ITSUS- Self Study Modules

Teaching Ultrasound by Exploring Anatomy

 

Objectives

 

Pre-scan

 

 

 

 

Musculoskeletal Ultrasound - Self-Guided Practice

CARPAL TUNNEL AND FOREARM

 

BEGINNER – Carpal Tunnel Anatomy

To acquire a view of the carpal tunnel and median nerve:

 

 

 

INTERMEDIATE – Color Doppler

From a view of the radial artery:

 

ADVANCED – Anisotropy

From a view of the median nerve:

FINGER AND HAND

 

BEGINNER - Finger

 

ADVANCED – Radial Artery

From a view of the radial artery:

 

 

 

 After Scanning

 

Saving and Labeling Images

 

Head and Neck Ultrasound - Self-Guided Practice

 

 

 

Objectives

 

Pre-scan

1.     Press the power button to turn on the ultrasound machine

 

2.     Press the patient button and enter your Med Center username, year, and program into the “Last Name” field (e.g. DOE01.MS1.TUBEA)

 

3.     Enter the appropriate anatomy in the “First Name” field (e.g. Carotid Sheath)

 

4.     Make sure that the linear probe is selected and that the “Vascular” preset is selected

 

5.     Accept the changes and create the new patient

CAROTID SHEATH

 

BEGINNER – Carotid Sheath Anatomy

 

INTERMEDIATE – Color Doppler

From a view of the carotid sheath:

 

 

ADVANCED – Pulse Wave Doppler

From a centered image of the common carotid artery:

 

VERTEBRAL ARTERY

 

ADVANCED

From a longitudinal view of the carotid artery

VOCAL CORDS

 

ADVANCED

Change the settings of the probe from vascular to superficial. Point the probe to the patient’s right and aim the beam neutrally. Place the probe over the thyroid cartilage so that you get a cross-sectional view of the larynx

After Scanning

 

Saving and Labeling Images

 

Cardiothoracic Ultrasound - Self-Guided Practice

 

 

Objectives

 

Pre-scan

 

 

 

 

PLEURAL VIEW

 

BEGINNER – Pleural Sliding

Put the probe along the right sternal border, with the leading edge toward the model’s head.

 

ADVANCED – Pleural M-mode Tracing

Press M MODE and have your model breathe normally. The motion trace should look a sandy beach

PARASTERNAL LONG AXIS

 

BEGINNER – Parasternal Long Axis and Anatomy

Acquire a parasternal long-axis view

 

INTERMEDIATE – Color Doppler

From a standard parasternal long axis view:

 

INTERMEDIATE – Scrolling Through Saved Frames

From a standard parasternal long axis view:

 

ADVANCED – Changing Image Orientation

From a standard parasternal long-axis view in B mode:

 

ADVANCED – End-Point Septal Separation

From a standard parasternal long-axis view:

 

 

PARASTERNAL SHORT AXIS

 

BEGINNER – Parasternal Short Axis and Anatomy

From a standard parasternal long axis view:

 

 

ADVANCED – Dual Window

From a standard parasternal long-axis view:

APICAL 4-CHAMBER

 

ADVANCED – A4C View and Interpretation

After Scanning

1.     Press the power button to turn off the machine

2.     Remove the sheets from the bed you used and put them in the linens basket. Put new sheets on the bed

3.     Wipe off the probes (and yourself/your model) with towels, and put the towels in the linens basket.

4.     Unplug the machine and wrap the power cord around the back. Make sure all the other wires are in place. Put the machine back where you found it.

5.     Sign-in on the computer in the ultrasound room using the instructions in front of the screen. For the SESSION NAME field, select TUBE-A

 

Saving and Labeling Images

Aortic Ultrasound - Self-Guided Practice

 

 

Objectives

 

Pre-scan

 

 

 

 

 

BEGINNER – Abdominal Aorta and Branches

Note-  When scanning the aorta, bowel gas can occasionally obstruct your view of the structures. You can try to move the gas out of the way by trying to push the bowel gas out of the way.

 

 

INTERMEDIATE – Renal Arteries

Begin by finding the SMA as described above.

 

 

ADVANCED – Pulse-wave Doppler of Aorta and IVC

Begin by finding the abdominal aorta in cross-section, as described above.

