copyright © 2009 wolters kluwer health | lippincott williams & wilkins week 6: chapter 16...
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Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
Week 6: Chapter 16
Neurology
Instructor: Kathleen Bishop
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
What you will need for this class
– Medical Transcription Fundamentals, Gilmore
– AAMT Book of Style for Medical Transcription
– Any other resource books you may have available such as medical dictionary, PDR, Merck Manual, etc.
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
How this class will work• This is an open book Seminar. • Be prepared to respond to the questions on each slide.• Be prepared to share your thoughts with the other class
participants.• After the questions slide you will see an answer slide so
you can check to see how you did.
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
Employee vs. Independent Contractor• Employee• Independent Contractor
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Employee
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
Independent Contractor
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Independent Contractor vs. EmployeeIndependent Contractor at X per 65-character line
7891011121314
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
Independent Contractor vs. EmployeeStatutory Employee at X
per 65-character line6.467.398.319.2410.1611.0812.0112.93
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
250 Lines/hr dictationRate per line
Lines per
hour of dict
Each hour of dictatio
n earns
Hours of
dict to earn $1,000 (gross)
Hrs/ day,
5 days/ week
Hrs/ day,
4 days/ week
Hrs/ day 3
days/ week
.07 250 17.50 57.14 11.43 Na Na
.09 250 22.50 44.44 8.89 na na.095 250 23.75 42.11 8.42 na na.10 250 25.00 40.00 8 10 13.33
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
500 lines/hr DictationRate per line
Lines per
hour of dict
Each hour of dictatio
n earns
Hours of
dict to earn $1,000 (gross)
Hrs/ day,
5 days/ week
Hrs/ day,
4 days/ week
Hrs/ day 3
days/ week
.07 500 35.00 28.57 5.71 7.14 9.52
.09 500 45.00 22.22 4.44 5.56 7.41.095 500 47.50 21.05 4.21 5.26 7.02.10 500 50.00 20.00 4.0 5.0 6.67
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
600 Lines/hr DictationRate per line
Lines per
hour of dict
Each hour of dictatio
n earns
Hours of
dict to earn $1,000 (gross)
Hrs/ day,
5 days/ week
Hrs/ day,
4 days/ week
Hrs/ day 3
days/ week
.07 600 42.00 23.81 4.76 5.95 7.94
.09 600 54.00 18.52 3.70 4.63 6.17.095 600 57.00 17.54 3.51 4.39 5.85.10 600 60.00 16.67 3.33 4.17 5.56
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
Soundalike Word ChoiceWhich is the correct word in the following sentences. • 1. The patient was involved in an motor vehicle accident that damaged
his spinal (core, cord).• 2. This is a Hispanic female who has been previously diagnosed with
trigeminal (arthralgia, neuralgia) on the right side.• 3. Her CT scan showed (vesicular, ventricular) brain abnormalities
consistent with a mild stroke.• 4. The child was admitted to the hospital where a workup eventually
diagnosed (absent, absence) seizures.• 5. HEENT examination revealed extraocular movements to be intact
with no (nystagmus, nystatin) and no diplopia.
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
Soundalike Word Choice Answers• 1. The patient was involved in an motor vehicle accident that
damaged his spinal (core, cord).• 2. This is a Hispanic female who has been previously diagnosed
with trigeminal (arthralgia, neuralgia) on the right side.• 3. Her CT scan showed (vesicular, ventricular) brain
abnormalities consistent with a mild stroke.• 4. The child was admitted to the hospital where a workup
eventually diagnosed (absent, absence) seizures.• 5. HEENT examination revealed extraocular movements to be
intact with no (nystagmus, nystatin) and no diplopia.
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
Soundalike Word Choice (cont.)• 6. (Electroencephalogram, Electrocardiogram) revealed
background activity seen in the posterior regions of the brain, which was responsive to eye opening and eye closure.
• 7. Ms. Dolan was found to have a mass in the (basil, basal) ganglia.• 8. Unfortunately, the patient sustained a left (thalamic, thymic)
infarct after his cardiac catheterization last month.• 9. The bundle of nerves at the base of the spine is called the cauda
(equation, equina).• 10. Sensations are grossly intact, and deep tendon (reflexes,
refluxes) are symmetric.
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
Soundalike Word Choice Answers• 6. (Electroencephalogram, Electrocardiogram) revealed
background activity seen in the posterior regions of the brain, which was responsive to eye opening and eye closure.
• 7. Ms. Dolan was found to have a mass in the (basil, basal) ganglia.
• 8. Unfortunately, the patient sustained a left (thalamic, thymic) infarct after his cardiac catheterization last month.
• 9. The bundle of nerves at the base of the spine is called the cauda (equation, equina).
