Point-of-Care Ultrasound Education from the Internal Medicine Program at the University of British Columbia
Answer: Fanning (sometimes referred to as tilting or angling)
This probe movement allows the operator to pass through an object from one end to the other
For example, if the view on the screen was a short axis view of the superior pole of the kidney, the mid kidney and inferior pole could be viewed by fanning the probe in the caudal direction
Answer: The linear array transducer is the preferred transducer for imaging superficial structures
The linear array transducer is the high frequency transducer. It provides the best spatial resolution but, gives up depth of penetration. Although it is a great tool to look for pleural sliding, it is not well equipped for a comprehensive lung scan
Answer: Turn down the gain
The image is washed out with filling artifact (the appearance of echoes where there shouldn’t)
This makes it difficult to see details like tissue planes as well as could make finding a small stripe of free fluid within Morrison’s pouch difficult
Answer: Dirty shadowing
Shadowing refers to the effect of a medium or obstacle that prevents the ultrasound from being able to resolve an object below
This may be because the beam is unable to penetrate the obstacle or the beam is scattered by the obstacle
In this case an irregular pattern of bowel gas along the bowel wall scatters the beam producing a dirty (fuzzy) shadow preventing the ultrasound beam from reaching more posterior structures
Answers: Utilizing the liver as a window and using compression to displace the bowel
The liver is a very uniform structure that is easily penetrated by the ultrasound beam making abdominal structures deep to the liver accessible by ultrasound
Compression will displace bowel and bring the transducer closer to the posterior abdomen. This may be helpful for looking at the aorta. It should not be used for an IVC assessment as this will increase intra-abdominal pressure
