Chapter 1: Before, During, and After the Ultrasound Examination Curry/Prince: Sonography, 5th Edition TRUE/FALSE 1. The sonographer should always review available patient information. ANS: T
A sonographer is responsible for acquiring patient information pertinent to the ultrasound study before the examination procedure. OBJ: Describe the importance of reviewing the patient's chart/EMR (electronic medical record) prior to the examination. TOP: Before the Ultrasound Examination 2. The sonographer should write technical observations of the ultrasound examination in the
patient’s chart. ANS: F
The sonographer’s technical observations serve as a reference for the interpreting physician. Written documentation of any type almost always becomes part of the patient’s medical record. Final interpretation of the ultrasound images and technical observations is always the responsibility of the interpreting physician. OBJ: Describe the importance of reviewing the patient's chart/EMR (electronic medical record) prior to the examination. TOP: Before the Ultrasound Examination 3. The sonographer should always review the ultrasound request form. ANS: T
The process of reviewing available patient information begins with the sonographer reviewing the ultrasound request form. OBJ: Describe the importance of reviewing the patient's chart/EMR (electronic medical record) prior to the examination. TOP: Before the Ultrasound Examination 4. The sonographer should always provide the interpretive report. ANS: F
An interpretive report is a formal, legal report of the ultrasound findings by a sonologist, radiologist, or other interpreting physician. A sonographer should never provide diagnoses, because this would be unjustified and potentially legally compromising. OBJ: Contrast technical observation and interpretive report. TOP: How to Describe Ultrasound Findings 5. Procedural consent forms are found in the patient’s chart. ANS: T
Consent forms for routine examinations, treatment, surgical procedures, medical procedures, and anesthesia are found in the patient’s chart. OBJ: Describe the importance of reviewing the patient's chart/EMR (electronic medical record) prior to the examination. TOP: Before the Ultrasound Examination 6. Laboratory values are part of the patient’s clinical history. ANS: T
Laboratory values are part of the patient’s clinical history and usually are found in the patient’s chart. OBJ: Describe the importance of reviewing the patient's chart/EMR (electronic medical record) prior to the examination. TOP: Clinical History 7. A living will can be found in the patient’s chart. ANS: T
If the patient has a living will, it is kept in the patient’s chart. OBJ: Describe the importance of reviewing the patient's chart/EMR (electronic medical record) prior to the examination. TOP: Before the Ultrasound Examination 8. Test results are found in the patient’s chart. ANS: T
Reports from correlating modality studies are found in the patient’s chart. OBJ: Describe the importance of reviewing the patient's chart/EMR (electronic medical record) prior to the examination. TOP: Before the Ultrasound Examination 9. The ultrasound request form contains the patient’s identification number. ANS: T
The ultrasound request form should include the patient’s identification data, the clinical symptoms, the type of examination requested, and the reason for the examination. OBJ: Describe the importance of reviewing the patient's chart/EMR (electronic medical record) prior to the examination. TOP: Before the Ultrasound Examination 10. The ultrasound request form contains the patient’s Social Security number. ANS: F
The patient’s Social Security number is not included on the ultrasound request form. OBJ: Describe the importance of reviewing the patient's chart/EMR (electronic medical record) prior to the examination. TOP: Before the Ultrasound Examination 11. The ultrasound request form indicates whether the examination is a regularly scheduled
exam or a “stat” exam. ANS: T
Generally, the ordering physician checks a box on the ultrasound request for stat or portable sonograms. OBJ: Describe the importance of reviewing the patient's chart/EMR (electronic medical record) prior to the examination. TOP: Before the Ultrasound Examination 12. The ultrasound request form contains the patient history. ANS: T
The ultrasound request form should include the patient’s identification data, the clinical symptoms, the type of examination requested, and the reason for the examination. OBJ: Describe the importance of reviewing the patient's chart/EMR (electronic medical record) prior to the examination. TOP: Before the Ultrasound Examination 13. The ultrasound request form contains the type of examination. ANS: T
An ultrasound request form should include the patient’s identification data, the clinical symptoms, the type of examination requested, and the reason for the examination. OBJ: Describe the importance of reviewing the patient's chart/EMR (electronic medical record) prior to the examination. TOP: Before the Ultrasound Examination 14. Sources of infection for HBV and HIV include saliva. ANS: T
HBV and HIV can be transmitted in body fluids, such as blood, saliva, semen, vaginal secretions, amniotic fluid, cerebrospinal fluid, synovial fluid, and pericardial fluid. OBJ: Describe the importance of reviewing the patient's chart/EMR (electronic medical record) prior to the examination. TOP: Understanding Standard Precautions 15. Sources of infection for HBV and HIV include amniotic fluid. ANS: T
HBV and HIV can be transmitted in body fluids such as blood, saliva, semen, vaginal secretions, amniotic fluid, cerebrospinal fluid, synovial fluid, and pericardial fluid. OBJ: Describe the importance of reviewing the patient's chart/EMR (electronic medical record) prior to the examination. TOP: Understanding Standard Precautions 16. Sources of infection for HBV and HIV include blood. ANS: T
HBV and HIV can be transmitted in body fluids, such as blood, saliva, semen, vaginal secretions, amniotic fluid, cerebrospinal fluid, synovial fluid, and pericardial fluid. OBJ: Describe the importance of reviewing the patient's chart/EMR (electronic medical record) prior to the examination. TOP: Understanding Standard Precautions 17. Sources of infection for HBV/HIV include pericardial fluid.
