Ch: 2, 6, 10, 11, 14, & App. 3 Flashcards
Severe and sudden onset
Acute
Gradual onset or ongoing condition
Chronic
Commission on accreditation of allied health education programs; the national accreditation granting body for sonography education
CAAHEP
A fluid-filled structure; presents no echoes; black on ultrasound
Anechoic
Produces many echoes; very bright on ultrasound image
Echogenic/ hyperechoic
Structure with both fluid and solid components; therefore, it presents a mixed echogenicity
Complex structure
The principal that health care workers have a duty to take reasonable steps to keep personal medical information confidential consistent with the person’s medical preferences
HIPAA
Health Insurance Portability and Accountability Act
Differing in composition; “patchy” with inconsistent echogenicity
Heterogeneous
Ex) liver with multiple masses
Uniform in composition; “smooth” with consistent echogenicity
Homogeneous
Ex) healthy liver, healthy/ normal spleen
Same echogenicity (used as a comparative term)
Isoechoic
The amount of sound beam passing through a structure - seen posterior to fluid-filled structures
Through transmission
Ex) cysts, bladder, blood vessels
The process of gaining permission before a medical procedure is conducted
Informed consent
The narrowing of an artery
Arterial stenosis
Stocked with necessities needed to resuscitate a patient experiencing cardiac arrest
Crash cart
Written order by physician directing healthcare workers not to perform lifesaving measures
DNR
DO NOT RESUSCITATE
Difficulty swallowing
Dysphasia
Painful or difficulty urinating
Dysuria
Blood clot/ thrombus located within a pulmonary artery - often results in deep vein thrombosis
Pulmonary embolus
Fainting
Syncope
Common cause of fainting brought in by involuntary stimulation of nerve, resulting in decreased blood flow to the brain
Vasovagal reaction
Drop in maternal blood pressure secondary to the fetus compressing the maternal ivc
Supine hypotensive syndrome
How can hypotensive syndrome be relieved?
Place the patient right lateral decubitus or left lateral decubitus to relieve the pressure on the ivc and aorta
What is the patient preparation for a transvaginal sonogram?
No patient preparation needed
What term relates to increased vascularity in an organ or structure?
Hyperemia
What is the surgical connection btw two structures?
Anastomosis
The formation of a blood clot is termed ___.
Thrombosis
What is the name for areas located outside of the uterus posterior to the broad ligaments?
Adnexas
What is the medical term for twisting?
Torsion
Why should you do if you observe a crack in a transducer before a sonographic exam?
Tell someone in charge immediately
What is the term for abnormal lymph nodes?
Lymphadenopathy
What is the first measurement of the embryo called in the first trimester?
Crown-rump length
The splitting of one vessel into two vessels is termed a(n) ____.
Bifurcation
What is a valuable trait to have as a sonography student?
Assertiveness
Believing in yourself and your abilities is
Self confidence
Term defined as to achieve for the sake of achieving
Motivation
Having the ability to recognize the emotions of self and others and the capacity to use those emotions in the decision-making process
Emotional intelligence
What is not a reason why one should identify his or her personality type?
To make appropriate personality changes based on circumstances
Defined as the pleasure one gains from being able to help others
Compassion satisfaction
The form of reasoning by which one makes an educated guess based on facts
Inductive reasoning
An educated guess based on clinical history findings
Clinical hypothesis
The strength of mind that allows someone to face difficult circumstances
Fortitude
Without echoes
Anechoic
Having few echoes
Hypoechoic
Work-related condition in which one experiences physical and emotional exhaustion
Burnout
What is the correct sequence of the sonographic reasoning process?
Clinical history Clinical hypothesis Investigative imaging Sonographic findings Clinical correlation
What is not provided on sonographer report?
At least three differential diagnoses
What is one thing that would be least likely to disrupt your work relationship with a sonographer?
Being chronically early
What is the least helpful technique for acquiring extra scan time?
Being erratic with protocol images needed for examination
Means same echogenicity
Isoechoic
A set of values based on hard work and diligence
Work ethic
What is not considered one of the first-rate standards in sonography?
Playing by your own rules
Process we use to make choices based on our moral principles and personal values
Ethical decision making
Accepted rules of conduct
Moral principles
Ethical theory may also be referred to as consequentialism?