• 10. Sensations are grossly intact, and deep tendon (reflexes, refluxes) are symmetric.
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
Matching1. CNS A. Parkinson disease 2. SPECT B. peripheral nervous system 3. MS C. cerebrospinal fluid 4. VP D. central nervous system 5. PNS E. Glasgow Coma Scale 6. PET F. magnetic resonance angiography 7. LP G. electroencephalography 8. MRI H. single photon emission computed tomography 9. CSF I. computed tomography 10. CT J. lumbar puncture 11. PD K. ventriculoperitoneal 12. TN L. magnetic resonance imaging 13. GCS M. trigeminal neuralgia 14. MRA N. positron emission tomography 15. EEG O. multiple sclerosis
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
Matching Answers• 1. D• 2. H• 3. O• 4. K• 5. B• 6. N• 7. J• 8. L• 9. C• 10. I• 11. A• 12. M• 13. E• 14. F• 15. G
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
Fill in the Blanks
Fill in the blanks of the following paragraph with the correct terms from the text. Some terms may be used more than once. 1.The brain is an amazing organ. It is divided into four major parts: The ____________, ____________, ____________, and ____________.2.The largest and uppermost part of the brain is called the ____________. It is divided into two parts called the ____________ and ____________ hemispheres. They are joined by a band of fibers called the ____________. The ____________ beneath the cerebral cortex does not do any real thinking or feeling.3.The ____________ structures are often called the “feeling brain” because they are involved in emotions. One of these structures, called the ____________, serves as a relay station for the cerebral cortex. Another structure, called the ____________, regulates automatic functions like eating and drinking.
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
Fill in the Blanks Answers
1. The brain is an amazing organ. It is divided into four major parts: The cerebrum, limbic system, brainstem, and cerebellum.
2. The largest and uppermost part of the brain is called the cerebrum. It is divided into two parts called the right and left hemispheres. They are joined by a band of fibers called the corpus callosum. The white matter beneath the cerebral cortex does not do any real thinking or feeling.
3. The limbic system structures are often called the “feeling brain” because they are involved in emotions. One of these structures, called the thalamus, serves as a relay station for the cerebral cortex. Another structure, called the hypothalamus, regulates automatic functions like eating and drinking.
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
Fill in the Blanks (cont.)
1. The ____________ comes from the Latin word for little brain. Disruptions in the function of this part of the brain results in motor problems such as an unsteady gait, called ____________.
2. The ____________ is a tube-like column of tissue that connects the brain to the rest of the body. The reflexes of this part of the body can cause limbs to move, even when a patient is comatose, a phenomenon called the ____________.
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
Fill in the Blanks Answers1. The cerebellum comes from the Latin word for little brain.
Disruptions in the function of this part of the brain results in motor problems such as an unsteady gait, called ataxia.
2. The spinal cord is a tube-like column of tissue that connects the brain to the rest of the body. The reflexes of this part of the body can cause limbs to move, even when a patient is comatose, a phenomenon called the Lazarus sign.
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
Transcription Tip• References to the examination of cranial nerves are
transcribed often in medical reports. They may be transcribed using Arabic or Roman numerals, unless the dictator specifies a preference (Gilmore, 2009).
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
Define the Following1. corpus callosum2. bleb3. secondary brain tumor4. cauda equina5. limbic system6. Lazarus sign7. hydrocephalus8. trigeminal neuralgia9. relapsing-remitting multiple Sclerosis10.high-grade astrocytoma
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
Define the Following Answers1. A band of nerve fibers that connect the left and right
hemisphere of the cerebrum.2. A blister-like sac filled with blood.3. A brain tumor caused by a cancer that originates in another
part of the body.4. A bundle of nerves that extend beyond the end of the spinal
cord.5. A complex set of structures located in the cerebrum that are
involved in emotions, moods, and some functions of memory.
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
Define the Following Answers6. A complex spontaneous movement by nerves in the spinal
cord without conscious effort of the patient (such as after a patient is comatose or brain-dead).
7. A condition in which excess CSF fluid builds up in the brain.8. A disorder of the trigeminal nerve causing sudden attacks of
pain on one side of the face.9. A form of multiple sclerosis characterized by periods of flares
of symptoms, followed by periods of remission of symptoms.10.A glioma that occurs in the brainstem.
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
Define the Following1. demyelination2. enterovirus3. cerebral cortex4. subarachnoid hemorrhage5. hemorrhage6. antalgic (gait)7. spinal cord8. brain tumor9. microvascular decompression10.Parkinson disease
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Define the Following Answers1. A gradual destruction of the myelin that surrounds and
protects neurons.2. A group of common viruses that is a common cause of
viral meningitis.3. A layer of millions of neurons and glia on the surface of the
brain that carry out the many functions of the cerebrum.4. A leak of blood into the space between the brain and the
skull.5. A leak of blood, or bleeding, from a vessel.
