Module 5: US Scanning and Protocols

What is the term for the number of deliveries > 20 weeks?

Parity

An adequately filled bladder usually extends _______ the fundus of a nongravid uterus.

Just beyond

On average, which transducer is most appropriate for transabdominal US of the pelvis?

3 MHz curvilinear

Prior to an endovaginal ultrasound, the transducer should be lubricated. Which lubricant is generally used?

K-Y jelly/Surgilube

The sonographer can adjust power levels and scan efficiently to minimize patient exposure levels. This is known as:

ALARA

What does ALARA stand for?

As Low As Reasonably Achievable

Which of the following is TRUE about transvaginal/endovaginal ultrasound?

The patient should have an empty bladder for the exam

True or false: If performing high level disinfection, cleaning of the transducer beforehand is not necessary

False

True or False: All solid organs should be measured in three orthogonal planes

True

True or False: Ovaries commonly lie alongside the internal iliac vessels

True

True or False: It is okay to use nonsterile probe covers for TVUS

False

True or False: When performing a TVUS-only, it is not necessary to also look transabdominally

False

True or False: The fallopian tubes are routinely documented and measured

False

When a full urinary bladder is needed, how long before a pelvic ultrasound should a patient finish drinking water?

45 - 1 hour before scan

What are some contraindications for performing transvaginal ultrasound?

• patient is a virgin.

• patient refuses

• patient has vaginal stenosis/atrophy

• uterine prolapse

• pediatric (unless pregnant)

What are two alternatives to transvaginal ultrasound that may be helpful for examining the urethra or vagina?

1. Transperineal ultrasound

2. Transabdominal ultrasound

Top portion of the uterus

Fundus

Imaging through the abdomen

Transabdominal

Within the vagina

Endovaginal

Removal of uterus, ovaries, and uterine tubes

TAH-BSO

What does TAH-BSO stand for?

Total Abdominal Hysterectomy with Bilateral Salpingo-Oophorectomy

Biophysical results of the interaction of sound waves and tissue

Bioeffects

Area of the transducer that comes in contact with the patient and emits ultrasound

Transducer footprint

Area adjacent to the uterus

Adnexa

Position of the patient with the feet in stirrups

Lithotomy position

Inside a cavity such as the abdomen or pelvis

Endocavity

Nonpregnant

Nongravid

electronic measurement tools on US machine

Calipers

Removal of uterine tube(s)

Salpingectomy

Removal of the uterus and cervix

Total abdominal hysterectomy

Hysterectomy

Removal of ovary or ovaries

Oophorectomy

A 75-year-old woman presents for sonographic evaluation of her pelvis because of a suspected mass. What patient history would be most helpful?

Prior imaging studies

Which of the following best describes the scanning technique to document endometrial thickness?

Midline sagittal, through the thickest portion of the double layers

Before performing an endovaginal examination, which question should be asked of the patient before selecting the proper transducer sheath?

Do you have latex allergies?

What is the purpose of putting pressure or rubbing the tip of the endovaginal probe after sheathing?

to eliminate air bubbles

For a transabdominal pelvis sonogram, the patient should do which of the following prior to the examination?

finish 24 oz - 32 oz of water 1 hour prior

Which of the following best describes an advantage of the transabdominal pelvic imaging technique?

it provides a global view of the pelvis

Which of the following best describes how to sonographically assess if the patient's bladder is distended adequately for an ultrasound examination?

the bladder should extend just beyond the uterine fundus on sagittal imaging

A patient is instructed to position herself so that her knees are flexed with her feet in exam stirrups. Which of the following is the term for this position?

lithotomy position

Which of the following describes how to calculate ovarian volume?

(length x width x height) x 0.523

Which of the following uterine positions is best evaluated using endovaginal US?

retroflexion

Endovaginal scanning techniques is not beneficial for?

Large pelvic masses

True or false: Never include endometrial fluid in endometrial measurements

True

Fluid from ovulation will most likely be found where?

In the posterior cul-de-sac

The infant uterus and ovaries are likely what size?

Enlarged due to maternal hormones

When is it okay to perform an empty bladder ultrasound?

When you are performing a TV ultrasound

The purpose of the full bladder with transabdominal (TA) scanning is...

• The get the endometrial stripe perpendicular to the beam

• To push bowel gas out of the way

Which of the following is needed for transvaginal ultrasound (TVUS)?

• lubrication

• probe cover

• chaperone (in many labs)

With TVUS you would use what transducer?

higher frequency endocavity transducer

If you cannot visualize the uterus transabdominally, which of the following is a possible cause?

• Bladder too empty

• Bladder too full

• Pants not low enough

• Probe is too superiorly located on patient

To scan the left ovary on a patient transabdominally, the probe should be placed on the patient's _____ side

Right

Which of the following is TRUE about the ovary?

They lie posterior to the broad ligaments

Which if the following is a contraindication for TVUS?

patient is a virgin

True or False: If the probe undergoes high level disinfection, it does not need to be cleaned first

False

If you are imaging a patient with an anteverted/anteflexed uterustransvaginally, you need to angle (aim) the beam______________ to see the fundus

Anteriorly

Which of the following is NOT a reason for performing transvaginal ultrasound?

pedunculated fundal mass