ANS: T
HBV and HIV can be transmitted in body fluids, such as blood, saliva, semen, vaginal secretions, amniotic fluid, cerebrospinal fluid, synovial fluid, and pericardial fluid. OBJ: Describe the importance of reviewing the patient's chart/EMR (electronic medical record) prior to the examination. TOP: Understanding Standard Precautions 18. Using self-sheathing needles is a strategy for reducing exposure to blood-borne pathogens. ANS: T
Strategies for reducing exposure to blood-borne pathogens include using sterilization techniques, self-sheathing needles, and proper disposal methods; wearing protective gear (e.g., gloves, face shields, and gowns); and frequent hand washing. OBJ: Explain the roles of the sonographer and sonologist/radiologist. TOP: Understanding Standard Precautions 19. Performing frequent hand washing is a strategy for reducing exposure to blood-borne
pathogens. ANS: T
Strategies for reducing exposure to blood-borne pathogens include using sterilization techniques, self-sheathing needles, and proper disposal methods; wearing protective gear (e.g., gloves, face shields, and gowns); and frequent hand washing. OBJ: Explain the roles of the sonographer and sonologist/radiologist. TOP: Understanding Standard Precautions 20. Wearing gloves when handling body fluids is a strategy for reducing exposure to
blood-borne pathogens. ANS: T
Strategies for reducing exposure to blood-borne pathogens include using sterilization techniques, self-sheathing needles, and proper disposal methods; wearing protective gear (e.g., gloves, face shields, and gowns); and frequent hand washing. OBJ: Describe the importance of reviewing the patient's chart/EMR (electronic medical record) prior to the examination. TOP: Understanding Standard Precautions 21. Sagittal and coronal scanning plane images show only longitudinal sections of structures. ANS: F
A structure’s appearance in any image, sagittal or otherwise, depends on how it lies (or is situated or oriented) in the body. For example, a sagittal scanning plane image at the mid epigastrium shows longitudinal sections of some structures (aorta, superior mesenteric artery, for example) and axial sections of other structures (pancreas body, splenic vein, for example). OBJ: Explain the roles of the sonographer and sonologist/radiologist. TOP: Ultrasound Scanning Planes
22. Transverse scanning plane images show only axial or short axis sections of structures. ANS: F
A structure’s appearance in any image, transverse or otherwise, depends on how it lies (or is situated or oriented) in the body. For example, a transverse scanning plane image at the mid epigastrium shows longitudinal sections of some structures (pancreas, splenic vein, left renal vein, for example) and axial sections of other structures (aorta, inferior vena cava, superior mesenteric artery, for example). OBJ: Explain the roles of the sonographer and sonologist/radiologist. TOP: Ultrasound Scanning Planes 23. Long axis measurements are taken in either the sagittal or coronal scanning plane. ANS: F
Long axis measurements of a structure are taken in the scanning plane that depicts the length of the structure; this is determined by how the structure lies (or is situated or oriented) in the body. OBJ: Explain the roles of the sonographer and sonologist/radiologist. TOP: Ultrasound Scanning Planes 24. Sterilization is required for all endocavitary probes. ANS: F High level disinfection procedures are required for all endocavitary probes and probes contaminated with blood or infectious body fluids. Dirty probes should be initially cleaned with an enzymatic cleanser and then carried in covered containers to a high-level disinfectant processor for timed disinfection. OBJ: Explain the roles of the sonographer and sonologist/radiologist. TOP: Understanding Standard Precautions 25. The sonographer should have the patient verbally say their name and date of birth prior to beginning the exam. ANS: T It is important to take time out to verify patient identifiers such as a verbal recitation to verify the patient name and/or date of birth. OBJ: Explain the roles of the sonographer and sonologist/radiologist. TOP: Before the Ultrasound Examination 26. With regard to echo texture characteristics, a disease can be described as diffuse and localized. ANS: T With regard to the echo texture of affected tissue, a disease can be characterized as diffuse (infiltrative) or localized (a mass or multiple masses circumscribed to a specific area). OBJ: Contrast technical observation against the interpretive report. TOP: How to Describe Ultrasound Findings
27. HBV and HIV can be transmitted through accidental injuries caused by contaminated sharp objects. ANS: T Diseases can be transmitted in many ways. Accidental injuries from contaminated sharp objects (e.g., needles, scalpels, broken glass, and exposed dental wires) are the most common means of transmission. OBJ: Describe the importance of reviewing the patient's chart/EMR (electronic medical record) prior to the examination. TOP: Understanding Standard Precautions 28. A person can become infected with HBV or HIV by touching contaminated surfaces and transferring contaminants to the eyes, nose or mouth. ANS: T Touching contaminated surfaces and transferring the infectious material to the mouth, nose, or eyes is a more indirect means of transmission. OBJ: Describe the importance of reviewing the patient's chart/EMR (electronic medical record) prior to the examination. TOP: Understanding Standard Precautions 29. There is a specific patient position that is best for visualization of each organ. ANS: F The best patient position is determined by what will produce optimal views of areas of interest. OBJ: Explain the roles of the sonographer and sonologist/radiologist. TOP: During the Ultrasound Examination MULTIPLE CHOICE 1. Structures are accurately identified on ultrasound images by a. scanning plane interpretation. b. two-dimensional cross-sections. c. their location. d. their sonographic appearance. ANS: C
Body structures are accurately identified on ultrasound images by their location, not by their sonographic appearance, which may be altered by a pathologic condition or other factors. OBJ: Contrast technical observation against the interpretive report. TOP: How to Describe Ultrasound Findings 2. Documented areas of interest a. are represented in a single scanning plane. b. cover approximately every 2 cm of a structure. c. must be represented in at least two scanning planes. d. must include survey images. ANS: C
Documented areas of interest or required images must be represented in at least two scanning planes perpendicular to each other for a more dimensional and therefore accurate representation. OBJ: Contrast technical observation against the interpretive report. TOP: How to Describe Ultrasound Findings 3. Organ parenchyma is described in terms of a. echo texture. b. location. c. focal zone. d. refraction. ANS: A
As sonographers become practiced at recognizing the echo patterns of normal anatomy, they can more easily identify changes in the normal appearance that may suggest the presence of an abnormality. OBJ: Contrast technical observation against the interpretive report. TOP: How to Describe Ultrasound Findings 4. Sonographically, the lumen of the gastrointestinal tract a. resembles a “bull’s eye.” b. has an appearance that depends on the lumen’s contents. c. is hypoechoic relative to its walls. d. is highly reflective. ANS: B
The sonographic appearance of the gastrointestinal tract is dependent on its contents. A fluid-filled lumen appears anechoic or echo free. A gas- or air-filled lumen will appear bright, highly echogenic, and generally hyperechoic relative to adjacent structures. The lumen can also have a complex or mixed appearance, displaying anechoic portions from fluid, along with echogenic portions that vary in brightness depending on their composition (partially digested food, indigestible material, gas, air). All or individual sections of the GI tract may cast a posterior shadow where air or gas is present in the lumen because air/gas attenuates the sound beam. Empty, collapsed bowel has a distinctive “bull's eye” appearance due to the contrast between the very bright collapsed lumen and dark/black walls. OBJ: Contrast technical observation against the interpretive report. TOP: How to Describe Ultrasound Findings 5. When an organ is described as hypoechoic to another organ, this means that a. one organ is diseased relative to the other. b. one organ is less echogenic relative to the other. c. one organ is visualized inferior to the other. d. one organ is visualized posterior to the other. ANS: B
A structure that is hypoechoic has decreased echogenicity relative to adjacent structure(s). OBJ: Contrast technical observation against the interpretive report.
TOP: How to Describe Ultrasound Findings 6. Structures that cast an acoustic shadow a. attenuates the sound beam. b. are nonattenuating. c. are always directly in front of another structure. d. show acoustic enhancement. ANS: A
Structures that cast a shadow (e.g., calculi) reflect and impede (attenuate) sound waves. OBJ: Contrast technical observation against the interpretive report. TOP: How to Describe Ultrasound Findings 7. The term through transmission is synonymous with a. sound attenuation. b. posterior enhancement. c. acoustic shadowing. d. infiltrative process. ANS: B
The terms through transmission, posterior through transmission, posterior enhancement, and acoustic enhancement describe the bright, highly echogenic appearance of the unimpeded sound beam posterior to fluid-filled structures. OBJ: Contrast technical observation against the interpretive report. TOP: How to Describe Ultrasound Findings 8. Pathologic findings that are in a specific area or localized are referred to as a. focal. b. diffuse. c. enhanced. d. regional. ANS: A
Localized (focal) disease represents a circumscribed mass or multiple masses. Diffuse disease parenchymal texture appears heterogeneous with varying degrees of echogenicity. OBJ: Contrast technical observation against the interpretive report. TOP: How to Describe Ultrasound Findings 9. A characteristic of an intraorgan mass is a. discontinuity of the organ capsule. b. obstruction of other organs and structures. c. disruption of the normal internal architecture. d. internal invagination of organ capsules. ANS: C
Features of an intraorgan mass include disruption of the normal internal architecture, external bulging of organ capsules, and displacement or shifting of adjacent structures. OBJ: Contrast technical observation against the interpretive report.
