医学交流课件：GENERAL WALK ABDOMEN.pptVIP

GENERAL WALK THROUGH THE ABDOMEN Best way to scan? Dorsal recumbency Better distribution of organs (spread out) Better topographic anatomy Gas in GIT rises to surface Liver in deep-chested dogs difficult Lateral recumbency Organs overlap Topographic anatomy confusing GIT gas rises to lateral surface - easier to scan GIT Lateral liver lobes easier to visualise in deep-chested dogs Where to start? Consistency important Systematic and thorough examination Do not be misled by the obvious Spleen easiest to start with – confidence builder! Work your way around in a clockwise direction Difficulties in Ultrasound Following blood vessels Finding lymph nodes and adrenals Differentiating planes of organs Moving the transducer in the right direction! Blood vessel vs lymph node Ways to improve scanning skills In dorsal recumbency Organs are more laterally located than presumed! Pressure Vary according to depth Lighter – more superficial More pressure – deeper structures (liver) Ways to improve scanning skills Adjust one thing at a time Sweep Fan Rotate Keep one hand on the buttons Keep an anatomy atlas handy! SPLEEN Beginner-friendly organ Easy to find Left hemi-abdomen Patient has time to settle down Homogenous Fine echotexture Always two planes? LEFT KIDNEY Lateral to spleen Always two planes Complex architecture Mobile, especially cats Steady with free hand if needed May hide under rib LEFT ADRENAL The easier one to find Two methods Use kidney Use aorta Renal artery Bean shaped Typical architecture BLADDER Difficult to find when empty Most artefacts occur (careful with interpretation) Important landmark for uterus, prostate and rectum PROSTATE Intact males Easy to find, just caudal to trigone and terminal urethra Castrated males Difficult to find, small and often overlooked UTERUS / OVARIES Not routinely scanned Ovaries very difficult Uterus seen between bladder and rectum Uterine stump in spayed bitches RIGHT KIDNEY Often lies in oblique plane Deep-ches