POCUS Fundamentals Test

Freq Range-Infrasound

0-25 Hz

At what frequency is considered ultrasound?

1-20 MHz

Freq Range - Ultrasound

20-100 kHz

Freq Range-Audible

20Hz to 20 kHz

The ideal time frame to perform a FAST exam is

5 min or less

2.) This is a way to describe how equally distributed the echoes are, and/or how uniform appearance then organ is as a whole or in part. a.) Homogeneous b.) Hyperechoic c.) Hypoechoic d.) Heterogeneous

A. Homogeneous

The loss of sound energy due to converting into thermal energy is known as

Absorption

The accumulation of serous fluid in the peritoneal cavity is called

Acites

_________describes a structure that is completely black, lacking any echos at all

Anechoic

The ______ pulses with the beat of the heart, whereas the _ is responsive to breathing movements

Aorta IVC

Before disinfecting the ultrasound probe the operator should: a. use only a germicidal agent approved by the manufacturer of the probe b. remove any visible gel and?or debris from the probe c. wipe or spray the probe with a germicidal agent d. allow to completely air dry before next use.

B. REMOVE ANY VISIBLE GEL AND/OR DEBRIS FROM THE PROBE

Color Doppler

Color doppler is a motion doppler that detects movement either towards or away from the transducer. It is used to determine presence or absence of blood flow and is also beneficial in differentiating an anechoic structure from a vessel. Color doppler is adjusted by the sonographer. Doppler shift is defined as the change in frequency of sound wave due to a reflector moving towards or away from the transducer. When the transducer emits soundwaves at a certain frequency and they are reflected back at the same frequency, this tells us the reflector is not in motion. However, if the reflecting source is in motion either toward or away from the emitting source the frequency of the sound waves received will be higher (positive Doppler shift) or lower (negative Doppler shift) than the frequency at which they were emitted, this is called the doppler shift and is how the ultrasound unit determines direction of flow. Color doppler has many helpful uses in the field. It can help you confirm the presence or absence of blood flow, differentiate vessels from non-vascular structures and determine the presence and direction of flow. Top color = towards the transducer. Bottom color = away from the transducer The same principles of overall gain are used with color Doppler gain. The brightness of the red or blut color can be increased by increasing the doppler gain.

Most commonly used probe for the abdomen

Curved Array Curved Array - used on abdominal, thoracic and pelvic patients due to frequency of probe. The frequency is typically 2-5 MHz, best for deep imaging.

A common transducer used to scan the abdomen would be a(n)

Curved array

Ultrasound images can be nearly impossible or impossible to obtain due to which of the following factors? a. inability to move patient b. body habitus c. bowel gas d. all of the above

D. ALL OF THE ABOVE

The following motion(s) can be helpful when obtaining ultrasound images a. Fanning b. Angling C. Rotating d. All of the above

D. All of the above

1.) The abdomen contains all of the following organs except: a.) Liver b.) Kidneys c.) Gallbladder D.) Uterus

D. Uterus

The image ________ is typically displayed in centimeters on the side of the image

Depth

2. Which hyperechoic muscular structure separates the thoracic cavity from the abdominal cavity? a. Mediastinum b. Pleural cavity c. Diaphragm d. Pericardial cavity

Diaphragm

When imaging through a weak structure, the image beyond the structure will be very bright due to the increased attenuation of the structure. This artifact is called

Enhancement

The Focused Assessment by Sonography in Trauma exam is also know as

FAST exam

An exam used to determine the patient's fluid volume status

FSA- fluid status assessment

What is being measured in the following image

Fetal HT

Freeze

Freeze The freeze button allows the operator to pause the image, typically before measuring an object or printing an image

HIMAP stands for

Heart IVC Morrison's Pouch Aorta Pulmonary view

The renal arter, vein and ureter all enter the kidney at the renal _____-

Hilum

The renal pelvis is _______ to the cortex in a normal kidney

Hyperechoic

________ describes an organ or object that reflects echoes with a bright intensity

Hyperechoic

A collapsed IVC and normal/dry ling sounds are signs that your patient can benefit from fluids

IVC

What region of the abdomen is the spleen located int?

LUQ

Thsi mode of imaging is best to evaluate the fetal heart rate

M mode

_____ can be useful in detectin lung sliding because it picks up motion on ultrasound

M-mode

M-mode (motion mode)

M-mode scanning is used predominantly for documenting the fetal heart: in a first trimester ultrasound, proving fetal viability, but can also be helpful in lung examination. The fetal heart rate is measured by placing a caliper at the peak of each wave (sometimes 2 waves).

The interface between the sag right kidney and the sag liver is called

Morison's pouch

The potential space between the liver and kidney where fluid can collect is known as:

Morrison's pouch

The M in M-mode scanning stands for

Motion

When scanning a patient lying supine in the area of the pelvis in a transverse scan plane, the leading edge of the probe is pointed towards the _______

Operator; patient's right side

1. The uterus lies in the:

Pelvic cavity

When fluid is seen around the heart within the pericardial sac, this abnormality is called

Pericardial effusion

The beam is ideally reflected when the transducer is ______ to the structure being imaged

Perpendicular

The space posterior to the uterus is called:

Pouch of Douglas

An enlarged right ventricle with an enlarged IVC is suggestive of ______

Pulmonary embolism

Ultrasound exam of the heart, the IVC, Morison's Pouch, Aorta and Pulmonary view is the protocol for which emergent exam?

