Ultrasound in Perioperative Setting
45 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is an assumption made in ultrasound imaging?

  • The speed of sound in tissues is 1500 m/s.
  • The speed of sound in tissues is 1540 m/s. (correct)
  • Sound waves travel in a curved line.
  • Tissue at different angles does not change the angle of return.

    • What is a benefit of using ultrasound in the perioperative setting?

  • It is only used in trauma cases.
  • It enhances patient care and safety. (correct)
  • It only provides 2D imaging.
  • It is only used for airway evaluation.

    • What is a characteristic of modern ultrasound equipment?

  • It is only used in the ICU.
  • It has advanced capabilities such as 3D imaging. (correct)
  • It is bulky and non-portable.
  • It is only used for lung imaging.

    • What is an example of an application of ultrasound in the perioperative setting?

    <p>Gastric ultrasound.</p> Signup and view all the answers

    When did ultrasound equipment become more compact and portable?

    <p>In the early part of the 21st century.</p> Signup and view all the answers

    What property of tissue can generate shadows in ultrasound imaging?

    <p>All of the above.</p> Signup and view all the answers

    What is a major advantage of using perioperative ultrasound?

    <p>Portability of ultrasound machines and probes</p> Signup and view all the answers

    What is a common similarity between superficial vessels and nerve blocks?

    <p>Techniques used</p> Signup and view all the answers

    What is a potential disadvantage of using perioperative ultrasound?

    <p>Costs of initial purchase and maintenance of equipment</p> Signup and view all the answers

    What type of transducer is best suited for imaging shallow structures at high frequency?

    <p>Linear</p> Signup and view all the answers

    What is a benefit of using perioperative ultrasound in terms of radiation risks?

    <p>Reduces ionizing radiation risks</p> Signup and view all the answers

    What is the primary purpose of FOCUS in emergency situations?

    <p>To narrow down the list of possible diagnoses and guide anesthetic management</p> Signup and view all the answers

    What is the primary focus of the article by Romero-González et al. (2022)?

    <p>PoCUS in Nephrology</p> Signup and view all the answers

    What is the primary benefit of using ultrasound in vascular access?

    <p>To guide cannulation of peripheral and central venous access</p> Signup and view all the answers

    What is the title of the journal in which the article by Via et al. (2014) was published?

    <p>Journal of the American Society of Echocardiography</p> Signup and view all the answers

    What type of transducer is best suited for imaging deeper structures in the abdomen?

    <p>Curvilinear</p> Signup and view all the answers

    What information is obtained from a FOCUS exam?

    <p>All of the above, plus volume response</p> Signup and view all the answers

    What is the purpose of the RUSH exam in emergency shock situations?

    <p>To provide a rapid diagnosis of problems and guide management of intraoperative shock</p> Signup and view all the answers

    What is the primary advantage of using ultrasound in lung imaging?

    <p>It can detect pneumothorax with equal or superior accuracy to CXR</p> Signup and view all the answers

    What type of transducer is best suited for imaging thoracic organs?

    <p>Phased array</p> Signup and view all the answers

    What is a key advantage of using ultrasound in the perioperative setting?

    <p>All of the above</p> Signup and view all the answers

    What is a common similarity between superficial vessels and nerve blocks?

    <p>Techniques used</p> Signup and view all the answers

    According to Romero-González et al. (2022), what is the title of the journal in which the article was published?

    <p>Clinical Kidney Journal</p> Signup and view all the answers

    What is a potential disadvantage of using perioperative ultrasound?

    <p>Costs of initial purchase and maintenance of equipment</p> Signup and view all the answers

    What is the focus of the article by Via et al. (2014)?

    <p>Focused cardiac ultrasound</p> Signup and view all the answers

    What is a characteristic of modern ultrasound equipment?

    <p>Portability and high frequency</p> Signup and view all the answers

    What is an advantage of using perioperative ultrasound in terms of radiation risks?

    <p>Reduced radiation risks to patients</p> Signup and view all the answers

    What is the purpose of the article by Romero-González et al. (2022)?

    <p>To discuss the application of PoCUS in nephrology</p> Signup and view all the answers

    What is a benefit of using perioperative ultrasound in terms of image acquisition?

    <p>Rapid acquisition of images</p> Signup and view all the answers

    What is a limitation of perioperative ultrasound?

    <p>All of the above except b</p> Signup and view all the answers

    What happens when a strong acid or a strong base is added to water?

    <p>It will completely ionize</p> Signup and view all the answers

    What is the characteristic of acid-base reactions?

    <p>Transfer of a hydrogen ion from the acid to the base</p> Signup and view all the answers

    What happens to a weak acid or a weak base when added to water?

    <p>It will partially ionize and partially remain unionized</p> Signup and view all the answers

    What is the result of an acid-base reaction?

