Foundations of Sonography Exam 1

Scanning Motions: Rotate

Motion is useful to navigate between the ribs or to change from transverse to longitudinal planes, where the transducer is held in one area and rotated 90 degrees to the opposite plane. • Rotate is also used in smaller increments as the transducer is slowly turned around the area of interest.

Scanning Motions: Slide

Motion used when the transducer is physically moved along the abdomen, such as a longitudinal movement to follow the course of the abdominal aorta into the bifurcation of the iliac arteries.

Scanning Motions: Rock or Pivot

Once an area of interest is located, the sonographer may pause over the structure and slowly "rock" or pivot the transducer back and forth or up and down to image the area completely or to follow the anatomical structure

Trendelenburg Position

Person in the supine position with the feet raised higher than the level of the head at an angle of 15-20 degrees - venous/incompetent cervix scans

Convex/Curvilinear probe

Probe good for deep structures - low frequency, poor resolution but better at seeing deep structures

Linear array probe

Probe good for superficial structures - has high frequency, and better resolution, but doesn't see deep structures well

Right anterior oblique VS. Left anterior oblique

RAO- lying semiprone on the right slide, and elevating the left LAO- lying semiprone on the left slide, and elevating the right

Doppler Technology

Relates to the effect of differing frequencies within motion - Doppler notes when sound impinges on a stationary reflector, there is no shift or change in the reflected frequency back to the transducer - Also noted there was a frequency shift if the reflector was moving - Typically the structures we analyze that are moving are red blood cells w/in various organs • Continuous-wave Doppler • Pulsed-wave Doppler- we saw these in lab • Color Doppler imaging • Power Doppler

Sanning Motions: Sweep

Requires the transducer to remain in one area while using a large wrist motion with the probe perpendicular to the skin surface to sweep through the abdomen.

Right lateral decubitus vs Left lateral decubitus

Right lateral decubitus (RLD)- lying on right side Left lateral decubitus (LLD)- lying on left side

Right posterior oblique vs Left posterior oblique

Right posterior oblique (RPO)- lying semisupine, rolled up on right side slightly elevating left Left posterior oblique (LPO)- lying semisupine, rolled up on left side slightly elevating right - can also be anterior: lying semiprone arm and leg of other side positioned slightly forward rather than back

Transducer notch in Sagital & Transverse planes

Sagittal- notch is superior Transverse- notch is to the patients right

Scanning Motions: Fan

Smaller version of the sweep motion, which is used when the transducer is minutely swept, pivoting on a point of interest. • This may be useful in the superficial structures such as the breast when differentiation is needed between the duct and the invasive lesion within the duct.

Superficial

Superficial structures are those located close to the surface of the body. Your skin is superficial to your muscles.

Supine vs. Prone

Supine- lying on back Prone- lying face down

Abdominal Quadrants

The abdominopelvic cavity is divided into four quadrants 1. Right upper quadrant (RUQ) 2. Left upper quadrant (LUQ) 3. Right lower quadrant (RLQ) 4. Left lower quadrant (LLQ) • The quadrant is determined by the midsagittal and transverse planes that pass through the umbilicus.

Attenuation

The weakening of sound as it travels through a medium

Transducer Positions: Angled

Transducer is angled superiorly, inferiorly, or right/left laterally at varying degrees

Transducer Positions: Subcostal

Transducer is angled superiorly, just beneath the inferior costal margin

Transducer Positions: Intercostal

Transducer is in between the ribs. Can be perpendicular, subcostal or angled

Transducer Positions: Rotated

Transducer is rotated at avrying degrees

Transducer Positions: Perpendicular

Transducer is straight up and down

The 3 abdominal section planes

Transpyloric Plane- horizontal plane passes through the pylorus, duodenal junction, neck of the pancreas, and hilum of the kidneys. Subcostal- The upper horizontal line joins the lowest point of the costal margin on each side of the body. Intertubercular- The lowest horizontal line joins the tubercles on the iliac crests.

Fowler Position

Various inclined positions in which the head of the bed is raised- typically raised 18-20 inches above the heart with the knees elevated - Prostate biopsy

Acoustic Gel

acts as a means whereby the ultrasound waves can pass through the body - Also provides lubrication

Lateral

away from the midline of the body or pertaining to the side; situated at or on the side

Distal

farther away from the attachment point or origin of an extremity to the trunk of the body

Contralateral

on the opposite side of the body

Ipsilateral

on the same side of the body

Realtime imaging

the ability of the machine to gather information and display it on the screen almost instantaneously. - Combining realtime with B-mode results in what we use to obtain our images- the real-time b-scan technique

Knobology

the study of knobs or the functionality of controls. • Many of the controls on ultrasound machines are actually touch-screen buttons.

Anterior/Ventral

toward the front of the body, or in front of another body part

Medial

toward the middle of the body or an organ

Proximal

toward the origin or attachment of a structure to the trunk

Inferior/Caudal

towards the feet or away from the head; structure lower than another body part; lower part of an organ/structure

Cranial/Superior/Cephalic

towards the head or higher in the body

Coronal Plane

(COR) Divides the body into anterior and posterior - Reads left and right up and down - Read superior to inferior across

Sagittal/Longitudinal Plane

(SAG,LONG) Divides the body into left and right, screen displays superior to inferior

Transverse Plane

(TRV, TRANS) Divides the body into superior and inferior parts, screen displays right to left

Anatomic position

Assumes that the body is standing erect, the eyes are looking forward, and the arms are at the sides with the palms and toes directed forward.

Deep

Deep structures are those located farther inward, away from the body surface. Your Aorta and IVC are deep structures.

Transducer

Device used to obtain an image of the human body using an ultrasound - "probe" - Operates using pule-echo principle: Crystals inside transducer produces the ultrasound wave once pulsed with electricity. Wave is sent into the body and returns to the transducer again - Comes in a variety of shapes

Brightness mode (B-Mode)

Displays the returning echoes as dots of varying brightness related to the strength of the echo. - Brightness of the dots relates to the strength of echo that has returned to the body

Midsagittal plane

Divides the body into equal left or right halves

Care and Cleaning of Transducers

Do not drop or roll over cords - report any cracks/damage to supervisor - never autoclave - transducers used topically should be cleaned with manufacturer recommended disinfectants - intracavity probes should be cleaned with glutaraldehyde-based solution.

Amplitude mode (A-mode)

Echocardiology may use this to display the amplitude or strength of returning echoes as spikes on a scale, rather than producing an image