Thoracic ultrasound
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This document discusses thoracic ultrasound and provides guidance on its use. It outlines scanning zones and views that should be used in a focused exam, including the sagittal or coronal views and "bat view" to visualize the pleural line and rib shadows. Key signs of a pneumothorax are described, including the absence of lung sliding and seeing the lung point. The conclusion emphasizes the benefits of thoracic ultrasound and that pathology is rarely isolated, requiring consideration of artifacts and multiple signs.
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Thoracic ultrasound
- 1. Thoracic Ultrasound Dr.Tarek Sabri INTENSIVIST Fujairah Hospital UAE October 28 - 2017
- 2. Ultrasound is not for everyone, but everyone can understand the terminology, recognize a good scan from a poor one, and understand its error rate. DISCLAIMER
- 4. -FAST - Pulmonary Edema - Pleural Effusion - Pneumothorax
- 11. 1 2 3 4 Volpicelli et al, Am J Emerg Med 2006; 24: 689-696 Region 2 is usually above the nipple
- 15. Focused exam – 8 views Sagittal or coronal views RIB SHADOWS confirm position and guide you to pleura.
- 16. THE BAT VIEW Chest wall Pleural line
- 21. • Pneumothorax
- 36. Pneumothorax
- 37. 1 2 3 4 Volpicelli et al, Am J Emerg Med 2006; 24: 689-696 Region 2 is usually above the nipple
- 42. No sliding – PNTX or Adhesion straight straight
- 43. No sliding- PNTX or adhesion VERY SENSITIVE, LESS SPECIFIC WALL MOTION ARTIFACT PLEURA straight speckled
- 44. Additional PNTX signs LUNG PULSE NO PNTX LUNG POINT PNTX OR ADHESION
- 46. Conclusion • Benefit of thoracic US • Scanning Zones . • Artifacts are keys. • Pathology rarely in isolation.
Editor's Notes
- Using the curved array probe, this the sort of still image you’ll get on a well optimised viewing window transverse to the rib line. The area just deep to the transducer is the chest wall. Along here we should see two (or more) echogenic, curvilinear lines representing the ribs. Deep to these we expect to see the posterior acoustic shadowing artefact we call, surprisingly enough, rib shadows. In between the ribs & immediately deep to the chest wall, we should see an echogenic line that disappears underneath the ribs in a continuous manner, this is the pleural line, made up of echoes from both the visceral and parietal surfaces of the pleura. Why the batwing view? – well the shapre made by the ribs and the chest wall is reminiscent of the outline of bat on the wing.