Lesson 1 Normal anatomy.pptx

Lesson 1 Part 1 If I am skipping slide during a lecture, it is because I will explain the same with image on the screen. When you review the PP do not skip anything! They may be hidden for my slide show but still important. Objectives Regions and Quadrats of the abdomen ⮚ 9 Regions of the abdomen ⮚...

Lesson 1 Part 1 If I am skipping slide during a lecture, it is because I will explain the same with image on the screen. When you review the PP do not skip anything! They may be hidden for my slide show but still important. Objectives Regions and Quadrats of the abdomen ⮚ 9 Regions of the abdomen ⮚ 4 Quadrants Scan planes ⮚ Sagittal ⮚ Transvers ⮚ Coronal ⚫Sonographic Terminology ⚫Two helpful Artifacts Learning approach for each organ ANATOMICAL TERMINOLOGY Anterior- front Posterior- back Superior- Towards the head Inferior- Towards the feet Lateral- Away from the midline Medial- Towards the midline https://www.google.com/search? q=anterior+vs+posterior+images&rlz=1C1 GCEA_enCA921CA921&tbm=isch&source=i u&ictx=1&fir=_dGMhNE2a0LKIM %252CORkvLIkse9jlwM %252C_&vet=1&usg=AI4_kSs4Jmmmpp2_CXdTMMnxBKu2i7usA&sa= X&ved=2ahUKEwjN36vY1P3tAhVvRN8KHYy zA58Q9QF6BAgKEAE#imgrc=_dGMhNE2a0 LKIM cephalad Dorsal Ventral Caudal https://www.google.com/search? q=anterior+vs+posterior+images&rlz=1C1GCEA_enCA921CA921&tbm=isch&source =iu&ictx=1&fir=_dGMhNE2a0LKIM%252CORkvLIkse9jlwM %252C_&vet=1&usg=AI4_kSs4Jmmmpp2_CXdTMMnxBKu2i7usA&sa=X&ved=2ahUKEwjN36vY1P3tAhVvRN8KH YyzA58Q9QF6BAgKEAE#imgrc=npa_zhDXalRa2M PLANES Sagittal or Longitudinal Transverse or Short Axis Coronal Sagittal Meaning long axis to the structure being imaged Left of the screen is the Head or superior portion Right of the screen is the feet or inferior portion Top of the image is anterior Bottom of the image is posterior https://www.grepmed.com/images/2142/orientationultrasound-diagnosis-pulmcrit-anatomy Sagittal AortaAnterior Head Feet Posteri or Transverse Shows the Right of structure and Left of structure Left of the image is the patient’s right and the right side of image is the patient’s left Anterior (top of image) Posterior (bottom of image) https://www.google.com/search? sca_esv=560863457&rlz=1C1GCEA_enCA921CA921& q=transverse+plane&tbm=isch&source=lnms&sa=X&ve d=2ahUKEwie_LzI44CBAxWfFFkFHb1KAUQQ0pQJeg QICRAB&biw=1920&bih=1083&dpr=1#imgrc=eB9UbW D1MIJ9BM Transverse of middle of body https://www.google.com/search?q=ultrasound+orientation&tbm=isch&chips=q:ultrasound+orientation,g_1:transverse:eDtfpmqcVnE %3D&rlz=1C1GCEA_enCA921CA921&hl=en&sa=X&ved=2ahUKEwj9xfiz4YCBAxWyJlkFHXeVAs8Q4lYoBHoECAEQPA&biw=1903 &bih=1083#imgrc=qBGiSyCMWSZy8M Transverse Aorta Anterior Right Left Posterior Coronal Plane The coronal plane is a vertical plane which passes through the body longitudinally – but perpendicular (at a right angle) to the sagittal plane. It divides the body into a front (anterior) section and back (posterior) section. https://teachmeanatomy.info/the-basics/anatomical-terminology/planes/ https://www.healthline.com/health/body-planes#bottom-line Coronal Planes 19 Directional Terminology and Sectional Planes ⬤Coronal ⬤Sagittal ⬤Transverse/ Axial 20 Lesson 1 Part 2 Making Sense of Ultrasound So many shades of Grey, white and Black Curry and Prince: Sonography, 5th Edition Chapter 6 Objectives Ultrasound Parameters  Echogenicity  Echotexture  Size  Contour  Artifacts Windows Near Field and Far Field How do Sonographer’s Differentiate between different tissues? Fluid appears black on ultrasound Anechoic Fluid types vary can be blood, bile etc… What other structures in the body do you think are fluid filled and will appear anechoic? How do Sonographer’s Differentiate between different tissues? Basics first need to determine if something is solid