MIDI II - Ultrasound Sonosim
The pyramidal lobe of the thyroid gland is a tapered, triangular-shaped extension of the isthmus or either thyroid lobe. It tapers and often extends superiorly towards the hyoid bone. A. True B. False
A. True
The size of each thyroid lobe should be recorded in anterior-posterior, transverse, and longitudinal dimensions. A. True B. False
A. True
T/F: The distance between a peritonsillar abscess and the carotid artery and internal jugular vein cannot be accurately determined using the endocavitary probe.
False
T/F: The fascia that envelops a muscle belly is hypoechoic relative to the muscle.
False
T/F: The two-needle localization method is the only proven method to safely identify and remove embedded foreign bodies using ultrasonography.
False
T/F: Ultrasound has a very limited ability to detect embedded foreign bodies within superficial soft tissues.
False
The parathyroid glands vary in shape and number amongst the general population. A. True B. False
A. True
The internal jugular vein joins the subclavian vein to form the brachiocephalic vein, which drains into the superior vena cava. A. True B. False
A. True
Which of the following interventions are recommended methods of improving thyroid gland imaging? A. Have the patient swallow to bring the inferior pole of the thyroid lobe into view. B. Scan while the patient holds a deep inspiratory effort. C. Have the patient fast prior to scanning. D. Rotate the patient into a left lateral decubitus position. E. All of the above
A. Have the patient swallow to bring the inferior pole of the thyroid lobe into view.
Which of the following serves as a useful anatomic landmark for localizing the subscapularis tendon with ultrasonography? A. Long head of biceps tendon B. Infraspinatus muscle C. Teres minor muscle D. All of the above E. B and C only
A. Long head of biceps tendon
How can peritonsillar lymph nodes be distinguished from a peritonsillar abscess? A. Lymph nodes are hyperemic when imaged using color Doppler B. Lymph nodes often have swirling debris within them when compressed C. Lymph nodes are not present in the peritonsillar region D. All of the above E. None of the above
A. Lymph nodes are hyperemic when imaged using color Doppler
Which of the following structures inserts along the lesser tuberosity? A. Subscapularis muscle B. Deltoid muscle C. Supraspinatus muscle D. Infraspinatus tendon E. None of the above
A. Subscapularis muscle
Which of the following statements correctly characterizes the parathyroid glands? A. They receive arterial blood from branches of the thyroid arteries. B. They are uniform in shape and number across individuals. C. Normal glands measure two to three centimeters in length. D. All of the above E. A and C only
A. They receive arterial blood from branches of the thyroid arteries.
A popular method of ultrasound guidance involves using a transverse view to identify the target structure and select a site for needle entry through the skin. The transducer is then rotated to a longitudinal view, and the needle is tracked through soft tissues while advancing towards its target. A. True B. False
A. True
Anisotropic artifact can often be mitigated with precise scanning technique and approaches. A. True B. False
A. True
Calcitonin's overall effect is to decrease blood calcium levels, whereas parathyroid hormone's effect is to increase blood calcium levels. A. True B. False
A. True
Thyroid follicles __________. A. are spherical structures with colloid-filled lumens B. contain thyroglobulin, which the thyroid gland uses to synthesize calcitonin C. are composed of C-cells D. All of the above E. A and B only
A. are spherical structures with colloid-filled lumens
Compared to other sites, the internal jugular vein has a higher incidence of catheter-associated bloodstream infection. A. True B. False
B. False
The external jugular vein typically lies just posterior to the internal carotid artery and the internal jugular vein. A. True B. False
B. False
The subscapularis tendon is best sonographically visualized by maintaining the shoulder in an adducted and slightly internally rotated position. A. True B. False
B. False
Which probe should generally be used when scanning soft tissues? A. Curved-abdominal probe B. High-frequency linear probe C. Low-frequency phased-array probe D. Endocavitary probe E. None of the above
B. High-frequency linear probe
Which of the following correctly describes characteristics of the shoulder joint? A. It has a very limited range of motion. B. It is one of the more commonly dislocated joints in the body. C. Tendinous attachments provide a majority of its stability. D. All of the above E. A and C only