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
Define the Following Answers6. A limping-type gait.7. A long, tube-like column of nervous tissue that extends from
the base of the skull to near the bottom of the spine, which carries both incoming and outgoing messages between the brain and the rest of the body.
8. A mass of abnormal cells growing in the brain.9. A microsurgical displacement of a blood vessel causing
compression of the nerve root of the trigeminal nerve.10.A motor system disorder caused by deterioration of nerve
cells in the brain that control body movement.
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Define the Following1. pronator muscle2. ventricles3. single photon emission computed tomography (SPECT)4. positron emission tomography (PET)5. lateral ventricles6. neurologist7. bone flap8. plasmapheresis9. microvascular clipping10.stereotactic radiosurgery
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Define the Following Answers1. A muscle that returns a part into the prone position from
supine.2. A network of four chambers in the brain that produce
cerebrospinal fluid (CSF).3. A nuclear diagnostic test that obtains images of blood flow to
tissues.4. A nuclear diagnostic test that provides images of brain
activity using radioactive isotopes injected into the bloodstream.
5. A pair of ventricles in the brain where CSF is produced.
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
Define the Following Answers6. A physician who specializes in the field of neurology.7. A portion of the skull temporarily removed from the cranium but
left attached to overlying muscle-fascial blood supply during a surgical procedure.
8. A procedure of plasma exchange in patients with sudden, severe attacks of multiple sclerosis.
9. A procedure that involves cutting off the flow of blood supply to an aneurysm with the use of a spring-loaded clip.
10.A procedure that involves delivering a single highly concentrated dose of ionizing radiation to a target at the trigeminal nerve root.
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
Define the Following1. percutaneous stereotactic rhizotomy2. deep brain stimulation (DBS)3. shunt revision4. debulking5. corpus callosotomy6. photodynamic therapy (PDT)7. lumbar puncture (LP)8. coil embolization9. status epilepticus10.cerebral aneurysm
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
Define the Following Answers1. A procedure that involves destroying the part of the trigeminal
nerve that causes pain with a heating current.2. A procedure that involves implanting a device to deliver mild
electrical stimulation to block the brain signals that cause tremors in patients with Parkinson disease.
3. A procedure that involves repairing or replacing a shunt.4. A procedure that involves surgically reducing as much as possible
the size of a tumor that cannot be completely removed.5. A procedure that severs the network of neural connections
between the right and left hemispheres of the brain as a treatment for seizures.
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
Define the Following Answers6. A procedure that uses a photosensitizing agent, which is
activated by exposure to light in order to destroy cancer cells.7. A procedure used to evaluate the CSF from the space
surrounding the spinal cord.8. A procedure whereby tiny platinum coils are placed directly
into an aneurysm to block blood flow and prevent rupture.9. A prolonged seizure, or series of seizures, that lasts for more
than 30 minutes, during which time the patient is unconscious.10.A sac-like outpouching that can occur in the large arteries at
the base of the brain.
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
Define the Following1. Glasgow Coma Scale (GCS)2. proprioception3. subpial resection4. neurologic assessment5. anterior communicating artery (AComA)6. ventriculoperitoneal (VP) shunt7. shunt8. reflex9. aura10.ventriculostomy
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
Define the Following Answers1. A scoring system used to quantify a patient's level of
consciousness following a brain injury.2. A sense or a perception, usually at a subconscious level, of the
movements and position of the body and especially its limbs, independent of vision but by input from sensory nerves.
3. A series of surgical cuts to help isolate the area of the brain that is causing seizures.
4. A series of tests used to assess brain function of a patient and to evaluate for possible neurologic damage.
5. A short artery that joins the two anterior cerebral arteries in the brain.
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
Define the Following Answers
6. A shunt that is placed inside one of the ventricles of the brain and the other end into the abdominal cavity.
7. A silicone rubber tube used to divert CSF flow away from the brain to elsewhere in the body.
8. A simple nerve circuit.9. A subjective warning sign that occurs immediately
before the onset of a seizure.10.A surgical opening made between two ventricles to
allow flow of CSF to be unobstructed.
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
References• http://www.mtdaily.com/math.html• http://www.irs.gov/newsroom/article/
0,,id=173423,00.html• Gilmore, D. (2009). Medical Transcription Fundamentals.
Lippincott, Williams & Wilkins.
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
The End• Well that’s all for tonight! • Thanks for joining us. I hope you learned
something to help you in your transcription career.
• See you next week! Same time—same place!
• Bye for now!
Dr. B and her Mom at church dinner
theater
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