BOOK
Sonography Exam Review: Physics, Abdomen, Obstetrics and Gynecology - E-Book
(2014)
Additional Information
Book Details
Abstract
Be confident that you can answer any and all questions on your registry exams correctly when you prepare with this complete review. MosbyÂ’s Comprehensive Review for General Sonography Examinations provides study resources for all three main exams required for general ultrasound practice: physics, abdomen, and ob/gyn. Each chapter is arranged in table and outline format with 50 review questions at the end of the chapter and a mock exam at the end of each section. Access additional mock exams for each subject area on the companion CD or Evolve site. These exams give you experience with timed test taking in an electronic environment that simulates the actual registry exam experience. With this realistic preview of the exam environment and solid review of the material, youÂ’ll be prepared to ace the exams!
"..no doubt that this is a worthwhile text which could provide a useful revision platform for sonography students in the UK." Reviewed by Sue Halson-Brown on behalf of RAD Magazine, February 2015
- Complete preparation for the three general ARDMS exams (physics, abdomen, and ob/gyn)
- Content review in outline and tabular format provides a quick review of all the material you need to learn, including key terms, anatomy, functions, scanning techniques, lab values, and pathology.
- More than 2,500 questions in Registry format cover everything you’ll be tested on in the Registry exams.
- Rationales for answers to mock questions help you understand why an answer is correct or incorrect and increase your comprehension.
- More than 350 ultrasound scans included in the abdominal and ob/gyn sections prepare you for exam questions that ask you to identify pathology on scans.
- Color insert with Doppler images of the liver, biliary, and umbilical cord helps you be ready to answer questions related to Doppler imaging.
- Companion CD provides extra timed, graded mock exams and two entertaining, interactive games: Sonography Millionaire and Tournament of Sonography.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front cover | Cover | ||
| Front matter | i | ||
| Sonography exam review: | i | ||
| Physics, abdomen, obstetrics and gynecology 2nd edition | i | ||
| Copyright page | ii | ||
| About the author | iii | ||
| Dedication | iv | ||
| Reviewers | v | ||
| Preface | vi | ||
| Content and organization | vi | ||
| Features | vi | ||
| Registry-level questions | vi | ||
| Images and illustrations | vi | ||
| Evolve | vii | ||
| How to use | vii | ||
| Acknowledgments | viii | ||
| Table of contents | ix | ||
| I: Physics | 1 | ||
| 1 Clinical safety | 2 | ||
| Key terms | 2 | ||
| Occupational safety and health act (osha) | 2 | ||
| Ergonomics | 2 | ||
| Work-related musculoskeletal disorders (wrmsd) | 3 | ||
| Causes of WRMSD in sonography | 3 | ||
| Types of injuries | 3 | ||
| Prevention of injury | 3 | ||
| Bioeffects and alara principle | 4 | ||
| Safety | 4 | ||
| ALARA principle | 4 | ||
| Intensity of ultrasound | 5 | ||
| Spatial peak (SP) | 5 | ||
| Spatial average (SA) | 5 | ||
| Temporal peak (TP) | 5 | ||
| Temporal average (TA) | 5 | ||
| Pulse average (PA) | 5 | ||
| Intensity values (lowest to highest) | 5 | ||
| Spatial average–temporal average (SATA) | 5 | ||
| Spatial peak–temporal average (SPTA) | 5 | ||
| Spatial average–pulse average (SAPA) | 5 | ||
| Spatial peak–pulse average (SPPA) | 6 | ||
| Spatial average–temporal peak (SATP) | 6 | ||
| Spatial peak–temporal peak (SPTP) | 6 | ||
| Instrument output | 6 | ||
| Biological effects | 6 | ||
| Cavitation | 6 | ||
| Stable cavitation | 6 | ||
| Transient cavitation | 6 | ||
| Acoustic output labeling standards | 7 | ||
| System maintenance | 8 | ||
| Bioeffects and safety review | 9 | ||
| 2 Physics principles | 13 | ||
| Key terms | 13 | ||
| Sound categories | 14 | ||
| Infrasound | 14 | ||
| Audible sound | 14 | ||
| Ultrasound | 14 | ||
| Sound waves | 14 | ||
| Pulse ultrasound | 16 | ||
| Propagation of ultrasound | 16 | ||
| Incident beam = reflected beam + transmitted beam | 17 | ||
| Perpendicular incidence | 17 | ||
| Oblique incidence | 17 | ||
| Reflection of ultrasound | 17 | ||
| Specular reflections | 17 | ||
| Scatter | 18 | ||
| Rayleigh’s scatter | 18 | ||
| Harmonic frequencies | 18 | ||
| Transmission of ultrasound | 18 | ||
| Refraction of ultrasound | 18 | ||
