Aorta Exam

The Quick and Dirty! (for quick review)

Probe: curvilinear

Position: supine

Acquisition:

AAA: >3cm, from outer to outer wall


Indications

Acquisition

The Views

The Patient

The Probe

Aorta Short Axis

Place the probe in the subxiphoid area with the probe marker pointing to the patient’s right. 

Identify your landmarks!    

Vertebral bodies: hyperechoic in the far field.

IVC: superior to the vertebral bodies, on the right of the aorta and have respiratory variability (aka, will change in size with inspiration)!

Aorta: sits on top of the vertebral body or slightly to the left.

Identify the celiac trunk

Sweep the transducer caudally, pushing hard enough to displace bowel gas.

The celiac trunk will be the first branch off of the aorta. The celiac trunk, common hepatic artery, and splenic artery form a "seagull sign!"

Identify the superior mesenteric artery (SMA)

Continue to sweep the transducer caudally, pushing hard enough to displace bowel gas.


The SMA is the second branch off of the aorta. In short axis, the echogenic area around the SMA is called the "donut sign!"

Identify the bifurcation of the iliac arteries

Continue to sweep the transducer caudally, pushing hard enough to displace bowel gas.

The aorta will bifurcate into the right and left iliac arteries, around the level of the umbilicus.

Aorta Long Axis

Place the probe in the subxiphoid area with the probe marker pointing to the patient’s head. 

Rotate the probe until the vessel does not taper at the edges. Vessels should reach from leading edge to receding edge.

Slide your probe caudally. Identify the celiac branches and the SMA coming off of the aorta. They are usually about 1 cm apart from each other!

Slide your probe caudally to identify where the aorta bifurcates into the right and left iliac arteries.

Obtain an abdominal aortic diameter measurement

Abdominal Aortic Aneurysm (AAA)

A diameter > 3cm is diagnostic of AAA. A diameter >5cm is an indication for emergent surgery!

In the image below, you can see evidence of wall thickening & calcifications.

Aortic Dissection

How to identify an aortic dissection

Tips and Tricks

Ultrasound G.E.L. Podcast

Want to learn more? Take a listen to a review of the literature!