    <p>One acid and one base on the reactant side, and one acid and one base on the product side</p> Signup and view all the answers

    Which of the following is true about the reaction equilibrium in acid-base reactions?

    <p>It always favors the formation of the weaker acid</p> Signup and view all the answers

    What is a characteristic of strong acids?

    <p>They are essentially 100% ionized when dissolved in water</p> Signup and view all the answers

    What is a characteristic of strong bases?

    <p>They are soluble ionic hydroxides and ionize essentially 100% to produce the OH− ion</p> Signup and view all the answers

    What happens when a weak acid dissolves in water?

    <p>It establishes a dynamic equilibrium between the molecular form and the ionized form</p> Signup and view all the answers

    What is a characteristic of weak bases?

    <p>They are able to accept hydrogen ions from acids, but are less determined to do so</p> Signup and view all the answers

    What is a key difference between strong and weak acids?

    <p>Strong acids are essentially 100% ionized when dissolved in water, while weak acids are not</p> Signup and view all the answers

    What is the relationship between pH and pKa of a drug?

    <p>When pH is equal to pKa, the drug is 50% ionized and 50% unionized</p> Signup and view all the answers

    What determines whether a drug can cross the blood-brain barrier (BBB)?

    <p>The lipid solubility of the drug</p> Signup and view all the answers

    What is the effect of increasing the Ka of a weak acid?

    <p>The reaction tends to favor the products</p> Signup and view all the answers

    What is the role of a salt in a weak acid or weak base?

    <p>To provide a counterion for the drug</p> Signup and view all the answers

    What is the difference between a weak acid and a weak base?

    <p>A weak acid donates H+, while a weak base accepts OH-</p> Signup and view all the answers

    Study Notes

    Objectives

    • Familiarize yourself with the uses of ultrasound in the perioperative setting
    • Discuss how ultrasound enhances patient care and safety
    • List the uses of ultrasound in the perioperative setting
    • Explain how ultrasound enhances patient care

    History of Ultrasound

    • Early 21st century: Ultrasound equipment became more compact and portable
    • Exploration of other uses of ultrasound in perioperative setting began
      • Lung
      • Gastric
      • Spine
      • Trauma
      • ICU
      • Airway evaluation

    Artifacts

    • Speed of sound in tissues is assumed to be 1540 m/s
    • Sound waves are assumed to travel in a straight line
    • Tissue at different angles and echogenic properties change the angle of return
    • Refractive and reflective properties of tissue generate shadows

    Equipment

    • Several machines and transducers are available for perioperative use
    • Point-of-Care-UltraSound (POCUS) equipment provides basic images and advanced capabilities (e.g. 3D imaging, pulse doppler)
    • Three basic types of transducers:
      • Linear: Shallow structures, high frequency, high definition
      • Phased array: Lower frequencies, better at spatial depth, good for thoracic organs
      • Curvilinear: More depth of field, used for deeper structures in abdomen

    Trans-Thoracic Echocardiography (TTE) and Focused Cardiac Ultrasound (FOCUS)

    • FOCUS is a qualitative exam
    • Used to evaluate heart, valves, and vessels
    • Used in conjunction with physical exam
    • Limited in scope
    • Can be used to narrow down list of possible diagnoses

    FOCUS Information

    • Global biventricular systolic function
    • Atrial and Ventricular chamber size
    • Valvular abnormalities
    • Pericardial effusion or tamponade
    • Volume response

    Emergency Use of Ultrasound

    • Uses of POCUS include FOCUS for multi-organ system evaluation
    • Rapid Ultrasound in Shock (RUSH) for rapid diagnosis of problems and management of intraoperative shock

    Lung Ultrasound

    • Uses linear transducer
    • Can diagnose:
      • Pneumothorax
      • Pleural effusion
      • Pneumonia
      • Pulmonary edema
      • Esophageal or endobronchial intubation
    • Detection of pneumothorax is equal to or superior to CXR

    Vascular Access

    • Ultrasound can be used for cannulation of peripheral and central venous access
    • Can also be used for intra-arterial blood pressure monitoring
    • Techniques used are similar to those used for nerve blocks

    Advantages and Disadvantages of Perioperative Ultrasound

    • Advantages:
      • Versatility
      • Rapid acquisition of images
      • Ability to perform repeated examinations
      • Portability of ultrasound machines and probes
      • Absence of ionizing radiation risks
    • Disadvantages:
      • Costs of initial purchase and maintenance of equipment
      • Training and availability of skilled clinicians

    Objectives

    • Familiarize yourself with the uses of ultrasound in the perioperative setting
    • Discuss how ultrasound enhances patient care and safety
    • List the uses of ultrasound in the perioperative setting
    • Explain how ultrasound enhances patient care

