Chapter 25 point of care sonography

laparotomy

a procedure in which an incision is made in the abdomen to insert a camera to visualize the abdomen and pelvic structures and spaces

hemothorax

accumulation of blood in the pleural cavity

Although absent sliding suggests pneomothorax, it can occur in the presence of what condition?

acute respiratory distress syndrome

Which of these is a major pitfall in scanning the thoracic cavity?

air in the lung reflects the sound

Which of the following is NOT evaluated in cases of the emergency cardiac examination?

diagnosis of mitral valve prolapse

Where would free fluid flow and be most visible in the trendelenburg position?

hepatorenal and perisplenic spaces

The space located between the liver capsule and the right kidney is called the _______ ______ or ________ _______.

hepatorenal space, morrison's pouch

What is the echo characteristic pattern of the diaphragm?

hyperechoic

The phenomenon of demonstrating absent lung sliding and normal lung sliding occurring between the pneumothorax and the normal lung is known as the _____ ______. The lung may sometimes be identified as a _________ structure superior to the _________.

lung point, triangular diaphragm

cardiac tamponade

mechanical compression of the heart resulting from large amounts of fluid collecting in the pericardial space, limiting the heart's normal range of motion

If a pericardial effusion is present, then what must be demonstrated to make the diagnosis of percardial tampanade?

right ventricular collapse

On M-mode, the normal sliding lung will demonstrate a _________sign. In the case of pneumothorax, the M-mode will reveal a series of ______ ______ lines called the ________or _________ sign.

seashore, parallel horizontal, barcode, stratosphere

which of the following is the most sensitive at detecting pneumothorax?

sonography

In the subxiphoid window, blood will most often be noted ________________ or posteriorly as it outlines the free wall of the left atria and ventricle.

superior to the right ventricle

The examination is performed with the patient in a _______ position, but placing the patient in the ________ position shifts areas of dependency and increases the sensitivity of the fast exam in detection of free fluid in the hepatorenal space and the perisplenic space.

supine, trendelenburg

Which of the follwing is NOT one of the most common acoustic windows used in emergency echocardiography?

suprasternal

diagnostic peritoneal lavage

surgical procedure used to insert a catheter through the abdominal wall and fascia; used to evaluate for bleeding in the abdomen

deep vein thrombosis

the formation or presence of a thrombus within a vein

hemoperitoneum

the presence of extravasated blood in the peritoneal cavity

A patient presents to the emergency room with a history of trauma to the chest. When evaluating the thorax, you visualize the "gliding sign" as the patient breathes in and out. This sign is appreciated bilaterally. What does this represent?

This sign is normal; no pneumothorax is seen

When ____ or _____ abdominal trauma occures, the FAST examination may be used to locate ____ ______.

blunt, penetrating, free fluid

A 32 year old patient presents to the emergency room following a serious motor vechicle accident. What condition is demonstrated if fluid is noted around the heart and the intraventricular septum apears to bow into the left ventricle?

cardiac tamponade

with cardiac tamponade the outer wall of the ventricles depress _________. The intraventricular septum bows into the ______ ventricle, which is known as ______ ______ _____.

centrally, left, paradoxical septal movement

A modified examination of the deep venous system of the lower extremities focuses on a three-point evaluation of the ______ ______ vein at the _______ junction, the proximal ______ and ______ ______ vein, and the __________ vein.

common femoral, saphenous, deep, superficial femoral, popliteal

what is the main purpose of the FAST exam?

evaluate for free fluid or blood in the abdomen following trauma

The primary purpose of the fast exam is a methodical search for free _____ or ________ in the dependent portions of the _________, _________ spaces, ______spaces, and the ___________.

fluid, blood, pericardium, pleural, intraperitoneal, retroperitoneum

with the transducer oriented transversely in the subxiphoid region, the _________ __________ image can be seen. The _____ of the heart including both atria should be located on the patient's right side. The ______ of the heart is located more to the patient's left side.

four chamber, base, apex

The normal, back and forth movement of the pleural layers causes a _______ sign or a ________ sign. Absence of sliding indicates there is a ________. The more _______ location is the common site for pneumothorax.

gliding, sliding, pneumothorax, superior

Two layers of pericardium surround the heart, the ______ pericardium and the ______ pericardium. Up to _____mL of normal serous fliud can collect within the pericardial sac.

parietal, visceral, 10

When the patient is supine, the ______ is the most dependent portion of the peritoneal cavity.

pelvis

Many life-threatening injuries cause bleeding in the ______,__________, _________ and _________ regions.

percardium, thorax, abdomen, pelvic

What is fluid surrounding the heart and located within the pericardial sac called?

pericardial effusion

parietal pleura

pleura that lines the inner chest walls and covers the diaphragm

A patient with a pneumothorax will present with absent lung sliding on real time sonography. Which of the following conditions CANNOT cause this finding?

pleural embolism

The primary purpose of the eFAST is to extend the search to determine what sequelae of trauma?

pneumothorax

what is indicated when an M-mode documents a barcode sign or a stratosphere sign?

pneuomothorax

In the symptomatic , emergent patient, which vein is included in the three point evaluation?

popliteal vein

pleural effusion

presence of fluid in the pleural cavity

pericardial effusion

presence of fluid within the pericardium

Which of the following statements regarding percardial effusion is FALSE?

rapid hemorrhage can cause hypertension

In normal patients, a sliding motion can be seen and is caused by the movement of the ________ pleura during respiration along the static ______ pleura. This is seen as an ________ line that moves with respiration.

visceral, parietal, echogenic