TOP: How to Describe Ultrasound Findings 10. Which of the following terms would NOT be used to describe a true cyst? a. Anechoic b. Irregular margins c. Posterior enhancement d. Refractive shadows ANS: B
The criteria for describing a true cyst are anechoic; posterior acoustic enhancement; smooth, thin wall margins; and in some cases refractive shadowing. OBJ: Contrast technical observation against the interpretive report. TOP: How to Describe Ultrasound Findings 11. Which term refers to decreased echogenicity as compared with other body structures? a. Anechoic b. Isoechoic c. Hyperechoic d. Hypoechoic ANS: D
Hypoechoic is a comparative term used to describe an area on a sonogram where the echoes are decreased or not as bright compared to surrounding structures. OBJ: Contrast technical observation against the interpretive report. TOP: How to Describe Ultrasound Findings 12. Which of the following occurs during an initial scanning survey? a. Measurements of abnormal anatomy are obtained. b. No images are taken during an initial scanning survey. c. Images required by the institution’s protocol are obtained. d. Sagittal and transverse scanning plane images of pertinent anatomy are obtained. ANS: B
During the survey portion of an ultrasound examination no images are taken; areas of interest are evaluated in at least two scanning planes, abnormalities are ruled out, and technique and scanning approach(es) are determined. OBJ: Contrast technical observation against the interpretive report. TOP: During the Ultrasound Examination 13. Which anatomic area is NOT demonstrated in a sagittal scanning plane image? a. Lateral b. Inferior c. Anterior d. Posterior ANS: A
A sagittal scanning plane image demonstrates anterior, posterior, superior, and inferior anatomic areas.
OBJ: Contrast technical observation against the interpretive report. TOP: Ultrasound Scanning Planes 14. Which anatomic area is NOT demonstrated in a transverse scanning plane image? a. Medial b. Anterior c. Posterior d. Superior ANS: D
A transverse scanning plane image demonstrates anterior, posterior, medial, and lateral anatomic areas. OBJ: Contrast technical observation against the interpretive report. TOP: Ultrasound Scanning Planes 15. Which anatomic area is NOT demonstrated in a coronal scanning plane image? a. Medial b. Lateral c. Anterior d. Inferior ANS: C
A coronal scanning plane image demonstrates medial, lateral, superior, and inferior scanning planes. OBJ: Contrast technical observation against the interpretive report. TOP: Ultrasound Scanning Planes 16. Sonographers must a. have excellent handwriting. b. be licensed by the state. c. present images to the interpreting physician. d. diagnose disease. ANS: C Sonographers primary work involves using ultrasound imaging equipment to produce cross-section images of anatomy and diagnostic data. Specific responsibilities include the following: excellent communication skills; strong computer skills; ability to obtain and record patient data pertinent to the ultrasound study; proper use of ultrasound systems; provide quality patient care; acquire, analyze, modify, and select images to store and present to the interpreting physician for diagnosis; use ultrasound terminology to document the technical summary of the ultrasound findings, which are presented or sent to the interpreting physician. OBJ: Explain the roles of the sonographer and sonologist/radiologist. TOP: Image Documentation Criteria 17. Which of the following is an example of professional and clinical standards? a. Wearing an identification badge b. Discussing the sonographic findings with the patient c. Using slang words, so patients feel more comfortable d. Not inquiring about the patient’s illness, so they do not get upset ANS: A
Whether in a classroom or clinical setting, certain professional and clinical standards should be followed: conversations with patients should be proper and professional; never discuss the sonographic findings or offer your opinion of the study results with a patient; inquire about the patient's symptoms and history of illness or surgeries. OBJ: Explain the roles of the sonographer and sonologist/radiologist. TOP: Clinical Criteria 18. Coronal planes divide the body into unequal a. medial and lateral sections. b. anterior and posterior sections. c. superior and inferior sections. ANS: B The coronal plane is any plane parallel to the long axis of the body and perpendicular to sagittal scanning planes. OBJ: Contrast technical observation against the interpretive report. TOP: Ultrasound Scanning Planes 19. Transverse planes divide the body into unequal a. right and left sections. b. anterior and posterior sections. c. superior and inferior sections. ANS: C A transverse scanning plane image demonstrates the anatomy visualized in an anterior-to-posterior (or posterior-to-anterior) dimension and right-to-left dimension or a lateral-to-medial dimension and anterior-to-posterior dimension. OBJ: Contrast technical observation against the interpretive report. TOP: Ultrasound Scanning Planes 20. Sagittal planes divide the body into unequal a. right and left sections. b. anterior and posterior sections. c. superior and inferior sections. ANS: A A sagittal scanning plane image demonstrates the anatomy visualized in an anterior-to-posterior (or posterior-to-anterior) dimension and superior-to-inferior dimension. OBJ: Contrast technical observation against the interpretive report. TOP: Ultrasound Scanning Planes 21. Which planes are parallel to the long axis of the body? a. Transverse and coronal b. Sagittal and transverse c. Sagittal and coronal ANS: C The sagittal and coronal planes are parallel to the long axis of the body. OBJ: Contrast technical observation against the interpretive report. TOP: Ultrasound Scanning Planes
22. Longitudinal views show a structure’s depth and a. height. b. volume. c. width. d. length. ANS: D Longitudinal (long axis) views demonstrate the depth and length of a structure. Measurement calipers are used to obtain length, width, and anteroposterior measurements to provide the dimensions or total volume of a structure of interest. OBJ: Contrast technical observation against the interpretive report. TOP: Ultrasound Scanning Planes 23. The normal echotexture appearance of soft tissues is characterized as a. homogeneous. b. heterogenous. c. isoechoic. d. complex. ANS: A Normal organ parenchyma (soft tissue) is demonstrated on a sonogram as homogeneous, or uniform in texture. OBJ: Contrast technical observation against the interpretive report. TOP: How to Describe Ultrasound Findings 24. With regard to composition, a mass is classified as a. high gain or low gain. b. cystic, complex or solid. c. big, medium, or small. d. single or many. ANS: B A mass may be described as solid, cystic, or complex, depending on its composition. OBJ: Contrast technical observation against the interpretive report. TOP: How to Describe Ultrasound Findings 25. A “circumscribed disease process” describes a. diffuse disease. b. intraorgan features. c. extraorgan features. d. a mass. ANS: D A mass is a circumscribed disease process. OBJ: Contrast technical observation against the interpretive report. TOP: How to Describe Ultrasound Findings 26. An accumulation of serous fluid in the abdominopelvic cavity is called a. ascites. b. pleural effusion.
