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Basic Abdominal Ultrasound Imaging :: Unit 1 :: Normal Abdomen Ultrasound with Sononerds

Sononerds・31 minutes read

The standard anatomical position is crucial for understanding directional anatomy terms and anatomical planes, which assist in proper imaging techniques using ultrasound transducers. Familiarity with transducer manipulation, labeling protocol, and terminology is essential for documenting and communicating findings effectively during ultrasound examinations.

Insights

  • The standard anatomical position serves as a reference point in anatomy, where the body is upright, facing forward, with feet flat and arms at the sides, although patients are often scanned in different positions like supine or lateral, which can affect visualization and interpretation of anatomical structures.
  • Understanding directional anatomy terms such as superior, inferior, proximal, and distal is essential for accurately locating body parts and organs, while the three anatomical planes—sagittal, coronal, and transverse—provide different perspectives that enhance the comprehension of the body's 3D structure during imaging.
  • Effective ultrasound techniques require familiarity with transducer manipulation methods like sweeping, sliding, and fanning, as well as proper labeling of images post-exam to ensure clarity and consistency in documentation, which is crucial for accurate diagnosis and communication with healthcare providers.

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Recent questions

  • What is the standard anatomical position?

    The standard anatomical position is a reference point used in anatomy to describe the location of body parts. In this position, the body is upright, facing forward, with feet flat and directed forward. The arms are at the sides, and the palms face forward. This position provides a consistent frame of reference for anatomical terminology and directional terms, allowing for clear communication about the location of structures in the body. It is important to note that while this is the standard position, patients may be scanned in various other positions, such as lying down or turned to the side, depending on the medical context.

  • What are directional anatomy terms?

    Directional anatomy terms are specific terms used to describe the locations of structures in relation to one another within the body. These terms include superior (towards the head), inferior (towards the feet), right and left (sides of the body), proximal (closer to the torso), distal (further from the torso), medial (towards the midline), and lateral (away from the midline). Understanding these terms is crucial for accurately identifying and communicating the positions of organs and body parts, especially in medical settings. They help healthcare professionals convey information clearly and effectively, ensuring that everyone involved in patient care has a common understanding of anatomical locations.

  • What are the three anatomical planes?

    The three anatomical planes are sagittal, coronal, and transverse, each serving as a method to divide the body into sections for better understanding of its structure. The sagittal plane divides the body into right and left halves, allowing for a view of the body from the side. The coronal plane separates the body into front (anterior) and back (posterior) sections, providing a view from the front or back. The transverse plane divides the body into upper (superior) and lower (inferior) parts, offering a cross-sectional view. These planes are essential in anatomy and medical imaging, as they help visualize and analyze the body's three-dimensional structure in a two-dimensional format.

  • How do you use a transducer in ultrasound?

    Using a transducer in ultrasound involves specific techniques to obtain clear images of internal structures. When using the transducer in the sagittal plane, it should be placed on the anterior abdomen with the notch pointed superiorly, allowing for visualization of anatomy from anterior to posterior and superior to inferior. In the transverse plane, the transducer is oriented sideways, with the notch facing the patient's right side, enabling a view of the anatomy from a different angle. Proper manipulation techniques, such as sweeping, sliding, rocking, and heel-toeing, are crucial for centering organs and obtaining optimal images. Additionally, applying appropriate pressure while maintaining contact with the skin helps enhance the quality of the images captured.

  • What is the 90/10 rule in ultrasound?

    The 90/10 rule in ultrasound refers to the observation that 10% of the buttons on an ultrasound machine are used 90% of the time during imaging procedures. This principle emphasizes the importance of becoming familiar with the key controls that are most frequently utilized, such as the preset button, transducer select, gain, depth, focus, time gain compensation (TGC), freeze, store, caliper, and annotation buttons. By mastering these essential functions, sonographers can operate the ultrasound machine more efficiently and effectively, leading to better imaging outcomes. Understanding this rule helps streamline the scanning process, allowing practitioners to focus on obtaining high-quality images while minimizing the cognitive load associated with navigating complex equipment.

