医学交流课件：腹部超声检查概况.pptVIP

GENERAL WALK THROUGH THE ABDOMEN腹部超声检查概况 Dr Ulrike Kafka BVSc (Hons) (DI) Best way to scan? 最好的检查方法 Dorsal recumbency 仰卧 Better distribution of organs (spread out) 脏器分布更好（舒展） Better topographic anatomy 解剖位置更准确 Gas in GIT rises to surface 气体在胃肠道上方 Liver in deep-chested dogs difficult 深胸型犬的肝脏较难检查 Lateral recumbency 侧卧 Organs overlap 脏器重叠 Topographic anatomy confusing 解剖位置不准确 GIT gas rises to lateral surface - easier to scan GIT 气体在胃肠道侧部－易检查 Lateral liver lobes easier to visualise in deep-chested dogs 深胸型犬肝外侧叶易见 Where to start? 从哪里开始？ Consistency important 保持一贯性很重要 Systematic and thorough examination 系统的整体的检查 Do not be misled by the obvious 不要被表面现象误导 Spleen easiest to start with – confidence builder! 从脾脏开始较容易－建立信心 Work your way around in a clockwise direction 顺时针方向检查 Difficulties in Ultrasound超声的难点 Following blood vessels 跟踪血管 Finding lymph nodes and adrenals 找到淋巴结和肾上腺 Differentiating planes of organs 分辨脏器的不同切面 Moving the transducer in the right direction! 按正确的方向移动探头 Blood vessel vs lymph node 血管和淋巴结 Ways to improve scanning skills提高探查技巧的途径 In dorsal recumbency 仰卧 Organs are more laterally located than presumed! 脏器比预想中的更靠外侧 Pressure 压力 Vary according to depth 根据深度而不同 Lighter – more superficial 轻压－更浅表的 More pressure – deeper structures (liver) 略重－深部结构（肝脏） Ways to improve scanning skills提高探查技巧的途径 Adjust one thing at a time 一次只调整一样 Sweep 平移扫查 Fan 扇形扫查 Rotate 旋转扫查 Keep one hand on the buttons 把一个手放在旋钮上 Keep an anatomy atlas handy! 手边备有解剖图谱 SPLEEN 脾脏 Beginner-friendly organ 初学者的朋友 Easy to find 容易找到 Left hemi-abdomen 左腹中部 Patient has time to settle down 动物有时间平静 Homogenous 均质 Fine echotexture 回声结构细 Always two planes? 总是用2种切面吗？ LEFT KIDNEY 左肾 Lateral to spleen 脾脏外侧 Always two planes 总是扫查2个切面 Complex architecture 结构复杂 Mobile, especially cats 可移动，尤其是猫 Steady with free hand if needed 用另一只手固定 May hide under rib 可在肋骨下 LEFT ADRENAL 左肾上腺 The easier one to find 较容易找到的一个 Two methods 两种方法 Use kidney 通过肾脏 Use aorta 通过