B. It is one of the more commonly dislocated joints in the body.
Which of the following is commonly used as a visual guide to facilitate ultrasound-guided internal jugular vein cannulation? A. Mirror-image artifact B. Reverberation artifact C. B-line artifact D. All of the above E. A and C only
B. Reverberation artifact
Which of the following statements correctly characterizes the sonographic appearance of the thyroid gland and surrounding structures? A. The carotid arteries and internal jugular veins typically lie medial to the thyroid lobes. B. The longus colli muscle runs posterior to the thyroid lobes. C. The thyroid gland often directly overlies the middle and superior margins of the thyroid cartilage. D. All of the above E. A and B only
B. The longus colli muscle runs posterior to the thyroid lobes.
Which of the following is a reason that the right internal jugular vein is a preferred site of cannulation over the left internal jugular vein? A. The diameter of the right internal jugular vein is smaller than that of the left. B. The right internal jugular vein provides a more direct path to the superior vena cava. C. The apex of the left pleural dome is lower (more inferior) than that of the right pleural dome. D. All of the above E. None of the above
B. The right internal jugular vein provides a more direct path to the superior vena cava.
Which of the following statements correctly characterizes the surface anatomy of the anterolateral neck? A. Sedillot's triangle is a unilateral structure found along the right side of the neck. B. The sternal and clavicular heads of the sternocleidomastoid muscle act as borders of Sedillot's triangle. C. The superior margin of the clavicle forms the superior border, or apex, of Sedillot's triangle. D. All of the above E. A and C only
B. The sternal and clavicular heads of the sternocleidomastoid muscle act as borders of Sedillot's triangle.
Which of the following statements correctly characterizes thyroid anatomy and physiology? A. The thyroid secretes TSH. B. The thyroid gland consists of multiple thyroid follicles, each filled with colloid. C. Each thyroid follicle is composed of C-cells that produce calcitonin. D. Thyroglobulin is stored in the space between the thyroid follicles. E. All of the above
B. The thyroid gland consists of multiple thyroid follicles, each filled with colloid.
Which of the following statements correctly characterizes the sonographic anatomy of the anterolateral neck? A. The internal jugular vein always lies lateral to the common carotid artery. B. The wall of the internal jugular vein is thinner than that of the carotid artery. C. The carotid artery normally demonstrates respirophasic variation. D. The internal jugular vein has a fixed, unvarying lumenal diameter. E. All of the above
B. The wall of the internal jugular vein is thinner than that of the carotid artery.
Which of the following foreign bodies and ultrasound findings are incorrectly paired? A. A metal needle appears hyperechoic with reverberation artifact. B. Wood appears hyperechoic with reverberation artifact. C. An embedded foreign body (day three) may have a hypoechoic rim of inflammation. D. All of the above E. None of the above
B. Wood appears hyperechoic with reverberation artifact.
Which angle combination best describes the "triangle rule" that is described in this course for estimating the site and trajectory of needle entry for out-of-plane vessel cannulation using a transverse imaging approach? A. 40-30-20 degree B. 30-60-90 degree C. 45-45-90 degree D. 10-20-60 degree E. None of the above
C. 45-45-90 degree
Which of the following correctly characterizes the sonographic characteristics of the internal jugular vein and its surrounding structures? A. The internal jugular vein's appearance does not vary with Valsalva maneuvers. B. The carotid artery typically displays marked respirophasic variation. C. Head rotation may position the carotid artery directly deep, or posterior, to the internal jugular vein. D. All of the above E. A and B only
C. Head rotation may position the carotid artery directly deep, or posterior, to the internal jugular vein.
Which of the following statements correctly characterizes the thyroid gland? A. It is an exocrine gland. B. It secretes thyroid hormone through a duct. C. It plays a role in body metabolism, growth, and development. D. All of the above E. A and C only
C. It plays a role in body metabolism, growth, and development.
T/F: Anisotropy is an artifact that requires changing gain settings to overcome.
False
Which of the following statements correctly characterizes the relationship between the internal jugular vein and the common carotid artery? A. The common carotid artery is always located lateral to the internal jugular vein. B. The common carotid artery is always located directly behind, or posterior to, the internal jugular vein. C. The relative position of the internal jugular vein and the common carotid artery can vary depending on head and neck positioning. D. None of the above E. A and C
C. The relative position of the internal jugular vein and the common carotid artery can vary depending on head and neck positioning.
