chapter 1: abdominal sono overview

anterior (ventral)

toward the front of the body or the front of a body part

contralateral

on the opposite side of the body

deep

away from the surface of the body or structure

distal

farther away from the point of attachment or origin of an extremity to the trunk of the body

inferior (caudal)

• toward the feet or away from the head

• a structure that is lower than another part of the body

• the lower part of an organ or structure

ipsilateral

on the same side of the body

lateral

away from the midline of the body or pertaining to the side

medial

toward the middle (midline) of the body or organ

posterior (dorsal)

toward the back or behind another structure

proximal

toward the origin or attachment of a structure to the trunk

superficial

closer to the surface of the body or structure

superior (cranial)

toward the head or high in the body

anechoic

without echoes

complex

having both cystic and solid components

echogenic

structure that produces echoes

heterogeneous

of differing composition

homogeneous

of uniform composition

hyperechoic

having many echoes

hypoechoic

having few echoes

isoechoic

having the same echogenicity

the normal echogenicity of the abdominal organs from greatest (brightest) to least (darkest) is:

renal sinus → pancreas → spleen → liver → renal cortex → renal pyramids → gallbladder

sono characteristics of a simple cyst (STAR criteria):

• smooth walls or borders

• through transmission (acoustic enhancement)

• anechoic

• round in shape

sono characteristics of a complex cyst:

• large amount of internal debris

• septations

• mural nodules

• contain a fluid-fluid level or other components

how long should pt’s, (especially with a gallbladder), fast for before an abdominal sono?

6-8 hrs

what is the purpose of fasting before an abdominal sono?

to ensure that the gallbladder is fully distended and to potentially reduce the amount of upper abdominal gas

leukocytosis in general indicates:

the presence of an inflammatory response owing to infection

a decrease in hematocrit can indicate:

bleeding like pts who have suffered recent trauma or have an active hemorrhage

basic pt care includes assessment of:

• body temp

• pulse

• respiration

• blood pressure

for pts with IV therapy, the IV fluid bag should be in what position?

it should be continually elevated to prevent retrograde flow

for pts with a urinary catheter, the urinary bag should be in what position?

should be placed below the level of the urinary bladder to prevent retrograde flow that could result in a UTI

what is one of the most common causes of nosocomial infections?

urinary tract infection (UTI)

what are the standard precautions/universal precautions sonographers should follow to prevent the spread of infection?

1. hand hygiene

2. the use of PPE

3. safe injection practices

4. sharps safety

5. respiratory hygiene and coughing etiquette

6. sterile instruments and devices

7. clean and disinfected environmental surfaces

the CDC recommends that healthcare workers use what as the primary mode of hand hygiene in the clinical setting?

an alcohol-based hand rub

medical asepsis

refers to the practices used to render an object or area free of pathogenic microorganisms

what is the cycle of infection?

1. reservoir

2. exit from reservoir

3. vehicle of transmission

4. portal of entry

5. susceptible host

what type of transducer should be used when imaging superficial structures (thyroid, scrotum, breast, MSK, appendix, pylorus)?

higher frequency linear array transducers → 7.5-18 MHz or higher

what type of transducer should be used for a general abdominal scan fort he assessment of deeper or larger structures like the liver, abdominal aorta or pancreas?

lower frequency curved array transducer → 2.0-5.0 MHz

when should a standoff pad be used?

when imaging superficial structures like splinters, superficial masses or foreign objects just below the surface of the skin