or fluid filled Ultrasound more than just determining Solid versus fluid We have to be able to describe different characteristics of organs within the body Sonographic Parameters Echogenicity Echotexture Size Contour Sonographic Parameters Echogenicity, Echotexture, contour and size Used to describe structures in Sonographic terms ECHOGENICITY Fundamental aspect of ultrasound Differences between organs and tissues seen as varying shades of grey Allow us to Differentiate Between different structures Normal versus Abnormal Compare between different organs Example: spleen has a different echogenicity than the liver Echogenicity Terminology Hypoechoic  darker than surrounding tissue Hyperechoic  brighter than surrounding tissue Isoechoic same echogenicity as surrounding tissue Anechoic  no echoes, black Echogenic  means producing echoes (bright) Normal Organs: Echogenicity Scale In order of increasing echogenicity Generally KIDNEYS (cortex)-LIVER-SPLEEN Comparison between the different organs can help us determine if an organ appears normal Echogenicity Comparison: hyperechoic, hypoechoic or isoechoic Normal Liver is slightly hyperechoic to the kidney Or might be a statement with no comparison between organs Diaphragm appears echogenic (bright) Liver is Hyperechoic to the Kidney Liver Rt kidney Kidney is hypoechoic to the liver Example of Isoechoic (mass is isoechoic the liver) Echotexture Echotexture Homogeneous even echogenicity throughout Inhomogeneous mixed echoes homogeneous or heterogeneous Contour Think border of a structure or organ Smooth or irregular Inhomogeneous/ heterogenous (echotexture) with lobulated contour What is the echotexture or the liver? What is the contour of the kidney? Compare the echogenicity of the liver to the cortex of the kidney. Size Measurements are routinely taken Normal range for organs Measurements U/S DESCRIPTIVE TERMINOLOGY Hypoechoic  darker than surrounding tissue Hyperechoic  brighter than surrounding tissue Isoechoic same echogenicity as surrounding tissue Anechoic  no echoes, black Echogenic  means producing echoes (bright) Homogeneous Even echogenicity Heterogeneous  mixed echoes, dark and light Inhomogeneous synonymous with heterogeneous Artifacts Something that is seen on an image but is not real due to properties of sound Often can be a problem Two that are useful: Shadowing  Absorbs or attenuates the sound waves more rapidly  Ex: stones Acoustic Enhancement  Sound Travels very fast through fluid causing brightness posterior to structure  Ex: Gallbladder (attenuates less sound than surrounding tissue) Common Artifacts that help us Shadowing Posterior Enhancement Learning approach for each organ Anatomy of the organ Sonographic Parameters Normal Variants (a lot of normal differences) Basic Function and lab values “When we know what normal looks like we will be able to recognize abnormal” Windows Windows or Approaches We cannot always scan in the same spot; we need to move our transducer as well as our patient Window: Refers to where we are best able to view the organ Could refer to anterior approach, coronal approach, subcostal (below ribs), intercostal Windows Different approaches needed to view an organ May need to move transducer on patient or angle probe differently to achieve a better “window” think of a real window, one is covered with a curtain, so you move to another window that does not have curtains to see into a house better Example of Windows Might use a structure in the body Example: move more superior and angle probe down to find a better window Use the liver to view a structure better Maneuvers Our patient’s can help us achieve better image’s Technique’s used to improve our image Think of some examples of Maneuver’s? Where is the Near Field and Far Field?