DMS 1303: Sonographic Terminology, Image Orientation, and Labeling

Comprehensive vocabulary flashcards covering anatomical directional terms, patient positioning, ultrasound physics, sonographic echogenicity, probe maneuvers, image orientation, and labeling standards from DMS 1303.

Proximal

Toward or nearest the point of origin.

Distal

Away from the point of origin.

Medial

Toward the midline or middle of the body.

Lateral

Away from the midline / pertaining to the side of the body.

Unilateral

Occurring on one side of the body.

Bilateral

Occurring on both sides of the body.

Ipsilateral

Affecting the same side of the body.

Contralateral

Affecting the opposite side of the body.

Anterior (Ventral)

Structure lying toward the front of the body or body part.

Posterior (Dorsal)

Structure lying toward the back of the body or behind another structure.

Superior (Cephalic, Cranial)

Structure closer or toward to the patient's head.

Inferior (Caudal)

Structure lying toward the patient's feet or away from the head.

Superficial

Structure is close to the body surface.

Deep

Structure is away from the body surface.

Scanning Planes

Describes the transducer's orientation relative to the body or a structure.

Sagittal Plane (Longitudinal, Long Axis)

Divides the body or body part into right and left sides.

Transverse Plane (Short Axis)

Divides the body or body part into superior and inferior portions.

Coronal Plane

Divides the body or body part into anterior and posterior portions.

Oblique Plane

On a slant from the other planes.

Supine

Patient position lying face up.

Prone

Patient position lying face down.

Lateral Decubitus

Patient position lying on side.

Right Lateral Decubitus (RLD)

Lying on right side (right side of body down against the cart).

Left Lateral Decubitus (LLD)

Lying on left side (left side of body down against the cart).

Trendelenburg Position

A supine position in which the feet are higher than the head.

Reverse Trendelenburg Position

A supine position with the head higher than the feet.

Fowler Position

Head of the bed (cart) raised to various levels.

Ultrasound

Sound waves having a frequency above the audible range of the human ear.

Acoustics

The science of sound, including its production, propagation and effects.

Acoustic Wave

A mechanical disturbance which propagates through a continuous medium.

Acoustic Window

Optimal location on the body for sound waves to travel to the location of interest (also known as Sonographic Window).

Sonographic Window

Another term for acoustic window, denoting the optimal body location for sound waves to reach the area of interest.

Acoustic Power

Ultrasound knob that controls the amount of energy the transducer is emitting into the patient (also known as Output Power).

Output Power

An alternate term for acoustic power, which controls the transducer's energy output into the patient.

ALARA Principle

As Low As Reasonably Achievable; minimal exposure of sound intensity to the patient to avoid the potential for tissue heating and cavitation.

Cavitation

Formation of gas-filled cavities in tissue, a potential bioeffect minimized by following the ALARA principle.

Tissue Heating

A potential biological effect of sound intensity on patient tissue that ALARA seeks to avoid.

Real Time Imaging

Continual imaging of the body as if you were watching a movie.

Grayscale Imaging

Image displayed in multiple shades of gray.

Color Flow Imaging

Ability of blood flow to be displayed in various color hues depending on the speed and direction of blood flow.

Duplex Imaging

Simultaneous display of grayscale and/or color with Doppler.

Doppler

Describes the behavior of sound waves as they reflect off moving red blood cells in blood.

Christian Johann Doppler

The historical scientist credited with the foundational Doppler principles referenced in sonography.

Doppler Waveform

A waveform produced on the ultrasound image reflecting the Doppler shift and flow characteristics of blood.

Color Doppler

Shows speed and direction of blood flow by showing various color hues.

Power Doppler

Looks at strength (amplitude) of the returning signal; more sensitive for slow moving blood flow.

Amplitude (Power Doppler)

The strength of the returning signal assessed in Power Doppler to detect slow moving flow.

Continuous Wave Doppler

Doppler using two elements: one that continuously sends ultrasound into the body, and one that continuously receives the returning signal (Indirect).

Indirect Doppler

A classification describing continuous wave Doppler, which continuously sends and receives ultrasound signals.

Pulsed Wave Doppler

Technique using pulses of sound to obtain a Doppler signal from a specified depth (Direct).

Direct Doppler

A classification describing pulsed wave Doppler, which targets a specified anatomical depth.

M-mode

Demonstrates the motion of structures along a single scan line.

Clinical Uses of M-mode

Used in obstetrics (OB) for the fetal heart and echocardiography to evaluate motions of structures like heart valves.

Transducer (Probe)

Device used to obtain an image that converts energy from one form to another.