Teleological theory
Application of our moral principles with others in the medical profession, including our coworkers, patients, and community
Medical ethics
Medical ethics principle that relates to honesty in all aspects of life
Principle of veracity
Group held beliefs that are agreed upon by individuals or groups of individuals
Norms
Medical with is principle that relates to never making promises that you cannot keep
Principle of fidelity
When a patient refuses to have a sonographic procedure, you should
Not perform the procedure
Medical ethics principle that relates to treating all patients equally, no matter what economic, physical, or mental condition
Principle of justice
If a pregnant patient asked you if she should have an abortion, you should
Tell her to seek professional medical guidance concerning abortion
Regarding keepsake sonography, the American institute of ultrasound in medicine states that
The procedure is inappropriate if it is not medically indicated and ordered by a physician
Actions aimed at increasing the welfare of others
Altruism
Not a principle of professionalism according to board of internal medicine
Altruism
Duty
Humanism
Atheism
Atheism
The everyday practice of good manners and being agreeable within the exercise of one’s occupation
Professional etiquette
What is not appropriate professional etiquette?
Referring to patient by their first name
Demanding your very best
Excellence
Who makes final decisions about a patient’s care?
The patient
“Do to others what you would have them do to you”
The golden rule
Which is an appropriate topic to discuss at work?
Politics
Religion
Movies
Career aspirations
Movies
Most common way to obtain a pulse in an adult
Radial artery
Refers to rapid heart rate
Tachycardia
A common nosocomial infection
UTI
A urinary catheter should always be located
Below the patient’s bladder
Term for difficult breathing
Dyspnea
What would not typically result in increased respiration’s?
Hypothermia
The body’s ability to maintain internal equilibrium
Homeostasis
Typical oxygen therapy ranges between
1 and 15 LPM
The normal range for adult respirations is
12-20 breaths a minute
The normal blood pressure for an adult is
120/80 mm Hg
What would typically not lead to decreased respiratory rate?
Fever
What would be least likely to affect blood pressure?
Drowsiness
Which is not a cause of bradycardia?
Exercise
Typical pulse rate for an adult
Btw 60 and 100 bpm
Which is not a means of monitoring pulse?
Sphygmomanometer
Arterial line
Electrocardiogram
Pulse oximeter
Sphygmomanometer
What is the pulse site in the neck?
Carotid pulse
Term for abnormal rhythm of the pulse
Arrhythmia
Normal average body temp
98.6
What is pulse obtained on the medial side of the ankle?
Posterior tibial pulse
What is typically the first step for the sonographer in most emergency situations in the hospital system?
Alert the emergency response team
Also referred to as a mini stroke
Transient ischemic attack
What type of shock results from the loss of blood or other bodily fluids?
Hypovolemic shock
Type of shock that results in peripheral vasodilation due to nervous system dysfunction
Neurogenic shock
Bluish discoloration of the skin
Cyanosis
What type of occurrence can result from a patient’s apprehension about an invasive procedure?
Vasovagal reaction
What stage of shock continuum results in lactic acidosis?
Progressive
What medical emergency consists of the heart abruptly stopping its function and the loss of consciousness?
Cardiac arrest
Not considered a typical symptom of diabetes mellitus
Polymenorrhea
Typical cause of pulmonary embolism?
Deep vein thrombosis
You are performing sonogram on patient with history of epilepsy. Suddenly, the patient becomes rigid, her eyes stretch wide open, and she begins to jerk. What most likely is happening?
Seizure
An increased depth of breath
Hyperpnea
Heart dysfunction as the result of pressure cause by fluid around the heart
Cardiac tamponade
Low pressure caused by rapid change in position is referred to as
Orthostatic hypotension
What type of shock is associated with an invasion of bacteria and the body’s subsequent reaction?
Septic shock
What term is defined as profuse perspiration?
Diaphoresis
What would cause an obstetric patient who is at 32 weeks’ gestation to experience syncope symptoms during an obstetric sonogram?
Supine hypotensive syndrome
Which type of diabetes is diagnosed most often when patients are younger than 30 years old?
Type 1
What should the sonographer do in the case of a patient who has a DNR?
Follow protocol for DNR orders for your institution
What type of shock is associated with an extreme allergic reaction?
Anaphylactic shock
Enlargement of an organ or structure
Hypertrophy
Test used to evaluate for peripheral artery disease that establishes a ratio of the blood pressure in the lower legs to the blood pressure in the arms
Ankle brachial index
What is the patient preparation for a transvaginal exam?
No prep required
In the first trimester of pregnancy, the fetal neck may be examined with sonography and a measurement obtained. What is the measurement called?
Nuchal translucency
What contrast solution is typically used in sonohysterography?
Saline
Increased vascularity in an organ or structure
Hyperemia
Surgical connection between two structures
Anastomosis
The formation of a blood clot
Thrombosis
Another word for perpendicular
Orthogonal
What is the name for areas located outside of the uterus posterior to the broad ligaments?