    History of Ultrasound

    • Early 21st century: Ultrasound equipment became more compact and portable
    • Exploration of other uses of ultrasound in perioperative setting began
      • Lung
      • Gastric
      • Spine
      • Trauma
      • ICU
      • Airway evaluation

    Artifacts

    • Speed of sound in tissues is assumed to be 1540 m/s
    • Sound waves are assumed to travel in a straight line
    • Tissue at different angles and echogenic properties change the angle of return
    • Refractive and reflective properties of tissue generate shadows

    Equipment

    • Several machines and transducers are available for perioperative use
    • Point-of-Care-UltraSound (POCUS) equipment provides basic images and advanced capabilities (e.g. 3D imaging, pulse doppler)
    • Three basic types of transducers:
      • Linear: Shallow structures, high frequency, high definition
      • Phased array: Lower frequencies, better at spatial depth, good for thoracic organs
      • Curvilinear: More depth of field, used for deeper structures in abdomen

    Trans-Thoracic Echocardiography (TTE) and Focused Cardiac Ultrasound (FOCUS)

    • FOCUS is a qualitative exam
    • Used to evaluate heart, valves, and vessels
    • Used in conjunction with physical exam
    • Limited in scope
    • Can be used to narrow down list of possible diagnoses

    FOCUS Information

    • Global biventricular systolic function
    • Atrial and Ventricular chamber size
    • Valvular abnormalities
    • Pericardial effusion or tamponade
    • Volume response

    Emergency Use of Ultrasound

    • Uses of POCUS include FOCUS for multi-organ system evaluation
    • Rapid Ultrasound in Shock (RUSH) for rapid diagnosis of problems and management of intraoperative shock

    Lung Ultrasound

    • Uses linear transducer
    • Can diagnose:
      • Pneumothorax
      • Pleural effusion
      • Pneumonia
      • Pulmonary edema
      • Esophageal or endobronchial intubation
    • Detection of pneumothorax is equal to or superior to CXR

    Vascular Access

    • Ultrasound can be used for cannulation of peripheral and central venous access
    • Can also be used for intra-arterial blood pressure monitoring
    • Techniques used are similar to those used for nerve blocks

    Advantages and Disadvantages of Perioperative Ultrasound

    • Advantages:
      • Versatility
      • Rapid acquisition of images
      • Ability to perform repeated examinations
      • Portability of ultrasound machines and probes
      • Absence of ionizing radiation risks
    • Disadvantages:
      • Costs of initial purchase and maintenance of equipment
      • Training and availability of skilled clinicians

    Strong Acids

    • Very determined to donate protons to a base
    • Essentially 100% ionized when dissolved in water
    • Strong acids are relatively rare

    Strong Bases

    • In water, the strongest possible base is the hydroxide ion (OH−)
    • A strong base ionizes essentially 100% to produce the OH− ion
    • A strong base is a soluble ionic hydroxide

    Weak Acids

    • Able to donate hydrogen ions to bases, but are less determined to do so than strong acids
    • Establish a dynamic equilibrium between the molecular form and the ionized form when dissolved in water

    Weak Bases

    • Able to accept hydrogen ions from acids, but are less determined to do so than strong bases
    • Do not completely ionize in water to produce an equivalent concentration of the hydroxide ion
    • Establish a dynamic equilibrium between the molecular form and the ionized form when dissolved in water

    Acid-Base Reactions

    • Involve a transfer of a hydrogen ion from the acid to the base
    • To predict the products of an acid-base reaction, identify the acid and base, move an H+ ion from the acid to the base, and convert the acid into its conjugate base and the base into its conjugate acid
    • Any acid-base reaction has two acids and two bases: one acid and one base on the reactant side, and the conjugate acid and conjugate base on the product side
    • The base almost always has a lower (more negative) charge than the acid
    • Hydrogen is almost always the first atom listed in the formula of an acid
    • The reaction equilibrium always favors the formation of the weaker acid

    Ionization of Weak Acids/Strong Base

    • A drug with a low pKa (e.g. 3.5) is more non-ionized, while a drug with a high pKa (e.g. 8.5) is more ionized
    • pH affects ionization: at pH 1.0, the drug is more acidic and non-ionized, while at pH 14, the drug is more basic and ionized
    • Lipid solubility and ability to cross the blood-brain barrier (BBB) depend on ionization state

    Drugs and Acids/Bases

    • Most drugs are weak acids or weak bases
    • Weak acids are usually paired with a positive ion (e.g. Na+, Ca+, Magnesium), while weak bases are paired with a negative ion (e.g. chloride, sulfate)
    • Drug ionization affects its behavior and effects in the body

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    Lung Cardiac and vascular Ultrasound-1.pptx
    ChemistryAnes2024.pptx

    Description

    Become familiar with the uses of ultrasound in the perioperative setting, discuss its benefits, and list its uses in enhancing patient care and safety.

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser