Thoracic us
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Transcript of Thoracic us
![Page 1: Thoracic us](https://reader036.fdocuments.us/reader036/viewer/2022062300/554b545db4c9051b458b47ec/html5/thumbnails/1.jpg)
Thoracic Ultrasonographic
Examination
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I- Lung and Pleura
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Right side Left side
Applied Anatomy
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Applied Anatomy
Lower airway Trachea
Incomplete tracheal rings
Tracheal bronchus
Left Lung – 2 lobes Divided Cranial Caudal
Right Lung – 4 lobes Divided Cranial Middle Caudal Accessory
(shaded)
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Normal ultrasound of lung and pleura
Reverbration artifacts presents medially to the pleural layers due to presence of air inside the alveoli 3.5 MHz
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Reverbration artifacts presents medially to the pleural layers due to presence of air inside the alveoli 5 MHz
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Reverbration artifacts presents medially to the pleural layers due to presence of air inside the alveoli 6 MHz
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Lung diseases diagnosed by
ultrasonography
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1 -Pneumonia
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Sonogram of a lung of a calf with pneumonia of the cranial lobe the normal lung tissue with reverberation artifacts on the left is distinctly delineated from the abnormal hypoechoic tissue with hyperechoic dot
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Drenching pneumonia
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2-Lung abscesses
Unripe lung abscesses appeared as anechoic areas surrounded by hypoechoic lines
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Ripened abscesses appeared as hypoechoic areas
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Old caseatyed abscesses appeared as echogenic circumscribed areas
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3-Emphysema
Sonogram of pulmonary emphysema (5 MHz): the numerous echogenic bands (C) from the lung surface are comet-tail
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Pleural diseases diagnosed by
ultrasonography
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Pleurisy
Early stage of pleuropneumonia
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Early stage of pleural effusion
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Fibrinous pleuro-pneumonia
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II- Heart (Echocardiography)
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Applied Anatomy
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• Right parasternal long axis view• Right parasternal short axis view• Left parasternal view
Techniques of echocardiograph
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•4th intercostal space (ICS) midway between point of shoulder (POS) and point of elbow (POE)
•Scan plane marker dorsal and slightly cranial (1 o'clock position)
Right parasternal long axis view
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B mode ultrasonography
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Right parasternal long axis view
Right ventricular out flow view tract
RVOT
Left ventricular out flow view tract
LVOTFour chamber view
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A- RVOT
B- LVOT
C- 4- chamber view
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Right ventricular out flow view tractRVOT
Angle transducer towards the left 3rd ICS
Should image:
1. the right atrium (RA)
2. tricuspid valve (TV),
3. right ventricle (RV),
4. pulmonic valve (PV)
5. pulmonary artery (PA)
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RVOT
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Left ventricular out flow view tractLVOT
Angle transducer straight across the thorax towards the left 4th ICS for left ventricular outflow tract (LVOT). Should image:
1-Right atrium (RA),
2-Tricuspid valve (TV),
3-Right ventricle (RV),
4-Interventricular septum (IVS)
5-Aortic valve (AV),
6-Aortic root (AR)
7-Left ventricle
7-Left atrium (LA).
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LVOT
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Four chamber view
Angle transducer caudally towards the left 5th ICS. Should image:
• Right atrium (RA)
• Tricuspid valve (TV)
• Right ventricle (RV)
• Interventricular septum (IVS)
• Left ventricle (LV)
• Mitral valve (MV)
• Left atrium (LA)
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4 chamber view
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Right parasternal short axis view
Rotate the transuducer 90 oSo that the scan plan is cranial and slightly ventral (4 o'clock)
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Right parasternal short axis view
Left ventricularview Mitral valve view Aortic valve view
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A- LV. view
B- Mitral valve view
C- Aortic valve view
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Left ventricular view tractLVOT
Aim slightly ventrally to include the cardiac apex and papillary muscles.Should image the
1- right ventricle (RV)
2- interventricular septum (IVS)
3- left ventricle (LV)
4- dorsal aspects of the papillary muscles
5- left ventricular free wall
(LVFW).
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LV view
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Mitral valve view
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Aortic valve view
Aim dorsally and slightly clockwise for AV Should image1- Tricuspid valve (TV),
2- Aortic root (AR)
3- Aortic valve (AV),
4- Left atrium (LA)
5- Left atrial appendage (LAA).
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Aortic view
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Left parasternal long axis view
• Should be done if:-LA or LV enlargement-MR, PR or AR-Atrial Fibrillation-Pericardial effusion-When all left heart cannot be visualized adequately from right side
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Left parasternal long axis view
RVOT and PA LVOT and AR Mitral Valve
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A- RVOT and PA
B- LVAT and AR
C- Mitral valve
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RVOT and PA
Place transducer in left 3rd ICS and aim straight across the thorax and the scan plane marker facing cranially for PV Should image:
1- Pulmonary artery (PA)
2- Pulmonic valve (PV)
3- Tricuspid valve (TV)
4- Right ventricle (RV)
5- Aortic root (AR).
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MV. View
Place the transducer in the left 5th ICS and aim straight across the thorax with scan plane marker facing dorsally and slightly cranially
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M mode ultrasonography
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RV.length (diastole)--- 3.8 cm
RV.length (systole)--- 2.7 cm
LV length (diastole)----11.9cm
LV length (systole)---- 7.35 cm
IVS d ------------------ 3.02 cm
IVS s ------------------ 4.55 cm
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Cardiovascular diseases diagnosed by
ultrasonography
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1 -Congenital diseases
1-Ventricular septal defect (VSD)
2- Atrial septal defect (ASD)
3- Parent ductus arteriosis (PDA)
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VSD
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1 -Aquired diseases
1-Pericardial diseases (pericarditis) 2- Myocardial diseases (myocardial degeneration) 3- Endocardial diseases (endocarditits)
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1-Pericardial diseases (pericarditis)
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Pericarditis appeared from left parasternal view at 4th intercostal space
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2 -Myocardial diseases (myocardial degeneration)
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3-Endocardial diseases (endocarditis)
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Tricasped endocarditis
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