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Chapter 13
https://t.me/medicina_free
Appendix: Test Yourself—Answers
MauroZago, DiegoMariani, andMarinaTroian
Chapter 2
Q1—In the vast majority of cases, how many layers of a hollow viscus can you
detect by US?
A1—3.
Comment: Even if there are ve intestinal layers, trans-abdominal US allows you
to see mainly three layers. Remember to use a linear probe for higher quality
denition!
Q2—Normal peristalsis is easily detectable in the…
A2—Small bowel.
Comment: The appendix has no peristalsis; large bowel peristalsis is rarely
detected by US.
Chapter 4
Q1—Look at Fig. 4.4. How dilated is the bowel loop?
A1—30mm.
Comment: Have a look on the right side of the picture. There is a graded scale,
each step corresponding to 10mm. Remember that measuring the loop diameter is
essential, as you can get an idea “at a glance.”
Q2—What do you need to search for conrming an SBO on US?
A2—Empty distal small bowel.
M. Zago (*)
General and Emergency Surgery Unit, General Surgery Department, ASST Lecco, “A.
Manzoni” Hospital, Lecco, Italy
D. Mariani
Department of General Surgery, ASST Ovest Milanese, “Ospedale Nuovo” di Legnano,
Legnano (Milan), Italy
M. Troian
Cardiothoracic and Vascular Department, ASUGI Cattinara University Hospital, Trieste, Italy
© The Author(s), under exclusive license to Springer Nature
Switzerland AG 2023
M. Zago et al. (eds.), Point-of-care US for Acute Abdomen,
https://doi.org/10.1007/978-3-031-40231-9_13
115
116
https://t.me/medicina_free
M. Zago et al.
Comment: The detection of both empty distal ileum and dilated proximal small
bowel loops is the easiest way to conrm SBO.
Chapter 5
Q1—A colonic diverticulum usually appears as…
A1—A hyperechoic round-shaped image surrounded by hypoechoic peri-
colic fat.
Comment: If in doubt, look again at Fig. 4.3, Chap. 4.
Q2—POCUS landmarks for nding the left colon are…?
A2—ASIS, iliac muscle, descending/sigmoid colon.
Comment: If it is still not clear, go back to Fig. 4.1, Chap. 4.
Chapter 6
Q1—The maximum normal diameter of the appendix is…?
A1—6mm.
Comment: The bladder should preferably be empty when performing US for
acute appendicitis.
Q2—POCUS landmarks for acute appendicitis are…?
A2—Cecum, psoas, iliac vessels, distal ileum.
Chapter 8
Q1—For getting the Zenith sign, you need to ask the patient to…
A1—Turn on the left side.
Q2—The peritoneal stripe thickening sign means…
A2—Bubbles of free air “trapped” behind the parietal peritoneum.
Chapter 9
Q1—Pre-stenotic dilation in Crohn’s disease is dened as…?
A1—>25–30mm.
Q2—Pathological thickening of a bowel wall is…
A2–>3mm.
Chapter 10
Q1—CEUS is possible…
A1—If you have the software on the US equipment.
Comment: If in doubt, read again the “Scanning technique” paragraph in Chap. 9.
Chapter 11
Q1—Do you think E-FAST views can be useful for a right decision in a wide range
of situations out of trauma settings?
Comment: This is a question challenging your mindset. If your answer is yes, we
are pleased to share this knowledge with you. If your answer is no, we regret your
decision and we hope you will be able to possibly change your mind in the future.
Chapter 12
Q1—Routine use of SP-POCUS contribute to save and reduce.
A1—All of the above.
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