Which of the following statements correctly characterizes the anatomic relationship of the thyroid gland to surrounding structures? A. The thyroid gland directly overlies the superior margin of the thyroid cartilage. B. The thyroid gland is normally found posterior to the trachea. C. The thyroid gland is affixed to the cricoid cartilage and trachea. D. All of the above E. A and B only
C. The thyroid gland is affixed to the cricoid cartilage and trachea.
Which of the following muscles is classified as one of the strap muscles of the neck? A. Longus colli muscle B. Sternocleidomastoid muscle C. Thyrohyoid muscle D. All of the above E. A and C only
C. Thyrohyoid muscle
Which of the following statements regarding ultrasound-guided peritonsillar abscess drainage is (are) correct? A. Color Doppler ultrasound imaging has no role in this procedure B. Lymph nodes are easily distinguished from an abscess based solely on appearance C. Ultrasound-image guidance can decrease risk of inadvertent arterial puncture D. A linear high-frequency transducer has an ideal physical footprint for this procedure E. All of the above
C. Ultrasound-image guidance can decrease risk of inadvertent arterial puncture
The thyroid gland __________. A. synthesizes thyroid hormone and parathyroid hormone B. stores iodine in parafollicular cells (C-cells) C. contains thyroid follicles, which contain colloid within their lumen D. All of the above E. A and C only
C. contains thyroid follicles, which contain colloid within their lumen
Which of the following statements correctly characterizes ultrasound-guided central venous cannulation? A. Complication rates are operator dependent. B. Ultrasound guidance decreases the number of attempts required. C. Ultrasound guidance increases time to successful cannulation. D. A and B E. A and C
D. A and B
The thyroid's arterial supply typically originates from the __________. A. external carotid artery B. internal carotid artery C. subclavian artery D. A and C E. B and C
D. A and C
Which of the following statements correctly characterizes transducer selection for performing ultrasound-guided internal jugular vein cannulation? A. Linear-array transducers are preferred. B. Curvilinear transducers are ideally suited for imaging neck vessels. C. High-frequency transducers (15 to 5 MHz) are preferred. D. A and C E. B and C
D. A and C
Which statement regarding ultrasound imaging of cellulitis is incorrect? A. Cobblestoning represents hyperechoic islands of inflamed soft tissue with surrounding hypoechoic areas of edema B. Cobblestoning can be seen in regions of non-infection-related inflammation C. Cobblestoning is a nonspecific yet characteristic finding seen with cellulitis D. A focal hypoechoic area with clearly defined margins suggests cellulitis E. None of the above
D. A focal hypoechoic area with clearly defined margins suggests cellulitis
Which of the following statements regarding ultrasound imaging of superficial structures of the finger is (are) incorrect? A. A linear high-frequency transducer should be used B. A standoff pad can help improve image resolution C. A water bath can serve as an acoustic window D. A kinetic exam (e.g., moving a finger) is contraindicated during ultrasonography E. None of the above
D. A kinetic exam (e.g., moving a finger) is contraindicated during ultrasonography
As part of pre-procedure planning, which of the following elements should be considered? A. Patient positioning B. Ultrasound machine positioning C. Infection prevention measures D. All of the above E. A and C only
D. All of the above
Calcitonin affects the blood's serum calcium levels by acting at which of the following sites? A. Kidney B. Bones C. Intestines D. All of the above E. A and C only
D. All of the above
Joint spaces can be differentiated from fractures by __________. A. noting a smooth curved-end to both bone margins B. observing a "Seagull Sign" C. the lack of surrounding soft-tissue edema D. All of the above E. None of the above
D. All of the above
When attempting to view a structure that is close to skin, it is often helpful to create an acoustic window between the area of interest and the probe. Which of the following techniques can be used to optimize imaging? A. A sterile latex glove filled with water placed over the target area B. A commercially sold standoff pad C. Submerge the area of interest in a water bath and scan D. All of the above E. None of the above
D. All of the above
Which of the following are well-described anatomic variants of the thyroid gland? A. Ectopic thyroid tissue (e.g., lingual thyroid tissue) B. Absence of a thyroid isthmus C. A pyramidal lobe D. All of the above E. None of the above
D. All of the above
Which of the following factors commonly influences site selection for central venous cannulation? A. Operator preference B. Patient anatomy C. Relative contraindications D. All of the above E. None of the above
D. All of the above
