Module 9: Part 4 Flashcards
The pleural line is comprised of _______, but will appear as _______
the parietal and visceral pleura;
a single, thin hyperechoic line
During normal respiration, (horizontal/vertical) lung sliding occurs as the parietal and visceral pleura slide in opposition
horizontal
The pleural line between the ribs will appear to move or shimmer
Small vertical white lines , also referred to as ______, may extend from the pleura
comet-tail artifacts
These confirm the pleural layers are in contact
Helps exclude a pneumothorax
Easier to identify with high frequency transducers
What does the appearance of A-lines indicate?
The appearance of A-lines indicates the presence of subpleural air, but does not differentiate between alveolar air and pleural air
A-lines in the presence of lung sliding indicate alveolar air and not a pneumothorax
A-lines in the absence of lung sliding may indicate a pneumothorax, but requires additional findings
Sound waves will reflect between the transducer and pleura several times, producing the _____ lines
repetitive
Subpleural air creates a large difference in ______ at the interface between the chest wall and the air filled alveoli
acoustic impedance
After obtaining a B-mode image, a _______ is placed over the pleura between the ribs
single scan line
What does M-mode measure?
Measures the motion of a structure over a period of time
How will a normal aerated lung present in M-mode?
A normal aerated lung will present as the “seashore sign” or “waves on the beach”
The “waves” will appear as horizontal, hyperechoic lines
Represents the lack of motion in the chest wall
The area below the pleural line will appear granular
Results from the motion of the lung
The presence of B-lines can be used to identify ______, but cannot distinguish between ______
she highlighted this one
interstitial syndrome;
pulmonary edema, ARDS, or fibrosis
B-lines with lung sliding are indicative of _____
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pulmonary edema
B-lines without lung sliding, may indicate ___ or ____
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ARDS or pneumonia
3 or more B-lines between ribs in any zone are (normal/pathologic) findings
pathologic
2 or less B-lines between 2 ribs in any zone are a (normal/pathologic) finding
normal
B-lines are most commonly seen in ____; also seen with:
pulmonary edema
Also seen with interstitial pneumonia, acute respiratory distress syndrome , pulmonary fibrosis, pulmonary contusion, atelectasis and malignancy
How do B-lines appear?
Hyperechoic, vertical reverberation artifacts
Extend from the pleural line to the bottom of the screen
Obliterate A-lines
Move synchronously with lung sliding
What do B-lines result from?
Results from interlobular septal thickening surrounded by air filled alveoli
This produces a significant acoustic impedance gradient, resulting in the reverberation artifacts
is lung sliding present with pulmonary edema?
yes
pulmonary edema results from ____
Results from an increase of fluid in the lung interstitium
what confirms the presence of pulmonary edema?
3 or more B-lines in at least 2 zones confirm the presence of pulmonary edema
____ is the most common cause of B-lines
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Pulmonary edema
As the severity of the edema progresses, ______ are produced
multiple diffuse B-lines
What are the different grades for gastric scan interpretation?
Empty stomach (Grade 0): low aspiration risk
Clear fluid visible
Volume <1.5 ml/kg (Grade 1): low aspiration risk
Volume > 1.5 ml/kg (Grade 2): high aspiration risk
Solid food: high aspiration risk
