Physics Flashcards by lindsay crouse

Which of the following will increase the amount of color displayed in the abdominal AO?

increase frame rate
decrease color gain
decrease color threshold
increase wall filter

increase frame rate

**changing to a smaller sample size will increase frame rates

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What type of transducer produced the image?

sector phased array
linear sequential array
curvilinear phased array
vector phased array

sector phased array

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You are evaluating an obese patient with a known AAA. While using color Doppler to assess flow within the aneurysm, minimal flow is detected in the anechoic lumen. You decrease the color scale and increase the color gain but there is no improvement. Which of the following adjustments will most improve the color display on this exam?

decrease the color threshold
switch from a 4MHz curved array to a 4MHz linear array
increase color sample size
increase the color threshold

increase the color threshold

**increasing the color threshold will increase the amount of color displayed

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What determines the transducer frequency used for the evaluation of a foreign body?

composition of the foreign body
depth of the foreign body
the radiologist reading the exam
age of the foreign body

depth of the foreign body

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What acoustic artifact is demonstrated by the red arrow?

reverberation
refractive shadowing
mirror imaging
ringdown

refractive shadowing

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The primary factor that determines transducer selection for a biopsy is:

physician preference
thickness of the sterile cover
depth of the mass
composition of the mass

depth of the mass

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Which of the following would cause artifactual debris within a simple cyst?

increased rejection settings
short distance from the transducer
activation of spatial compounding
reduced gain settings

short distance from the transducer

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Which of the following best describes the areas indicated by the yellow arrows?

reverberation artifact
refractive shadowing
PE element damage
posterior shadowing

PE element damage

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A large angiomyolipoma in the right kidney is most commonly associated with what acoustic artifact?

mirror image
reverberation
comet tail artifact
propagation speed artifact

propagation speed artifact

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What is the BEST way to evaluate the indicated vessel for the presence of blood flow?

color Doppler
PW Doppler
power Doppler
B-color

power Doppler

**preferred for smaller vessels and those coursing perpendicular to the US beam

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Which of the following will reduce ansiotropy artifact?

dual screen imaging
turn of harmonic imaging
reduce color Doppler gain
rocking the transducer

rocking the transducer

**ansiotropy artifact refers to falsely hypoechoic areas of a tendon that occur when the transducer is not completely parallel to the tendon

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Which of the following acoustic artifacts is identified on the image?

reverberation
lobe artifact
mirror image
misregistration

reverberation

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Overgaining on an US exam can cause ___.

blood to appear anechoic
underestimation of arterial stenosis
overestimation of Doppler velocity
increased posterior shadowing

overestimation of Doppler velocity

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You are scanning the GB and there appears to be sludge within the lumen. Which of the following will aid in differentiating the sludge from artifact?

ask the patient to perform the Valsalva maneuver
increase the transducer frequency
apply color Doppler
ask the patient to fast for 3-4 more hours and rescan

increase the transducer frequency

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____ occurs posterior to highly attenuating structures.

enhancement
speckle
shadowing
refraction

shadowing

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Acoustic Radiation Forced Impulse (AFRI) evaluation of the liver:

is performed with a subcostal midline window
is helpful in cases of suspected abscess formation
should be performed with the patient in the prone position
should be performed in the right lobe

should be performed in the right lobe

**used to assess the liver for signs of chronic disease

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All of the following are characteristics of Power Doppler, EXCEPT:

demonstrates presence or absence of flow
demonstrates organ perfusion better than color Doppler
more sensitive to slow flow than color Doppler
demonstrates velocity of flow within the organ

demonstrates velocity of flow within the organ

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When evaluating a liver transplant, you must use angle correction during Doppler evaluation of:

PVs only
HAs only
HAs and PVs
HAs and HVs

HAs and PVs

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What system control should be turned off when trying to differentiate a small stone in the GB from a sludge ball?

compound imaging
harmonic imaging
focal zone
time gain compensation

compound imaging

** turning this feature off can improve visualization of posterior shadowing and enhancement

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If there is no diastolic flow demonstrated on a Doppler tracing of the interlobar artery of the upper pole of the right kidney, what will the RI be?

unable to calculate RI, not enough information
0
1.0
0.5

1.0

(PSV - EDV)/PSV

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Which type of transducer would be used to evaluate a patient with increased LFTs and height 5’3” and weight 275lbs?