After Scanning

1.     Press the power button to turn off the machine

2.     Remove the sheets from the bed you used and put them in the linens basket. Put new sheets on the bed

3.     Wipe off the probes (and yourself/your model) with towels, and put the towels in the linens basket.

4.     Unplug the machine and wrap the power cord around the back. Make sure all the other wires are in place. Put the machine back where you found it.

5.     Sign-in on the computer in the ultrasound room using the instructions in front of the screen. For the SESSION NAME field, select TUBE-A

 

Saving and Labeling Images

1.     When you have an image you like, press freeze

2.     To place a text label, press TEXT and use the trackpad to move the text box near the piece of anatomy you’re labeling. Use the keyboard to enter your label. Press TEXT again to save your label and bring up a new text box.

3.     To place an arrow, press the button with an arrow on it and move it around with the trackpad. Press ____ to save the arrow in that position.

4.     Put a text box in the lower left corner to describe the body part and the view you have acquired (e.g. R FOREARM CROSS SECTION)

5.     Press SAVE to store your labeled image

 

Hepatobiliary Ultrasound - Self-Guided Practice

 

 

Objectives

 

Pre-scan

 

 

 

 

 

 

 

 

 

LIVER AND PORTAL SYSTEM

 

BEGINNER – Hepatic Veins

 

BEGINNER – Portal and Hepatic Veins

 

INTERMEDIATE – Portal System Anatomy

 

ADVANCED – Pulse-wave Doppler of the Portal Vein

GALLBLADDER

 

BEGINNER – Basic Approach to Gallbladder

 

BEGINNER – Costal Approach to Gallbladder

 

 

INTERMEDIATE – Hepatorenal Approach to Gallbladder

 

INTERMEDIATE – Neck of the Gallbladder

PORTAL TRIAD

 

ADVANCED – Portal Triad Flows

 

ADVANCED – Common Bile Duct Diameter

 

 

DUODENUM AND PYLORUS

 

BEGINNER – Duodenal Anatomy

·       Place probe in sagittal plane (indicator pointing cephalaud) below xiphoid.

·       Sweep probe laterally observing liver in near field.

·       Identify duodenum by the classic appearance of bowel (hypo- to anechoic rim of muscularis with hyperechoic mucosa in center)

·       Once identified, center the structure using sliding and rocking.

·       Save image with appropriate labels (liver, duodenum)

  

INTERMEDIATE - Peristalsis

·       Rotate the probe clockwise to identify the long axis of the 1st part of duodenum as it connects to the stomach and pylorus.

·       Use zoom to enlarge the image

·       If possible, drink a glass of water and identify water entering the stomach

·       Watch peristalsis as fluid moves through stomach and enters the duodenum through the pylorus

After Scanning

 

Saving and Labeling Images

 

Renal Ultrasound - Self-Guided Practice

 

 

Objectives

 

Pre-scan

 

 

 

 

KIDNEYS

 

BEGINNER - HEPATORENAL

 

 

BEGINNER - SPLENORENAL

 

INTERMEDIATE – POWER DOPPLER

 

BLADDER

 

BEGINNER – TRANSVERSE VIEW OF BLADDER

 

INTERMEDIATE – BLADDER VOLUME

 

 

 

 

 

 

ADVANCED – URETERAL JETS AT THE TRIGONE

 

After Scanning

 

Saving and Labeling Images

Press SAVE to store your labeled image

Thyroid Ultrasound - Self-Guided Practice

 

 

 

Objectives

 

Pre-scan

 

 

 

 

THYROID

 

BEGINNER – Thyroid Anatomy

 

INTERMEDIATE – Width of the Thyroid Lobes

 

INTERMEDIATE – Superior Thyroid Artery

 

ADVANCED – Vocal Cords

After Scanning

 

Saving and Labeling Images

Press SAVE to store your labeled image

 

Pelvic Ultrasound - Self-Guided Practice

 

 

Objectives

 

Pre-scan

 

 

 

 

UTERUS

 

BEGINNER – Sagittal Uterus

Place the endoluminal probe into the vagina, with the leading edge along the ventral surface. The leading edge is on the same side of the probe as your thumb.

 

 

INTERMEDIATE – Coronal View of the Ovary

Acquire a sagittal view of the fundus of the uterus, with the endometrial stripe visible

 

ADVANCED – Ovarian Volume

Begin from a coronal view of the uterus

GESTATIONAL SAC

 

ADVANCED – Estimate Gestational Age

Begin with a sagittal view of the uterus

After Scanning

 

Saving and Labeling Images