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