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Summary

00:00

Understanding Anatomical Position and Ultrasound Techniques

  • The standard anatomical position is defined as the body being upright, facing the observer, with feet flat and directed forward, and upper limbs at the sides with palms facing forward, although patients are typically scanned in various positions such as supine or lateral.
  • Directional anatomy terms include superior (towards the head), inferior (towards the feet), right and left (sides of the body), proximal (closer to the torso), distal (further from the torso), medial (towards the midline), and lateral (away from the midline), which help in identifying locations relative to the body or organs.
  • The three anatomical planes are sagittal (divides the body into right and left), coronal (divides the body into front and back), and transverse (divides the body into upper and lower), each creating a 2D slice of the body for better understanding of anatomy in 3D.
  • When using the transducer in the sagittal plane, it should be placed on the anterior abdomen with the notch pointed superior, allowing for visualization of anterior to posterior and superior to inferior anatomy.
  • In the transverse plane, the transducer is oriented sideways on the body, with the notch facing the patient's right, allowing for visualization of anterior at the top and right lateral on the left side of the screen, with opposites being anterior to posterior and right to left.
  • The coronal plane is achieved by placing the transducer on either flank with the notch oriented superior, allowing for visualization from lateral to medial and superior to inferior anatomy, with the ability to move the transducer towards the patient's front or back for new slices.
  • The 90/10 rule in ultrasound indicates that 10% of the buttons on the machine will be used 90% of the time, emphasizing the importance of familiarizing oneself with key controls such as the preset button, transducer select, gain, depth, focus, TGCs, freeze, store, caliper, and annotation buttons.
  • Key transducers include convex transducers (5-9.2 MHz for abdominal scans), microconvex transducers (8.5 MHz for pediatric patients), vector transducers for cardiac work, phased array transducers for detailed heart imaging, and endovaginal probes for transvaginal ultrasounds, each suited for specific imaging needs.
  • Transducer manipulation techniques include sweeping (large wrist motions to scan a wide area), sliding (moving within the same plane), rocking (pivoting for fine-tuning), and heel-toeing (rocking the transducer for better angles), which are essential for locating and centering organs in the viewing area.
  • Practicing directional anatomy recognition and transducer manipulation can be enhanced by labeling ultrasound images found online and using a workbook for hands-on learning, reinforcing the understanding of 2D images in relation to 3D anatomy.

14:57

Ultrasound Imaging Techniques and Documentation Essentials

  • When using a transducer, apply pressure to one side to push it deeper into the body while maintaining contact across the entire transducer; this technique helps to bring anatomical structures, such as the aorta or kidneys, into a more horizontal view on the screen.
  • Fanning the transducer involves small, controlled movements similar to sweeping, which fine-tunes the anatomical view, allowing for better visualization of structures.
  • Rotating the transducer from a sagittal position to a transverse plane requires a 90-degree turn; this should be done in small increments to focus on specific areas of interest, such as vessels or masses, ensuring the anatomy remains visible during the process.
  • After obtaining a diagnostic image, it is essential to label or annotate it with the plane (e.g., longitudinal or transverse), the side (left or right), and the organ being examined; these three elements are the minimum required for proper documentation.
  • Additional directional labels can enhance clarity, especially when imaging through the kidney, such as labeling images as long right kidney lateral, mid, and medial; this is particularly useful when the anatomy is not clearly identifiable.
  • While scanning a patient in a supine position typically does not require labeling, it is advisable to annotate the position if the patient is in left lateral decubitus (LLD) or right lateral decubitus (RLD) to clarify any deviations from standard presentations.
  • Standard abbreviations are acceptable for labeling images, but it is crucial to use widely recognized terms rather than creating new ones; consistency in terminology, such as distinguishing between longitudinal and sagittal, is important for clarity.
  • Protocols for imaging are site-specific and based on billing standards and radiologist preferences; they help ensure uniformity among sonographers and reduce the cognitive load on interpreting providers.
  • When documenting pathology, at a minimum, include transverse and longitudinal images, three measurements, and a color image; labels should describe the location of the pathology without making a diagnosis, such as indicating "left lobe above the liver" instead of labeling it as a cyst.
  • Familiarity with ultrasound terminology is vital; for example, anechoic areas appear black, echogenic structures are brighter, and hypoechoic structures are darker than surrounding tissues; understanding these terms aids in accurately describing findings and communicating with the reading provider.

29:27

Ovarian Cyst Examination and Documentation Process

  • The examination reveals a hemorrhagic cyst in the right ovary, characterized by a complex, avascular mass with a thicker wall and heterogeneous solid appearance due to clotted blood, rather than a fluid level, indicating that the solid structure is not fluid but rather a denser material. Blood flow is only observed within the ovarian tissue and not within the cyst itself, confirming its avascular nature.
  • After completing the ultrasound exam, the sonographer must return to the tech area to review images and fill out a text sheet, which may vary by facility. Essential components of the text sheet include the patient's information (often a sticker), the type of exam performed, relevant patient history, and any lab results. Measurements taken during the exam should be documented, typically rounded to the nearest tenth for centimeters and whole numbers for millimeters, with sections for negative and positive findings.
  • The text sheet should also include detailed notes on any positive findings, including descriptions of pathology observed during the exam, and may require sketches to illustrate these findings. For example, a completed tech sheet may document a patient with pancreatitis, a pseudocyst, and gallstones. Additionally, students are encouraged to review sections 1.1 and 1.5 for ultrasound resources and patient care, and optional activities in section 1.6 for practical application of knowledge, along with section 1.7 for study questions.
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