Frequency of the Transducer

Determines the penetration of the sound beam into the patient.

Megahertz (MHz)

Unit of measurement for transducer frequencies equal to one million cycles per second ($10^6\,\text{cycles/second}$).

High MHz Transducers

Frequencies in the range of $7.5 - 15\,\text{MHz}$, which yield shallow penetration.

Low MHz Transducers

Frequencies in the range of $1.5 - 5\,\text{MHz}$, which yield deep penetration.

Sector

Shape of the image that depends on the type of transducer used and the alignment of elements in the transducer.

Transducer Elements

Internal components whose alignment determines the sector shape of an ultrasound display.

Echogenicity

Describes the appearance of the echoes on an image.

Anechoic (Sonolucent)

No internal echoes; shows black on the image.

Hypoechoic

Contains only a few echoes; shows dark gray but not black on the image.

Hyperechoic

Contains many echoes; shows solid bright white on the image.

Echogenic

Structure or tissue producing high echoes.

Isoechoic

Has the same echogenicity as compared to the surrounding tissue.

Homogenous

Sense of having a uniform echogenicity; smooth consistent echo pattern.

Heterogenous

Irregular echogenicity; patchy inconsistent echo pattern.

Solid Mass

Describes a mass with no fluid filled areas (can be hypoechoic, hyperechoic, or isoechoic).

Cystic Mass

Describes a fluid filled mass (will be a pathology that is anechoic).

Complex Mass

Describes a mass having both fluid filled and solid components (will have mixed echoes).

Interface

Surface (boundary) between 2 structures.

Artifacts

Part of the image that does not accurately represent the underlying anatomy.

Shadowing

Failure of the sound beam to pass through an object, producing a blackening of the image posterior to a solid (calcified) structure.

Acoustic Enhancement

Increased echo intensity posterior to a fluid-filled structure, producing an area of brightness (also known as posterior enhancement).

Posterior Enhancement

Alternative name for acoustic enhancement, characterized by increased brightness behind a fluid-filled object.

Anechoic Anatomical Structures

Fluid filled structures showing black on the ultrasound image, such as the gallbladder, urinary bladder, or simple cyst.

Structures Showing Acoustic Enhancement

Fluid filled objects producing posterior brightness, including the urinary bladder, simple cyst, gallbladder, and blood vessels.

Attenuation

Progressive weakening of the sound beam as it travels through body tissue; can be visualized in dense or diseased organs.

Probe Maneuvers

The four basic movements used to manipulate the transducer: sliding, angling, rocking, and rotating.

Sliding

Moving the probe along the surface of the skin in a superior/inferior or lateral/medial movement.

Angling (Sweeping, Tilting)

With the probe face in a fixed position, moving the beam across its axis either side to side or up and down.

Sweeping

Alternative term for angling the probe across its axis with the probe face fixed.

Tilting

Another term for angling the probe face side to side or up and down in a fixed location.

Rocking (Heel/Toe)

With probe face in a fixed position, rocking (like a rocking chair) the probe along the curved or rounded portion of the scan head.

Heel/Toe

Alternative name for the rocking motion of an ultrasound transducer.

Rotating

With the probe face in a fixed position, twisting the probe in a circular motion.

Three Requirements for Image Orientation

Patient position, transducer orientation, and scanning surface (where you are scanning from).

Scanning Surface

The exact location on the patient's body surface where the transducer is positioned to scan.

Image Presentation

The way the image is presented on the monitor, based on transducer position on the scanning surface and the direction of the transducer indicator.

Top of the Image Rule

Always represents the surface of the patient where the transducer is touching.

Bottom of the Image Rule

Represents the anatomical area directly opposite of where the transducer is touching.

Transducer Indicator

A notch, groove, or light on the probe used to align orientation with the monitor.

Monitor Display Indicator

An indicator dot, arrow, or letter of the manufacturer's insignia (usually upper left of screen) signifying transducer notch direction.

Sagittal to Transverse Probe Rotation Rule

Always turn the transducer $90^\circ$ toward you (the sonographer).

Sagittal Transducer Orientation

Transducer orientation where the notch is pointing towards the patient's head (Sag or Long).

Transverse Transducer Orientation

Transducer orientation where the notch is pointing towards the sonographer (TRV or Trans).

Side with the Notch (Image Orientation)

The side of the monitor screen corresponding to the anatomical direction the transducer notch is pointing.

Side Away from the Notch (Image Orientation)

The side of the monitor screen corresponding to the direction opposite to where the notch is pointing.

Supine/Sagittal Orientation

Scanning setup where the patient is lying supine and imaging is performed from an anterior aspect in a sagittal plane.