| Decibel (dB) | 19 | ||
| Attenuation | 19 | ||
| Attenuation coefficient | 20 | ||
| Half value layer | 20 | ||
| Range equation | 20 | ||
| Physics principles review | 22 | ||
| 3 Ultrasound transducers | 25 | ||
| Key terms | 25 | ||
| Diagnostic ultrasound transducers | 26 | ||
| Piezoelectricity (piezoelectric effect) | 26 | ||
| Types of transducers | 27 | ||
| Continuous wave | 27 | ||
| Pulse wave | 27 | ||
| Unfocused sound beam (figs. 3-1 and 3-2) | 28 | ||
| Focusing of the sound beam (fig. 3-3) | 29 | ||
| Types of focusing | 29 | ||
| Acoustic mirrors | 29 | ||
| Dynamic receive focusing | 29 | ||
| Electronic | 30 | ||
| External | 30 | ||
| Internal | 30 | ||
| Steering of the sound beam (fig. 3-4) | 30 | ||
| Resolution | 31 | ||
| Transducer care | 32 | ||
| Transducer review | 33 | ||
| 4 Pulse-echo instrumentation | 37 | ||
| Key terms | 37 | ||
| Display modes | 38 | ||
| A-mode | 38 | ||
| B-mode | 38 | ||
| M-mode | 38 | ||
| Volumetric scanning | 38 | ||
| Real-time imaging | 38 | ||
| Advantages | 38 | ||
| Limitations | 38 | ||
| Pulse-echo instrumentation | 40 | ||
| Functions | 40 | ||
| Power | 40 | ||
| Transducer | 40 | ||
| Channels | 40 | ||
| Master synchronizer | 40 | ||
| Pulser (transmitter) | 40 | ||
| Digital beam former | 41 | ||
| Pulse delays | 41 | ||
| Transmit and receiver switch (t/r switch) | 41 | ||
| Signal processing | 41 | ||
| Receiver | 41 | ||
| Amplification | 41 | ||
| Time gain compensation (fig. 4-1) | 41 | ||
| Compression | 42 | ||
| Demodulation | 42 | ||
| Rejection (threshold, suppression) | 42 | ||
| Image storage | 43 | ||
| Scan converter | 43 | ||
| Analog scan converter | 43 | ||
| Digital scan converter | 43 | ||
| Analog-to-digital converter | 43 | ||
| Digital memory | 43 | ||
| Digital-to-analog converter | 43 | ||
| Memory | 43 | ||
| Functions | 43 | ||
| Random-access memory (RAM) | 43 | ||
| Read-only memory (ROM) | 43 | ||
| Bit | 43 | ||
| Binary numbers | 44 | ||
| Preprocessing | 44 | ||
| Persistence | 44 | ||
| Region of interest/expansion | 44 | ||
| Write zoom | 44 | ||
| Postprocessing (contrast variation) | 44 | ||
| B-color | 44 | ||
| 3-D presentation | 44 | ||
| Read zoom | 44 | ||
| Image display | 45 | ||
| Matrix | 45 | ||
| Pixel | 45 | ||
| Pixel density | 45 | ||
| Voxel | 45 | ||
| Cathode ray tube (CRT) | 45 | ||
| Computer monitor | 45 | ||
| Liquid-crystal display (LCD) | 45 | ||
| Recording techniques | 46 | ||
| Hard copy imaging | 46 | ||
| X-ray film | 46 | ||
| Thermal processors | 46 | ||
| Laser imaging | 46 | ||
| Digital recording device | 46 | ||
| Videotape player | 46 | ||
| Archive storage | 46 | ||
| Magnetic-optical disk | 46 | ||
| Picture archiving and communication system (PACS) | 46 | ||
| Standards for archiving medical files | 46 | ||
| American college of radiology (ACR) | 46 | ||
| Digital imaging and communications in medicine (DICOM) | 46 | ||
| National electrical manufacturers association (nema) | 47 | ||
| Artifacts of ultrasound | 47 | ||
| Caused by | 47 | ||
| Assumptions in the design of ultrasound systems | 47 | ||
| Pulse-echo instrumentation review | 50 | ||
| 5 Doppler instrumentation and hemodynamics | 55 | ||
| Key terms | 55 | ||
| Hemodynamics | 56 | ||
| Cardiac circulation | 56 | ||
| Volumetric flow rate | 57 | ||
| Continuity rule | 57 | ||
| Types of blood flow | 57 | ||
| Venous hemodynamics | 58 | ||
| Doppler shift | 59 | ||
| Doppler equation | 59 | ||
| Doppler effect | 59 | ||
| Detection of doppler shift | 59 | ||
| Factors influencing the doppler shift | 59 | ||
| Spectral ratios | 61 | ||
| Pulsatility index | 61 | ||
| Resistant index (pourcelot index) | 62 | ||
| Hemodynamics and doppler review | 63 | ||
| 6 Quality assurance, protocols, and new technologies | 68 | ||
| Key terms | 68 | ||
| Quality assurance (QA) | 68 | ||
| Methods of evaluation | 68 | ||
| Operation testing | 68 | ||
| Acoustic output testing | 68 | ||
| Record keeping | 70 | ||
| Statistical indices | 70 | ||
| Protocols | 70 | ||
| New technologies | 71 | ||
| Contrast agents | 71 | ||
| Contrast harmonic imaging | 71 | ||
| Elastography | 71 | ||
| Quality assurance review | 72 | ||
| Physics Mock Exam | 75 | ||
| II: Abdomen | 85 | ||
| 7 Liver | 86 | ||
| Key terms | 86 | ||
| Physiology | 86 | ||
| Functions of the liver | 86 | ||
| Anatomy (figs. 7-1 and 7-2) | 86 | ||
| Liver divisions | 87 | ||
| Left lobe | 87 | ||
| Right lobe | 87 | ||