c. infiltrative disease. d. complex. ANS: A Ascites is an accumulation of serous fluid anywhere in the abdominopelvic cavity. OBJ: Contrast technical observation against the interpretive report. TOP: How to Describe Ultrasound Findings 27. “Homogenous liver texture” is an example of a. clinical history. b. technical observation. c. interpretive report. ANS: B Technical observations should be confined to descriptions of the ultrasound findings based on echo pattern and size. OBJ: Contrast technical observation against the interpretive report. TOP: How to Describe Ultrasound Findings 28. “Fever and chills x 3 days” is an example of a. clinical history. b. technical observation. c. interpretive report. ANS: A “Fever and chills 3 days” describes clinical symptoms (clinical history). OBJ: Contrast technical observation against the interpretive report. TOP: The Sonographer's Technical Observation and Comments 29. “Right lower quadrant pain” is an example of a. clinical history. b. technical observation. c. interpretive report. ANS: A Right lower quadrant pain is a clinical symptom and part of the patient’s clinical history. OBJ: Contrast technical observation against the interpretive report. TOP: The Sonographer's Technical Observation and Comments 30. “Splenomegaly” is an example of a. clinical history. b. technical observation. c. interpretive report. ANS: B Technical observations should be confined to descriptions of the ultrasound findings based on echo pattern and size. OBJ: Contrast technical observation against the interpretive report. TOP: The Sonographer's Technical Observation and Comments
31. “Inflammed appendix” is an example of a. clinical history. b. technical observation. c. interpretive report. ANS: C An interpretive report (final report) includes a detailed description of the ultrasound findings and a diagnosis (or diagnoses) derived from them. OBJ: Contrast technical observation against the interpretive report. TOP: The Sonographer's Technical Observation and Comments 32. “Chronic pancreatitis” is an example of a. clinical history. b. technical observation. c. interpretive report. ANS: C An interpretive report (final report) includes a detailed description of the ultrasound findings and a diagnosis (or diagnoses) derived from them. OBJ: Contrast technical observation against the interpretive report. TOP: The Sonographer's Technical Observation and Comments
Chapter 2: Ultrasound Instrumentation: “Knobology,” Imaging Processing, and Storage Curry/Prince: Sonography, 5th Edition MULTIPLE CHOICE 1. The alphanumeric keyboard is used to a. enter new patient information. b. perform the initial configuration at installation of the ultrasound unit. c. indicate which patient will be examined next. d. house the sonologist workstation. ANS: A
The alphanumeric keyboard controls allow the sonographer to enter the patient’s name, ID number, and full screen annotation. The keyboard also may include specific function keys. OBJ: Compare and contrast the functions of the keyboard controls: primary imaging controls, calculation controls, and additional controls. TOP: Knobology 2. Annotation On/Off a. erases the last character to the left of the cursor. b. erases all user-entered annotations, starting at the cursor’s location. c. clears the patient’s ID number and stored images. d. allows comments to be entered on the screen. ANS: D
When turned on, Annotation On/Off (also called Comments On/Off) allows annotation, or comments, to be entered on the screen. OBJ: Compare and contrast the functions of the keyboard controls: primary imaging controls, calculation controls, and additional controls. TOP: Knobology 3. The HELP menu provides quick access to the a. on/off switch. b. primary imaging controls. c. reference manual. d. clinical application specialist. ANS: C
Some systems employ a HELP menu to access and provide a quick reference manual to the system usage. This is often accessed through a HELP key located directly on the keyboard or is a function key located on the top row of the keyboard. OBJ: Compare and contrast the functions of the keyboard controls: primary imaging controls, calculation controls, and additional controls. TOP: Knobology 4. The frequency control ensures that a. imaging depth is appropriate. b. tissue resolution is adequate. c. the right focal zone is used. d. the image freezes.
ANS: B
The frequency control allows the sonographer to select the imaging frequency best suited to the patient’s anatomy and the type of examination. Better tissue resolution of superficial structures is attained with higher frequencies. A lower imaging frequency is used for deeper structures, but image definition is lost for more superficial structures. OBJ: Compare and contrast the functions of the keyboard controls: primary imaging controls, calculation controls, and additional controls. TOP: Knobology 5. The TGC control can strengthen echoes that are a. returning from deep tissues. b. emitted from the transducer to deep tissues. c. returning from superficial tissues. d. emitted from the transducer to superficial tissues. ANS: A
The TGC control equalizes the differences in received echo amplitudes due to reflector depth. Returning echoes from deep in the body are amplified so that information on deeper structures can be received. OBJ: Compare and contrast the functions of the keyboard controls: primary imaging controls, calculation controls, and additional controls. TOP: Knobology 6. When the focal zone indicator is set too deep for the organ being examined a. the echogenicity is too bright. b. the resolution is suboptimal. c. the light output is inadequate. d. the organ needs to be repositioned. ANS: B
The focal zone should be set at the level of the area of interest. It provides the correct scan depth, ensuring optimal visualization of the target organ. OBJ: Compare and contrast the functions of the keyboard controls: primary imaging controls, calculation controls, and additional controls. TOP: Knobology 7. The posterior border of the gallbladder cannot be seen on sagittal view; it appears to be cut
off. Which control is most likely to correct this? a. Depth b. Frequency c. TGC d. Cine loop ANS: A
The depth control places the area of interest in the center of the screen. The organ should appear large enough to fill a good portion of the image, yet the surrounding anatomy should be easily visualized. If the posterior portion of the organ is off the screen, the depth has been improperly set. OBJ: Compare and contrast the functions of the keyboard controls: primary imaging controls, calculation controls, and additional controls. TOP: Knobology
8. The sonologist has requested a side-by-side comparison view. Which control should be
used? a. Focal zone position b. Focal zone number c. Left/right key d. Imaging preset ANS: C
The dual image (i.e., left/right) key is used to produce a side-by-side view. In this view, measurements from two different images can be compared. OBJ: Compare and contrast the functions of the keyboard controls: primary imaging controls, calculation controls, and additional controls. TOP: Knobology 9. The trace function a. places cursors for distance measurement. b. erases cursors, outlines, and measurement results. c. places cursors for distance and transverse measurements. d. outlines circumference measurements. ANS: D
The trace function is a measurement key that outlines a circumference for measurements. OBJ: Compare and contrast the functions of the keyboard controls: primary imaging controls, calculation controls, and additional controls. TOP: Knobology 10. The body pattern control a. displays the body pattern to indicate patient positioning. b. adjusts automatically when the patient is turned to another position. c. allows pulsed wave and M-mode images to overlie the body pattern. d. adjusts the detail for images. ANS: A
The body pattern control displays the body pattern to indicate patient positioning. The pattern appears on the monitor screen. OBJ: Compare and contrast the functions of the keyboard controls: primary imaging controls, calculation controls, and additional controls. TOP: Knobology 11. Doppler can be added to the image by which control? a. M mode b. Brightness and contrast c. Power Doppler d. Trackball ANS: C
The Doppler function can be activated by the color Doppler or power Doppler controls. OBJ: Demonstrate the steps to operate the ultrasound system.
TOP: Knobology
12. Which is the proper order for operating the ultrasound system?
a. Adjust the TGC, focal zones, and image size; enter the patient’s name and ID
number; and select the transducer. b. Adjust the focal zones, image size, and TGC; select the transducer; and enter the
patient’s name and ID number. c. Enter the patient’s name and ID number; adjust the focal zones, image size, and
TGC; and select the transducer. d. Enter the patient’s name and ID number; select the transducer; and adjust the TGC,
focal zones, and image size. ANS: D
The recommended order for operating the ultrasound system is enter the patient’s name and ID number; select the appropriate transducer; place the transducer on the patient with a generous amount of coupling gel; and then adjust the TGC, focal zones, and image size. OBJ: Demonstrate the steps to operate the ultrasound system.