10MHz vector array
5MHz linear phased array
5MHz sector phased array
3MHz curvilinear phased array

3MHz curvilinear phased array

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Harmonic imaging leads to:

increased image noise
reduced signal to noise ratio
reduced appearance of lobe artifact
improved axial but degraded lateral resolution

reduced appearance of lobe artifact

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On a scrotal ultrasound exam, how do you differentiate acute epididymitis from post-vasectomy enlargement of the epididymis?

use dual screen imaging
use color Doppler
use power Doppler
use a stand off pad

use color Doppler

** hypervascularity is demonstrated with infection, but not with post-surgical changes

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The artifact that is produced when the incident beam hits a curved surface and produces an acoustic shadow is referred to as:

lobe artifact
posterior shadowing
refractive shadowing
comet tail artifact

refractive shadowing

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If the entire image is too dark, what console adjustment should you make first? adjust the near field TGC increase the output power adjust the far field TGC increase overall gain

increase overall gain

When performing a Doppler evaluation of the renal arteries the cursor angle should be set at ___ degrees or less for the main renal arteries and ___ degrees or less for the intraparenchymal arteries. 45, 60 20, 0 60, 20 60, 45

60, 20

If the entire image is too bright, what console adjustment should you make first? decrease the overall gain adjust the far field TGC adjust the near field TGC decrease the output power

decrease the output power

How are the gain settings adjusted to the proper level for evaluation of abdominal structures? A normal GB or IVC should look anechoic throughout the exam the spleen echogenicity should be set to a medium grey level at the start of the exam the liver echogenicity should be set to medium grey at the start of the exam the anterior abdominal fat should appear as a medium grey level throughout the exam

A normal GB or IVC should look anechoic throughout the exam

Which of the following is a resonance artifact only seen with a gas/tissue interface? mirror imaging misregistration ringdown posterior shadowing

ringdown

A patient presents for a liver ultrasound with contrast to evaluate a tumor. Which of the following lists the correct machine settings needed for the exam? MI over 1.5, harmonics off, and focal zone at the abdominal wall low MI, harmonics off, and focal zone at the abdominal wall highest output power setting available, harmonics on, and at least three focal zones surrounding the area of interest low MI, harmonics on, and focal zone placed at the area of interest

low MI, harmonics on, and focal zone placed at the area of interest

While performing a Doppler evaluation of the main RAs, multiple patient positions may be required in order to maintain a Doppler angle of ___ degrees or less. 0 30 60 90

Color Doppler demonstrates the ___. direction of flow only peak velocity of blood flow only average velocity and direction of flow peak velocity and direction of flow

average velocity and direction of flow

Which of the following techniques will lead to degraded lateral resolution? trapezoidal field of view on linear array increase in number of focal zones increased probe frequency none of the above

trapezoidal field of view on linear array **increasing size of FOV will lead to increased beam divergence which leads to reduced lateral resolution

What is the cause of the vertical acoustic shadow seen on the images? electrical interference element damage patient motion air in the trachea

element damage

Increasing the imaging depth will: improve temporal resolution reduce beam intensity increase the PRF reduce the frame rate

reduce the frame rate **pulses are longer/slower which reduces frame rate

Increasing the ___ will most improve the ability to properly trace the contour of this Doppler waveform. sweep speed velocity scale wall filter baseline

sweep speed **decreases the amount of Doppler information displayed over a shorter time

While performing color Doppler on a routine renal ultrasound, extreme turbulence is noted at the RRA origin. How should your exam change to evaluate the finding? use PW Doppler to record a flow pattern in the area of turbulence advise the patient that they may have to return for an additional exam because of the suspected renal stenosis have the patient perform the Valsalva maneuver and reassess the vessel for changes all of the above

use PW Doppler to record a flow pattern in the area of turbulence

Which Doppler artifact is demonstrated on the image? side lobes reverberation cross talk aliasing

cross talk

What change in system controls can reduce the appearance of color displayed over vessel walls? decreasing color priority decreasing color PRF increasing color threshold increasing persistence

decreasing color priority **lower threshold settings reduce the display of color

Which of the following exams does not require angle corrected Doppler evaluation? RA duplex TIPS evaluation IVC duplex AO duplex

