Ultrasonagraphy Flashcards

1
Q

Define Ultrasound (US)

A

Sound waves with frequencies higher than the human audible range,

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2
Q

Describe limits of frequencies

A

The upper limit is considered to be approximately 20kHz

< 20Hz = infasound
20Hz < audible < 20kHz
20kHz < ultrasound < 200mHz

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3
Q

Functions of US probe

A

First emit a sound wave

Then to receive the echoes from the original wave.

= This is the foundation principle of all Ultrasound applications and technology.

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4
Q

Describe pulse escho principle

A

Whenever the ultrasound wave passes through a tissue boundary it can be reflected or will pass through and continue propogating

Adjacent tissues with varying densities will reflect more of the sound wave,

adjacent tissues with similar densities will reflect less..

Eg Air in lungs creates a poor image

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5
Q

Describe relation of amplitude to reflections

A

High amplitude – strong reflections

Low amplitude – Poor reflections / no reflections

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6
Q

List clinical applications of US

A

Abdominal

Gynaecology

Urinary

Trauma - POCUS

Obstetrics

Testicular

Lungs

Musculo-skeletal
(MSK)

Breast

Head/Neck

Cardiology

Vascular

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7
Q

Advantages of US

A

Widely Accessible

Results can often be
Available immediately –
Bedside

No radiation

“real time” imaging

No documented side effects
In humans

Well tolerated

Usually non invasive

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8
Q

Disdvantages of US

A

Training is more resource intensive
For departments compared to other modalities

Ultrasound image quality is highly
Dependant on patient habitus

Effectiveness and accuracy
Are highly operator dependant

No known side effects?

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9
Q

Why have a selection of transducers

A

Increased choice of technical variables allows for optimisation of your image
Choice over sector width, scan depth (resolution), patient habitus, field of view..

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10
Q

Describe characteristics of 12wk obstetric US scan

A
-Fetus is approximately 45-84mm in
Length (11+2wks – 14wks)
-First routine scan offered to most low
Risk pregnancies
-Detects ‘Viability’, number of fetus’,
Gross anatomy, detectable major
Abnormalities, morphology of ovaries
And an accurate gestational age of 
The fetus.
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11
Q

Down’s syndrome define

A

Down’s syndrome is caused by a change in one of the genes in the egg before it is fertilised by the sperm (at the time of conception)

This is usually a completely random happening, though it is more common in older mothers

Throughout the world, the frequency of DS is about 3 per 2000 births.

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12
Q

Fetal nuchal translucency (NT) function

- when should it be performed

A

Fetal nuchal translucency (NT) screening uses
ultrasound to measure the size of the nuchal pad at
the nape of the fetal neck. It should be performed
between 11 weeks and 13 weeks + 6 days

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13
Q

The purpose of the 20 week scan in England is to identify abnormalities which:

A
  • may indicate the baby has a life-limiting condition
  • may benefit from antenatal treatment
  • may require early intervention following delivery
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14
Q

Other standard aims of 20 wk scan in England

A

Other standard aims;

Placenta localisation
Fetal Biometry
Fibroid Monitoring
Liquor Assessment

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15
Q

Spina bifida = define

A

Spina bifida is when a baby’s spine and spinal cord don’t develop properly in the womb = a gap in the spine

a type of neural tube defect

Cause not kbut a lack of folic acid before and in the early stages of pregnancy is a significant risk factor.

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16
Q

Spina bifida = risk factor

A

Lack of folic acid before and in the early stages of pregnancy is a significant risk factor.

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17
Q

Achondroplasia define

A

Achondroplasia is a genetic disorder that results in dwarfism.

Thickened soft tissue surrounding the long
bones

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18
Q

What do we measure in 20 wk scan

A

In England at the 20 week scan we measure
The distance from the lowest edge of the
Placenta to the internal OS of the cervix.

19
Q

Describe the effect of low lying placenta

A

f the placenta is within 2.5cm of the cervix
Then future scans are required. If the placenta
Does not raise higher closer to the due date then a C-Section may be required.

20
Q

Talipes - define

A

= club foot. It is a deformity of the foot and ankle = congenital

21
Q

Talipes - chance of getting it

A
If one parent had the 
Condition as a baby their
Own baby would have a 
1 in 30 chance of also 
Having talipes
22
Q

Umbilical Artery Doppler Assessment – function

A

Umbilical Artery Doppler Assessment –

Can be used to highlight the affects of pre-eclampsia and intrauterine growth restriction (IUGR)

Is used more frequently now as is being suggested we can improve perinatal mortality and morbidity.