| Caudate lobe | 88 | ||
| Liver ligaments | 88 | ||
| Coronary | 88 | ||
| Falciform | 88 | ||
| Gastrohepatic | 88 | ||
| Hepatoduodenal | 88 | ||
| Teres | 88 | ||
| Triangular | 88 | ||
| Venosum | 88 | ||
| Liver spaces | 88 | ||
| Morison pouch (hepatorenal pouch) | 88 | ||
| Subhepatic space | 88 | ||
| Subphrenic space | 89 | ||
| Vascular anatomy | 89 | ||
| Hepatic arteries | 89 | ||
| Hepatic veins | 89 | ||
| Portal veins | 89 | ||
| Location | 89 | ||
| Left lobe | 89 | ||
| Right lobe | 89 | ||
| Caudate lobe | 89 | ||
| Sonographic appearance | 90 | ||
| Liver | 90 | ||
| Bile ducts | 90 | ||
| Hepatic vein | 90 | ||
| Portal vein | 90 | ||
| Hepatic artery | 90 | ||
| Technique | 91 | ||
| Preparation | 91 | ||
| Examination technique and image optimization | 91 | ||
| Indications for examination | 91 | ||
| Laboratory values | 91 | ||
| Alkaline phosphatase | 91 | ||
| Alpha-fetoprotein | 91 | ||
| Alanine aminotransferase (ALT) | 92 | ||
| Aspartate aminotransferase (AST) | 92 | ||
| Bilirubin | 92 | ||
| Prothrombin time | 92 | ||
| Serum albumin | 92 | ||
| Hepatic transplant | 98 | ||
| Preoperative protocol | 98 | ||
| Postoperative complications | 98 | ||
| Liver review | 99 | ||
| 8 Biliary system | 105 | ||
| Key terms | 105 | ||
| Biliary system | 106 | ||
| Functions of the biliary system | 106 | ||
| Biliary anatomy (fig. 8-1) | 106 | ||
| Bile ducts | 106 | ||
| Common hepatic duct | 106 | ||
| Cystic duct | 106 | ||
| Common bile duct | 107 | ||
| Size of the normal bile duct | 107 | ||
| Sonographic appearance | 107 | ||
| Normal intrahepatic bile ducts | 107 | ||
| Normal extrahepatic bile ducts | 107 | ||
| Longitudinal plane | 107 | ||
| Transverse plane | 107 | ||
| Abnormal intrahepatic and extrahepatic ducts | 107 | ||
| Gallbladder physiology and anatomy | 107 | ||
| Functions of the gallbladder | 107 | ||
| Gallbladder divisions | 108 | ||
| Layers of the gallbladder wall | 108 | ||
| Gallbladder location | 108 | ||
| Gallbladder anatomical variants | 108 | ||
| Congenital anomalies | 108 | ||
| Gallbladder size | 108 | ||
| Sonographic appearance | 108 | ||
| Normal fasting gallbladder | 108 | ||
| Abnormal fasting gallbladder | 108 | ||
| Reasons for nonvisualization of the gallbladder | 109 | ||
| Noninflammatory causes of gallbladder wall thickening | 109 | ||
| Technique | 109 | ||
| Preparation | 109 | ||
| Examination technique and image optimization | 109 | ||
| Indications for ultrasound examination | 110 | ||
| Laboratory values | 110 | ||
| Alkaline phosphatase | 110 | ||
| Alanine aminotransferase (ALT) | 110 | ||
| Aspartate aminotransferase (AST) | 110 | ||
| Bilirubin | 110 | ||
| Biliary review | 116 | ||
| 9 Pancreas | 123 | ||
| Key terms | 123 | ||
| Pancreas physiology | 123 | ||
| Functions of the pancreas | 123 | ||
| Exocrine | 123 | ||
| Endocrine | 124 | ||
| Pancreas anatomy (fig. 9-1) | 124 | ||
| Pancreas divisions and location | 124 | ||
| Tail | 124 | ||
| Body | 124 | ||
| Neck | 124 | ||
| Head | 125 | ||
| Uncinate process | 125 | ||
| Ducts of the pancreas | 125 | ||
| Duct of wirsung | 125 | ||
| Duct of santorini | 125 | ||
| Congenital anomalies | 125 | ||
| Pancreatic divisum | 125 | ||
| Annular pancreas | 125 | ||
| Ectopic pancreatic tissue | 125 | ||
| Cystic fibrosis | 125 | ||
| Sonographic appearance | 126 | ||
| Normal pancreas | 126 | ||
| Abnormal pancreas | 126 | ||
| Normal pancreatic duct | 126 | ||
| Abnormal pancreatic duct | 126 | ||
| Technique | 126 | ||
| Preparation | 126 | ||
| Examination technique and image optimization | 126 | ||
| Indications for ultrasound examination | 127 | ||
| Laboratory values | 127 | ||
| Serum amylase | 127 | ||
| Urine amylase | 127 | ||
| Serum lipase | 127 | ||
| Glucose | 127 | ||
| Pancreatoduodenectomy (whipple procedure) (fig. 9-2) | 129 | ||
| Preoperative criteria | 129 | ||
| Basic procedure | 130 | ||
| Pancreas review | 131 | ||
| 10 Urinary system | 136 | ||
| Key terms | 136 | ||
| Physiology | 136 | ||
| Functions of the urinary system | 136 | ||
| Anatomy | 137 | ||
| Ureter anatomy | 138 | ||
| Arterial supply to the ureter | 138 | ||
| Location | 138 | ||
| Each kidney is located | 139 | ||
| Size | 140 | ||
| Adult | 140 | ||
| Child | 140 | ||
| Infant | 140 | ||
| Technique | 140 | ||
| Preparation | 140 | ||
| Examination technique and imaging optimization | 141 | ||
| Indications for examination | 142 | ||
| Laboratory values | 142 | ||
