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Advanced diagnostics > Week 4 > Flashcards

Week 4 Flashcards

1
Q

What is ultrasound imaging based on?

A

The creation, propagation, and monitoring of sound waves with the frequency of at least 20,000 Hz

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2
Q

What are the two categories ultrasound imaging?

A
  • Therapeutic (1930’s) used for treatment - heating

* Diagnostic (1950’s) used for imaging - reflection

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3
Q

What are the image generation challenges of sonography?

A
  • Principles of sound wave propagation
  • Effects of different tissue densities
  • Effect of frequency on penetration & resolution
  • Lack of clarity compared to other forms of imaging
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4
Q

What are the image recognition challenges of sonography?

A
  • Planes of view
  • Knowledge of anatomy
  • Constant monitoring of orientation of the sound head
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5
Q

What are the image interpretation challenges of sonography?

A

It comes with a steep learning curve in order to know how to interpret it

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6
Q

How are sound waves in an ultrasound generated?

A

They are generated by reverse piezoelectric effect, where they are sent down to a tissue, where the waves are absorbed, reflected and they scatter, and return and are attenuated on the sound head

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7
Q

What is the depth of sound wave penetration based on?

A

It is based on the frequency of the sound waves.

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8
Q

What do we see with higher frequencies of sound waves?

A

With higher frequencies, there is poor penetration however there is better formation of image

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9
Q

What do we see with lower frequencies of sound waves?

A

There is significantly increased tissue penetration, however resolution is poor

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10
Q

What are the characteristics of an anechoic structure on imaging?

A
  • Structures without internal reflectors
  • No echoes returned by sound waves
  • Seen as black, most commonly fluid like urine and blood vessels
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11
Q

What are the characteristics of an hypoechoic structure on imaging?

A
  • Structures with low-level echoes

* Seen as gray with things like: muscle, synovial tissue and peripheral nerves

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12
Q

What are the characteristics of an hyperechoic structure on imaging?

A
  • Structures with high level echoes

* Seen as bright gray/white and can be used to visualize bone, tendons and fascia

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13
Q

When looking at imaging, what are the things that we are looking at?

A

Because we have a layered view, it is about looking at changes in the echo or specific differentiation between tissues that will clue you in to what you’re looking at

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14
Q

Under the white reflection that is seen in bone, what can we see?

A

All we see is black, because of the almost 100% reflection that is seen from the bone

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15
Q

Why is therapeutic US present a greater risk than diagnostic US?

A 
Therapeutic US (0.5 – 3 W/cm2) presents a potentially greater risk than Diagnostic US (0.005-
0.03 W/cm2) due the higher intensities utilized and the higher risk of tissue heating
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16
Q

What are the biological effects of diagnostic US on patients?

A

There are no biological effects on patients caused by exposure to present diagnostic ultrasound instruments.

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17
Q

What are the benefits of US?

A
  • Inexpensive
  • Non-invasive
  • Safe
  • Real-time
  • In office
  • Bilateral examination
  • Dynamic Examination
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18
Q

What are the drawbacks of US?

A
  • Operator dependent

* Availability

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19
Q

What are the characteristics of the prudent use of diagnostic imaging?

A

Pregnancy
• ALARA principle (As Low As Reasonably Achievable)
• Informed consent, < 5 min of exposure to fetus.
Gaseous Cavities
• Avoid direct, prolonged exposure of lung tissue
• Do not use in individuals that have recently had a contrast medium injected.

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20
Q

What is the 2-5 MHz curved (sector) array US head used for?

A
  • Abdominal wall
  • Multifidus
  • Bladder images
  • Diaphragm
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21
Q

What is the 5-10 MHz linear array US head used for?

A
  • TrA
  • Multifidus
  • Diaphragm
22
Q

What are the advantages of a curvilinear probe of an ultrasound head?

A

It presents a wider field of view, because the array goes out, so a greater width of tissue is able to be seen. It can also provide more depth than the linear probe.

Transducer elements, sector footprint & wider far-field of view

23
Q

What are the advantages of a linear probe of an ultrasound head?

A

It presents image that are more squared, and it has a regular footprint with a better near field of view, but a limited far field of view. Not really used for structures that are deeper

24
Q

What is probably the most important aspect of utilizing an ultrasound?