TOP: Knobology
13. The Worklist electronic program allows sonographers to a. connect the Hospital Information System, Radiology Information System, and
Picture Archiving and Communication System in one database. b. order the patient examinations for the day. c. query for patient demographic information from the ultrasound system. d. engage the preset function of the system. ANS: C
Many hospitals and imaging centers now use the Worklist program, which transfers patient information electronically to the ultrasound system. Sonographers “query” Worklist from the ultrasound system through a dedicated computer network. Detailed, pertinent patient information (e.g., the patient’s full name and date of birth, the referring physician’s name, the patient’s medical record number, and the type of study to be done) then is populated into a patient information page on the ultrasound system. OBJ: Discuss the functions of the Worklist program. TOP: Image Processing and Storage 14. There is a mass in the anterior portion of the left lobe of the liver, but the borders are not well resolved. Which control should the sonographer adjust? a. Depth b. Overall gain c. TGC d. Frequency ANS: D Better tissue resolution is obtained with higher frequencies. OBJ: Compare and contrast the functions of the keyboard controls: primary imaging controls, calculation controls, and additional controls. TOP: Knobology 15. Which of the following controls allows you to position the measurement cursors? a. Trackball b. Cine Loop c. Freeze key d. Preset
ANS: A The trackball guides the cursor on the screen. OBJ: Compare and contrast the functions of the keyboard controls: primary imaging controls, calculation controls, and additional controls. TOP: Knobology TRUE/FALSE 1. The advantages of the Radiology Information System include appointment scheduling and
the use of work lists. ANS: T
The Radiology Information System (RIS) can be integrated with other hospital information systems, allowing patient scheduling, the use of work lists, and digital dictation. OBJ: Describe the differences between PACS, HIS, and RIS. TOP: Image Processing and Storage 2. The advantages of the Picture Archiving and Communication System include a capability
for remote radiologic consultation. ANS: T
The Picture Archiving and Communication System at external hospitals allows for remote radiologic consultation through electronic imaging. OBJ: Describe the differences between PACS, HIS, and RIS. TOP: Image Processing and Storage 3. An advantage of the Hospital Information System is electronic storage of patients’
demographics and chart information. ANS: T
The Hospital Information System electronically stores patients’ demographics and chart information. OBJ: Describe the differences between PACS, HIS, and RIS. TOP: Image Processing and Storage 4. Teleradiology involves radiologic consultations done within the imaging center where an
examination was performed. ANS: F
Teleradiology involves remote radiologic consultations done through the use of PACS at the sending and receiving institutions. OBJ: Describe the differences between PACS, HIS, and RIS. TOP: Image Processing and Storage 5. Sonographers must learn to use a wide range of technologic tools to ensure optimum
imaging and to facilitate sonologist reporting.
ANS: T
Sonographers have a wide range of technologic support at their disposal, such as ever-advancing ultrasound systems and electronically connected patient data and physician workstations. Therefore, it is important that sonographers develop superb technologic skills to ensure proper handling of the ultrasound system and additional electronic data systems at their disposal. Well-educated sonographers advance patient care and the ultrasound profession through the proper use of technology and their assistance to sonologists. OBJ: Compare and contrast the functions of the keyboard controls: primary imaging controls, calculation controls, and additional controls. TOP: Knobology 6. PACS is a computer technology system that automatically selects the correct frequency, depth, and focal zone controls. ANS: F Most hospitals and imaging centers currently run filmless by using a computer technology system called PACS, an acronym for Picture Archiving and Communication System. This computer technology allows for improved image resolution as images are stored in a digital format and are software controlled. Ultrasound images are acquired digitally and are viewed and stored on a computer and/or network server. This system can be dedicated to the ultrasound department or used on a larger scale throughout the entire radiology division and hospital. PACS can communicate with outside hospitals and imaging centers located anywhere in the world that are also equipped with PACS capabilities. OBJ: Describe the differences between PACS, HIS, and RIS. TOP: Image Processing and Storage 7. PACS is a computer technology system that unites the HIS and RIS and stores digital images. ANS: T Most hospitals and imaging centers currently run filmless by using a computer technology system called PACS, an acronym for Picture Archiving and Communication System. This computer technology allows for improved image resolution as images are stored in a digital format and are software controlled. Ultrasound images are acquired digitally and are viewed and stored on a computer and/or network server. This system can be dedicated to the ultrasound department or used on a larger scale throughout the entire radiology division and hospital. PACS can communicate with outside hospitals and imaging centers located anywhere in the world that are also equipped with PACS capabilities. OBJ: Describe the differences between PACS, HIS, and RIS. TOP: Image Processing and Storage
Chapter 3: General Patient Care Curry/Prince: Sonography, 5th Edition MULTIPLE CHOICE 1. What action conveys a sense of genuine interest in the patient? a. Making small talk b. Adjusting the tone and expression of your voice c. Obtaining a medical history d. Discussing your opinion of the ultrasound findings ANS: B
Conversation should be respectful, warm, and professional. Sonographers should adjust the tone and expression of their voice to convey a sense of genuine interest in the patient. OBJ: Describe effective interpersonal skills.
TOP: Interpersonal Skills
2. A signed informed consent form is required from patients for a. all ultrasound studies. b. endocavital studies. c. invasive procedures. d. ultrasound-guided biopsies and aspirations. ANS: C
For invasive procedures, such as ultrasound-guided biopsies or endocavital studies, patients must be informed of the details of the procedure and then must sign an informed consent form before the procedure can take place. OBJ: Describe the sonographer’s responsibilities regarding patient care. TOP: Patient Care During the Examination 3. During an ultrasound examination, it is acceptable for a sonographer to a. show the patient any abnormal findings. b. discuss his or her opinion of the ultrasound findings. c. provide a diagnosis. d. briefly point out one or more structures. ANS: D
Sonographers may briefly point out a structure or structures. However, they may not point out abnormal echo patterns or findings or give a patient their opinion of the findings. OBJ: Describe effective interpersonal skills.
TOP: Interpersonal Skills
4. The best types of questions to present to a patient to obtain a thorough patient history are a. those that require a “yes” or “no” answer. b. multiple choice questions that give them options to choose as an answer. c. true or false questions. d. open-ended questions that can provide accurate and specific details. ANS: D
When obtaining a patient history, sonographers should avoid using medical terms that a patient may not understand and asking questions that require a yes or no answer. Questions should be open-ended to obtain more accurate and specific details. OBJ: Describe effective interpersonal skills.
TOP: Interpersonal Skills
5. A practice to protect patients from infection due to germs is referred to as a(an) a. aseptic technique. b. valsalva maneuver. c. Fowler’s technique. d. invasive procedure. ANS: A
Aseptic technique is the procedure and practices used in any clinical setting to protect patients from infection due to germs. OBJ: Describe the sonographer’s responsibilities regarding patient care. TOP: Patient Care During the Examination 6. In order to ensure you have the correct patient, the sonographer should a. call the patient’s name and when someone responds, that is the correct patient. b. use two patient identifiers, having the patient repeat their name and date of birth while checking the identification bracelet. c. ask the clerk in the lobby to identify the patient. d. check all the identification bracelets of the patients in the lobby until the sonographer finds the name they are looking for. ANS: B
Prior to an exam, sonographers must make sure they have the correct patient. Patients have been known to answer to the wrong name. The sonographer should check the patient’s identification bracelet or number against the patient chart and request form; they should ask outpatients to repeat back their names. OBJ: Describe the sonographer’s responsibilities regarding patient care. TOP: Patient Care During the Examination 7. If a patient wanders too far off the subject during the medical history, the sonographer
should a. explain that the questions they are being asked are important and direct them to stay on topic. b. let the patient talk about any topic of interest before interrupting. c. gently lead the person back to the reason for the question. d. explain to the patient that there is a limited time to complete the exam. ANS: C
The sonographer must learn to be a good listener and pay close attention to the patient’s answers. If the patient wanders too far off the subject, the sonographer should gently lead the person back to the reason for the question without appearing disinterested in those other concerns. OBJ: Describe effective interpersonal skills.