| Creatinine | 142 | ||
| Blood urea nitrogen | 142 | ||
| Hematuria | 142 | ||
| Proteinuria | 143 | ||
| Concentration–dilution urinalysis | 143 | ||
| Renal dialysis | 147 | ||
| Renal transplant | 147 | ||
| Normal sonographic appearance of the renal transplant | 148 | ||
| Abnormal sonographic appearance of the renal transplant | 148 | ||
| Normal doppler appearance of the renal transplant | 148 | ||
| Abnormal doppler appearance of the renal transplant | 148 | ||
| Urinary bladder anatomy | 148 | ||
| Apex | 148 | ||
| Neck | 148 | ||
| Trigone | 149 | ||
| Normal sonographic appearance | 149 | ||
| Urinary system review | 150 | ||
| 11 Spleen | 158 | ||
| Key terms | 158 | ||
| Physiology | 158 | ||
| Function of the spleen | 158 | ||
| Anatomy (fig. 11-1) | 158 | ||
| Splenic vasculature | 158 | ||
| Location | 159 | ||
| Normal sonographic appearance | 160 | ||
| Technique | 160 | ||
| Preparation | 160 | ||
| Examination technique and image optimization | 160 | ||
| Indications for examination | 160 | ||
| Laboratory values | 161 | ||
| Erythrocyte | 161 | ||
| Leukocyte | 161 | ||
| Hematocrit | 161 | ||
| Hemoglobin | 161 | ||
| Spleen review | 164 | ||
| 12 Retroperitoneum | 170 | ||
| Key terms | 170 | ||
| Physiology | 170 | ||
| Adrenal glands (fig. 12-1) | 170 | ||
| Function of the adrenal glands | 170 | ||
| Epinephrine (adrenaline) | 170 | ||
| Norepinephrine | 170 | ||
| Glucocorticoids | 170 | ||
| Gonadal hormones | 171 | ||
| Mineral corticoids | 171 | ||
| Anatomy | 171 | ||
| Location | 171 | ||
| Size | 171 | ||
| Vascular anatomy | 171 | ||
| Normal sonographic appearance | 172 | ||
| Technique | 172 | ||
| Preparation | 172 | ||
| Examination technique and image optimization | 172 | ||
| Indications for examination | 172 | ||
| Laboratory values | 173 | ||
| Adrenocorticotrophic hormone (ACTH) | 173 | ||
| Aldosterone | 173 | ||
| Potassium | 173 | ||
| Sodium | 173 | ||
| Retroperitoneum | 175 | ||
| Borders of the retroperitoneum | 175 | ||
| Spaces in the retroperitoneum | 175 | ||
| Anterior pararenal | 175 | ||
| Posterior pararenal | 175 | ||
| Perirenal | 175 | ||
| Lymph nodes | 176 | ||
| Functions of lymph nodes | 176 | ||
| Divisions of lymph nodes | 176 | ||
| Parietal nodes | 176 | ||
| Visceral nodes | 176 | ||
| Sonographic appearance of the normal lymph node | 176 | ||
| Sonographic appearance of the abnormal lymph node | 176 | ||
| Sonographic appearance of retroperitoneal masses | 176 | ||
| Retroperitoneum review | 179 | ||
| 13 Abdominal vasculature | 184 | ||
| Key terms | 184 | ||
| Physiology and anatomy | 184 | ||
| Functions of the vascular system | 184 | ||
| Vessel wall layers | 184 | ||
| Tunica adventitia | 184 | ||
| Tunica media | 184 | ||
| Tunica intima | 184 | ||
| Arterial anatomy (fig. 13-1) | 185 | ||
| Abdominal aorta | 185 | ||
| Main visceral branches of the abdominal aorta | 185 | ||
| Celiac axis (CA) | 185 | ||
| Superior mesenteric artery (SMA) | 186 | ||
| Middle suprarenal arteries | 186 | ||
| Main renal arteries | 186 | ||
| Gonadal arteries | 186 | ||
| Inferior mesenteric artery | 186 | ||
| Main parietal branches of the abdominal aorta | 186 | ||
| Inferior phrenic artery | 186 | ||
| Lumbar arteries | 187 | ||
| Median sacral artery | 187 | ||
| Additional abdominal arteries | 187 | ||
| Gastroduodenal artery (GDA) | 187 | ||
| Hepatic artery | 187 | ||
| Left gastric artery | 187 | ||
| Splenic artery | 187 | ||
| Venous anatomy (fig. 13-2) | 187 | ||
| Inferior vena cava (IVC) | 187 | ||
| Main venous tributaries | 187 | ||
| Common iliac veins | 187 | ||
| Renal veins | 188 | ||
| Hepatic veins | 188 | ||
| Additional abdominal veins | 188 | ||
| Main portal vein | 188 | ||
| Splenic vein | 189 | ||
| Superior mesenteric vein | 189 | ||
| Gonadal veins | 189 | ||
| Lumbar veins | 189 | ||
| Location | 189 | ||
| Abdominal aorta | 189 | ||
| Inferior vena cava | 189 | ||
| Size | 190 | ||
| Abdominal aorta | 190 | ||
| Inferior vena cava | 190 | ||
| Sonographic appearance | 190 | ||
| Technique | 190 | ||
| Preparation | 190 | ||
| Examination technique and image optimization | 190 | ||
| Indications for examination | 191 | ||
| Abdominal vasculature review | 194 | ||
| 14 Gastrointestinal tract | 199 | ||
| Key terms | 199 | ||
| Gastrointestinal (GI) tract (fig. 14-1) | 199 | ||
| Physiology | 199 | ||
| Functions of the gi tract | 199 | ||
| Anatomy | 200 | ||
| Esophagus | 200 | ||
