Ultrasound 2

Question 1

Which setting on the US machine is used to adjust the strength of the returning echoes displayed on the screen?
A. Depth
B. Attenuation
C. Gain
D. M mode

Answer 1

C. Gain

Question 2

_______ determines how deeply you can see into the body

Answer 2

Depth

Question 3

_______ produces a real-time image of the sonoanatomy and most bedside US procedures utilize this modality.

Answer 3

B mode

Question 4

The “B” in b-mode stands for the

Answer 4

Brightness of the pixels on the screen

Question 5

M-mode stands for ______ and is an alternative US modality similar to a time-lapse photo, it illustrates the reflective movement of structures over time

Answer 5

Motion

Question 6

According to the Doppler effect, what changes occur when the sound source moves closer to a person listening to that sound?
1. Wavelength becomes shorter
2. Pitch increases
3. Doppler shift becomes negative

Answer 6

1. & 2.

Question 7

If the source moves towards an observer, then the wavelength gets _______ in this direction, and the frequency (pitch) appears to _______. We call this a _______ Doppler effect.

Answer 7

Shorter, increase, positive

Question 8

The Doppler effect describes the change in the

Answer 8

Perceived frequency of a sound wave when there’s relative motion between the sound’s source and an observer

Question 9

In terms of ultrasound, a positive Doppler shift appears _____, and a negative Doppler appears

Answer 9

Red; blue

Question 10

When evaluating the Doppler shift, you must understand the

Answer 10

Angle of insonation

Question 11

The degree of Doppler shift depends on

Answer 11

Frequency of the US beam
Blood flow velocity
Angle of intonation

Question 12

According to the standard convention, the orientation marker on the US probe should point towards

Answer 12

The head of the right

Question 13

This breaks the standard convention of having the orientation marker on the right

Answer 13

Cardiology convention

Question 14

The _________ describes the angle at which the US waves encounter a structure.

Answer 14

The angle of incidence

Question 15

You’ll obtain the best image quality when the US beam encounters a structure at

Answer 15

90 degrees

Question 16

Describe in plane vs out of plane

Answer 16

In-plane: needle runs parallel to the transducer, long axis of the needle
Out- of plane- perpendicular, short axis of the needle

Question 17

Describe tilting.

Answer 17

Moving the probe backward and forward at the same point of contact to changes the angle of incidence

Question 18

Describe rocking.

Answer 18

Moving the transducer from side to side while in the long axis
Helpful while viewing a narrow acoustic window

Question 19

Describe compression.

Answer 19

Improves image resolution by reducing the distance between the probe and the image

Question 20

Describe sliding.

Answer 20

Moving the transducer up and down while maintaining the sample angle of incidence

Question 21

Describe rotation.

Answer 21

Moving the transducer in a clockwise or counter clock-wise fashion in the same axis of compression; helpful when changing from long to short axis

Question 22

What is reverberation?

Answer 22

Occurs when a sound wave bounces between two strong parallel reflecting surfaces

Question 23

You may see reverberation when

Answer 23

Imaging the pleura or when you’re using a highly attenuating wide bore needle

Question 24

Common ultrasound artifacts include

Answer 24

Air, shadow, acoustic enhancement, mirror image, reverberation, bayoneting

Question 25

Air artifact appears as

Answer 25

A black region

Question 26

Air artifact is solved by

Answer 26

Applying more gel, applying more pressure, or selecting a transducer with a footprint that allows for better contact

Question 27

Because acoustic energy doesn’t penetrate bone very well, you’ll observe ________ deep to the hyperechoic border

Answer 27

Acoustic shadow

Question 28

_____________ is the best way to minimize the influence of a shadow artifact

Answer 28

Adjusting the scanning plane to find a better acoustic window

Question 29

______ occurs when the US beam gets trapped between two highly reflective tissues and this causes a time delay in some of the returning echoes

Answer 29

Mirror image

Question 30

________ occurs when the needle passes through the adjacent tissues of different acoustic impedance

Answer 30

Bayoneting

Question 31

Bayoneting appears like

Answer 31

The needle bending as it penetrates a tissue boundary

Question 32

During a cardiac POCUS examination, what structures are visible on a parasternal short-axis view of the heart?
Right ventricle
Aorta
Left ventricle
Pericardium

Answer 32

Left ventricle & pericardium

Question 33

The basic cardiac exam relies on three standard imaging windows including

Answer 33

Parasternal
Apical
Subcostal

Question 34

The basic cardiac exam consists of five views

Answer 34

Parasternal long-axis
Parasternal short-axis
4 chamber apical
4 chamber subcostal
IVC

Question 35

Cardiac POCUS allows us to answer yes/no questions about the patient’s clinical status including

Answer 35

Is there ventricular function failure, valvular dysfunction, pericardial effusion, patient’s volume status, regional wall motion abnormalities, responsiveness to fluids, are there gross signs of chronic hear disease, is there an inter cardiac mass

Question 36

In the parasternal window we can view the

Answer 36

Parasternal long axis & parasternal short axis

Question 37

In the apical window we can view

Answer 37

An apical 4 chamber

Question 38

In the subcostal window we can view

Answer 38

Subcostal 4 chamber & subcostal IVC

Question 39

Structures viewed in the parasternal long axis include

Answer 39

LA, LV, mitral valve, aortic valve, aorta, pericardium

Question 40

The parasternal long axis view can be utilized to interpret

Answer 40

LV function, aortic and mitral valve lesions, and pericardial effusions

Question 41

In the parasternal short axis we can view the structures of the

Answer 41

LV+ papillary muscle, RV, and pericardium

Question 42

In the parasternal short axis view, we can use this to interpret

Answer 42

LV and RV function, pericardial effusion

Question 43

In the apical 4-chamber view, structures visualized include

Answer 43

RA, RV, LV, LA, mitral valve, aortic valve, pericardium

Question 44

The apical 4 chamber view can be utilized to interpret

Answer 44

LV and RV function , AV valve lesions, pericardial effusion

Question 45

The subcostal 4 chamber view can be utilized to visualize

Answer 45

RA, RV, LV,LA, mitral and aortic valves, liver

Question 46

The subcostal 4 chamber view can be used to interpret

Answer 46

RV function. Pericardial effusion

Question 47

The structures visualized in the subcostal IVC include

Answer 47

IVC, RA, and liver

Question 48

The subcostal IVC can be used to interpret

Answer 48

Volume status

Question 49

IVC collapse suggests

Answer 49

Hypovolemia

Question 50

Lung US is useful for diagnosing

Answer 50

Pneumothorax and endobroncheal intubation

Question 51

Gastric contents are best assessed with ultrasound when the patient is in the _______ position

Answer 51

right lateral decubitus

Question 52

Performing gastric ultrasound in the supine position will

Answer 52

likely underestimate the volume of gastric contents

Question 53

If the stomach is empty, the antrum will appear

Answer 53

flat or like a small oval, sometimes referred to as a “bull’s eye”

Question 54

Clear contents inside the stomach will make the antrum look

Answer 54

round and distended
clear liquids will be anechoic

Question 55

Particulate matter inside the stomach will make the antrum look

Answer 55

round and distended and appear hyperechoic or bright particulate matter