Module 9: Emergent Ultrasound Procedures
what are clinical findings of cholecystitis
-RUQ pain -fever -nausea and vomiting -leukocytosis
what are clinical findings of paraumbilical hernia
-asymptomatic -mild discomfort -palpable mass -valsalva showing exaggeration of mas
what is the sono appearance of appendicitis
-distended noncompressible appendix color flow McBurney's sign
what is the sono appearance of urolithiasis
-echogenic foci with shadowing -hydronephrosis may be present look for uterteral jets
what are causes of aortic dissection
-hypertension -marfan syndrome -pregnancy -acquired or congenital aortic stenosis -coarctation of aorta -trauma -iatrogenic
what is examined during a fast exam
4 quads, limited abdomen, pelvis, and pericardium to look for fluid collections suggesting fresh hemorrhage
what is McBurney's sign
Pain upon palpation of the RLQ
negative ultrasound does not include____________
intraperitoneal injury
how is the epigastrium imaged
trv subcostal, angle transducer inferiorly
how is the pericardium imaged
trv subcostal, angle transducer superiorly
appearance of hepatic and splenic injury varies depending on ____________
type and time of injury
ct is not suitable for patients who are __________ clinically
unstable
parenchymal injuries are suggested when
visceral organ is heterogenous
What is POCUS
Point-of-care US
what is the technique for a fast exam
abd transducer supine
how long does FAST take
about 5 mins
hematomas vary with _______
age
what is the appearance of a pancreatic injury
heterogenous enlargement of tail
how do injuries appear
heterogenous or hyperechoic
how do hematomas and localized lacerations initially appear
hypoechoic with low level echoes from red blood cells
what is hyperemia
increased vascularity
what are clinical findings of appendicitis
-intense RLQ pain -nausea/vomiting -fever -leukocytosis
what is the sono appearance of paraumbilical hernia
-lower abd mass -look for peristalsis of bowel hernia
what are clinical findings of pancreatitis
-mid epigastric pain radiating to back -fever -leukocytosis -amylase -lipase
what is the sono appearance of pancreatitis
-normal to edematous gland -hypoechoic texture -irregular borders -increased vascular flow
FAST protocol
-subxiphoid to look for pericardial fluid -RUQ to look for liver texture abn -Epigastrium -LUQ -RLQ -LLQ
what are the clinical findings or aortic dissection
-sudden onset of severe chest pain -radiating pain to arms, neck, or back -syncope may be present
What is eFAST
Extended Focused Abdominal Sonography in Trauma
how do hematomas and localized lacerations appear with onset of hemolysis
anechoic over time
what is the sono appearance of aortic disessection
aneurysm look for flap at site of dissection look for false lumen
what is the finger sign
appendicitis
what is the most common cause of appendicitis
appendicolith- fecal matter
what is hemoperitoneum
blood in peritoneal cavity
how do hematomas and localized lacerations appear as blood coagulates
echogenic
What is the main concern for abdominal trauma
is there blood in the abdomen
what sign is specific to cholecystitis
murphy's sign
FAST is preformed simultaneously with physical assessment, _____________ , and stabilization of trauma patient
resuscitation
what spaces are assessed during fast FAST
pericardial sac, peritoneal, retroperitoneal, internal architecture of visceral organs
free fluid can be
simple or complex
what modality is best at detecting liver lacerations or contusions
sonography
what are clinical findings of urolithiasis
spasmodic flank pain pain may radiate to pelvis leukocytosis hematuria fever
what is the criteria to get a CT
stable patient abd pain decreasing hematocrit
what is peritoneal lavage
test in which catheter inserted into intraperitoneal space to sample for evidence of internal bleeding
what is the sono appearance of cholecystitis
thickened GB wall + murphy sign pericholecystic fluid dilated gallbladder