Clinical physiology

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Clinical physiology is both an academic discipline within the medical sciences and a clinical medical specialty for physicians in the health care systems of Sweden, [1] Denmark and Finland. Clinical physiology is characterized as a branch of physiology that uses a functional approach to understand the pathophysiology of a disease. [2]

Contents

Overview

As a specialty for medical doctors, clinical physiology is a diagnostic specialty in which patients are subjected to specialized tests for the functions of the heart, blood vessels, lungs, kidneys and gastrointestinal tract, and other organs. Testing methods include evaluation of electrical activity (e.g. electrocardiogram of the heart), blood pressure (e.g. ankle brachial pressure index), and air flow (e.g. pulmonary function testing using spirometry). In addition, Clinical Physiologists measure movements, velocities, and metabolic processes through imaging techniques such as ultrasound, echocardiography, magnetic resonance imaging (MRI), x-ray computed tomography (CT), and nuclear medicine scanners (e.g. single photon emission computed tomography (SPECT) and positron emission tomography (PET) with and without CT or MRI).

History

The field of clinical physiology was originally founded by Professor Torgny Sjöstrand in Sweden, and it continues to make its way around the world in other hospitals and academic environments. [3] Sjöstrand was the first to establish departments for clinical physiology separate than those of Physiology during his work at the Karolinska Hospital in Stockholm. [3] Along with Sjöstrand, another influential name in clinical physiology was P.K Anokhin. Anohkin heavily contributed to the branch of physiology where he worked diligently to use his theories of functional systems to solve medical mysteries amongst his patients. [4]

In Sweden, clinical physiology was originally a discipline by its own, however, between 2008 and 2015, clinical physiology was categorized as a sub-discipline to radiology. [1] For this reason, those pursuing a career in clinical physiology had to first become registered and certified radiologists before becoming clinical physiologists. Since 2015, clinical physiology is once again a separate discipline independent of radiology.

Role

Human physiology is the study of bodily functions. Clinical physiology examinations typically involve assessment of such functions as opposed to assessment of structures and anatomy. The specialty encompasses the development of new physiological tests for medical diagnostics. Using equipments to measure, monitor and record patients proves very helpful for patients in many hospitals. Moreover, it is helpful to doctors, making it possible for patients to be diagnosed correctly. [5] Some Clinical Physiology departments perform tests from related medical specialties including nuclear medicine, clinical neurophysiology, and radiology. In the health care systems of countries that lack this specialty, the tests performed in clinical physiology are often performed by the various organ-specific specialties in internal medicine, such as cardiology, pulmonology, nephrology, and others.

In Australia, the United Kingdom as well as many other commonwealth and European countries, clinical physiology is not a medical specialty for physicians. It is its own non-medical allied health profession - scientist, physiologist or technologist - who may practice as a cardiac scientist, vascular scientist, respiratory scientist, sleep scientist or in Ophthalmic and Vision Science as an Ophthalmic Science Practitioner (UK). [6] These professionals also aid in the diagnosis of disease and manage patients, with an emphasis on understanding physiological and pathophysiological pathways. [6] Disciplines within clinical physiology field include audiologists, cardiac physiologists, gastro-intestinal physiologists, neurophysiologists, respiratory physiologists, and sleep physiologists.

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The following outline is provided as an overview of and topical guide to health sciences:

<span class="mw-page-title-main">Medicine</span> Diagnosis, treatment, and prevention of illness

Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness. Contemporary medicine applies biomedical sciences, biomedical research, genetics, and medical technology to diagnose, treat, and prevent injury and disease, typically through pharmaceuticals or surgery, but also through therapies as diverse as psychotherapy, external splints and traction, medical devices, biologics, and ionizing radiation, amongst others.

<span class="mw-page-title-main">Physiology</span> Science regarding function of organisms or living systems

Physiology is the scientific study of functions and mechanisms in a living system. As a subdiscipline of biology, physiology focuses on how organisms, organ systems, individual organs, cells, and biomolecules carry out chemical and physical functions in a living system. According to the classes of organisms, the field can be divided into medical physiology, animal physiology, plant physiology, cell physiology, and comparative physiology.

<span class="mw-page-title-main">Radiology</span> Branch of Medicine

Radiology is the medical specialty that uses medical imaging to diagnose diseases and guide their treatment, within the bodies of humans and other animals. It began with radiography, but today it includes all imaging modalities, including those that use no ionizing electromagnetic radiation, as well as others that do, such as computed tomography (CT), fluoroscopy, and nuclear medicine including positron emission tomography (PET). Interventional radiology is the performance of usually minimally invasive medical procedures with the guidance of imaging technologies such as those mentioned above.

Medical physics deals with the application of the concepts and methods of physics to the prevention, diagnosis and treatment of human diseases with a specific goal of improving human health and well-being. Since 2008, medical physics has been included as a health profession according to International Standard Classification of Occupation of the International Labour Organization.

<span class="mw-page-title-main">Medical imaging</span> Technique and process of creating visual representations of the interior of a body

Medical imaging is the technique and process of imaging the interior of a body for clinical analysis and medical intervention, as well as visual representation of the function of some organs or tissues (physiology). Medical imaging seeks to reveal internal structures hidden by the skin and bones, as well as to diagnose and treat disease. Medical imaging also establishes a database of normal anatomy and physiology to make it possible to identify abnormalities. Although imaging of removed organs and tissues can be performed for medical reasons, such procedures are usually considered part of pathology instead of medical imaging.