Which of the following is a potential pitfall of using out-of-plane needle guidance for internal jugular vein cannulation? A. Inadvertent traversing of the posterior wall of the internal jugular vein B. Difficulty precisely tracking the advancing needle tip C. Difficulty cannulating flat or collapsing internal jugular veins with a 45-degree angle of approach D. All of the above E. A and C only
D. All of the above
Which of the following local findings may warrant selecting an alternative site for central venous cannulation? A. Cellulitis B. Scar tissue C. Venous thrombus D. All of the above E. None of the above
D. All of the above
Which of the following statements correctly characterizes infection prevention measures associated with internal jugular vein cannulation? A. Infection prevention measures apply to the operator, ultrasound machine, and transducer. B. Central venous cannulation should be performed using maximal sterile barrier precautions. C. Single-use, sterile gel should be used during the procedure. D. All of the above E. A and C only
D. All of the above
Which of the following statements correctly characterizes the anatomy of the thyroid gland and surrounding structures? A. Each thyroid lobe is located between strap muscles (anteriorly) and the longus colli muscle (posteriorly). B. The trachea is located along medial borders of the thyroid lobes. C. The carotid artery and internal jugular vein are located along the lateral borders of the thyroid lobes. D. All of the above E. None of the above
D. All of the above
Which of the following statements is (are) correct regarding the use of ultrasound in assessing soft-tissue infections? A. Ultrasound enables clear delineation of the margins of an abscess B. Hyperechoic debris can sometimes be seen swirling within a larger hypoechoic area if an abscess is present C. Ultrasound helps distinguish a localized abscess from cellulitis D. All of the above E. None of the above
D. All of the above
Which of the following statements is (are) true regarding anisotropy? A. It is evident when imaging muscles and tendons. B. It is a false hypoechogenicity resulting from oblique ultrasound beams. C. Its presence can be confirmed by tilting the probe at slight angles to the tendon or muscle and noting varying degrees of echogenicity. D. All of the above E. None of the above
D. All of the above
Which of the following statements regarding muscle tissue appearance on ultrasound is (are) correct? A. In the long axis, the muscle appears to have long striae that are hyperechoic. B. Muscle is surrounded by hyperechoic fascia. C. In the short axis, the muscular striae appear to have a punctate appearance. D. All of the above E. None of the above
D. All of the above
T/F: Cobblestoning of the subcutaneous tissue always implies an infectious process like cellulitis.
False
Which of the following statements regarding ultrasound appearance of joint cavities is (are) correct? A. Joints are a potential space and may not be filled with significant fluid B. Significant joint effusions are typically compressible with an ultrasound probe C. The "Seagull Sign" represents the coming together of two ends of bone at the margins of a joint cavity D. All of the above E. None of the above
D. All of the above
Which of the following statements regarding ultrasound-guided procedures is (are) correct? A. A pre-procedural scan can identify important structures and landmarks, such as arteries and veins, prior to an abscess drainage attempt. B. A pre-procedural scan can identify whether the abscess pocket extends to deep structures and may be better managed in the operating room (e.g., abdominal wall abscess extending deep to various layers of muscle). C. Real-time ultrasound assessment can determine whether sufficient evacuation of an abscess has occurred. D. All of the above E. None of the above
D. All of the above
Which of the following structures are matched appropriately with respective echogenicity? A. Fascia has an isoechoic appearance B. Muscle has a hyperechoic appearance C. Tendon has a hypoechoic appearance D. Bone is hyperechoic and exhibits shadowing E. None of the above
D. Bone is hyperechoic and exhibits shadowing
Which of the following statements regarding the ultrasound appearance of soft tissue is incorrect? A. Muscles and tendons display varying echogenicity when insonated at varying angles B. Tendon is very dense and has a hyperechoic appearance C. Muscle striae have a punctate hyperechoic appearance in a short-axis view D. Bone is hypoechoic relative to surrounding structures E. None of the above
D. Bone is hypoechoic relative to surrounding structures
How can local lymph nodes be distinguished from a peritonsillar abscess? A. Abscesses often exhibit swirling debris within them when compressed B. Lymph nodes are not present in the peritonsillar region C. Lymph nodes appear hyperemic when imaged using color Doppler D. Choices A and C E. All of the above
D. Choices A and C
T/F: Fractures cannot be seen with ultrasound.
