Measurements:
Heart:
- AOFT (mid-sinuses of valsalva leading edge to leading edge): <4cm
- Right atrium: <4cm
- Interventricular septum: ≤12-15mm
- Right ventricle free wall: ≤5mm
- RV:LV should be 0.6:1
- PC Eff: widest stripe on diastole small <1cm, mod 1-2cm, or lg >2cm
- Tamponade: Plethoric IVC, incomplete RV relaxation during diastole, incomplete RA relaxation during atrial diastole, >25% change in MV inflow with respiration
Lungs:
- Smallest pleural effusion detectable: 20cc (vs 200cc on CXR)
- B lines: >3 bilateral anterior intercostal space suggests interstitial edema
Vasculature:
- Inferior vena cava: <1.5cm and caval index >50% = CVP 0-5, >2 cm and caval index <50% = CVP 15-20
- Aortic outflow tract: <4cm (measured leading edge to leading edge)
- Abdominal aorta (measured outside to outside): <3cm
- Iliac artery: <1.5cm
Biliary:
- Gallbladder wall thickness: <3-4mm
- Common bile duct (measured inside to inside): ≤4mm (increases 1mm per decade after age 40)
- Dimensions of gallbladder: 4 x 10 cm
Ob/Gyn:
- Calculating gestational age: CRL – up to 12 weeks, BPD – 2nd trimester (measured leading edge to leading edge), femur length – 3rdtrimester
- Normal FHR: 120 – 180bpm by 6-7 weeks gestation
- Ovarian dimensions (avg): 1.5 x 1.5 x 3cm
- Ovarian cyst: ≥2.5cm
- Normal RI in ovarian (scrotal) ultrasound: less than 0.6
Miscellaneous:
- Bladder volume: <200cc (post-void)
- Appendicitis: >6mm (measure including fluid), noncompressible, no peristalsis, blind-ended
- 1cm strip in Morison’s Pouch = 1L fluid
- Smallest amount of free fluid detectable during FAST (in trendelenburg): 440cc
- Liver longest dimension (diaphragm to inferior tip) should be <15cm
- Spleen longest dimension (superior to inferior) should be <13cm
Tips:
Heart:
- Views: SX, PSLA, PSSA, A4C
- Interpretation: AOFT (exit), IVC (entrance), pc eff (effusion), squeeze—hyperdynamic, good, moderate, depressed (ejection), RV:LV (equality)
RUQ:
- Interpretation: GS, WT, SM, PCF (+/- CBD diameter)
Common Landmarks:
- Aorta: vertebral body
- Gallbladder: portal vein, main lobar fissure (sonographic cystic pedicle)
- Uterus: vaginal stripe and bladder
- Ovaries: iliacs (ovaries are medial and anterior to iliacs)
- Femoral vein: medial to artery
- Popliteal vein: posterior to artery
- Appendix: iliacs (post), psoas mm (lat), and peritoneal line (ant)
Abbreviations:
| CRL: crown rump length· BPD: biparietal diameter· FL: femur length· FHR: fetal heart rate· RI: resistance index· SX: subxiphoid· PSLA: parasternal long axis· PSSA: parasternal short axis | A4C: apical 4 chamber· AOFT: aortic outflow tract· PCeff: pericardial effusion· PLeff: pleural effusion· GS: gallstones· WT: wall thickening· SM: sonographic murphy’s· PCF: pericholescystic fluid· CBD: common bile duct |