IVC duplex

Which imaging plane can demonstrate the IVC and the AO on the same image in a normal patient? coronal and TRV coronal only mid SAG only TV only

coronal and TRV

When performing contrast enhanced ultrasound evaluation of the liver, when are the images obtained? after the saline flush, record an image the area of interest every 60 seconds when the contrast is first visualized in the areas of interest and again when it dissipates completely at the start of the contrast injection, record an image the area of interest every 30 seconds at the start of the saline flush, record the area of interest for 1 minute and image every 30-60 seconds until the 6 minute mark

at the start of the saline flush, record the area of interest for 1 minute and image every 30-60 seconds until the 6 minute mark

Put the following in order in decreasing echogenicity: renal sinus, renal parenchyma, liver, spleen, pancreas renal parenchyma, spleen, liver, pancreas renal sinus pancreas, spleen, liver, renal sinus, renal parenchyma renal sinus, pancreas, spleen , liver, real parenchyma

renal sinus, pancreas, spleen , liver, real parenchyma

Which type of transducer would be used to evaluate a palpable lump in the neck? 3MH curvilinear sequential array 12MHz linear phased array 12MHz curvilinear phased array 12MHz sector phased array

12MHz linear phased array

What acoustic artifact is commonly seen with a liver abscess, adenomyomatosis of the GB, and emphysematous cholecystitis? mirrior image artifact posterior enhancement propagation speed artifact posterior reverberation artifact

posterior reverberation artifact

You are currently using a curved probe with a 3.5MHz frequency to evaluate a patient's liver. What can be done to better visualize the area indicated by the arrow? switch to a 12MHz linear probe switch from a curved array to a vector array of the same frequency switch to a 2.5MHz curved probe switch to a 5MHz linear probe

switch to a 5MHz linear probe ** would provide the largest near field

All of the following techniques will aid in the visualization of a small renal calculi with questionable shadowing, EXCEPT: using multiple scanning planes to evaluate the kidney reducing the dynamic range decreasing transducer frequency rescanning the patient in the decubitus position

decreasing transducer frequency

What acoustic artifact is demonstrated by the mass within the liver? comet tail artifact reverberation posterior enhancement dirty shadowing

posterior enhancement

What can be used to alter the displayed brightness of the image after it has been stored in the memory? compression post-processing pre-processing rejection

post-processing

What acoustic artifact is demonstrated on the image by the red X? posterior enhancement speed error edge shadowing mirror imaging

mirror imaging

All of the following can cause artifactual debris within a simple cyst, EXCEPT: improper gain settings increased rejection settings superficial location of the cyst small size of the cyst

increased rejection settings

Which of the following adjustments would reduce the aliasing displayed on the image while maintaining the diagnostic quality? reducing the color Doppler gain is the preferred method to remove the appearance of color aliasing on the image repositioning the patient and scanning through the anterior abdominal wall will reduce or eliminate the color aliasing increasing the color scale velocity setting is the preferred method to reduce the aliasing in the RA increasing the color priority setting is the preferred method to reduce the aliasing in the RA

increasing the color scale velocity setting is the preferred method to reduce the aliasing in the RA

Which of the following operator controls adjusts the beam intensity? output overall gain dynamic range TGC

output

When you change the angle on the Doppler cursor, the ___ also changes. amplitude of the reflected signal the volume of flow interrogated the wall filter settings also change flow velocity displayed

flow velocity displayed

B-color can be helpful in the evaluation of: subtle differences in tissues low velocity blood flow high velocity blood flow anechoic fluid/cysts

subtle differences in tissues

What is the name of the universally accepted image file type that is used by a PACS system to store and view images? MPEG DICOM AVI JPEG

DICOM (digital imaging and communications in medicine)

Increasing the size of the field of view will ___ the frame rate. cause a 50% decrease decrease have no effect on increase

decrease

Which of the following machine adjustments will produce black and white 2D images? reducing the compression reducing overall gain increasing dynamic range reducing monitor contrast

reducing compression ** compression adjusts the dynamic range or number of shades of gray on the image

