Name: 如何氣胸的超聲檢查案例分析 (How to: Ultrasound for Pneumothorax Case Study)
Uploaded: 2021-01-14T07:12:34.000Z
Duration: 9 min 30 s
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and I'm the Emergency Ultrasound Coordinator

at the New York Presbyterian Hospital in New York City.

In this module we're going to look specifically

at Ultrasound of the Lung to Evaluate for Pneumothorax.

a classical belief was that the lung was not optimal

that actually ultrasound is an excellent modality

for viewing the pleura and for detecting pnemothoraces.

There's been a lot of research looking at this

and what's interesting is that ultrasound

has been found now to be more sensitive than chest X-ray

in the diagnosis of pneumothorax especially

And now we're going to add on views of the lungs

or the E-FAST exam that we'll be performing

We can also detect pneumothoraces as well

Now let's learn how to perform the ultrasound examination

Here we have the high frequency linear type array probe

looking in to about intercostal space three.

Now in most cases of pneumothorax with the patient supine

the air would be predominantly seen in this area.

Note we're looking in a long axis configuration

oriented superiorly towards the patient's head.

Once we've identified both the ribs and the pleura

we can swivel the probe into the short axis configuration

Here we have the probe oriented in a transverse

or short axis orientation between the ribs

Notice in this case the marker dot is located

towards the lateral aspect of the patient.

Using both long and short axis configurations

If no lung is seen on the anterior chest wall

by looking in the lateral positions as shown here.

Notice the probe on the lateral chest wall

in the short axis configuration between the ribs.

If lung is seen here laterally but not anteriorly,

this would tell you it was an incomplete pneumothorax.

by locating the probe into the long axis configuration

with the marker dot towards the patient's axilla

to further examine into these lateral areas

Notice that the ribs cast shadows posteriorly

to permeate the hard calcifications of the rib.

and note here the two layers of the pleura.

And we see here the outer parietal pleura,

Now while I've depicted these as two separate layers,

they're seen as a single shimmering white line

that moves back and forth as the patient breathes.

And as the patient breathes we can see white comet tails,

coming off the pleura down deep into the lung.

So that will be the normal finding of a lung

which is the opposition of the outer parietal

But note the location of the pleura deep to the ribs,

and that classic shimmering line back and forth

coming off the shimmering parietal and visceral pleura.

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如何氣胸的超聲檢查案例分析 (How to: Ultrasound for Pneumothorax Case Study)

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