Adnexas
What evaluates tissue stiffness?
Elastography
___ would most likely employ the valsalva technique.
Lower venous sonography
Which quality assurance phantom would be most likely used to evaluate the transducers effectiveness at identifying liver masses?
Doppler phantom
The FAST exam would most likely be used in what setting?
Emergency room
Medical term for twisting
Torsion
What should you do if you observe a crack in a transducer before a sonographic examination?
Tell someone in charge immediately
Abnormal lymph nod s
Lymphadenopathy
What is the first measurement of the embryo called in the first trimester?
Crown-rump length
The splitting of one vessel into two vessels
Bifurcation
If you roll the ultrasound machine over the transducer wire and notice damage, what should you do?
Report damage immediately and do not use transducer
Based upon findings, different possibilities of what it could be
Differential diagnoses
Reason for exam
Indication
Basic assessment of patient:
Alert
Confused
Drowsy
Unresponsiveness
ACDU scale is
Basic assessment
Types of shock:
Hypovolemic Cardiogenic Neurogenic Septic Anaphylactic
Shock where there is bacteria in the body
Septic
Shock where there is dysfunction of nervous system
Neurogenic shock
Medicine injected into patient and lights up differently on ultrasound (makes things easier to see)
Contrast agent
*must be attentive as the patient may have an allergic reaction
What is syncope?
Fainting/ loss of consciousness
When a patient isn’t getting enough blood supply to the brain due to hunger, trauma, or emotional distress, they may experience ____
Synecope
Symptom of synecope
Palor (paleness) Dizziness Nausea Hypernea (fast breathing) Tachycardia (rapid heart rate)
When a patient is experiencing supine hypotensive syndrome, you should ___
Turn them over on LEFT side
What is SIMS position?
Left side, right knee up
Blood clot that has traveled and now obstructs blood flow to the lungs
Pulmonary embolism (PE)
Deep vein thrombosis may lead to ___
Pulmonary embolism
Cerebrovascular accident is
A stroke (CVA)
Mini stroke that can be an indicator of an imminent, more severe stroke
Transient ischemic attack (TIA)
If a patient may have experienced a stroke, you should think ____ and ask yourself ___
-FAST Face Arm Speech Time
-does face look uneven? One arm hanging down? Slurred speech?
Name 3 symptoms of diabetes
Polyuria- extreme urination
Polydipsia- extreme thirst
Polyphagia- extreme hunger
Diabetes where the pt is insulin dependent and diagnosed before age 30
Type 1 diabetes
Diabetes where symptoms are gradual onset and diagnosed over the age of 40
Type 2 diabetes
Diabetes that forms while woman is pregnant
Gestational diabetes
Type 3
Hypoglycemia is
Low blood sugar
Diabetic ketoacidosis is
body poisoned from acid
If exam requires fasting, pt should be scheduled __
Early to prevent diabetic emergency
Tests machines, transducers, image quality (every year someone does this)
Quality assurance
ALARA stands for
As low as reasonably achievable
-minimal exposure of US to patient especially in 1st trimester OB (less exposure to baby)
3 lobes of liver
Right (largest)
Caudate (smallest)
Left
Painful gallbladder when pressure applied in the area
Positive Murphy Sign
* significant pain, not just a little discomfort
What scan plane should you be in to view a long pancreas?
Transverse
Enlarged lymph nodes
Adenopathy
When scanning the spleen, you should compare its echo texture to the
Left kidney
-and check for fluid collections, masses, and pleural effusion in left diaphragm
When viewing Howe, you should check for
Wall thickening, dilation, hypertrophy (enlargement of organ), and masses
Elastography is used to
Check stiffness and density of mass
Trans abdominal/transvesical
Urinary bladder
Adnex is
Lateral side of uterus (lateral portion of pelvic area)
Vital signs are a
Measure of body function
When checking for vital signs, you should check
Temp Pulse Respiration Blood pressure Pulse oximetry (Amt of oxygen in blood)
Number of heart beats per minute
Pulse
Interval btw beats
Rhythm
Any variation of normal heart rhythm
Arrhythmia
Abnormally rapid pulse rates
Tachycardia
>100 bpm
Bpm stands for
Beats per minute
Abnormally slow pulse rates
Bradycardia
<60 bpm
A normal heart rate can range between
60-100 bpm
-bpm is higher for infants and children
Pulse is usually found at the
Radial artery
Normal adult breathing is __-__ breaths/minute
16-20
Number of respirations per minute
Rate
Regular rate of breathing
Rhythm
Amount of air taken in with each respiration
Depth
How to count respirations?