A

Probe orientation

25
Q

In what direction should the transducer/ultrasound head be facing?

A

Head to toes

26
Q

What should be done to an ultrasound when a person is trying to get a better radiographic image?

A

Lower the frequency or zoom in

27
Q

What is an artifact?

A

Anything that is an incorrect representation of the

anatomy

28
Q

What could an artifact be?

A
  • Structure is not real
  • Structure is missing or improperly located
  • Structure of improper brightness, shape or size
29
Q

What causes an artifact?

A

Produced by improper equipment operation,

imaging technique or violation of previous assumptions

30
Q

What is an acoustic shadowing artifact?

A

When there is a deflection of the sound, which prevents the visualization of deeper structures

31
Q

What is an edge (Refractile) shadowing?

A

When we have a bypass through anechoic fluid and will allow for a deeper penetration underneath

32
Q

What is an acoustic enhancement artifact?

A

AN artifact that allows structures deep to an anechoic structure appear brighter than they should

33
Q

___ changes the behavior of a sound wave in an x-ray

A

Anechoic changes the behavior of a sound wave in an x-ray

34
Q

What are the things that an anechoic structure can do to an image?

A
  • Where it creates blind spots

- What it might do to tissues directly below

35
Q

What types of tears is a x-ray better at visualizing?

A

A full thickness tear

36
Q

What are the specific uses of ultrasound imaging to PT?

A 
• Pelvic Floor Muscles (PFM)
• Transversus Abdominis (TrA)
• Internal Oblique (IO)
• Rectus Abdominis (Diastasis
Recti)
• Multifidus
• Diaphragm
• Deep Neck Flexors
• Quadriceps Angle
37
Q

What is rehabilitative ultrasound imaging used for in pelvic floor?

A

It can be used as an indicator for when a person is able to contract and relax their pelvic floor muscles

38
Q

True or False

Ultrasound can be used for dry needling to help visualize trigger points

A

True, Ultrasound can be used for dry needling to help visualize trigger points

39
Q

What is scintigraphy/bone scans?

A

An aspect of nuclear medicine where a radioactive isotope
is injected IV and is absorbed by tissue target and scintillation camera detects the distribution of the isotope in order to form an image

40
Q

What is included in nuclear medicine?

A 
• Bone Scan
• Thyroid Scan
• Renal Scan
• Leukocyte Scan
• Cardiac Scan (Stress Test)
• Ventilation-perfusion Lung
Scan
41
Q

What is the most commonly used radioactive isotope used for bone scans, and why?

A

Technetium (Tc-99m) Methylene

Diphosphonate (MDP), because it bond well with areas of higher metabolism for the bone

42
Q

True or False

Bone scans are non specific, meaning it will not tell you the type of lesion that is being visualized

A

True, Bone scans are non specific, meaning it will not tell you the type of lesion that is being visualized

43
Q

Why do bone scans visualize the entire skeletal system?

A

Because there is constant remodeling of bones

44
Q

What do darker regions of a bone scan mean?

A

That there is more uptake of the isotope, which are referred to as hot spots

45
Q

What is a cold spot in a bone scan?

A

Spots of decreases in bony metabolism

46
Q

Why is the urinary bladder and kidney visualized in a bone scan?

A

Because of the mode of excretion of the isotope

47
Q

Why is the antecubital fossa of the elbow visualized in a bone scan?

A

Because it is the injection site of the isotopes

48
Q

Why is further evaluation of a bone scan generally needed?

A

Because a bone scan is not specific to a type of lesion, especially in instances of tumors

49
Q

What are the areas of increased uptake in a bone scan?

A
  • Healing fractures
  • Open growth plates
  • Primary bone tumors
  • Metastatic tumors
  • Stress fractures
  • Area of inflammation (bone around arthritis)
  • Areas of infection (may be hot of cold)
  • Increased vascularity
50
Q

What are the areas of decreased uptake in a bone scan?

A

• Avascular bone
• Certain metastases
(especially multiple myeloma)
• Areas of infection (may be hot or cold)

51
Q

What are the indications of bone scans for PT?

A 
• Stress response
  - (stress fractures, suspicion not showing on other images)
• Suspicion of bony metastasis
  - Insufficiency fractures
• Evaluation for polytrauma

Advanced diagnostics (8 decks)

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