Clinical Ultrasound: A Pocket Manual

360 Pages·2018·17.93 MB·English

by  Angela Creditt

Angela Creditt · Jordan Tozer
Michael Vitto · Michael Joyce
Lindsay Taylor
Clinical Ultrasound
A Pocket Manual
123
Clinical Ultrasound
Angela Creditt • Jordan Tozer
Michael Vitto • Michael Joyce
Lindsay Taylor
Clinical Ultrasound
A Pocket Manual
Angela Creditt Jordan Tozer
Emergency Medicine Emergency Medicine
Virginia Commonwealth Virginia Commonwealth
University University
Richmond, Virginia, USA Richmond, Virginia, USA
Michael Vitto Michael Joyce
Emergency Medicine Emergency Medicine
Virginia Commonwealth Virginia Commonwealth
University University
Richmond, Virginia, USA Richmond, Virginia, USA
Lindsay Taylor
Virginia Commonwealth
University
Richmond, Virginia, USA
ISBN 978-3-319-68633-2 ISBN 978-3-319-68634-9 (eBook)
https://doi.org/10.1007/978-3-319-68634-9
Library of Congress Control Number: 2017961310
© Springer International Publishing AG 2018
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Preface
Point-of-care ultrasound is quickly becoming the way of the
future for improving clinical care and patient safety. Its use
has become increasingly prominent in recent years and is
now a routine expectation in almost all fields of medicine due
to its ability to enhance care and expedite diagnosis. This is
mainly due to its real-time, portable, nonionizing image
acquisition without the risks of traditional imaging such as
radiation exposure. In addition, due to its low cost and ease
of deployability, it is rapidly becoming available for point-of-
care use anywhere health care is delivered. Providers are
traveling to developing countries with portable ultrasound
machines, military hospitals are using ultrasound on the
frontlines, rural practice offices are integrating ultrasound
within their patient visits, and emergency medical systems are
placing ultrasound machines on their ambulances and heli-
copters. Furthermore, medical schools are incorporating
ultrasound education into their core curriculum as they are
realizing the positive impact it has on the future career of
their learners.
With this increasing prevalence, the need for a reliable and
easy-to-follow comprehensive resource is obvious. While
training our own resident physicians here at Virginia
Commonwealth University, we realized there were no instruc-
tional resources available to provide concise step-by-step
instructions, as well as normal and abnormal images.
Frequently, learners would have to leave the ultrasound
machine to find a computer or book in order to look up the
image they were interested in obtaining. This is where we
came up with the idea of a pocket manual that can be easily
v
vi Preface
carried around and provide a quick reference for learning on
the job.
Whether you are an emergency medical technician or
senior physician, it is our hope that this manual will ease
some of the intimidation of learning ultrasound. Utilizing
simple bullet point instructions and a vast library of point-of-
care images, this book will be there with you at the bedside to
help with any study you want to complete!
Angela Bray Creditt Richmond, VA
Jordan Tozer Richmond, VA
Michael Vitto Richmond, VA
Michael Joyce Richmond, VA
Lindsay Taylor Richmond, VA
Acknowledgments
Thank you to our VCU Emergency Medicine family for your
persistent support and encouragement. Thank you to those
who have helped contribute to this book including L. Das
Narla M.D., Rashida Woods M.D., Tim Layng D.O., Rohit
Manaktala M.D., Trecia Henriques M.D., Evie Louka, and
Morgan Williams. Lastly, a tremendous thank you to Dr.
Dave Evans, Ultrasound Fellowship Director at VCU, for
educating our medical students, residents, faculty, and other
medical professionals in ultrasound.
vii
Contents
1 Introduction: Basic Ultrasound Principles ........ 1
Basic Terminology ............................ 1
Transducer Selection .......................... 8
Transducer Position ........................... 11
Ultrasound Artifact ........................... 13
References................................... 18
2 Extended Focused Assessment with
Sonography for Trauma........................ 19
Clinical Application and Indications............. 19
Normal EFAST Anatomy...................... 20
Image Acquisition ............................ 22
EFAST Pathology ............................ 34
References................................... 44
3 Cardiac Ultrasound ........................... 47
Normal Cardiac Anatomy...................... 48
Image Acquisition ............................ 49
Parasternal Long Axis......................... 49
Parasternal Short Axis......................... 51
Apical Four- and Two-Chamber................. 53
Subxiphoid................................... 56
Inferior Vena Cava............................ 57
Measuring Global Left Ventricular
Systolic Function ............................. 59
Cardiomyopathies ............................ 61
Right Ventricular Dilation ..................... 64
Pericardial Effusion and Tamponade............. 66
References................................... 72
ix
x Contents
4 Thoracic Ultrasound .......................... 75
Indications/Clinical Application................. 75
Normal Thoracic Anatomy ..................... 76
Image Acquisition ............................ 78
Image Acquisition ............................ 80
Thoracic Pathology............................ 84
References................................... 89
5 Head and Neck Ultrasound .................... 91
Tonsillar Ultrasound .......................... 91
Thyroid Ultrasound ........................... 95
Tracheal Ultrasound........................... 100
Carotid Artery Ultrasound..................... 104
Salivary Gland ............................... 105
References................................... 110
6 Musculoskeletal Ultrasound.................... 113
Clinical Application and Indications............. 113
Normal Musculoskeletal Anatomy .............. 114
Image Acquisition ............................ 115
Shoulder Joint................................ 119
Tendons ..................................... 121
Knee Joint................................... 126
Bone........................................ 128
Nerves ...................................... 130
References................................... 133
7 Abdominal Aortic Aneurysm Ultrasound ........ 135
Clinical Application/Indications................. 135
Normal Aortic Anatomy....................... 136
Image Acquisition ............................ 138
Abdominal Aortic Pathology ................... 142
References................................... 147
8 Biliary Ultrasound ............................ 149
Clinical Application and Indications............. 149
Normal Biliary Anatomy....................... 150
Imaging Overview ............................ 150
Gallbladder Pathology......................... 156
Contents xi
Common Bile Duct Pathology.................. 162
References................................... 164
9 R enal and Bladder Ultrasound ................. 167
Clinical Application and Indications............. 167
Genitourinary Anatomy ....................... 168
Image Acquisition ............................ 169
Renal Pathology.............................. 176
Bladder Pathology ............................ 181
References................................... 184
10 Abdominal Ultrasound ........................ 185
Clinical Application and Indications............. 185
Normal Abdominal Anatomy................... 186
Image Acquisition ............................ 186
Abdominal Pathology ......................... 188
References................................... 195
11 Gynecologic Ultrasound ....................... 197
Clinical Application and Indications............. 197
Normal Gynecologic Anatomy.................. 198
Image Acquisition ............................ 199
Gynecologic Pathology ........................ 204
References................................... 211
12 Obstetric Ultrasound.......................... 213
Clinical Application and Indications............. 213
Normal Gynecologic Anatomy.................. 214
Image Acquisition ............................ 214
Evaluation for Intrauterine Pregnancy ........... 220
Obstetric Pathology........................... 226
References................................... 235
13 Testicular Ultrasound ......................... 237
Clinical Application and Indications............. 237
Normal Testicular Anatomy .................... 238
Image Acquisition ............................ 238
Testicular Pathology........................... 241
References................................... 252