Intro Chapter 5 Test

_______  is when part of the body, such as the arm, is moved away from the midline of the body.

abduction

  __________ is when part of the body, such as the arm, is moved toward the midline of the body.

adduction

________ is the ability to use the right or left arm to manipulate the transducer during scanning while the other arm is used for keyboarding.

Ambidextrous Scanning

______ is a closed, fluid-filled sac that contains synovial fluid.

bursa

_________ is a repetitive strain disorder characterized by the median nerve becoming compressed or aggravated within the carpal tunnel of the wrist.

Carpal tunnel syndrome

__________ is a repetitive strain disorder characterized by the ulnar nerve becoming compressed or aggravated within the cubital tunnel of the elbow.

Cubital Tunnel Syndrome

_________ is a repetitive motion injury that is characterized by tenosynovitis of the thumb side of the wrist.

deQuervian disease

______  are the processes used to improve a worker’s comfort, safety, and productivity.

Ergonomic Interventions

_________ is the scientific study of creating tools and equipment that help the human body adapt to the work environment.

Ergonomics

______ relates to how much pressure is applied by one object (transducer) to the surface of another object (the patient)

force

______ is the involuntarily contraction of a muscle

Muscle Spasm

______ is another name for a pinched nerve

Nerve Entrapment

________   is a physical injury acquired carrying out one’s job duties.

Occupational Injuries

_______ are the medical instruments used to promote the use of proper body mechanics by aligning, immobilizing, or supporting parts of the musculoskeletal system.

Orthotic Devices

___________ is a technique that ensures that the spine is in appropriate alignment for virtually any position required to function in one’s daily tasks, such as moving, sitting, standing, and lifting.

proper body mechanics

_________  is maintained muscle work over a long period of time, which is thought to result in the gradual damage to muscles due to abnormal contraction and consequent buildup of fibrous tissue within the muscles.

Static Muscle Loading

___________ is a nerve entrapment disorder that results in the inflammation or irritation of the tibial nerve located within the tarsal tunnel in the foot.

Tarsal Tunnel Syndrome

_______ is the inflammation of a tendon

tendinitis

________ is the compression of the nerves and blood vessels of the neck and shoulder due to repetitive strain

Thoracic Outlet Syndrome

_________ are occupationally acquired or occupationally aggravated injuries to an individuals muscles, tendons, ligaments, or cartilage that result from repetitive use

Work-Related Musculoskeletal Disorders

What percent of clinical sonographers have experienced symptoms of work-related musculoskeletal disorders?

90%

What percent of sonographers experienced career ending injuries

20%

Most common areas of work-related injuries for sonographers

• Shoulders = 84%

• Neck = 83%

• Wrist = 61%

• Back = 58%

• Hands = 56%

Body Mechanics

• center of gravity at the pelvis

• spine is properly aligned

Risk Factors for Developing WRMSD’s

• Posture and body positioning

• Repetitive motions and force

• Room and equipment design

• Job design

• Other threatening physical predisposing factors

• Risks specific to some specialties

Abduction of the arm

• arm moved away from the midline of the body

• overreaching beyond 30 cm for a prolonged period of time can result in muscle fatigue and possible injury

Adduction of the Arm

moving the arm closer to the midline

WRMSDs Preventative Pre-Examination Steps

1. Obtain all necessary equipment for the exam (gel, towels, and positioning devices)

2. choose a comfortable chair that provides good lumbar and foot support and that can swivel

3. Position the ultrasound machine where it is directly in front of you, with your eyes even with the top of the monitor. Make sure that the keyboard is in a place that prevents overstretching of your nonscanning arm.

4. Raise the examination table to prevent excessive leaning, reaching, and bending.

5. Position the patient as close to you as possible to reduce arm abduction and abnormal posturing of the wrist.

6. Place a support cushion under your scanning arm if needed. Occasionally, you can rest your scanning arm on the patient with permission.

7. Make appropriate changes to accommodate for good posture throughout the examination when the patients position must change

The pressure applied with the transducer in combination with sustaining a static posture can lead to

static muscle loading

The majority of exams are given from the

left side of the bed with the use of the sonographers right arm

Varying room design accommodates

ambidextrous scanning and prevents repetitive injury

Equipment Design

• machines lighter

• transducers lighter

• adjustable monitor

• adjustable keyboard

• adjustable console height

• lightweight compared to older models

what is this

neutral standing scanning posture with abduction of scanning arm limited to 30 degrees

what is this

Neutral standing scanning posture with nonscanning arm close to the body with 90-degree elbow flexion.

what is this

Neutral seated scanning posture with abduction of scanning arm limited to 30 degrees

what is this

Neutral seated scanning posture with nonscanning arm close to the body with 90 degree blow flexion

Underlying Predisposing Conditions

• previous trauma

• diabetes

• chronic fatigue

• obesity

• smoking

• excessive alcohol consumption

• rheumatoid arthritis

• Lyme disease

• conditions associated with excessive fluid retention

• having an unhealthy lifestyle

Tenosynovitis

inflammation of the sheath around a tendon

Epicondylitis

inflammation of the periosteum in the area of insertion of the biceps tendon on the distal humerus

Bursitis

inflammation of the bursa within a joint

Pinched Nerve

disorder that results from compression, abnormal stretching, or constriction of a nerve or group of nerves

Common Locations for Pinched Nerves

elbow, wrist, and neck

What is the best treatment for WRMSDs

prevention

• ergonomics intervention

• conditioning and stretching exercises