| Stomach | 200 | ||
| Small intestines | 201 | ||
| Duodenum | 201 | ||
| Jejunum | 201 | ||
| Ileum | 201 | ||
| Colon | 201 | ||
| Cecum | 201 | ||
| Appendix | 201 | ||
| Ascending colon | 202 | ||
| Transverse colon | 202 | ||
| Descending colon | 202 | ||
| Sigmoid | 202 | ||
| Rectum | 202 | ||
| Anal canal | 202 | ||
| Location | 202 | ||
| Esophagus | 202 | ||
| Stomach | 202 | ||
| Small intestines | 202 | ||
| Duodenum | 202 | ||
| Jejunum | 202 | ||
| Ileum | 203 | ||
| Colon | 203 | ||
| Size | 203 | ||
| Sonographic appearance | 203 | ||
| Technique | 203 | ||
| Preparation | 203 | ||
| Examination technique and image optimization | 203 | ||
| Indications for examination | 204 | ||
| Gastrointestinal tract review | 207 | ||
| 15 Superficial structures: Breast, abdominal wall, and musculoskeletal sonography | 212 | ||
| Key terms | 212 | ||
| Physiology | 213 | ||
| Function of the breast | 213 | ||
| Function of the anterior abdominal wall | 213 | ||
| Function of the musculoskeletal system | 213 | ||
| The breast | 213 | ||
| Breast anatomy and location (Fig. 15-1) | 213 | ||
| Terminal ductal lobular unit | 213 | ||
| Lobe | 213 | ||
| Lactiferous duct | 213 | ||
| Fibrous planes of the breast | 214 | ||
| Skin | 214 | ||
| Subcutaneous fat layer | 214 | ||
| Cooper ligaments | 214 | ||
| Superficial fascia | 214 | ||
| Mammary zone | 214 | ||
| Retromammary space | 214 | ||
| Deep fascia | 214 | ||
| Pectoralis muscles | 214 | ||
| Pectoralis major muscle | 214 | ||
| Pectoralis minor muscle | 214 | ||
| Breast vasculature | 214 | ||
| Arterial supply | 214 | ||
| Venous system | 215 | ||
| Congenital breast anomalies | 215 | ||
| Sonographic appearance of the breast | 215 | ||
| Technique | 215 | ||
| Preparation | 215 | ||
| Examination technique and image optimization | 215 | ||
| Indications for a breast examination | 216 | ||
| Anterior abdominal wall and musculoskeletal system | 218 | ||
| Anterior abdominal wall anatomy (Fig. 15-2) | 218 | ||
| Linea alba | 218 | ||
| Rectus abdominis muscles | 218 | ||
| External oblique muscles | 219 | ||
| Internal oblique muscles | 219 | ||
| Transversus abdominis muscle | 219 | ||
| Musculoskeletal anatomy | 219 | ||
| Achilles tendon | 219 | ||
| Hip joint | 220 | ||
| Knee joint | 220 | ||
| Shoulder joint | 220 | ||
| Sonographic appearance of the anteriora bdominal wall | 220 | ||
| Sonographic appearance of the musculoskeletal system | 220 | ||
| Technique | 220 | ||
| Preparation | 220 | ||
| Examination technique and image optimization | 220 | ||
| Indications for an anterior abdominal wall examination | 221 | ||
| Indications for a musculoskeletal examination | 221 | ||
| Superficial structures review | 223 | ||
| 16 Scrotum and prostate | 229 | ||
| Key terms | 229 | ||
| Physiology | 229 | ||
| Function of the scrotum | 229 | ||
| Functions of the epididymis | 229 | ||
| Functions of the testis | 229 | ||
| Functions of the prostate gland | 230 | ||
| Anatomy | 230 | ||
| Scrotum (fig. 16-1) | 230 | ||
| Epididymis | 230 | ||
| Testes | 230 | ||
| Tunica albuginea | 230 | ||
| Tunica vaginalis | 230 | ||
| Mediastinum testis | 231 | ||
| Rete testis | 231 | ||
| Spermatic cord | 231 | ||
| Vas deferens | 231 | ||
| Prostate gland (fig. 16-2) | 231 | ||
| Central zone (CZ) | 231 | ||
| Peripheral zone (PZ) | 232 | ||
| Transitional zone (TZ) | 232 | ||
| Periurethral glands | 232 | ||
| Seminal vesicles | 232 | ||
| Surgical capsule | 232 | ||
| Verumontanum | 232 | ||
| Vascular anatomy | 232 | ||
| Scrotum | 232 | ||
| Testicular arteries | 232 | ||
| Centripetal arteries | 232 | ||
| Cremasteric and deferential arteries | 232 | ||
| Testicular veins | 233 | ||
| Spermatic vein | 233 | ||
| Prostate | 233 | ||
| Prostaticovesical arteries | 233 | ||
| Inferior vesical artery | 233 | ||
| Capsular arteries | 233 | ||
| Urethral artery | 233 | ||
| Size | 234 | ||
| Adult | 234 | ||
| Prepuberty | 234 | ||
| Infant | 234 | ||
| Sonographic appearance | 234 | ||
| Scrotum | 234 | ||
| Testes | 234 | ||
| Epididymis | 234 | ||
| Spermatic cord | 234 | ||
| Prostate | 234 | ||
| Technique | 234 | ||
| Scrotum preparation | 234 | ||
| Prostate preparation | 235 | ||
| Examination technique and image optimization | 235 | ||
| Scrotum | 235 | ||
| Prostate | 235 | ||
| Indications for scrotal examination | 235 | ||
| Indications for prostate examination | 235 | ||
| Laboratory values | 236 | ||
| Prostate specific antigen | 236 | ||