RUSH

_______ allows the operator to amplify or boost ALL ECHO SIGNALS and make the entire image brighter

Receiver gain

Gain

Receiver gain (overall gain) allows the operator to increase (make brighter) or decrease (make darker) the echoes that are received back from the body. The operator can either darken or brighten the echogenicity of the entire image. If the gain is set too high, artifactual echoes or 'noise will be displayed throughout the image. Adjusted by: Gain button- rolling knob/toggle or single button on compact machines

The artifact is caused by the sound beam hitting a strong reflector and bouncing back and forth between the strong reflector and the transducer

Reverberation

The leading edge of the probe is typically pointed towards the patient's _______ side or toward the patient's_____

Right Head

Which vessel is circled in the image?

SMA

This artifact is caused by the sound beam being blocked by a rib.

Shadowing

3.) The diaphragm is seen ______ to the liver and spleen a. Inferior b. Superior C. Lateral d. Medial

Superior

The most frequently used position to scan the abdomen is _________

Supine

A device that converts one form of energy into another to create an ultrasound image.

Transducer/probe

Doppler shift is defined as the change in frequency of sound wave due to a reflector moving towards or away from the transducer.

True

In the case of an obstructing renal stone, urine can back up into the kidney and cause hydronephrosis

True

No confirmation of harmful bioeffects from exposure to diagnostic ultrasound have ever been reported

True

The greatest risk with ultrasound is using a probe with cracked housing

True

Ultrasound images containing patient information should remain confidential at all times and only be presented to other healthcare professionals on a 'need to know' basis.

True

How the image is created

Ultrasound images are created by electrical energy being converted into sound waves via the transducer. The transducer sends sound waves into the body, the sound waves bounce off or penetrate through various structures/organs within the body and return to the transducer to be converted back into electrical energy and to create an image on the screen. The machine knows where to place the reflected sound waves due to the time it took for the sound wave to return to the transducer. This determines the depth, the type of reflector, solid or fluid filled, determines the color of the reflector (echogenicity).

The RUSH exam is indicted when the patient is experiencing

Undifferentiated non-traumatic hypotension

Time Gain Compensation (TGC)

Uniform brightness- TGC allows the operator to increase or decrease the brightness of the echoes that are received back from the body at different depths. The operator can either darken or brighten the echogenicity of the image at specific locations. The operator must adjust the gain to compensate for the time the sound wave takes to travel back to the machine. The depth of the structure being imaged is determined by the amount of time it takes for the transmitted sound wave to return to the transducer. The sound wave weakens with the increased depth of the image. *Reminder, this is due to attenuation. The weakening of the original ultrasound signal as it leaves the transducer and courses through the body.

Various features of B mode and M mode

Various features of B mode and M mode B mode or brightness modulation, is the result of an ultrasound wave being sent into the body, bouncing off a reflector and returning back to the ultrasound system. The image is displayed in brightness, based on the amplitude of the reflected echo. M mode or motion mode, is the result of a series of B mode scans rapidly repeated to represent motion of the image over time.

__________are compressible, __________ are not compressible

Veins Arteries

Color Doppler is used for all of the following except:

a. Confirm the presence or absence of blood flow b. Differentiate vessels from non-vascular structures C. Determine the presence and direction of flow -d. IMAGE BONES MORE ACCURATELY

All of the following are ultrasound artifact assumptions except

a. Sound travels in a straight line b. Sound travels directly to a reflector and back C. Sound travels in soft tissue at exactly 1,540m/s d. THE IMAGE PLANE IS VERY THICK

Which view of the hear can be imaged by placing the probe just below the left nipple?

apical 4 chamber

The vascular system is composed of all the following except a. heart b. ligaments c. veins d. arteries

b. ligaments

All of the following are considered image annotation EXCEPT: a probe position b. patient gender c. area/object imaged d. position on area/object

b. patient gender

All of the following signs are associated with an abnormal lung except a. absent lung sliding b. Barcode sign c. comet tail artifacts d. greater than 3 B-lines per frame

c. Comet tail artifacts

The female pelvis contains all of the following except a bladder b. uterus c. prostate d. ovaries

c. prostate

The FAST exam includes evaluating which of hte following organs? a. liver b. splenorenal recess c. paracolic gutters d. all of the above

d. all of the above

On a lung ultrasound the two layers of peura we observe are called a. visceral b. parietal c. peritoneal d. both a & b

d. both a & b

Which organs are included in the thorax? a. liver b. heart c. lungs d. both b and c

d. both b and c

All of the following are indicateive of an intrauterine pregnancy EXCEPT a. gestation sac seen within the uterus b. yolk sac seen within the gestational sac c. fetal heart rate captured within the gestational sac d. free fluid with debris seen lateral to the uterus

d. free fluid with debris seen lateral to the uterus

A non-copressible common femoral vein is indicateive of

deep vein thrombosis

The cortex of the normal kidney is ____ to the liver

hypoechoic

LMP stand for

last menstrual period

The right and left paracolic gutters are located____ to the ascending and descending colon

lateral

The space behind the uterus where a small amount of fluid can collect in ovulating females and still be considered normal is called

pouch of Douglas

Oxygen poor blood enters the ____ atrium through the ____

right vena cava

Renal stones will appear as bright structures in the kidneys that can cause _____

shadowing

The space above the bladder can be described as

supravesical space

Typically, the wall of the left ventricle is_____ than right

thicker

Small amounts of fluid seen posterior to the uterus during ovulation is normal

true

The RUSH exam is used to help the first responder identify the reason for shock when there is not an obvious cause after examination of the patient

true

The femoral vein is a branch of the exernal iliac vein

true

The fetal heartrate cannot be visualized before the 5th week when scanning transabdominally

true

subchorionic hemorrhage is a frequent cause of vaginal bleeding in the first trimester

true