Pelvis (non pregnant) EDE

Question 1

What are the external and internal landmarks of an abdominal pelvic US?

Answer 1

Internal- bladder
External- midline just cephalad to symphysis pubis

Question 2

What are the areas in the interest in an abdominal pelvic US for males and females?

Answer 2

Males- Rectovesical space
Females- Vesico- and rectouterine space

(looking for free fluid)

Question 3

You should always start abdominal pelvic US in the _______ plane.

Answer 3

Longitudinal

Question 4

What is the endpoint of the pelvic US in transverse and longitudinal planes for females?

Answer 4

Transverse- Sweep probe caudad and cephalad until uterus disappears in both directions
Longitudinal- Sweep probe L to R until uterus disappears in both directions

Question 5

The recto-vesicular space is _____ to the bladder but _______ to the seminal vesicles using the longitudinal approach.

Answer 5

Posterior, cephalad

Question 6

What is the endpoint of the male pelvic US when evaluating for free fluid in longitudinal and transverse planes?

Answer 6

Longitudinal- Sweep L to R until the bladder completely disappears in both directions

Transverse- Sweep cephalad from seminal vesicles until the bladder disappears

Question 7

What is the starting point for the male pelvic US in the transverse plane?

Answer 7

Starting point is the seminal vesicles

(Technique: identify bladder, sweep caudad until you find prostate/rectum, then sweep slightly cephalad to find the seminal vesicles for your starting point)

Question 8

What are four troubleshooting tips for the abdominal pelvic US?

Answer 8

1) Ensure probe is place right against symphysis pubis
2) Press and hold to displace bowel gas
3) Slide the probe off centre and heel/toe back (transverse view) or sweep back (longitudinal view)
4) Fill the bladder (can use IV fluids if pt should be NPO)

Question 9

What is a technique to find a uterus that is not midline and also obscured by overlying bowel?

Answer 9

Move probe away from uterus and angle it back through the bladder (“bladder sandwich”)

Question 10

What are two pitfalls in image interpretation for the male pelvic US?

Answer 10

Misidentifying the seminal vesicles and/or prostate as free fluid

Question 11

_________ position can make the pelvic free fluid more visible.

Answer 11

Reverse trendelenberg

Question 12

What is one way to overcome acoustic enhancement caused by a full bladder?

Answer 12

Turn gain down

(Acoustic enhancement can cause a “washout” of a small amount of pelvic free fluid)