- don’t tell patient your counting
- take pulse 30 sec and x2
- then for next 30 secs, watch ride and fall of chest and x2
- any irregularities, count for full minute
Dyspnea
Difficult breathing
Apnea
Without breathing
Hyperventilation
Rapid breathing
Respiratory arrest
Not breathing
Pallor
Pale/white
Pressure extorted on arterial walls by heart
Blood pressure
Systole is when
The heart contracts
Diastole is when
Heart relaxes and refills
Sphygmomanometer is
Blood pressure cuff
Optimal adult blood pressure is
120 (systolic) / 80 (diastolic)
Hypertension
High blood pressure
-causes damage to inner lining of arteries
Hypotension
Low blood pressure
- less than 80/50
- low blood volume (hemorrhage can cause bp to drop)
Steps of getting blood pressure
- Place cuff on upper portion of arm
- arm must be at level of heart
- place over brachial artery
- must be firmly placed and tight on arm
After the pressure of released on BP cuff, the first sound you hear is ___ and then you hear ____
Thumping which is systolic and then change in sound is diastolic
% of oxygen measured in arterial blood
Pulse oximetry
Normal range is 95-100%
Hypoxia is
Lack of oxygen
A Foley catheter ____ and you want to make sure the bag stays ___
Drains urine
Low
IV poles keep the patient ___ and keep the bag ___.
Hydrated
High
With an IV, the pt should keep arm ___ and IV should be kept ___
Straight
Above the point of needle insertion
Tube that feeds the patient , drains fluid, and treat obstructions
Nasogastric tube (NG tube)
___ is considered a drug and should be ordered by a physician
Oxygen
Venturi mask
Hard plastic mask that administers oxygen
Tubing inserted into nostril
Nasal catheter
-Oxygen therapy
Most common oxygen therapy that is placed in nose
Nasal cannula
You should look at LPM (liters per minute) before ___ and plug into ___
Unplugging oxygen from wall
Portable at the same #
Look at ___ to see how much pt has been prescribed before unhooking oxygen.
LPM
Opening in colon
Colostomy
Opening in ileum
Ileostomy
If you are scanning near a colostomy or ileostomy, you should ____
Use sterile gel and a transducer cover
Always ask nurse’s approval to remove ____ before you scan.
Wound dressings
JCAHO is
Patient safety/ surgery facilities
*accredits hospitals
As a student, you should never do a ____ alone.
Portable
Ambulatory means
Patient can walk by themself/ able to walk
HIPAA stands for
Health Insurance Portability and Accountability Act
Increased blood flow to an organ or area
Hyperemia
How to you prove a CBD?
Add color to the duct
- Less than 6mm
- add 1mm per decade of life (90 yr old= 9mm CBD)
The stomach is ___ to pancreas
Anterior
Diaphragm is ___ to spleen
Anterior
In SAG, you see ___ to ___ and ___ to ___.
Anterior to posterior
Superior to inferior
In TRANS view you see ___ to ___ and ___ to ___.
Anterior to posterior
Right to left
Thoracic fluid = ___ which needs a ___ procedure
Pleural effusion
Thoracentesis
Abdominal fluid= ___ and needs a ___ procedure.
Ascites
Paracentesis
Area for fluid build up the right kidney and liver
Morrison’s pouch
Narrowing for veins
Stenosis
Bulging of a vessel
Aneurysm
What steps are taken with abnormal images/pathology?
Measured in 2 planes
B mode in 2 planes
Color
BI-RAD is
Breast Imaging Recording and Database System
Scoring system that goes from 0-6
0=best case scenario (def not cancer)
6=worst case scenario (confirmed cancer)
Elastography is typically used with ___ and ___ exams
Liver and breast
No blood flow in testicles due to twisted vessels
Testicular torsion
Normal lymph node should measure
1cm or less
Normal- hypoechoic outer edge and hyperechoic inner
Abnormal- completely hypoechoic
The bladder is ___ to the uterus.
Anterior
Full bladder is necessary for trans abdominal exam bc ____
A full bladder can push bowel out of the way, acts as an acoustic window (giving clearer image) and full bladder pushes uterus down to bring uterus into full view
Muscular layer of uterus
Myometrium
Inner tissue of uterus that sheds each month
Endometrium
Pt prep for transvaginal exam
Bladder needs to be EMPTY
Pt prep for trans abdominal exam
Bladder needs to be FULL
