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Basics > pocus > Flashcards

pocus Flashcards

1
Q

what is the FATE exam

A

Focused assess transthoracic echocardiogram
IVC assessment

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2
Q

what can be assessed in a pulm echo

A

normal lung
pnuemothorax
pulm edema
pleural effusion
diaphragm assessment

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3
Q

what can be assessed in abdomen US

A

gastric
FAST
Bladder

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4
Q

what are the three types of POCUS probes

A

linear
curvilinear
phased

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5
Q

what is linear probe used for

A

central lines,
PIC,
lung ultrasound,
superficial structures,
crisp images,
high frequency
nerve blocks

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6
Q

what is curvilinear probe used for

A

FAST exam,
gastric ultrasound,
deep 4-8 cm,
low frequency,
images not crisp but better depth

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7
Q

what do we use phased array probes for

A

cardiac, pulmonary, gastric
smaller footprint
fewer PZE crystals activated in different phases to allow steering of the beam and a small footprint (in between ribs)
transthoracic

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8
Q

how does a low gain present

A

darker

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9
Q

how does a high gain present

A

white out

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10
Q

what is TGC

A

Time gain compensation
helps keep the brightness of same tissues the same

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11
Q

what are hyperechoic structures

A

dense structures are white:
bone, needle, nerve bundles

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12
Q

what are hypoechoic structures?

A

grey, less dense structures:
lymph nodes, nerves

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13
Q

what are anechoic structures

A

black: air and fluid

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14
Q

what pattern do nerves appear as

A

hypoechoic areas separated by hyperechoic
honeycomb

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15
Q

What is the seashore sign? in lungs

A

on M-mode structures above pleural line dont move (lines)
pleura below moves (sand)
normal finding

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16
Q

what is stratosphere sign or barcode sign in lungs

A

straight lines all the way through, air in between parietal and visceral pleura
abnormal- pnueomothorax

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17
Q

what is a lung pulse

A

small lung movements with cardiac pulsations

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18
Q

when do you usually see lung pulse

A

apneic patients

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19
Q

what does a lung pulse mean

A

lung that is aerated but not ventilated
also means there is no air between the pleura

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20
Q

what are B-lines in lungs

A

hyperechoic beams emanating from the pleural line and extending through the field
moves with lung sliding

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21
Q

what does 1-2 B lines and lower lobes tell you

A

normal in dependent areas

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22
Q

what do many B lines suggest

A

pulm edema

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23
Q

what are A-lines in lungs

A

normal horizontal artifact at regular intervals

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24
Q

what are normal lung signs on US

A

lung sliding
A-lines
1-2 B lines
seashore sign

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25
Q

what are pneumothorax lung signs

A

no lung sliding
no B lines
no lung pulse
stratosphere sign
LUNG POINT

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26
Q

how accurate is lung point sign for pneumo

A

95-100%

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27
Q

what is a lung point

A

interface between aerated and non-aerated lung
seashore and barcode sign intermittent in M mode

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28
Q

what are the steps to determining pneumo on ultrasound

A

lung sliding (no=pneumo)
B-lines (no=pneumo)
Lung pulse (no=pneumo)
Seashore (no=pneumo)
stratosphere with Lung Point= pnemo

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29
Q

what probe do you use for a pleural assessment

A

linear at the axillary line

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30
Q

what is spine sign indicative of

A

pleural effusion

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31
Q

where do you find spine sign

A

axillary line, base of lung

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32
Q

how does spine sign present

A

dark anachoic triangle with spine visible is abnormal and indicative of pleural effusion

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33
Q

why is spine not usually visible through lung

A

ultrasound cant move through air

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34
Q

where do you perform diaphragm assessment

A

zone of apposition

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35
Q

how do you position the probe for diaphragm assessment

A

point it cephalad

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36
Q

what is a normal diphragm sign

A

30% thickening at end inspiration

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37
Q

what is occurring if the diaphragm does not thicken by 30%

A

diaphragmatic peresis

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38
Q

what would you do FATE exam for pre op

A

screen high risk
volume assess

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39
Q

what would you use FATE exam for post-op

A

MI
pulm embolism
hypovolemia

40
Q

what complication can FATE exam differentiate

A

MI, PE, Tamponade, LV failure

41
Q

what is goal of FATE exam

A

abnormal vs normal
exclude obvious pathology
assess wall thickness
assess contractility
evaluate volume status

