 Second Year: Topics, Objectives, and Expected Competencies Welcome back scanathon practice: All image acquisition will be evaluated based on the following criteria: -Can the organ and anatomy of interest be identified? -Is the proper transducer being used with the correct indicator orientation? -Was the image obtained at the proper depth, gain, and frequency? -Were the correct measurements taken? -Were the correct applications used? Ultrasound in the Evaluation of Fever  Online Videos: UCI Podcast #5 UCI Podcast #14 LP UCI Podcast #2 Thyroid Optional Videos: Ultrasound Podcast Gallbladder Ultrasound Podcast Peritonsillar Abscess Ultrasound for Pneumonia Ultrasound Podcast for Appendicitis 1. Examine for lymphadenopathy in the: a. pre-auricular space b. submandibular region 2. Identify the LP Landmarks, mark them 3. A-Lines in the 8 different lung zones 4. Apical 4-chamber view of the heart - assess for endocarditis a. Without color Doppler b. With color Doppler 5. Using the water bath technique, observe the tendons in the palmar aspect of the hand. 6. Gallbladder a. Sagittal (long axis) b. Transverse (short axis) 7. Fan through the liver observing its architecture to rule out liver abscess. 8. Compress abdominal musculature down to psoas muscle in the right lower quadrant in the location of the appendix. All image acquisition will be evaluated based on the following criteria: -Can the organ and anatomy of interest be identified? -Is the proper transducer being used with the correct indicator orientation? -Was the image obtained at the proper depth, gain, and frequency? -Were the correct measurements taken? -Were the correct applications used? Focused Assessment of the Thorax Exam (FATE) Online Videos: UCI Podcast #2 - FATE 1. Subxiphoid 4-chamber view 2. Inferior vena cava assessment 3. Apical 4-chamber view a. Colorflow Doppler across mitral valve 4. Apical 2-chamber view 5. Parasternal long axis a. Note mitral valve excursion and LV contractility 6. Parasternal short axis a. Papillary muscles b. Fish-mouth mitral valve c. Mercedes-Benz aortic valve 7. Left chest 8. Right chest All image acquisition will be evaluated based on the following criteria: -Can the organ and anatomy of interest be identified? -Is the proper transducer being used with the correct indicator orientation? -Was the image obtained at the proper depth, gain, and frequency? -Were the correct measurements taken? -Were the correct applications used? Lung Ultrasound Online Videos: UCI Podcast #6 UCI Podcast #7 Pneumothorax Optional Videos: Ultrasound of the Dyspneic Patient Lung Ultrasound with Vicki Noble Part 1 Lung Ultrasound with Vicki Noble Part 2 Lung Ultrasound with Mike Stone Part 1 Lung Ultrasound with Mike Stone Part 2 Pneumothorax 1. Choose the correct transducer to assess for pneumothorax. 2. Place the patient in the correct position to assess for pneumothorax. 3. Identify bilateral lung sliding in 2D and M-mode. a. What is the VPPI? b. Describe “ants marching” and “sky-ocean-beach”. 4. Demonstrate how to assess for pneumothorax size. Pleural Effusion 5. Choose the correct transducer to assess for pleural effusion. 6. Place the patient in the correct position to assess for pleural effusion. 7. Identify the diaphragm and the mirror image artifact. a. Right chest b. Left chest Pulmonary Edema 8. Choose the correct transducer to assess for pulmonary edema. 9. Demonstrate the 8 locations (4 per chest). a. Identify A-lines in these locations. Pneumonia 10. Choose the correct transducer to assess for pneumonia. 11. Place the patient in the correct position. 12. Identify the locations of the transducer needed to assess for pneumonia. All image acquisition will be evaluated based on the following criteria: -Can the organ and anatomy of interest be identified? -Is the proper transducer being used with the correct indicator orientation? -Was the image obtained at the proper depth, gain, and frequency? -Were the correct measurements taken? -Were the correct applications used? Gastrointestinal and Genitourinary Ultrasound Online Videos: UCI Podcast #19 Hepatobiliary System 1. Choose the correct transducer to assess the hepatobiliary system. 2. Place the patient in the correct position to assess the hepatobiliary system. 3. Demonstrate the gallbladder in long and short axis using both approaches: a. Subcostal Sweep. b. X minus 7. 4. Demonstrate the portal vein, hepatic veins, and IVC. 5. Measure the common bile duct. 6. Measure the long and short axis of the spleen. Intestinal System 7. Choose the correct transducer to assess the intestinal system. 