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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5820_Библиотеки_им_академика_М_И_Перельмана.pdf
Image Protocol for the Sonographic Study of Multiple Gestations n 400
3. Demonstration of fetal tone.
Labeled: HAND
4. Demonstration of FETAL GROSS BODY MOTION.
Labeled: MOTION
Image Protocol for the Sonographic Study of Multiple Gestations n 401
SCANNING TIP: Occasionally it is necessary to
measure the resistance to blood flow within the
umbilical arteries. This measurement is obtained
by interrogating the umbilical cord artery with
low power Doppler. The ratio of the peak systolic
flow to the end diastolic flow is calculated (SD
ratio). This number varies with the age of the fetus and charts are available to determine if blood
flow through the cord is adequate.
PART V
Image Protocol for the Sonographic Study of Multiple Gestations n 402
5. Umbilical artery Doppler measurement and determination of the SD ratio.
Labeled: DOP/UMB ART
Labeled: DOP/UMB ART
Image Protocol for the Sonographic Study of Multiple Gestations n 403
SCANNING TIP: In some cases, the physician may
also want to determine if blood flow to the placenta from the mother’s circulation is adequate,
so another Doppler measurement is made at the
interface between the placenta and uterus or
in the uterine artery if possible. The SD ratio for
the Doppler waveform is calculated and checked
against a chart value for the appropriate gestational age.
PART V
Image Protocol for the Sonographic Study of Multiple Gestations n 404
6. Uterine artery Doppler measurement and determination of the SD ratio.
Labeled: DOP/UT AR
PART VI
SMALL PARTS
SECTION ONE □ Image Protocol for the
Sonographic Study of the Musculoskeletal
System
Image Protocol for the Sonographic Study of the Musculoskeletal System n 406
Criteria
• Begin studies with a survey of structures in at least 2 scanning planes.
• Do not share study results with the patient. Legally, only physicians can give a
diagnosis.
Musculoskeletal Study (Rotator Cuff, Carpal Tunnel, and Achilles Tendon)
Rotator Cuff Study
1. Axial image of the bicep tendon.
TRV BICEP TENDON
Labeled: (RT or LT) BT TRV
Image Protocol for the Sonographic Study of the Musculoskeletal System n 407
2. Longitudinal image of the bicep tendon.
PART VI
LONG BICEP TENDON
Labeled: (RT or LT) BT SAG
Image Protocol for the Sonographic Study of the Musculoskeletal System n 408
3. Long axis image of the subscapularis tendon.
D
BT
TRV SUPRACLAVICULAR TENDON
S
COR
Labeled: (RT or LT) SUBSCAP TRV
4. Axial image of the subscapularis tendon.
D
S
H
LONG SUPRACLAVICULAR TENDON
Labeled: (RT or LT) SUBSCAP SAG
5. Long axis image of the supraspinatus tendon.
D
6. Axial image of the supraspinatus tendon.
D
SS
H
TRV SUPRASPINATOUS
Labeled: (RT or LT) SUPRASPIN TRV
Image Protocol for the Sonographic Study of the Musculoskeletal System n 409
SS
H
LONG SUPRASPINATOUS
Labeled: (RT or LT) SUPRASPIN SAG
PART VI