Which supplemental technique, used to better visualize the size of a large hydrocele, is demonstrated on the image? extended field of view vector array imaging harmonic imaging curved array imaging

curved array imaging

Harmonic imaging: improves the spatial resolution but causes degradation of temporal resolution is not recommended for use on fetal exams due to increased beam intensity uses information from reflections creates by the non-linear behavior of sound waves to form the image improves spatial resolution but causes degradation of contrast resolution

uses information from reflections creates by the non-linear behavior of sound waves to form the image

Posterior shadowing can be helpful in the diagnosis of all of the following, EXCEPT: GB calculi choledocholithiasis nephrocalcinosis steatosis

steatosis

___ may be a cause for liver echoes distal to the GB to appear brighter than the surrounding parenchyma. posterior enhancement decreased gain settings portal venous reflections posterior shadowing

posterior enhancement

Why did the sonographer steer the US image during the thyroid biopsy? to make the US beam more perpendicular to the nodule to reduce the side lobe artifact to make the US beam more perpendicular to the long axis of the needle to better visualize the borders of the nodule

to make the US beam more perpendicular to the long axis of the needle

Which statement is true about the image? the red arrows are pointing to the anterior wall of the Baker cyst and the associated enhancement the red arrows are pointing to the posterior wall of the Baker cyst and the associated shadowing the red arrows are pointing to the anterior wall of the Baker cyst and the associated shadowing the red arrows are pointing to the posterior wall of the Baker cyst and the associated enhancement

the red arrows are pointing to the anterior wall of the Baker cyst and the associated enhancement

In order to assess low velocity flow, which of the following operator adjustments should be made? decrease wall filter setting and compression increase scale setting decrease compression decrease the rejection and wall filter setting

decrease the rejection and wall filter setting

When the sonographer decreases the imaging depth the ___. PRF will decrease frame rate will decrease PRF will increase elevational resolution will improve

PRF will increase

Time gain compensation is necessary due to: the inability of high frequency transducers to penetrate the body effectively sound impedance difference between transducer and skin the non-linear behavior of sound waves reflection, refraction, and scatter

reflection, refraction, and scatter

Which imaging plane is most commonly used to obtain the length of the spleen during an abdominal ultrasound? TRV SAG axial coronal

coronal

A patient presents with a palpable lump adjacent to the umbilicus. Which of the following transducers would be best to use for this exam? 10MHz linear array 3.5 MHZ linear array 3.5MHz curvilinear array 8MHz sector array

10MHz linear array

Which of the following would be associated with posterior enhancement artifact in the liver tissues? fatty infiltration lymphoma dilated intrahepatic ducts large lipoma

dilated intrahepatic ducts

Power Doppler: is preferred for evaluation of blood flow in a TIPS shunt is preferred for evaluation of blood flow in a patient with suspected PHTN is less sensitive than color Doppler when evaluating renal transplant perfusion display is not dependent on incident beam angle

display is not dependent on incident beam angle

An average sized patient presents with a fever, acute RLQ pain and vomiting. The ER physician wants to rule out appendicitis in this patient. Which transducer would best be suited for the exam? 5MHz curvilinear 3MHz curvilinear 12MHz linear 5MHz linear

5MHz linear

The use of multiple focal zones will improve ___ but degrade ___. axial resolution, lateral resolution temporal resolution, lateral resolution lateral resolution, axial resolution lateral resolution, temporal resolution

lateral resolution, temporal resolution

___ resolution is defined as the ability of an ultrasound system to differentiate structures on an image based on variations in the brightness of the echo/pixel. contrast axial elevational lateral

contrast

Which acoustic artifact is demonstrated on the image? posterior shadowing comet tail mirror imaging range resolution

mirror imaging

All of the following controls affect the amount of color fill in a vessel evaluated with color Doppler, EXCEPT: sample size color Doppler baseline sample angle color Doppler scale settings

color Doppler baseline ** affects what color is displayed but not how much color is displayed

Which imaging plane can produce a longitudinal image of the IVC and the AO on the same image? coronal and TRV mid SAG only coronal only TRV only

coronal only

A contrast agent consists of a cellulose suspension is administered to a patient to better visualize: an aortic aneurysm the pancreatic tail functioning thyroid nodules non-functioning adrenal adenomas

the pancreatic tail

What is the twinkle artifact? mosaic color pattern displayed in a linear pattern posterior to a dense object, such as a renal stone thin line of reverberation artifact that is caused by calcium deposits in the renal parenchyma varied brightness of vascular calcifications causes a twinkling effect on 2D describes the color display seen as urine is entering the bladder during real time imaging

mosaic color pattern displayed in a linear pattern posterior to a dense object, such as a renal stone

