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ANE 8509 Principles of Anesthesia I Updated '24 > Final- Ultrasound (7/24/23) > Flashcards

Final- Ultrasound (7/24/23) Flashcards

1
Q

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

A
  • 1950’s
  • Popular first in obstetrics
  • It was popular because there was no ionizing radiation.
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2
Q

Advantages of ultrasound.

A
  • Identify anatomical structures
  • Relationship of the needle to tissues
  • Increases accuracy
  • “See” spread of LA
  • May decrease time performing pain blocks/assessments
  • May decrease complications
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3
Q

Ultrasound waves travel between these Mhz.

A
  • 2-20 Mhz
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4
Q

What is the range of audible sounds?

A
  • 20-20,000 Hz
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5
Q

What can ultrasound waves do when they encounter a surface?

A
  • Transmit through the surface
  • Reflect on the surface
  • Something in between
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6
Q

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

A
  • No signal
  • Anechoic
  • Dark
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7
Q

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

A
  • Lots of signals
  • Hyperechoic
  • Bright
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8
Q

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

A
  • Iso/hypoechoic
  • Shades of gray
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9
Q

Which picture represents a solid?
Which picture represents fluid?

A
  • Picture A: Solid
  • Picture B: Fluid
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10
Q

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

A
  • Piezo Electric Crystals
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11
Q

What are the three types of transducers used in POCUS?

A
  • Linear Array
  • Curve Array
  • Phased Array
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12
Q

Describe a Linear Array

A
  • High frequency (7-15 MHz)
  • Better resolution at a superficial depth
  • Great to use to start a central line with to look for an IJ
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13
Q

Describe a Curve Array

A
  • Low frequency (2-5 MHz)
  • Poorer resolution
  • Great for deeper tissue
  • Used to look at gallbladder or stomach to assess NPO
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14
Q

Describe a Phased Array

A
  • Lowest frequency (1-3 MHz)
  • Useful for echocardiography
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15
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.

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16
Q

Tips and Tricks for using Ultrasound.

A
  • Proper Ergonomics
  • Use Conductive gel
  • Hold the Transducer probe like a pencil
  • Focus using gain and depth buttons
17
Q

What is gain?

A
  • Gain is the brightness signal quality usually adjusted with a knob.
  • Twist the knob back and forth until fluid is black and soft tissue is mid-grey
18
Q

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

A
  • needle
19
Q

What is the advantage of in-plane ultrasound?

Disadvantage?

A
  • Advantage: See the whole needle
  • Disadvantage: Easy to be off plane
20
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
21
Q

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

A
  • Vanishing Sign

IJ example: Scan high to low. The lower you go–> visualize more

The higher you go–>less you see–>Vanishes

22
Q

Common anesthesia use for ultrasound.

A
  • Guided IV Access
  • Focused Assessment with Sonography for Trauma
  • Ultrasound-guided Nerve Blocks
  • Gastric Ultrasound
23
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
24
Q

What are the contraindications for using USG IV Access?

A
  • Does not substitute for IO access in life-threatening situations
25
Q

Indications to use a FAST.

A
  • To rule out free fluid in the abdomen and pericardium
26
Q

What probe is used for a FAST?

A
  • Curvilinear probe
27
Q

What are the assessment points for FAST?

A
  • (1) RUQ- Morison’s pouch (Liver, Right Kidney)
  • (2) LUQ- Peri-splenic view (Spleen, Left Kidney)
  • (3) Pelvic view- Suprapubic (Bladder rupture)
  • (4) Cardiac view (Pericardial sac)
28
Q

When performing a USG peripheral nerve block, what can be done to the transducer to maintain parallel alignment with the US monitor?

A
  • Heeling
29
Q

What are the indications for the gastric US?

A
  • Lack of adherence to fasting instructions
  • Unclear fasting history
  • Potential delay in gastric emptying
30
Q

Grade the Antrum

A
  • Grade 0 Antrum: Empty Stomach
  • Bull’s Eye
31
Q

Grade the Antrum

A
  • Grade 1 Antrum: < 1.5 ml/kg
  • Aspiration Unlikely
32
Q

Grade the Antrum

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

ANE 8509 Principles of Anesthesia I Updated '24 (28 decks)

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