False
T/F: Studies have suggested that plain radiography is superior to ultrasonography for localizing embedded wooden foreign bodies within soft tissues.
False
Which of the following statements regarding imaging approaches is true for ultrasound-guided internal jugular vein cannulation? A. The internal jugular vein should only be viewed in long axis. B. The internal jugular vein should only be viewed in short axis. C. A transverse imaging approach has no role in internal jugular vein cannulation. D. None of the above E. A and C
D. None of the above
Which of the following anatomic structures commonly displays anisotropic artifact? A. Bone B. Bursa C. Veins D. Tendons E. None of the above
D. Tendons
Which of the following ergonomic factors is an important consideration when performing internal jugular vein cannulation? A. The transducer and ultrasound machine are ideally positioned in a convenient location for the operator. B. The ultrasound screen should be close enough to the practitioner so that image detail can be adequately appreciated. C. The ultrasound machine must be positioned directly adjacent to the left side of the operator during the procedure. D. All of the above E. A and B only
E. A and B only
Which of the following is a key element of the pre-procedural survey scan performed prior to internal jugular vein cannulation? A. Assessment of the relative size and patency of the internal jugular vein B. Examination of the position of the internal jugular vein in relation to the carotid artery C. Sterile preparation of the skin prior to performing the survey scan D. All of the above E. A and B only
E. A and B only
Which of the following is true regarding thyroxine? A. It contains four iodine ions. B. It is converted to T3 in peripheral body tissues. C. It is more physiologically active than T3. D. All of the above E. A and B only
E. A and B only
Which of the following statements correctly characterizes thyroid hormone production and release? A. The hypothalamus regulates thyroid hormone levels. B. The thyroid gland synthesizes and releases thyroid hormones in response to TSH. C. Low blood levels of thyroid hormone inhibit the release of TRH and TSH. D. All of the above E. A and B only
E. A and B only
Which of the following statements correctly describes the internal anatomy of the neck? A. The internal jugular vein returns blood from the brain, face, and neck to the right atrium. B. The carotid sheath encases the vagus nerve. C. The common carotid artery is always found medial to the internal jugular vein. D. All of the above E. A and B only
E. A and B only
Which of the following statements regarding the sonographic anatomy of the thyroid gland and surrounding structures is correct? A. The vagus nerve is typically found posterior to the strap muscles, sandwiched between the common carotid artery and internal jugular vein. B. The vagus nerve typically has a honeycomb, heteroechoic appearance. C. The recurrent laryngeal nerve runs adjacent and parallel to the vagus nerve. D. All of the above E. A and B only
E. A and B only
Which of the following statements underscores the benefits of using ultrasound to perform internal jugular vein cannulation? A. Ultrasound guidance reduces the risk of inadvertent puncture of surrounding critical structures. B. Neck surface anatomy often makes blind or landmark-based approaches difficult. C. The internal jugular vein can be traced along its entire course with ultrasound, even when it passes beneath bones and gas-filled structures. D. All of the above E. A and B only
E. A and B only
Which of the following muscles is part of the rotator cuff muscle group? A. Supraspinatus muscle B. Trapezius muscle C. Teres minor muscle D. Splenius capitis muscle E. A and C
E. A and C
Which of the following statements regarding sonographic anatomy of the anterolateral neck is correct? A. The carotid artery consists of common, internal, and external carotid artery segments. B. The carotid artery typically has a highly variable and dynamic appearance. C. The internal jugular vein normally collapses with compression. D. A and B E. A and C
E. A and C
Which of the following statements regarding thyroid sonography technique is correct? A. A high-frequency linear transducer should generally be used for thyroid sonography. B. A curvilinear, low-frequency transducer has no role in thyroid gland imaging. C. The thyroid gland should be scanned in at least two orthogonal planes. D. Patients should be scanned in a supine position with the neck hyperflexed. E. A and C
E. A and C
Which of the following ligaments provides structural support for the acromioclavicular joint? A. Trapezoid ligament B. Transverse humeral ligament C. Conoid ligament D. All of the above E. A and C only
E. A and C only