8. Demonstrate the esophagus and observe saliva being swallowed. 9. Demonstrate compression of the abdominal wall musculature down to psoas muscle in an effort to visualize the appendix. Renal 10. Choose the correct transducer to assess the kidneys. 11. Demonstrate a long axis and short axis of each kidney. a. Differentiate the renal capsule, cortex, and pelvis. Bladder 12. Choose the correct transducer to assess the bladder. 13. Measure the three planes of the bladder and estimate the bladder volume. 14. If time permits, use power flow Doppler with a very low pulse repetition frequency to assess for bladder jets. All image acquisition will be evaluated based on the following criteria: -Can the organ and anatomy of interest be identified? -Is the proper transducer being used with the correct indicator orientation? -Was the image obtained at the proper depth, gain, and frequency? -Were the correct measurements taken? -Were the correct applications used? Cumulative Skills Knobology: a. New patient information input b. 2-D c. M-mode d. Color Doppler e. Power Doppler f. Frequency (Gen-Pen-Res) g. Transducers h. Depth i. Gain j. Artifacts (posterior acoustic enhancement, refraction, reverberation, mirror) DVT: femoral and popliteal Online videosAbdominal vasculature: aorta, IVC, left renal vein, SMA, splenic vein. Online videos a. Aorta assessment b. IVC assessment Carotid: Intimal medial thickness Thyroid short and long axes Eye: Anterior chamber, lens, iris, pupil, posterior segment, retina, optic nerve sheath MSK a. Tissue differentiation (muscle vs bone vs. tendon) b. Patellar tendon c. Gastrocnemius and soleus muscles d. Shoulder joint e. Radius and ulna bones in long and short axis Cardiac 1. Subxiphoid 4-chamber view 2. Inferior vena cava assessment 3. Apical 4-chamber view a. Colorflow Doppler across mitral valve 4. Apical 2-chamber view 5. Parasternal long axis a. Note mitral valve excursion and LV contractility 6. Parasternal short axis a. Papillary muscles b. Fish-mouth mitral valve c. Mercedes-Benz aortic valve 7. Left chest 8. Right chest Pneumothorax 1. Choose the correct transducer to assess for pneumothorax. 2. Place the patient in the correct position to assess for pneumothorax. 3. Identify bilateral lung sliding in 2D and M-mode. a. What is the VPPI? b. Describe “ants marching” and “sky-ocean-beach”. 4. Demonstrate how to assess for pneumothorax size. Pleural Effusion 5. Choose the correct transducer to assess for pleural effusion. 6. Place the patient in the correct position to assess for pleural effusion. 7. Identify the diaphragm and the mirror image artifact. a. Right chest b. Left chest Pulmonary Edema 8. Choose the correct transducer to assess for pulmonary edema. 9. Demonstrate the 8 locations (4 per chest). a. Identify A-lines in these location. Pneumonia 10. Choose the correct transducer to assess for pneumonia. 11. Place the patient in the correct position. 12. Identify the locations of the transducer needed to assess for pneumonia. Hepatobiliary System 1. Choose the correct transducer to assess the hepatobiliary system. 2. Place the patient in the correct position to assess the hepatobiliary system. 3. Demonstrate the gallbladder in long and short axis using both approaches: a. Subcostal Sweep. b. X minus 7. 4. Demonstrate the portal vein, hepatic veins, and IVC. 5. Measure the common bile duct. 6. Measure the long and short axis of the spleen. Intestinal system 7. Choose the correct transducer to assess the intestinal system. 8. Demonstrate the esophagus and observe saliva being swallowed. 9. Demonstrate compression of the abdominal wall musculature down to psoas muscle in an effort to visualize the appendix. Renal 10. Choose the correct transducer to assess the kidneys. 11. Demonstrate a long axis and short axis of each kidney. a. Differentiate the renal capsule, cortex, and pelvis. Bladder 12. Choose the correct transducer to assess the bladder. 13. Measure the three planes of the bladder and estimate the bladder volume. 14. If time permits, use power flow Doppler with a very low pulse repetition frequency to assess for bladder jets. All image acquisition will be evaluated based on the following criteria: -Can the organ and anatomy of interest be identified? -Is the proper transducer being used with the correct indicator orientation? -Was the image obtained at the proper depth, gain, and frequency? -Were the correct measurements taken? -Were the correct applications used? |
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