| Scrotum and prostate review | 239 | ||
| 17 Neck | 245 | ||
| Key terms | 245 | ||
| Physiology | 245 | ||
| Function of the thyroid glands | 245 | ||
| Function of the parathyroid glands | 245 | ||
| Function of the carotid arteries | 245 | ||
| Function of the jugular veins | 245 | ||
| Anatomy (fig. 17-1) | 246 | ||
| Muscles of the neck | 246 | ||
| Longus colli muscles | 246 | ||
| Platysma muscles | 246 | ||
| Sternocleidomastoid muscles | 246 | ||
| Strap muscles | 246 | ||
| Vasculature of the neck | 246 | ||
| Common carotid arteries | 246 | ||
| External carotid arteries | 246 | ||
| Internal carotid arteries | 246 | ||
| Vertebral arteries | 247 | ||
| Internal jugular veins | 247 | ||
| External jugular veins | 247 | ||
| Vertebral veins | 247 | ||
| Anatomy of the thyroid glands | 247 | ||
| Vasculature of the thyroid glands | 247 | ||
| Anatomy of the parathyroid glands | 247 | ||
| Location | 247 | ||
| Thyroid lobes | 247 | ||
| Thyroid isthmus | 248 | ||
| Parathyroid glands | 248 | ||
| Congenital anomalies | 248 | ||
| Pyramidal lobe | 248 | ||
| Absent isthmus | 248 | ||
| Ectopic parathyroid gland location | 248 | ||
| Size | 248 | ||
| Sonographic appearance | 248 | ||
| Technique | 248 | ||
| Preparation | 248 | ||
| Examination technique and image optimization | 248 | ||
| Indications for examination | 249 | ||
| Laboratory values | 249 | ||
| Thyroid | 249 | ||
| Thyrotropin (TSH) | 249 | ||
| Thyroxine (T4) | 249 | ||
| Triiodothyronine (T3) | 249 | ||
| Calcitonin | 249 | ||
| Parathyroid | 250 | ||
| Parathormone (PTH) | 250 | ||
| Calcium | 250 | ||
| Thyroid pathology | 250 | ||
| Hyperthyroidism | 250 | ||
| Hypothyroidism | 250 | ||
| Thyroid nodules | 250 | ||
| Parathyroid pathology | 252 | ||
| Hypercalcemia | 252 | ||
| Hyperparathyroidism | 252 | ||
| Hypocalcemia | 252 | ||
| Hypoparathyroidism | 252 | ||
| Neck review | 254 | ||
| 18 Peritoneum, noncardiac chest, and invasive procedures | 259 | ||
| Key terms | 259 | ||
| Physiology | 260 | ||
| Functions of the peritoneum | 260 | ||
| Peritoneum anatomy (fig. 18-1) | 260 | ||
| Greater omentum | 260 | ||
| Lesser omentum (gastrohepatic omentum) | 260 | ||
| Organs contained within the peritoneum include: | 260 | ||
| Peritoneal spaces | 261 | ||
| Lesser sac (omental bursa) | 261 | ||
| Morison pouch (hepatorenal pouch) | 261 | ||
| Paracolic gutters | 261 | ||
| Pelvic spaces | 261 | ||
| Subhepatic space | 261 | ||
| Subphrenic spaces | 261 | ||
| Location of the peritoneum | 261 | ||
| Anatomy of the pleura | 262 | ||
| Sonographic appearance | 262 | ||
| Technique | 262 | ||
| Preparation | 262 | ||
| Examination technique and image optimization | 262 | ||
| Indications for peritoneal cavity examination | 262 | ||
| Indications for pleural cavity examination | 262 | ||
| Laboratory values | 263 | ||
| Invasive procedures | 264 | ||
| Types of invasive procedures | 264 | ||
| Biopsy | 264 | ||
| Fine-needle aspiration | 264 | ||
| Paracentesis | 264 | ||
| Thoracentesis | 265 | ||
| Technique | 265 | ||
| Preparation | 265 | ||
| Examination technique | 265 | ||
| Peritoneum, noncardiac chest, and invasive procedures review | 266 | ||
| Abdomen mock exam | 271 | ||
| III: Obstetrics and Gynecology | 295 | ||
| 19 Pelvic anatomy | 296 | ||
| Key terms | 296 | ||
| Pelvic anatomy (fig. 19-1) | 296 | ||
| True pelvis | 296 | ||
| False pelvis | 296 | ||
| Pelvic ligaments | 298 | ||
| Pelvic spaces | 299 | ||
| Female reproductive system (fig. 19-2) | 299 | ||
| Vagina | 299 | ||
| Sonographic appearance of the vagina | 300 | ||
| Uterus | 300 | ||
| Tissue layers of the uterus | 300 | ||
| Perimetrium | 300 | ||
| Myometrium | 300 | ||
| Endometrium | 300 | ||
| Location of the uterus | 301 | ||
| Normal sonographic appearance of the uterus | 301 | ||
| Normal sonographic appearance of the endometrium | 301 | ||
| Measuring the uterus (Fig. 19-3) | 301 | ||
| Measuring the endometrium (Fig. 19-4) | 301 | ||
| Congenital uterine anomalies | 303 | ||
| Ovaries | 304 | ||
| Anatomy of the ovaries | 304 | ||
| Physiology of the ovaries | 304 | ||
| Function | 304 | ||
| Location of the ovaries | 304 | ||
| Normal sonographic appearance of the ovary | 304 | ||
| Measuring of the ovaries (Fig. 19-5) | 305 | ||
| Ovarian size | 305 | ||
| Menarche | 305 | ||
| Ovarian volume | 305 | ||
| Anatomical ovarian variant | 306 | ||
| L-shaped ovary | 306 | ||
| Congenital ovarian anomalies | 306 | ||
