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