TOP: Interpersonal Skills
8. In order to properly assist shorter patients on and off the exam table, the sonographer should a. lift the patient on and off the table. b. explain that if the patient cannot get on the table unassisted the sonographer cannot perform the exam. c. provide a chair for them to step on to get on the exam table. d. provide a step stool with handles. ANS: D
Sonographers should always have a handled step stool available for shorter patients or those who require a little more assistance. OBJ: Describe a “patient-ready” ultrasound examination room. TOP: Ultrasound Examination Room 9. When assisting a wheelchair patient, the sonographer should a. verbally direct the patient when they are ready for them to get in or out of the
chair. b. make certain that both brakes are locked and the leg- and footrests have been
pushed out of the way. c. lock at least one brake on the wheelchair. d. push the footrests out of the way. ANS: B
When helping a patient into or out of a wheelchair, the sonographer must make sure both brakes are locked and the leg- and footrests have been pushed out of the way. OBJ: Describe the sonographer’s responsibilities regarding patient care. TOP: Patient Care During the Examination 10. What is the appropriate procedure for leaving a confused or uncooperative patient in the examination room unattended? a. If the patient will only be alone for 5 minutes, it is acceptable to provide blankets and pillows as necessary. b. Make sure to leave the stretcher side rails up. c. The brakes must be locked on the stretcher. d. Patients who are confused or uncooperative should never be left unattended. ANS: D
Patients who are confused, upset, or uncooperative should never be left unattended in the examination room. OBJ: Describe the sonographer’s responsibilities regarding patient care. TOP: Patient Care During the Examination 11. If patients ask about the ultrasound findings, the sonographer should a. point out and explain the abnormal echo patterns on the screen. b. give the patient their opinion of the ultrasound findings. c. explain that they do not make diagnoses but will provide the images to the
interpreting. d. physician who will provide a report to the patient’s physician not respond. ANS: C
Patients should be told that sonographers do not provide a diagnosis; rather, they provide the sonographic images to an interpreting physician, who sends an interpretive report to the patient’s referring physician. Sonographers work under the delegated authority of the interpreting physician and are not trained or legally qualified to provide a diagnosis. OBJ: Describe the sonographer’s responsibilities regarding patient care. TOP: Patient Care During the Examination 12. To maintain a sterile field, all a. areas below the level of the sterile drapes are considered sterile. b. items that enter the sterile field must be sterile. c. packages containing sterile items are opened simultaneously. d. sterile drapes are placed prior to cleaning the site. ANS: B
A sterile field is created by placing prepackaged sterile drapes around the cleaned site. All packages containing sterile items should be opened in such a way that the contents do not touch nonsterile surfaces or items. Areas below the level of the sterile drapes are outside the field and are not sterile. To maintain a sterile field, all items that enter the sterile field must be sterile. OBJ: Describe specific practices comprising aseptic technique. TOP: Aseptic Technique 13. If a patient is incapacitated and unable to communicate, the sonographer should obtain
permission to perform an invasive procedure from a. a patient representative. b. the nurse. c. the reading physician. d. no one, consent is not needed. ANS: A If a patient is incapacitated and cannot speak or sign, a patient representative, such as a family member or the referring physician can grant permission for an invasive procedure to be performed. OBJ: Describe the sonographer’s responsibilities regarding patient care. TOP: Patient Care During the Examination 14. The interests of the patient and sonographer can best be protected during endocavitary
procedures by having a. the patient’s family member present during the procedure. b. another healthcare professional witness the procedure. c. a witness designated by the patient. d. verbal consent by the patient. ANS: B
In an effort to protect the interests of the sonographer and patient, it is recommended that endocavital procedures be witnessed by another health care professional. OBJ: Describe the sonographer’s responsibilities regarding patient care. TOP: Patient Care During the Examination
TRUE/FALSE 1. A sonographer’s dress is irrelevant to the quality of care a patient receives. ANS: F
When patients feel comfortable, they become more focused and receptive. A sonographer’s dress should be professional and include a visible, easy-to-read source of personal identification. OBJ: Describe effective interpersonal skills.
TOP: Interpersonal Skills
2. If a patient requests a drink of water following an abdominal ultrasound examination, it is
recommended that the sonographer immediately provide it. ANS: F
If a patient requests something to eat or drink, the sonographer should first check the patient’s chart or ultrasound request to ensure that the patient is not scheduled for another examination that requires him or her to be fluid or food-restricted. It is essential to check all available patient information and/or contact the referring physician, floor nurses, or the outpatient’s physician’s office to be sure prior to allowing the patient to eat or drink. OBJ: Describe the sonographer’s responsibilities regarding patient care. TOP: Patient Care During the Examination 3. All patients are susceptible to infection, but those with burns or immune disorders are at
greater risk. ANS: T
All patients are susceptible to infection, particularly those with excessive burns or immune disorders that disturb the body’s natural defenses. OBJ: Describe specific practices comprising aseptic technique. TOP: Aseptic Technique 4. It is a sonographer’s responsibility to be aware of the institution’s policies on universal
precautions, isolation, and “Code” procedures. ANS: T
To provide patients with the best possible care, a sonographer should be aware of the institution’s universal precautions and isolation policies and “Code” procedures for incidences of heart failure. OBJ: Describe the sonographer’s responsibilities regarding patient care. TOP: Patient Care During the Examination 5. Since it is the physician who performs interventional procedures, it is not necessary for the
sonographer to be able to perform asepsis techniques. ANS: F
Ultrasound is routinely used for invasive percutaneous needle-guided biopsies, aspiration and drainage procedures, as well as interventional and intraoperative procedures. To adequately assist the physician in an ultrasound-guided percutaneous procedure and to protect the patient from obtaining an infection during the procedure, a sonographer must be adept at implementing asepsis technique. OBJ: Describe specific practices comprising aseptic technique. TOP: Aseptic Technique
Chapter 4: Introduction to Ergonomics and Sonographer Safety Curry/Prince: Sonography, 5th Edition MULTIPLE CHOICE 1. The science or study of work is referred to as a. interaction. b. an occupation. c. presbyopia. d. ergonomics. ANS: D
The science or study of work is ergonomics. The application of ergonomics is important for improving work performance and the well-being of workers. OBJ: Define ergonomics and discuss the history of ergonomics as it relates to sonography and the Occupational Safety and Health Act’s (OSHA) involvement. TOP: Ergonomics Defined 2. The significance of evaluating ergonomics in the workplace is to a. improve worker morale. b. reduce employee spending. c. improve performance and quality, reduce injuries, and reduce absenteeism and
turnover. d. improve patient satisfaction. ANS: C
The use of ergonomics is important in the workplace to improve performance and quality, reduce injuries, and reduce absenteeism and turnover. OBJ: Define ergonomics and discuss the history of ergonomics as it relates to sonography and the Occupational Safety and Health Act’s (OSHA) involvement. TOP: Ergonomics Defined 3. When ultrasound equipment was transitioned from static scanners with an articulated arm
to real-time scanning with heavy cables attached to the transducers, sonographers began experiencing muscle strain in the a. ankle, knee, and elbow. b. thumb, wrist, and shoulder. c. knee, elbow, and shoulder. d. fingers, toes, and wrist. ANS: B
As the industry moved to new technology, the transducer was no longer fixed to an articulated arm but connected to a long and heavy cable. By the mid-1990s, sonographers began to complain of muscle strain in the wrist, base of the thumb, shoulder, neck, and back. OBJ: Define ergonomics and discuss the history of ergonomics as it relates to sonography and the Occupational Safety and Health Act’s (OSHA) involvement. TOP: Ergonomics Defined 4. Industry Standards for the Prevention of WRMSD injuries in sonography were first
introduced by the
a. b. c. d.