| Agenesis | 306 | ||
| Unilateral ovary | 306 | ||
| Fallopian tubes (oviduct) (Fig. 19-6) | 306 | ||
| Physiology of the fallopian tubes | 306 | ||
| Function | 306 | ||
| Location of the fallopian tubes | 307 | ||
| Sonographic appearance of the fallopian tube | 307 | ||
| Size | 307 | ||
| Urinary bladder | 307 | ||
| Anatomy | 307 | ||
| Normal sonographic appearance | 307 | ||
| Radiographic procedures | 308 | ||
| Pelvic anatomy review | 309 | ||
| 20 Physiology of the female pelvis | 315 | ||
| Key terms | 315 | ||
| Normal physiology | 315 | ||
| Laboratory values | 315 | ||
| Estradiol | 315 | ||
| Estrogen | 315 | ||
| Follicle-stimulating hormone (FSH) | 316 | ||
| Follicle-stimulating hormone–releasing factor | 316 | ||
| Luteinizing hormone (LH) | 316 | ||
| Luteinizing hormone-releasing factor (LHRF) | 316 | ||
| Progesterone | 316 | ||
| Endometrium | 317 | ||
| Premenarche | 317 | ||
| Precocious puberty | 317 | ||
| Precocious pseudopuberty | 317 | ||
| Menarche | 317 | ||
| Ovaries | 320 | ||
| Postmenopause | 323 | ||
| With hormone replacement therapy | 323 | ||
| Without hormone replacement therapy | 323 | ||
| Contraception | 324 | ||
| Physiology of the female pelvis review | 325 | ||
| 21 Uterine and ovarian pathology | 331 | ||
| Key terms | 331 | ||
| Uterine pathology | 331 | ||
| Ovarian pathology | 334 | ||
| Uterine and ovarian pathology review | 337 | ||
| 22 Adnexal pathology and infertility | 343 | ||
| Key terms | 343 | ||
| Infertility | 345 | ||
| Methods of assisted reproductive technologies (ART) | 345 | ||
| Ovarian induction therapy | 345 | ||
| In vitro fertilization | 345 | ||
| Gamete intrafollicular transfer | 345 | ||
| Zygote intrafallopian transfer | 345 | ||
| Ultrasound evaluation of the uterus | 345 | ||
| Ultrasound monitoring of the endometrium | 345 | ||
| Ultrasound monitoring of the ovaries | 345 | ||
| Baseline study before therapy | 345 | ||
| During induction therapy | 346 | ||
| Complications of art | 346 | ||
| Ectopic pregnancy | 346 | ||
| Multiple gestations | 346 | ||
| Ovarian hyperstimulation syndrome | 346 | ||
| Adnexal pathology and infertility review | 347 | ||
| 23 Assessment of the first trimester | 353 | ||
| Key terms | 353 | ||
| Early embryology (fig. 23-1) | 353 | ||
| Blastocyst development (fig. 23-2) | 354 | ||
| Anatomy | 356 | ||
| Laboratory values | 356 | ||
| Human chorionic gonadotropin (hCG) | 356 | ||
| First-trimester measurements | 356 | ||
| Mean sac diameter (MSD) | 356 | ||
| Crown–rump length (CRL) | 356 | ||
| Nuchal translucency | 357 | ||
| First-trimester protocol | 357 | ||
| Evaluate and document the following: | 357 | ||
| Indications for sonographic evaluation | 357 | ||
| Assessment of the first-trimester review | 362 | ||
| 24 Assessment of the second trimester | 368 | ||
| Key terms | 368 | ||
| Second trimester biometric measurements | 368 | ||
| Biparietal diameter | 368 | ||
| Head circumference | 368 | ||
| Cephalic index | 369 | ||
| Abdominal circumference | 369 | ||
| Femur length | 369 | ||
| Laboratory values | 369 | ||
| Alpha-fetoprotein | 369 | ||
| Causes of high alpha-fetoprotein | 369 | ||
| Causes of low alpha-fetoprotein | 369 | ||
| Second trimester protocol | 369 | ||
| Assessment of fetal age | 369 | ||
| Fetal anatomy | 370 | ||
| Fetal circulation | 370 | ||
| Assessment of the second trimester review | 374 | ||
| 25 Assessment of the third trimester | 379 | ||
| Key terms | 379 | ||
| Third trimester | 379 | ||
| Third-trimester measurements | 379 | ||
| Fetal growth | 379 | ||
| Decrease in fetal growth | 380 | ||
| Small for gestational age | 380 | ||
| Intrauterine growth restriction | 380 | ||
| Increase in fetal growth | 380 | ||
| Large for gestational age | 380 | ||
| Macrosomia | 380 | ||
| Amniotic fluid | 381 | ||
| Functions of the amniotic fluid | 381 | ||
| Amniotic fluid volume | 381 | ||
| Measuring amniotic fluid volume | 381 | ||
| Fetal well-being | 382 | ||
| Biophysical profile | 382 | ||
| Fetal presentation | 383 | ||
| Cephalic or vertex | 383 | ||
| Transverse | 383 | ||
| Oblique | 383 | ||
| Breech | 383 | ||
| Frank breech | 383 | ||
| Complete breech | 383 | ||
| Incomplete breech | 383 | ||
| Assessment of the third trimester review | 384 | ||
| 26 Fetal abnormalities | 388 | ||
| Key terms | 388 | ||
| Fetal abnormalities review | 396 | ||
| 27 Complications in pregnancy | 401 | ||
| Key terms | 401 | ||