Which of the following statements correctly characterizes parathyroid hormone? A. It stimulates the release of calcium from bones. B. It inhibits reabsorption of calcium within the kidney. C. It increases the production of Vitamin D. D. All of the above E. A and C only
E. A and C only
Which of the following statements correctly characterizes the sonographic anatomy of the anterior neck? A. The vagus nerve is typically located between the medially positioned carotid artery and the laterally positioned internal jugular vein. B. The esophagus is typically located immediately posterior to the trachea, along midline. C. The left recurrent laryngeal nerve is typically bordered by the left thyroid lobe, trachea, and esophagus. D. All of the above E. A and C only
E. A and C only
Which of the following statements regarding head and neck positioning for internal jugular vein cannulation is correct? A. Slight head rotation may be required to gain access to the operative field. B. Rotation of the head 60 to 90 degrees will minimize any overlap between the internal jugular vein and carotid artery. C. Head rotation may affect the relative position of the internal jugular vein and carotid artery. D. All of the above E. A and C only
E. A and C only
Which of the following factors may dictate the shape of the internal jugular vein? A. Intravascular volume B. Overlying tissue compression C. Intrathoracic pressure changes D. Patient positioning E. All of the above
E. All of the above
Which of the following methods can be used to assist in foreign body localization with ultrasound guidance? A. Placement of dual needles at opposite ends of the foreign body B. Placement of a single needle marker over the foreign body C. A guide wire threaded through an introducer needle followed by blunt dissection along the trajectory of the guide wire D. Pen marking of the skin overlying the foreign body E. All of the above
E. All of the above
Which of the following statements correctly characterizes the sonographic appearance of the thyroid gland? A. Normal thyroid tissue has a homogeneous and moderately echogenic appearance. B. Thyroid tissue has a similar echotexture to that of normal liver tissue. C. Thyroid tissue is hyperechoic, compared to surrounding muscles. D. The thyroid gland is encased in a thin, echogenic, fibrous capsule. E. All of the above
E. All of the above
Which of the following statements correctly characterizes thyroid hormone regulatory control? A. The hypothalamus releases thyrotropin-releasing hormone (TRH). B. Thyrotropin-releasing hormone stimulates the release of thyroid-stimulating hormone (TSH). C. A decrease in TRH and TSH levels results in a decrease in thyroid hormone production. D. Both the anterior pituitary gland and hypothalamus play prominent regulatory roles. E. All of the above
E. All of the above
Which of the following statements regarding foreign body localization and removal aided by the use of ultrasound is (are) correct? A. Ultrasound is a proven method of detecting superficial foreign bodies B. Injection of local anesthetic can help detection of embedded foreign bodies C. Metallic foreign bodies are hyperechoic and display reverberation artifact D. Retained organic foreign bodies (e.g., wood) often elicit an inflammatory response within 48 to 72 hours of penetrating soft tissues E. All of the above
E. All of the above
Which of the following correctly characterizes critical elements of performing internal jugular vein cannulation? A. Reverse Trendelenburg position is ideally used. B. The patient should be on cardiac and oxygen telemetry monitoring. C. A survey scan should be performed prior to needle insertion. D. A and B E. B and C
E. B and C
Which of the following statements best characterizes thyroid gland anatomy? A. The thyroid gland is typically located just superior to the larynx. B. The thyroid gland is composed of two lobes, generally connected by an isthmus. C. The thyroid gland is affixed to the cricoid cartilage and trachea. D. A and B E. B and C
E. B and C
Which of the following statements correctly characterizes elements associated with obtaining informed consent for performing internal jugular vein cannulation? A. Informed consent is not required if ultrasound is used to guide cannulation. B. Procedure risks should be disclosed. C. Alternatives to the procedure should be discussed. D. A and B E. B and C
E. B and C
The thyroid veins drain into the __________. A. external jugular veins B. brachiocephalic veins C. internal jugular veins D. A and B only E. B and C only
E. B and C only
Which of the following is a well-described application of sonography? A. Assessment of the the functional status of the thyroid gland B. Screening of the thyroid gland for cysts and solid masses C. Image guidance for thyroid mass biopsies D. All of the above E. B and C only
E. B and C only