Occupational Safety and Health Act (OSHA). American Institute of Ultrasound in Medicine (AIUM). Society of Diagnostic Medical Sonographers (SDMS). Joint Review Committee – Diagnostic Medical Sonographers (JRC-DMS).
ANS: C
The Society of Diagnostic Medical Sonographers introduced industry standards for the prevention of WRMSD injuries in sonography in May 2003. OBJ: Learn how the industry has changed over the years to counteract injury and describe the various practice changes made. TOP: Creating a Safe Environment 5. A specific type of tendonitis that is due to repeated and intense gripping of the transducer
is a. b. c. d.
carpal tunnel syndrome. rotator cuff injury. plantar fasciitis. de Quervain’s disease.
ANS: D
De Quervain’s disease is a specific type of tendonitis that involves the thumb and is thought to be caused by repeated gripping of the transducer. OBJ: List the types of injuries most likely to occur while scanning. TOP: Types of Injuries 6. Inflammation on the sole of the foot is referred to as a. carpal tunnel syndrome. b. rotator cuff injury. c. plantar fasciitis. d. de Quervain’s disease. ANS: C
Plantar fasciitis is inflammation of the fascia on the sole or plantar surface of the foot. OBJ: List the types of injuries most likely to occur while scanning. TOP: Types of Injuries 7. Entrapment of the median nerve defines what condition? a. Carpal tunnel syndrome b. Rotator cuff injury c. Bursitis d. de Quervain’s disease ANS: A
Carpal tunnel syndrome is entrapment of the median nerve as it runs through the carpal bones of the wrist. OBJ: List the types of injuries most likely to occur while scanning. TOP: Types of Injuries
8. A leader in the field of sonography who has dedicated her career to awareness and
prevention of workplace injuries is a. Marie Curie. b. Joan Baker. c. Inge Edler. d. Elizabeth Kelly. ANS: B
Through the pioneering work of Joan Baker and other sonography leaders, strategies to prevent WRMSDs and improve sonographer workplace safety remain an important focus in scanning laboratories. OBJ: Learn how the industry has changed over the years to counteract injury and describe the various practice changes made. TOP: Creating a Safe Environment 9. The group that is most instrumental in making changes in the industry to prevent
workplace injuries is a. sonographers. b. sonologists. c. employers. d. equipment manufacturers. ANS: D
The most significant changes in the industry have been made by equipment manufacturers. They continue to develop ergonomically designed ultrasound systems that decrease twisting and turning and have designed lighter transducers and transducer cables. OBJ: Learn how the industry has changed over the years to counteract injury and describe the various practice changes made. TOP: Creating a Safe Environment 10. The highest average number of scans per day is performed in the specialty area of a. OB/GYN. b. abdomen. c. adult cardiac. d. vascular. ANS: C
The highest average number of scans per day is in the adult cardiac specialty followed by OB/GYN. OBJ: Explain the causes and risk factors that influence work-related musculoskeletal disorders (WRMSD) and musculoskeletal injuries (MSI). TOP: Causes and Risk Factors of Workplace Injuries 11. Extension of the shoulder and arm away from the body is referred to as a. abduction. b. awkward postures. c. ergonomics. d. force. ANS: A
Movements such as twisting and bending of the neck and torso, abduction (extension) of the shoulder, and applying pressure to the transducer contribute to musculoskeletal pain and discomfort. OBJ: Explain the causes and risk factors that influence work-related musculoskeletal disorders. TOP: Types of Injuries 12. Signs and symptoms that indicate a WRMSD may be developing include cramping of the
hand/wrist, loss of grip, tingling, and a. forceful strain. b. decreased movement. c. numbness. d. swelling. ANS: D
WRMSDs are injuries that result in restricted work. The following are important signs and symptoms of developing a work-related injury: cramping or pain of the hand/wrist, loss of grip, stiffness, tingling, swelling, and spinal degeneration. OBJ: Explain the causes and risk factors that influence work-related musculoskeletal disorders. TOP: Types of Injuries 13. Spinal degeneration is caused from awkward and static postures, bending, and a. twisting. b. gripping the transducer too tight. c. repetitive motion. d. swelling. ANS: A
Intervertebral disc degeneration results from awkward and static postures, bending, and twisting while scanning. OBJ: List the types of injuries most likely to occur while scanning. TOP: Types of Injuries TRUE/FALSE 1. Sonographers are not at fault for ergonomic injuries when they are required to work in a
stressful environment. ANS: F
Sonographers should take responsibility for their own actions and behaviors by taking mini-rest breaks, especially when performing portable exams. Sonographer awareness of stress and possible coping mechanisms are keys to maintaining a healthy and stress-free workplace. OBJ: Explain the causes and risk factors that influence work-related musculoskeletal disorders (WRMSD) and musculoskeletal injuries (MSI). TOP: Causes and Risk Factors of Workplace Injuries
2. Possessing a positive attitude is a contributing factor toward preventing workplace
injuries. ANS: T
Possessing a positive attitude, not taking yourself too seriously, getting a restful night’s sleep, and exercising can benefit the sonographer immensely in the reduction of workplace stress. OBJ: Explain the causes and risk factors that influence work-related musculoskeletal disorders (WRMSD) and musculoskeletal injuries (MSI). TOP: Causes and Risk Factors of Workplace Injuries 3. It is acceptable for a sonographer to rearrange furniture in a patient’s room during a
portable examination to position the ultrasound machine close to the bed. ANS: T
Sonographers and supervisors should work with other health care members to move furniture and equipment out of the way to make room for the sonographer to work as safely as possible. OBJ: Explain the causes and risk factors that influence work-related musculoskeletal disorders (WRMSD) and musculoskeletal injuries (MSI). TOP: Causes and Risk Factors of Workplace Injuries 4. Behavioral modification techniques are useful in the prevention of presbyopia. ANS: T
Eyestrain is a concern for the sonographer. Over time, a focusing issue known as presbyopia can develop. Resting between patients or following the 20-20-20 rule can help to reduce fatigue. The rule states that for every 20 minutes of scanning, the sonographer should look 20 feet away for 20 seconds. This may sound simple, but it is difficult to manage without behavioral modification techniques and practice. OBJ: Explain the causes and risk factors that influence work-related musculoskeletal disorders (WRMSD) and musculoskeletal injuries (MSI). TOP: Causes and Risk Factors of Workplace Injuries 5. It is the sole responsibility of the employer to ensure that sonographers do not experience
work-related injuries. ANS: F
Ergonomics create a safe scanning environment for the sonographer and sonologist, but the prevention of injury in the workplace must center around manufacturer, sonographer, and employer awareness. OBJ: Describe what comprises a stress-free and safe, injury-free scanning environment and how that environment is managed. TOP: Creating a Safe Environment 6. Degeneration of the intervertebral discs is not related to sonographic scanning. ANS: F
Spinal degeneration is a deterioration of the intervertebral discs and is a common injury or disorder among sonographers. OBJ: List the types of injuries most likely to occur while scanning. TOP: Types of Injuries 7. Good eating habits are a contributing factor in the prevention of work-related injuries. ANS: T
Actions to reduce the risk for injury include adopting good posture, taking brief rest breaks during scan times, stretching throughout the day to control stiffness, getting proper rest, exercising, and maintaining good eating habits. OBJ: Describe what comprises a stress-free and safe, injury-free scanning environment and how that environment is managed. TOP: Creating a Safe Environment 8. Stress does not generally contribute to work-related injuries in sonography. ANS: F
Stress for sonographers in the workplace takes many forms, including overload of patient schedules, communication issues, ethical and legal conflicts, and not enough available resources to do the job properly. As a result of these common stressors, the sonographer can develop physical and/or psychosocial stress-related symptoms that may increase the susceptibility to illness or injury. OBJ: Explain the causes and risk factors that influence work-related musculoskeletal disorders (WRMSD) and musculoskeletal injuries (MSI). TOP: Causes and Risk Factors of Workplace Injuries 9. Psychosocial symptoms such as low self-esteem and a feeling of failure may be
contributing factors of workplace injuries. ANS: T
Psychosocial stress-related symptoms such as withdrawal, low self-esteem, feeling of failure, and frustration increase the susceptibility of illness or injury. Continuation of these stressors without positive or compassionate intervention can lead to burnout, a result of chronic work-related stress. OBJ: Explain the causes and risk factors that influence work-related musculoskeletal disorders (WRMSD) and musculoskeletal injuries (MSI). TOP: Causes and Risk Factors of Workplace Injuries 10. The incorporation of voice recognition on ultrasound machines is a tool for reducing
work-related injuries. ANS: T
Manufacturers design state-of-the-art and ergonomically designed ultrasound systems with adjustable monitors and keyboards. Another creative tool that allows hand-free scanning is voice recognition. OBJ: Describe what comprises a stress-free and safe, injury-free scanning environment and how
that environment is managed.