<span class="mw-page-title-main">Neuropsychology</span> Study of the brain related to specific psychological processes and behaviors

Neuropsychology is a branch of psychology concerned with how a person's cognition and behavior are related to the brain and the rest of the nervous system. Professionals in this branch of psychology focus on how injuries or illnesses of the brain affect cognitive and behavioral functions.

<span class="mw-page-title-main">Nuclear medicine</span> Medical specialty

Nuclear medicine or nucleology is a medical specialty involving the application of radioactive substances in the diagnosis and treatment of disease. Nuclear imaging, in a sense, is "radiology done inside out" because it records radiation emitted from within the body rather than radiation that is transmitted through the body from external sources like X-ray generators. In addition, nuclear medicine scans differ from radiology, as the emphasis is not on imaging anatomy, but on the function. For such reason, it is called a physiological imaging modality. Single photon emission computed tomography (SPECT) and positron emission tomography (PET) scans are the two most common imaging modalities in nuclear medicine.

<span class="mw-page-title-main">Scintigraphy</span> Diagnostic imaging test in nuclear medicine

Scintigraphy, also known as a gamma scan, is a diagnostic test in nuclear medicine, where radioisotopes attached to drugs that travel to a specific organ or tissue (radiopharmaceuticals) are taken internally and the emitted gamma radiation is captured by gamma cameras, which are external detectors that form two-dimensional images in a process similar to the capture of x-ray images. In contrast, SPECT and positron emission tomography (PET) form 3-dimensional images and are therefore classified as separate techniques from scintigraphy, although they also use gamma cameras to detect internal radiation. Scintigraphy is unlike a diagnostic X-ray where external radiation is passed through the body to form an image.

<span class="mw-page-title-main">Neuroimaging</span> Set of techniques to measure and visualize aspects of the nervous system

Neuroimaging is the use of quantitative (computational) techniques to study the structure and function of the central nervous system, developed as an objective way of scientifically studying the healthy human brain in a non-invasive manner. Increasingly it is also being used for quantitative research studies of brain disease and psychiatric illness. Neuroimaging is highly multidisciplinary involving neuroscience, computer science, psychology and statistics, and is not a medical specialty. Neuroimaging is sometimes confused with neuroradiology.

The American College of Radiology (ACR), founded in 1923, is a professional medical society representing nearly 40,000 diagnostic radiologists, radiation oncologists, interventional radiologists, nuclear medicine physicians and medical physicists.

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<span class="mw-page-title-main">Wolf-Dieter Heiss</span>

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<span class="mw-page-title-main">Biomedical sciences</span> Application of science to healthcare

Biomedical sciences are a set of sciences applying portions of natural science or formal science, or both, to develop knowledge, interventions, or technology that are of use in healthcare or public health. Such disciplines as medical microbiology, clinical virology, clinical epidemiology, genetic epidemiology, and biomedical engineering are medical sciences. In explaining physiological mechanisms operating in pathological processes, however, pathophysiology can be regarded as basic science.

Medical image computing (MIC) is an interdisciplinary field at the intersection of computer science, information engineering, electrical engineering, physics, mathematics and medicine. This field develops computational and mathematical methods for solving problems pertaining to medical images and their use for biomedical research and clinical care.

Bruce Rosen is an American physicist and radiologist and a leading expert in the area of functional neuroimaging. His research for the past 30 years has focused on the development and application of physiological and functional nuclear magnetic resonance techniques, as well as new approaches to combine functional magnetic resonance imaging (fMRI) data with information from other modalities such as positron emission tomography (PET), magnetoencephalography (MEG) and noninvasive optical imaging. The techniques his group has developed to measure physiological and metabolic changes associated with brain activation and cerebrovascular insult are used by research centers and hospitals throughout the world.

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References

  1. 1 2 Arheden H (December 2009). "Clinical physiology: a successful academic and clinical discipline is threatened in Sweden". Advances in Physiology Education. 33 (4): 265–7. doi:10.1152/advan.00072.2009. PMID   19948671. S2CID   12888994.
  2. ↑ Arheden, Håkan (2009-12-01). "Clinical physiology: a successful academic and clinical discipline is threatened in Sweden". Advances in Physiology Education. 33 (4): 265–267. doi:10.1152/advan.00072.2009. ISSN   1043-4046. Archived from the original on 2022-07-03. Retrieved 2023-06-26.
  3. 1 2 Linderholm, H. (May 10, 1990). "Clinical physiology: an accepted branch of physiology". Clinical Physiology. 10 (3): 215–219. doi:10.1111/j.1475-097X.1990.tb00089.x. ISSN   0144-5979.
  4. ↑ Makarov, V. A. (1997). "[Contribution of P.K. Anokhin to the development of clinical physiology]". Vestnik Rossiiskoi Akademii Meditsinskikh Nauk (12): 56–61. ISSN   0869-6047. PMID   9484016. Archived from the original on 2023-03-03. Retrieved 2023-06-26.
  5. ↑ "Clinical Physiologist". www.careers.govt.nz. Archived from the original on 2021-01-25. Retrieved 2021-02-04.
  6. 1 2 "Clinical Physiology." Archived 2013-04-20 at the Wayback Machine from Griffith University. Retrieved December 2013
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