42
Q

what probe is preferred for FATE exam

A

phased array

43
Q

what are the four parts of FATE exam

A
  1. subcostal
  2. apical 4-chamber
  3. PLAX (long Axis)
  4. PSAX (LV short axis)
44
Q

where do you place probe for subcostal 4-chamber view of FATE exam

A

below xiphoid pointed toward shoulder

45
Q

how does pericaridal effusion appear

A

anachoic line around heart

46
Q

how should legs be placed in abdomen

A

down so abd doesnt push on chest

47
Q

what are you looking for in subcostal 4-chamber view of FATE

A

MV/TV disease
pericardial effusion
massive PE
hypovolemia

48
Q

what is viewable in the subcostal IVC view

A

IVC, RA, Liver

49
Q

what are indications for subcostal IVC view

A

fluid status

50
Q

how can you get CVP from FATE

A

max IVC- min IVC/maxIVC (after sniff) x100

51
Q

a 50% change in IVC diameter with respiration indicated

A

hypovolemia

52
Q

where do you put probe for apical 4C view

A

PMI then into axillary line, patient must be as much on left side as possible

53
Q

what is the first strucutre you hit in apical 4C view

A

LV

54
Q

which direction does the IVS move in contraction

A

towards LV

55
Q

what are indications for apical 4C view

A

cardiac function
MV/TV
pericardial defects
septal wall defects
massive PE
hypovolemia

56
Q

where do you place probe for PLAX (parasternal long axis) of FATE exam

A

2-3 ICS LSB orientation towards R shoulder

57
Q

what is indication for PLAX

A

cardiac function
AV/MV
pericardial infusion
aortic stenosis
hypovolemia

58
Q

how should RV diameter appear

A

<3.3 CM or it is dialated
internal no more than 2/3 of LV
apex no more than 2/3 of LV

59
Q

where do you position probe for PSAX (parsternal short axis) view

A

2-3 ICS towards L shoulder

60
Q

what are indications for PSAX view

A

cardiac function
pericardial effusion
massive PE
hypovolemia

61
Q

what are findings of a massive PE

A

enlarged RV
flattened LV IVC (D sign)
McConnel sign in apical 4c view

62
Q

what is the goal of gastric ultrasound

A

decrease incidence of aspiration

63
Q

when do you do gastric ultrasound

A

patient is not NPO
delayed gastric emptying
inability to communicate
dishonest patient

64
Q

what can you tell from gastric ultrasound

A

gastric volume
participate load
gastric function

65
Q

what probe do you use for gastric ultrasound

A

curvilinear on abd setting, indicator toward head

66
Q

how do you position patient for abd exam

A

start in supine position
follow with the right lateral decubitus position

67
Q

do you say a stomach is empty based on supine alone

A

no

68
Q

what strucutres border the gastic antrum

A

L border of liver
pancrease

69
Q

what indicates an empty gastric antrum

A

donut look/bulleseye

70
Q

how does clear liquid appear on US

A

anachoic

71
Q

what does stary night appearance of antrum tell us

A

just drank
carbonated liquid

72
Q

how do you assess liquid volume from stomach

A

r lateral decubitus

73
Q

what is a grade of 0 of antral grading

A

empty in both supine and TLD
minimal volume
low aspiration risk

74
Q

what is a grade 1 of antral grading

A

empy in supine, clear fluid in RLD
<1.5 ml/kg compatable with baseline gastric secretions
low risk of aspiration

75
Q

what is a grade 2 of antral grading

A

clear fluid visible in both positions
>1.5 ml/kg in excess of baseline gastric secretions
high risk of aspiration

76
Q

how does recently ingested food appear on gastric US

A

frosted glass appearance due to ingested air with food

77
Q

how does digested food appear on US

A

hypoachoic (grey)

78
Q

what does a FAST exam identify

A

focused assess sonogram for trauma patients
looking for blood

79
Q

where does FAST exam look for fluid

A

peritoneal
retroperitoneal
pericardial

80
Q

what is in the retroperitoneal space

A

kidney
IVC
aorta
colon

81
Q

What is in the infraperitoneal area?

A

bladder
distal rectum

82
Q

how much blood does FAST exam detect

A

> 200ml

83
Q

how much fluid is in 1 cm of hypoechoic space

A

150 ml

84
Q

where does blood in upper abd collect

A

morisons pouch RUQ (from RUQ and LUQ down phrenicolic ligament)

85
Q

what if you see blood in LUQ

A

then morisons pouch is full, lots of blood

86
Q

where does blood from lower abd collect

A

bladder wall

87
Q

where is morisons pouch

A

RUQ between liver and kidney

88
Q

what structures do you look for in morrisons pouch

A

pleural space
infradiphragmatic space
caudal liver tip
hepatorenal space (actual pouch)

89
Q

what position is patient in for FAST

A

supine

90
Q

where is probe for FAST EXAM

A

start MCL, slide to MAL 10th rib

91
Q

what is the LUQ fast exam view

A

parasplenic view

92
Q

what is the area of fluid accumulation around bladder

A

pouch of douglas or pelvic couldesac

93
Q

where should orientation of probe be for pelvic FAST

A

right

94
Q

where does fluid appear in pelvic FAST

A

around bladder

95
Q

what is the sign of the ETT in tracheal lumen

A

double tract or double lumen sign

96
Q

what is soft tissue value for US speed

A

1540

97
Q

what is lung value for US speed

A

500

Basics (7 decks)

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