Body position
1
Supine
Body Postition
2
Prone
Body Position
3
Right Lateral Decubitus
Body Position
4
Right Posterior Oblique
Body Position
5
Sitting Semi-Erect
Body Position
6
Sitting Erect
Body Position
7
Left Lateral Decubitus
Body Position
8
Left Posterior Oblique
Liver Location
Right and Left hypochondrium
greater part of epigastrium
inferior to diaphragm
in contact with right kidney and IVC
Aorta lies posterior to left lobe
Pancreas Body Location
organ part lies inferior to the left lobe of liver
Subphrenic space
between the liver and diaphragm
common for abcess formation
Right subphrenic space
morrison's pouch
common for periotoneal fluid or blood to collect
Pancreas tail location
lies anterior to the left kidney
posterior to the left colic fixture and transverse colon
Pancreas neck location
lies directly anterior to the portal splenic confluence or SMV
Pancreas Head location
most inferior portion of gland
anterior to the IVC
right of the portal-splenic confluence
inferior to the MPV and caudate lobe
Gallbladder location
Lies on Visceral surface of liver
Main lobar fissure is sonographic landmarkleading to the fossa
Right Kidney location
Lies in retroperitoneal cavity near the posterior wall
just below diaphragm
slightly lower than left
Right lobe of liver pushes it inferior
Left Kidney location
lies in retropertoneal cavity near posterior wall
posterior to pancreas tail
medial of spleen
Spleen location
located between the stomach and the diaphragm in the left hypochondriac region
2.5-5MHz
Transducer Prefuencey for Adult abdominal scans
5-7MHz
Transducer Frequency for pediatric abdominal scans
Liver Function Tests
AST
ALT
LDH
Alk phos
Bilibrubin
PT
Albumin
Globulins
Liver scanning
TGC adjusted to balance near and far echos
overall gain-adjusted to adequatley penetrate the entire right lobe and a smooth homogeneous pattern
depth posterior right lobe positioned at the lower border of screen
focuses near the posterior border
transducer freq. Avg adult 2.5-5MHz, pediatric 5-7MHz
Liver Scanning evaluation
size in the longitudinal plane
attentuation of the parechyma
texture
presence of hepatic vascular structures, ligaments and fissures
Kidney
Cortex
Hilum
pyramids
calyx
Kidney Function
excretes waste
regulates composition of the blood by filtration of harmful wastes, conserving water and metabolites in the body
Kidney lab tests
Urinalysis,
Urine pH,
Protein,
Specific Gravity,
Blood, BUN,
Serum Creatinine,
Hematocrit,
Hemoglobin,
Creatinine clearance
Kidney imaging
always bilateral exam
nephrectomy-long and trvs image of the renal fossa looking for fluid collection
patiens should be hydrated
liver and spleen used and window
deep inspiration will allow approx 2 cm downward shift of kidneys for better visualization
start with RT longitudinal lateral-median then transverse sup-inferior making sure to scan beyond outer contours
Reidels Lobe
Right liver lobe normal variant
more prevalent in Women
ititus
suffix for inflamation
Patient Prep for Scan
NPO after midnight
fat free cream free supper
Longitudinal Scan screen orientation
Head Left
Feet Right
top anterior
bottom posterior
Transverse Scan screen orientation
Right = patient Left
Left = patient right
top anterior
bottom posterior
Patient breath and hold
moves gas
expands veins
expands intercostal region
Hepatapetal
above baseline
toward
Hepatafugal
below baseline
away from
Nephron
Functioning part of kidney
Hepatocyte
functioning unit of Liver
Portal Veins
vs
Hepatic veins
veins have brighter outline due to glycerins capsule
Aortic branches
Celiac Trunk
SMA
Left & Right Renal A
Left & Right Gonadal A
Left & Right Common Iliac
Celiac Trunk
Hepatic Artery
Splenic Artery
Gastric Artery
Main
Left and Right Hepatic Veins
Divide kidney into left, medial and right
Main & Left and Right Portal Veins
divide liver anteriorly and posteriorly