US Guided Procedures

Question 1

Out of plane vs in plane needle insertion

Answer 1

out of plane: inserting needle perpendicular to the probe marker (aka in the middle of the linear probe)
in plane needle insertion: inserting the needle at the probe marker / bump

Question 2

pros and cons to out of plane needle insertion

Answer 2

pros: see surrounding anatomy (ex/ artery), easy to steady probe over target

cons: only see part of the needle directly under the beam. Easy to lose needle tip and risk injury.

Question 3

pros and cons to in plane needle insertion

Answer 3

pros: visualize entire needle, decrease risk of inadvertent insertion or injection

cons: harder to steady probe over target. Need to align beam and needle exactly overtop of each other.

Question 4

ideal target vein

Answer 4

collapsable, large, superficial, straight, proximal to previous puncture sites, not close to artery/nerve.

Question 5

ideal veins on arm

Answer 5

cephalic, basilic, median cubital vein

not brachial because its close to the brachial artery

Question 6

quantifying pleural effusions

Answer 6

distance between lung and diaphragm(mm) x20 = volume (ml)

Question 7

When doing a thoracentesis, you should insert the needle over the __ rib

Answer 7

over the inferior rib to avoid hitting the intercostal artery and nerve bundles which are lined over top.

Question 8

quantifying ascites

Answer 8

depth cm = volume (L)

Question 9

anatomy to watch out for when doing a pericentesis

Answer 9

you want to be a bit more lateral on the abdomen so that you don’t hit the inferior epigastric artery that courses near the rectus abdominus/linea alba area of the abs.