23
Q

Characterisics of EPU - US

A
-The fetal pole is detected as an 
Area of thickening along the periphery
Of a yolk sac
-Minimum of 1-2mm in length for
Detection (5-6 wks)
-Cardiac Activity should be detected
Routinely from 4-5mm (6wks)
24
Q

Reasons for PW to be referred to GP

A

-Pregnant women can be referred by their GPs in cases of lower abdominal/pelvic pain,
Bleeding, confirmed history of recurrent miscarriage and sometimes due to previous
Obstetric history issues.

25
Q

Ectopic pregnancy - define + association

A

When an egg implants outside of the
Uterine cavity it is know as an ectopic
pregnancy

Associated with severe pain and
also bleeding

26
Q

Ectopic pregnancy - cause

A

Can be caused by tubal damage

from surgery, PIDS, endometriosis

27
Q

Multiple pregnancy cause

A

Multiple pregnancy usually caused by delays

In the fertilized egg reaching the womb before implanting.

28
Q

Fibroids - composition and growth

A

Fibroids consist of fibrous muscular tissue, many eventually grow until the
blood supply they receive can no longer support further growth,

but others can
get very large and require surgical interventions ( myomectomy / uterine
embolisation / hysterectomy)

29
Q

Uterine polyps - define and link to cancer

A

-Uterine Polyps – growths from the inner
Wall of the womb which extend throughout
The cavity and into the cervix and vagina.

Usually benign but on rare occasion some
Can turn cancerous. Surgery would be
Considered.

30
Q

Aneurysmal aorta definition

A

A section of abdominal aorta is defined
As aneurysmal when reaching 3cm in
AP diameter.

31
Q

AAA monitoring

A

AAAs are monitored in specialised clinics
And surgery is often considered once the
Aneurysm meets 5.5cm in AP diameter.

32
Q

EVAR - define + advantages

A

EVAR – Endovascular Aortic Repair

the placement of a stent-graft into the aneurysm through a small hole in the blood vessels in the groin.

less invasive + faster recovery

33
Q

Describe development of cirrhosis

A

Fatty liver = deposits of fat cause liver enlargement

Liver fibrosis = scar tissue forms + more liver cell injury occurs

Cirrhosis = scar tissue makes liver hard and unable to work properly

34
Q

Gallstones define

A

Gallstones are small stones, usually made of cholesterol, that form in the gallbladder

35
Q

Gallstones cause

A

Usually caused by an imbalance in the
Chemical make up within the bile in the
Gallbladder (high cholesterol / bilirubin)

36
Q

Murphy’s sign purpose

A

Murphy’s sign is one of the tests used on patients presenting with an acute abdomen to ascertain whether the abdominal pain is being caused by an inflamed gallbladder.

37
Q

The need for a breast US

A

> 35 breast tissue tends to be denser, this leads to difficulty with diagnosing the nature of breast lumps on mammograms

as differentiation between solid and fluid filled areas is relatively poor

ultrasound can make the differentiation at an improved rate (about 30% increased)

38
Q

US relation to breast tissue biopsies

A
Ultrasound also enables core
Biopsies to be taken of breast
Lumps to allow for histological
Investigation to allow for
Classification of the lump.
39
Q

US use in DVT

A

US is used to exclude or confirm the presence of a deep vein thrombosis in cases of pain and swelling in the lower limbs

It is often also used as a screening tool for DVT in post operative patients

and those with known pulmonary embolus to find the source of the clot

40
Q

Colour flow doppler use in DVT

A
Using colour flow doppler we
Can demonstrate that the 
Femoral vein is completely
Occluded by the lack of colour
In this region
41
Q

Applications of MSK US

A

Applications :

-Muscle/tendon tears
-Inflammation
-Nerve Entrapments
-Soft tissue lumps
-Cysts
-Hernias
-Paediatric CHD
-Infant Torticollis (neck twisting)
-Early RA
-Joint effusions
-Injection Guidance (contrast and
Therapeutic)
-and many more…

42
Q

POCUS - define

A

Point of Care Ultrasound – Focused Assessment with Sonography of Trauma

FAST is an ultrasound scan protocol undertaken at the time of presentation of a trauma patient.

43
Q

US vs plain X-ray

A

Ultrasound can detect as little as 20ml of free fluid, compared to the 200ml required with plain X-Ray