Imaging: Ultrasound I Flashcards
When an ultrasound machine is in cardiac mode, where is the probe marker on the screen?
To the left (matches where your heart is in your body)
- What is the best view to estimate ejection fraction?
- What valves is this fraction based on, and what is the normal range of ejection fraction for a healthy adult?
- How do you know a mitral valve is working properly to ensure correct ejection fraction?
- Parasternal long axis
- Mitral Valve
- 60 to 65%
- The valve slaps up to hit the septum without getting “stuck” anywhere.
- You estimate the ejection fraction by seeing the “relative loss of function” of the mitral valve.
What are the 5 steps of the Seldinger technique for central lines?
- What is the best view for seeing a pericardial effusion?
- SUBXIPHOID but you can use any view
What percentage of patients die if you don’t see cardiac activity?
99.999999999999%
What kind of probe do you use for cardiac POCUS and why?
- Phased Array
- Has a smaller footprint
- Sees motion well
- Low frequency, so has good depth
The right panel shows a normal heart. What is the red arrow pointing at in the left panel.
Effusion
- Where are the following structures in this figure?
- Right Ventricle
- Left Ventricle
- Mitral Valve
Mitral valve is the white ring within the left ventricle
You are doing a Parasternal long axis view
- Where is the probe in relation to the intercostal spaces?
- Where is the probe marker pointing?
- What is this view BEST used for?
Where are the following structures in the image provided?
- Left Atrium
- Left Ventricle
- Aortic Outflow
- Right Ventricle
- Descending Aorta
In ultrasound-guided central lines, what are the two planes of view you can use?
- In-plane (long axis)
- little more complicated
- Out of plane (short axis)
In this parasternal short axis view, point out the pericardial effusion as well as the left ventricle.
What is the difference in viewing the needle in In-plane (long axis) vs. out of plane (short axis) views?
In-plane (long axis)
- You can see MORE needle due to angle
Out of plane (short axis)
- You just see the part of the needle where the probe happens to be
How does ultrasound reduce complications of central lines?
Decreases complications
- Pneumothorax
- Arterial puncture
- 18% down to 6%
In a parasternal long axis view, what structure is the most important structure for determining if a patient has a pericardial effusion or a pleural effusion?
yellow is pericardial effusion
How do you get into the parasternal short axis view?
After doing the long axis view, rotate the probe 90 degrees clockwise so that the probe marker is pointing to the LEFT shoulder.
This is an image of a central line being performed. What is the mouse pointer hovering over?
Carotid Artery
Label A and B as either parasternal long axis or parasternal short axis
A. Parasternal long axis
B. Parasternal short axis
In ultrasound-guided central lines, what is held in your dominant hand?
Dominant hand: Needle
Other hand: Probe
What are the 3 main things to look for in cardiac POCUS?
- Pericardial Effusion
- Ejection Fraction esitmation
- Cardiac Activity
What view is this?
Parasternal Short Axis
What view is this?
PARASTERNAL LONG AXIS VIEW
Where are the following structures in the image provided?
- Left Atrium
- Left Ventricle
- Aortic Outflow
- Right Ventricle
- Descending Aorta
- What are the three common sites for a central line?
- What are the most common complications from a central line, aside from infection?
- Sites
- Internal jugular vein
- Subclavian Vein
- Not as common anymore
- Femoral Vein
- Arterial puncture and pneumothorax
Label each pic as In-plane (long axis) or out of plane (short axis)
- Top: In-plane (long axis)
- Bottom: out of plane (short axis)