Which of the following renal abnormalities is commonly associated with propagation speed artifact? staghorn calculus mycetoma hypernephroma 4cm renal angiomyolipoma

4cm renal angiomyolipoma

Increasing the wall filter setting could reduce the display of all of the following, EXCEPT: aliasing artifact clutter artifact beam width artifact cross talk artifact

aliasing artifact

Which of the following probe frequencies should be used when trying to evaluate the pancreas in an obese patient? 3MHz curvilinear 3MHz linear 5MHz vector 5MHz curvilinear

3MHz curvilinear

Harmonic imaging will: improve temporal resolution allow for deeper penetration with improved spatial resolution degrade lateral resolution and improve axial resolution reduce the appearance of microbubble contrast on a contrast echo

allow for deeper penetration with improved spatial resolution

Which acoustic artifact is a common sonographic sign of emphysematous pylonephritis? side lobe misregistration resonance artifact propagation speed error

resonance artifact

Acoustic Radiation Forced Impulse (AFRI) is typically used to assess the ___ for signs of ___. kidneys, obstructive calculi AO, stenosis abdominal wall, hernia formation liver, chronic disease

liver, chronic disease

No flow is detected while performing a color Doppler evaluation of a normal splenic vein. What will improve the color display? increase the color packet size increase the sample size increase the color velocity scale increasing angle of insonation

increase the color packet size

Which acoustic artifact will commonly be identified with hydrocele formation? edge shadowing posterior shadowing posterior enhancement comet tail artifact

posterior enhancement

Propagation speed artifact, reverberation artifact and the bayonet artifact are acoustic artifacts seen with: needles pneumothorax abdominal aortic aneurysms abscess formation

needles

Which of the following correctly describes why the arcuate arteries are not easily or accurately evaluated by PW Doppler? because the flow is very low resistance the renal capsule attenuates the Doppler signal so only limited information is reflected to the probe because the blood flows perpendicular to the Doppler sound beam because the blood flows parallel to the Doppler sound beam

because the blood flows perpendicular to the Doppler sound beam

Which acoustic property causes the echogenic appearance of the diaphragm related to surrounding structures? refraction attenuation specular reflection non-specular reflection

specular reflection **occurs with large smooth structure

When performing contrast enhanced ultrasound evaluation of the liver, when is the timer started for the procedure? when the contrast is first visualized in the areas of interest at the start of the contrast injection at the start of the saline flush after the saline flush

at the start of the saline flush

Which probe can best evaluate the surface nodularity of the liver in a patient with cirrhosis? vector 10MHz curved 8MHz curved 5MHz linear 7.5MHz

linear 7.5MHz

A mass that demonstrates propagation speed artifact may lead to a positive diagnosis of: lipoma staghorn calculus renal cyst RCC

lipoma

Which of the following will improve the color Doppler visualization of flow in the arcuate arteries? increased transducer frequency increased wall filter settings reduced color gain smaller packet size

increased transducer frequency ** for small vessels increase frequency, packet size, and color gain settings

Which of the acoustic artifacts is demonstrated on the image? range resolution volume averaging mirror image side lobes

mirror image

What system settings should be adjusted to better visualize the abnormality displayed? increase the dynamic range turn off compound imaging reduce the rejection settings turn up the overall gain

turn off compound imaging

Which of the following best describes the probe position used to evaluate the long axis of the pancreas? TRV oblique probe position at the midline with notch side of the probe rotated slightly superior to the side of the probe without the notch SAG probe position just to the left of midline with notch rotated slightly to the left side of the patient TRV oblique probe position at the midline with notch side of the probe rotated slightly inferior to the side of the probe without the notch SAG probe position just to the left of midline with notch rotated slightly to the right side of the patient

TRV oblique probe position at the midline with notch side of the probe rotated slightly inferior to the side of the probe without the notch

Potential bioeffects of ultrasound can be minimized by which of the following? increase PRF decrease overall gain reduce exam time using a lower frequency transducer

reduce exam time