TOP:
Creating a Safe Environment
11. OSHA classifies occupational injuries as repetitive motion injury, repetitive strain injury,
musculoskeletal strain injury. ANS: T
According to OSHA, an occupational injury can be classified under the categories of repetitive motion injury (RMI), repetitive strain injury (RSI), and musculoskeletal strain injury (MSI). OBJ: Explain the causes and risk factors that influence work-related musculoskeletal disorders (WRMSD) and musculoskeletal injuries (MSI). TOP: Types of Injuries 12. The area of the body that sustain the highest percentage of injury is the back. ANS: F
The upper extremities and neck appear to be the areas with the highest percentage of injury. OBJ: Explain the causes and risk factors that influence work-related musculoskeletal disorders. TOP: Types of Injuries 13. The group or party that has the greatest responsibility to provide working conditions that
reduce and eliminate a sonographer’s chance of work-related injury is the employer. ANS: T
It remains the employer’s responsibility to provide working conditions that reduce and eliminate the chance of injury from WRMSD. OBJ: Describe what comprises a stress-free and safe, injury-free scanning environment and how that environment is managed. TOP: Creating a Safe Environment 14. Cluttered or crowded scanning rooms are factors that contribute to stressful conditions in
the workplace. ANS: T
Factors contributing to stressful conditions in the workplace are environmental stress such as physical working conditions, vision problems such as eyestrain and eye fatigue, cluttered or crowded scanning rooms, and generalized stress whether self-imposed or otherwise. OBJ: Explain the causes and risk factors that influence work-related musculoskeletal disorders (WRMSD) and musculoskeletal injuries (MSI). TOP: Creating a Safe Environment 15. An ultrasound room that is too cold is a factor that contributes to workplace stress. ANS: T
Environmental stress factors include air quality, lighting, and scanning room design. A room that is too hot or cold or lacks good air exchange can lead to sonographer ailments or dissatisfaction with working conditions. A room that is too bright without light-dimming capabilities can cause eyestrain. OBJ: Explain the causes and risk factors that influence work-related musculoskeletal disorders (WRMSD) and musculoskeletal injuries (MSI). TOP: Creating a Safe Environment 16. Retraining staff and hiring temporary staff are considerations examined by employers
when trying to develop solutions for managing risk for injury. ANS: T
Employers must increase their awareness of WRMSDs and understand the costs of employee occupational injury. Worker’s compensation, hiring temporary staff, retraining staff, loss of productivity, and quality issues all must be examined and considered in developing solutions and managing risk for injury. OBJ: Describe what comprises a stress-free and safe, injury-free scanning environment and how that environment is managed. TOP: Creating a Safe Environment 17. Ninety percent of sonographers suffer from some form of WRMSD and of those, 30% will
experience a career-ending injury. ANS: F
Valuable information has been obtained from surveys of sonographers and sonologists regarding the number of occurrences of musculoskeletal symptoms, including pain, with up to 90% of sonographers suffering from some form of WRMSD. Of those, 20% will experience a career-ending injury. OBJ: Learn the importance of ergonomic training which is helpful in limiting injury. TOP: Creating a Safe Environment
Chapter 5: Interdependent Body Systems Curry/Prince: Sonography, 5th Edition MULTIPLE CHOICE 1. Ovulation is the a. mature ova. b. immature ova. c. encasement of immature ova. d. discharge of a mature ovum from its follicle. ANS: D
The release of a mature ovum from the ovarian follicle is called ovulation. OBJ: Explain the interrelationship of the various hormone-producing organs. TOP: Reproductive System 2. Which organ has two sets of capillary beds? a. Liver b. Kidney c. Pancreas d. Spleen ANS: B
The kidney is unique in that it has two sets of capillary beds, rather than a single set, as do all other areas of the body. The additional capillary bed enables the kidneys to assist the cardiovascular system, if necessary, by maintaining a state of blood pressure equilibrium even when the systematic pressure changes. OBJ: Explain how the body systems maintain homeostasis.
TOP: Urinary System
3. Which organ allows free mixing of oxygenated and deoxygenated blood within the
sinusoids? a. Liver b. Kidneys c. Pancreas d. Spleen ANS: A
In the liver, simultaneous free mixing of portal venous blood (deoxygenated) and hepatic arterial blood (oxygenated) takes place. OBJ: Describe the interdependence of body systems and why it is significant to sonographers. TOP: Cardiovascular System 4. Venous flow in the lower extremities is accomplished primarily by means of a. subatmospheric pressure. b. cardiac systolic contractions. c. skeletal muscle contractions. d. cardiac diastolic contractions.
ANS: C
Blood in the legs would stagnate were it not for the presence of valves in the veins and the skeletal muscle contractions that help move the venous blood up through the veins against the effects of gravity. OBJ: Describe the interdependence of body systems and why it is significant to sonographers. TOP: Cardiovascular System 5. The pleural sac is associated with the a. heart. b. lungs. c. kidneys. d. spleen. ANS: B
The pleural sac enables the lungs to expand and contract without adhering to the chest walls. OBJ: Describe the interdependence of body systems and why it is significant to sonographers. TOP: Respiratory System 6. Fertilization typically occurs in the a. uterus. b. ovary. c. fallopian tube. d. cervix. ANS: C
Fertilization usually takes place within 1 day of ovulation in the ampulla portion of the fallopian tube. OBJ: Describe the interdependence of body systems and why it is significant to sonographers. TOP: Reproductive System 7. Which of the following directs and monitors endocrine functions? a. Kidneys b. Pancreas c. Hypothalamus d. Parathyroid glands ANS: C
The endocrine system often is referred to as the neuroendocrine system, because the hypothalamus, in the brain, directs and monitors endocrine functions. OBJ: Explain the interrelationship of the various hormone-producing organs. TOP: Endocrine System 8. Which hormone can be detected in blood or urine, indicating a pregnancy? a. Follicle-stimulating hormone (FSH) b. Growth hormone (GH) c. Adrenocorticotropin (ACTH) d. Human chorionic gonadotropin (BhCG)