the doctor can match them with your Holter monitor findings.
There is no special preparation for the test. Your doctor will start the monitor. You'll be told how to replace the electrodes should they fall off or become loose. Tell your doctor if you are allergic to any tape or other adhesives. Make sure you shower or bathe before you start the test. You will not be able to do so while you are wearing a Holter monitor. This is a painless test. However, some people may need to have their chest shaved so the electrodes can stick. You must keep the monitor close to your body. This may make sleeping difficult for some people. You should continue your normal activities while wearing the monitor.
Holter monitoring is used to determine how the heart responds to normal activity. The monitor may also be used:
After a heart attack
To diagnose heart rhythm problems
When starting a new heart medicine
It may be used to diagnose:
Multifocal atrial tachycardia
Paroxysmal supraventricular tachycardia
Reasons for fainting
Slow heart rate (bradycardia)
Pulmonary Function Testing
Pulmonary Function Testing measures how well you are breathing. There are different types of pulmonary function tests that can be done. Spirometry is on type of pulmonary function test. This is a simple test to measure how much (volume) and how fast (flow) you can move air into and out of your lungs.
Why test my lung function?
Through routine spirometry, lung diseases can often be diagnosed in the early stages when treatment is most effective. Once a lung disease is diagnosed and treated, routine spiromety tests can monitor changes in lung functions with specific treatment. This will help your doctor find the best treatment plan for you.
What happens during the spirometry test?
You will be instructed how to perform spirometry. Basically, you will take in a deep breath and blow into a mouthpiece attached to the spirometer. You will blow out as hard and as fast as you can until your lungs feel absolutely empty. You will be asked to repeat the test several more times until there are two to three good efforts. You will be coached and encouraged to do your best during the test. A good effort during the test is important to get good results.
A computerized sensor (which is part of the spirometry) calculates and graphs the results. The results demonstrate a persons air flow rates or the colume forced out within the first second. This is the Forced Expiratory Volume in the first second (FEV1). This indicates whether or not there is airway obstruction. Spirometry also records the total volume of air forced out of the lungs. This is the forced Vital Capacity (FVC).
Ask your doctor about having your lungs tested with Spirometry to identify any lung flow problems.
The measurement, by a form of gas meter, of volumes of gas that can be moved in or out of the lungs. The classical spirometer is a hollow cylinder (bell) closed at its top. With its open end immersed in a larger cylinder filled with water, it is suspended by a chain running over a pulley and attached to a counterweight. The magnitude of a gas volume entering or leaving is proportional to the vertical excursion of the bell. Volume changes can also be determined from measurements of flow, or rate of volume change, that can be sensed and recorded continuously by a transducer that generates an electrical signal.
The flow signal can be continuously integrated to yield a volume trace.The volume of gas moved in or out with each breath is the tidal volume; the maximal possible value is the vital capacity. Even after the most complete expiration, a volume of gas that cannot be measured by the above methods, that is, the residual volume, remains in the lungs. It is usually measured by a gas dilution method or by an instrument that measures blood flow in the lungs. Lung volumes can also be estimated by radiological or optical methods.
At the end of an expiration during normal resting breathing, the muscles of breathing are minimally active. Passive (elastic and gravitational) forces of the lungs balance those of the chest wall. In this state the volume of gas in the lungs is the functional residual capacity or relaxation volume. Displacement from this volume requires energy from natural (breathing muscles) or artificial (mechanical) sources.
EMG’s are standard nerve conduction tests that are used to record the electrical activity of muscles. When muscles are active, they produce an electrical current. This current is usually proportional to the level of the muscle activity.
EMG’s can be used to detect abnormal muscle electrical activity that can occur in many diseases and conditions, including inflammation of the muscles, pinched nerves, peripheral nerve damage ( damage of upper and lower arms and legs ).
An EMG is most often performed when patients have unexplained pain, numbness, tingling and muscle weakness. The EMG helps to distinguish between muscle conditions in which the problem begins in the muscle and muscle weakness due to nerve disorders. The EMG can also be used to detect true weakness, as opposed to weakness from reduced use because of pain or lack of motivation.
Civil Surgeon (Immigration Physicals)
We are authorized to provide Immigration Physicals for the Department of Immigration Services. We provide full physicals, blood draws and immunizations for those coming to this country to become part of the american dream. You can contact us to schedule appointments for these services in our Moreno Valley office location at 22636, Suite A 400, Moreno Valley Ca. 92553