| Chromosomal abnormalities | 401 | ||
| Fetal syndromes | 402 | ||
| Hydrops fetalis | 403 | ||
| Multifetal gestations | 404 | ||
| Sonographic evaluation | 404 | ||
| Complications in pregnancy review | 406 | ||
| 28 Placenta and umbilical cord | 411 | ||
| Key terms | 411 | ||
| Placenta | 411 | ||
| Anatomy (fig. 28-1) | 411 | ||
| Physiology | 411 | ||
| Functions | 412 | ||
| Respiration | 412 | ||
| Nutrition | 412 | ||
| Excretion | 412 | ||
| Protection | 412 | ||
| Storage | 412 | ||
| Hormone production | 412 | ||
| Size | 412 | ||
| Normal sonographic appearance | 413 | ||
| First trimester | 413 | ||
| Second and third trimesters | 413 | ||
| Placental position | 413 | ||
| Placental maturity and grading | 413 | ||
| Grade 0 | 413 | ||
| Grade 1 | 413 | ||
| Grade 2 | 413 | ||
| Grade 3 | 413 | ||
| Placenta previa | 413 | ||
| Umbilical cord | 416 | ||
| Anatomy | 416 | ||
| Umbilical vein | 416 | ||
| Umbilical arteries | 416 | ||
| Size | 417 | ||
| Cervical os | 418 | ||
| Placenta and umbilical cord review | 419 | ||
| 29 Patient care and technique | 425 | ||
| Key terms | 425 | ||
| Patient care | 425 | ||
| Standard precautions and infection control | 425 | ||
| Patient–sonographer interaction | 427 | ||
| Sonographer responsibilities | 428 | ||
| Patient history | 428 | ||
| Transabdominal examination | 429 | ||
| Purpose of bladder distention | 429 | ||
| Optimal bladder distention | 429 | ||
| Underdistention | 429 | ||
| Overdistention | 429 | ||
| Orientation | 430 | ||
| Technique | 431 | ||
| Adult preparation | 431 | ||
| Child preparation | 431 | ||
| Gynecological examination technique | 431 | ||
| Indications | 431 | ||
| Obstetric examination technique | 431 | ||
| Indications | 432 | ||
| Transvaginal examination | 432 | ||
| Orientation | 432 | ||
| Technique | 433 | ||
| Preparation | 433 | ||
| Gynecological examination technique | 433 | ||
| Obstetrical examination technique | 433 | ||
| Translabial examination | 433 | ||
| Orientation | 433 | ||
| Technique | 434 | ||
| Preparation | 434 | ||
| Gynecological and obstetrical examination technique | 434 | ||
| Indications | 434 | ||
| Transducer care | 434 | ||
| Patient care and technique review | 435 | ||
| Obstetrics and gynecology mock exam | 440 | ||
| Physics answers | 460 | ||
| Chapter 1 clinical safety | 460 | ||
| Chapter 2 physics principles | 461 | ||
| Chapter 3 ultrasound transducers | 463 | ||
| Chapter 4 pulse-echo instrumentation | 464 | ||
| Chapter 5 doppler instrumentation and hemodynamics | 466 | ||
| Chapter 6 quality assurance, protocols, and new technologies | 467 | ||
| Physics mock exam | 469 | ||
| Abdomen answers | 473 | ||
| Chapter 7 liver | 473 | ||
| Chapter 8 biliary system | 475 | ||
| Chapter 9 pancreas | 478 | ||
| Chapter 10 urinary system | 480 | ||
| Chapter 11 spleen | 482 | ||
| Chapter 12 retroperitoneum | 484 | ||
| Chapter 13 abdominal vasculature | 486 | ||
| Chapter 14 gastrointestinal tract | 487 | ||
| Chapter 15 superficial structures: breast, abdominal wall, and musculoskeletal sonography | 489 | ||
| Chapter 16 scrotum and prostate | 490 | ||
| Chapter 17 neck | 492 | ||
| Chapter 18 peritoneum, noncardiac chest, and invasive procedures | 494 | ||
| Abdomen mock exam | 495 | ||
| Obstetrics and gynecology answers | 502 | ||
| Chapter 19 pelvic anatomy | 502 | ||
| Chapter 20 physiology of the female pelvis | 503 | ||
| Chapter 21 uterine and ovarian pathology | 505 | ||
| Chapter 22 adnexal pathology and infertility | 506 | ||
| Chapter 23 assessment of the first trimester | 508 | ||
| Chapter 24 assessment of the second trimester | 509 | ||
| Chapter 25 assessment of the third trimester | 511 | ||
| Chapter 26 fetal abnormalities | 512 | ||
| Chapter 27 complications in pregnancy | 514 | ||
| Chapter 28 placenta and umbilical cord | 515 | ||
| Chapter 29 patient care and technique | 516 | ||
| Obstetrics and gynecology mock exam | 517 | ||
| Bibliography | 523 | ||
| Illustration credits | 524 | ||
| Courtesies | 524 | ||
| Index | 525 | ||
| A | 525 | ||
| B | 526 | ||
| C | 526 | ||
| D | 527 | ||
| E | 527 | ||
| F | 528 | ||
| G | 528 | ||
| H | 528 | ||
| I | 529 | ||
| J | 529 | ||
| K | 529 | ||
| L | 529 | ||
| M | 530 | ||
| N | 530 | ||
| O | 531 | ||
| P | 531 | ||
| Q | 533 | ||
| R | 533 | ||
| S | 533 | ||
| T | 534 | ||
| U | 535 | ||
| V | 535 | ||
| W | 535 | ||
| X | 535 | ||
| Y | 535 | ||
| Z | 535 | ||
| How to use | IBC |