Which of the following statements best characterizes ultrasound imaging of the thyroid and parathyroid glands? A. The parathyroid glands are readily visualized with sonography in most patients. B. Ultrasound can be used to perform image-guided needle biopsies of thyroid masses. C. The thyroid gland is readily visualized with sonography in most patients. D. All of the above E. B and C only
E. B and C only
Which of the following statements correctly characterizes thyroid gland and parathyroid gland sonography? A. Doppler-mode imaging has no role in thyroid gland sonography. B. The thyroid gland should be imaged in sagittal, parasagittal, and transverse body planes. C. Normal adult parathyroid glands are not easily seen with sonography. D. All of the above E. B and C only
E. B and C only
Which of the following can be found along the posterior aspect of the scapula? A. Subscapularis muscle B. Teres minor muscle C. Coracoclavicular ligament D. Infraspinatus muscle E. B and D
E. B and D
Which of the following statements is (are) most correct regarding the appearance of muscle on ultrasound? A. In long-axis view, muscle appears to have long striae that are hyperechoic B. In short-axis view, the muscle striae have a hyperechoic punctate appearance C. Muscle is surrounded by a hypoechoic fascia D. All of the above E. Choices A and B
E. Choices A and B
Which of the following is (are) not an advantage of using ultrasound to visualize a peritonsillar abscess? A. Helps gauge how deep the needle should be inserted to aspirate pus B. Can identify blood vessels that must be avoided C. Can provide real-time procedural guidance D. All of the above E. None of the above
E. None of the above
Which of the following statements correctly characterizes the subacromial-subdeltoid bursa? A. In normal individuals, it is an easily identifiable, thick, hyperechoic structure. B. Bursal inflammation typically makes visualization more difficult. C. The subacromial-subdeltoid bursa cannot be visualized with ultrasonography. D. All of the above E. None of the above
E. None of the above
Which of the following statements regarding ultrasound imaging is incorrect? A. Long-bone fractures are typically well-visualized with ultrasonography B. A high-frequency probe is ideally suited for long-bone fracture screening C. Bony fracture is suggested by a sharply-angled defect in the bone cortex D. A normal joint space exhibits a "Seagull Sign" E. None of the above
E. None of the above
The reported complication rate associated with traditional blind, or landmark-based, techniques for central venous catheter insertion is __________. A. less than 0 .1 percent B. between 0.1 and 2 percent C. between 2 and 5 percent D. between 5 and 10 percent E. up to 15 percent
E. up to 15 percent
T/F: An abscess cavity can easily be identified because the cavity always has a hypoechoic appearance.
False
T/F: A 3.5 MHz curved-abdominal transducer may occasionally be successfully used as an alternative to standard linear transducers for soft-tissue imaging.
True
T/F: A hematoma can have a similar appearance to an abscess on ultrasound.
True
T/F: A peritonsillar abscess can be visualized using an endocavitary probe and has a similar appearance on ultrasound to other soft-tissue abscesses.
True
T/F: A peritonsillar abscess is typically best visualized with an endocavitary probe.
True
T/F: A soft-tissue ultrasound scan has better sensitivity and specificity for abscess identification than a physical exam.
True
T/F: A standoff pad serves to adjust the natural focal point of the transducer, which can be too deep relative to superficial areas an ultrasound operator is trying to insonate.
True
T/F: Anisotropy refers to tissues exhibiting ultrasound properties that differ according to the direction of ultrasound imaging. For example, muscles and tendons, depending on which angle you insonate them, would display variable echogenicity.
True
T/F: Lidocaine can aid in foreign body identification and removal by accentuating the hyperechoic appearance of the foreign body.
True
T/F: Soft tissue exhibiting a prominent cobblestoned appearance on ultrasound is consistent with cellulitis.
True
T/F: Tendon can be identified by its characteristic hyperechoic parallel fibrillar pattern when viewed in a longitudinal plane.
True
T/F: Tendons are hyperechoic when compared to muscles.
True
T/F: The identification of a tendon can be facilitated by putting the area of interest through a small degree of range of motion. This allows one to visualize the tendon slide through its natural trajectory.
True
T/F: The layers of soft and hard tissue visible while performing a simple extremity (e.g., forearm) ultrasound scan include: dermis, subcutaneous tissue (hypodermis), subcutaneous fascia, muscle, tendon, vasculature, and bone.
True
T/F: Water baths are especially helpful in assessing extremities and sensitive body parts since no direct contact must be made between the ultrasound probe and the patient's skin.
True
