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Principles I* > E4- Ultrasound > Flashcards

E4- Ultrasound Flashcards

1
Q

When was ultrasound first used in medicine?
What was it popular in?
Why was it popular?

A
  • 1950’s
  • obstetrics
  • no ionizing radiation.
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2
Q
  • US is described as seeing using _____________.
  • Examples in nature?
  • Military?
A
  • sound waves
  • bats + dolphins
  • submarines
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3
Q

Advantages of ultrasound.

A
  • Identify anatomical structures
    1. * Relationship of the needle to tissues
    1. * Increases accuracy
    1. * “See” spread of LA
    1. * May decrease time performing pain blocks/assessments
    1. * May decrease complications
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4
Q

Ultrasound waves travel between these Mhz.

A
  • 2-20 Mhz

Travels differently w/ different structures

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5
Q

What is the range of audible sounds?

A
  • 20-20,000 Hz
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6
Q
  • What 3 can ultrasound waves do when they encounter a surface?
    sound waves are ______ back to crystals + create impulse on computer
A
  • Transmit through the surface
  • Reflect on the surface
  • Something in between

Reflected

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7
Q

What is the result when ultrasound waves are transmitted through fluid?

A
  • No signal
  • Anechoic
  • Dark
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8
Q

What is the result when ultrasound waves are reflected on bones/stones?

A
  • Lots of signals
  • Hyperechoic
  • Bright
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9
Q

What results when ultrasound waves encounter soft tissue, muscles, and fat?

A
  • Iso/hypoechoic
  • Shades of grade
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10
Q

Which picture represents a solid?
Which picture represents fluid?

A
  • Picture A: Solid
  • Picture B: Fluid
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11
Q

What is inside the transducer’s head that changes shape with an electric impulse?

A
  • Piezo Electric Crystals

Starts to vibrate … generate sound wave

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12
Q

What are the three types of transducers used in POCUS?

A
  • Linear Array
  • Curve Array
  • Phased Array
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13
Q

Describe a Linear Array

A
  • High frequency (7-15 MHz)
  • Better resolution
  • superficial depth
  • IV, CVL, art line
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14
Q

Describe a Curve Array

A
  • Low frequency (2-5 MHz)
  • Poorer resolution
  • Great for deeper tissue
  • kidney, liver, spleen, bladder, GI
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15
Q

Describe a Phased Array

A
  • Lowest frequency (1-3 MHz)
  • Useful for echocardiography
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16
Q
  • axial plane?
  • coronal plane?
  • sagittal plane?
A
  • top : bottom
  • front : back
  • Left : right
17
Q

Static vs Dynamic Approach for Ultrasound

A

Static: Identifying the target vessel, assessing the patency, marking an appropriate insertion site, and cannulating blindly.

Dynamic: Performing the procedure in real-time and viewing the needle puncturing the vessel wall.

18
Q

Tips and Tricks for using Ultrasound.

A
  • Proper Ergonomics
  • Use Conductive gel
  • Hold probe like pencil
  • Focus using gain + depth
19
Q

What is gain?

A
  • brightness signal quality
  • adjusted with a knob.
  • Twist the knob back + forth until… fluid = black + soft tissue = mid-grey
20
Q

What is depth?

A
  • 2 up/down buttons
  • shown in cm on screen
  • start at highest depther + get object in middle of screen
21
Q

In-plane vs. Out-of-plane refers to the relationship of ______ to the ultrasound plane.

long/short axis refers to ___________ and should always be ______________ axis for procedures

A
  • needle
  • vessel ,, long
22
Q

What is the advantage of in-plane ultrasound?

Disadvantage?

A
  • Advantage: See the whole needle
  • Disadvantage: Easy to be off plane
23
Q

What is the advantage of out-of-plane ultrasound?

Disadvantage?

A
  • Advantage: The needle is positioned directly under the plane of an ultrasound
  • Disadvantage: Unclear where tip of the needle is
24
Q

What do you look for to determine that your guidewire is in the vessel’s lumen?

A
  • Vanishing Sign
25
Q

Common anesthesia use for ultrasound.

A
  • Guided IV Access
  • Focused Assessment with Sonography for Trauma (FAST)
  • Ultrasound-guided Nerve Blocks
  • Gastric Ultrasound
26
Q

What are the indications for using USG IV Access?

A
  • History of difficult cannulation
  • Multiple failed attempts
  • Best to use a linear probe
  • if the patient is obese = use the curve probe
27
Q

What are the contraindications for using USG IV Access?

A
  • Does not substitute for IO access in life-threatening situations
28
Q
  • what does FAST stand for?
  • Indications to use a FAST.
  • contraindications?
A
  • focused assessment w/ sonography for trauma
  • To rule out free fluid in the abdomen + pericardium
  • none
29
Q

What probe is used for a FAST?

A
  • Curvilinear probe
30
Q

What are the assessment order for FAST?

A
  • (1) RUQ = Morison’s pouch
  • (2) LUQ = Peri-splenic view
  • (3) Pelvic view = Suprapubic
  • (4) Cardiac view
31
Q

PNB

  • What should be done to plan for PNB route?
  • When performing a USG peripheral nerve block, what can be done to maintain parallel alignment with the US monitor?
  • await for _______________ .
  • verify nerve doesn’t __________ with needle
A
  • pre-block scan
  • Heeling
  • fascial “pop”
  • move
32
Q

What are the indications for the gastric US?

A
  • Lack of adherence to fasting instructions
  • Unclear fasting history
  • Potential delay in gastric emptying
33
Q

Grade the Antrum

A
  • Grade 0 Antrum: Empty Stomach
  • Bull’s Eye

NPO

34
Q

Grade the Antrum

A
  • Grade 1 Antrum: < 1.5 ml/kg
  • Aspiration Unlikely

Clear liquids

35
Q

Grade the Antrum

A
  • Grade 2 Antrum: > 1.5 ml/kg
  • Solid Food
  • High Risk of Aspiration

solid food

36
Q

What does NPO look like on US?

A

o Antrum = empty
o Small
o “bullseye sign”

37
Q

What does clear liquids look like on US?

A

o Rounder, more distended
 Thin walls
o “Starry night” – esp w/ air bubbles
o Peristalsis starts

38
Q

What does milk/thick fluids look like on US?

A

o Thinner walls
o Increased echogenicity

39
Q

What does solid food look like on US?

A

o Hyperechoic - bright

Principles I* (20 decks)

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