top of page

Imaging Windows

Each patient’s anatomy and body habitus is slightly different from one another. So, for all images acquired; depth, gain/TGC, and probe orientation must be adjusted in order to optimize the images obtained

Lung

Probe/Preset:

Linear, Phased Array / Lung, FAST, Cardiac, Pediatric Lung

Body Plane:

Sagittal

Probe Indicator:

Towards Head

Depth:

  • 6cm to Evaluate for Lung sliding

  • >16cm for Evaluation of Lung Pathology

Location:

  • Anterior: 2nd to 3rd Intercostal Space, Midclavicular Line

  • Lateral 4th to 5th Intercostal Space, Mid to Posterior Axillary Line

Identify:

  • Lung Sliding

  • Horizontal uniformly repeating A-Line reverberations 

  • Vertical B-line "comet-tails" that originate at the pleural line and extend to the deep field of the image.

Notes:

Slide Probe downwards towards the feet evaluating for lung sliding in multiple rib spaces.  May also consider scanning along the midaxillary line. A shallow scan will optimize visualization of lung sliding.  A deeper scan is required to evaluate for B-lines and other pathology. 2 or less B-lines per rib space is considered normal.

Screenshot (169)_edited.jpg
Deep Lung Gif.gif
Shallow lung gif.gif

Parasternal Long Axis 
(PLAX)

Probe/Preset:

Phased Array / Cardiac

Body Plane:

Relative to the heart 

Probe Indicator:

Towards Patient’s Right Shoulder

Depth:

At least 15cm

Location:

Left Sternal border, 3rd to 5th Intercostal Space. Similar location to V2

Identify:

  • Left Ventricle

  • Right Ventricle

  • Intraventricular Septum

  • Mitral Valve

  • Aortic Valve

  • Descending Aorta

 

Notes:

Assess for cardiac motion and the presents of a large pericardial effusion. Multiple views should be acquired to confirm the presents of a pericardial effusion. Global Cardiac function can be visually assessed or measured using M-Mode by evaluating E-Point Septal Separation (EPSS).  

PLAX Labeled GIf.gif
Screenshot (170)_edited.jpg
Screenshot (45)_edited.jpg
Screenshot (46)_edited.jpg

Parasternal Short Axis
(PSAX)

Probe/Preset:

Phased Array / Cardiac

Body Plane:

Relative to heart 

 

Probe Indicator:

Towards Patient’s Left Shoulder

 

Depth:

At least 15cm

 

Location:

Left Sternal border, 3rd to 5th intercostal space. Similar location to V2

 

Identify:

  • Left Ventricle

  • Right Ventricle

  • Mitral Valve

  • Papillary Muscles

 

Notes:

From the optimal PLAX view rotate the probe 90* right, towards the left shoulder, to obtain the PSAX view. By fanning the probe right and left you are able to evaluate the heart through multiple levels. (ex: Mitral Valve, Mid-Ventricular, Basal Left Ventricular Segments)

Screenshot (171)_edited.jpg

Apical Four Chamber
(A4C)

Probe/Preset:

Phased Array / Cardiac

Body Plane:

Relative to the heart

Probe Indicator:

Towards Patient’s left

 

Depth:

At least 20cm

 

Location

Point of Maximal impulse, approximately the 5th intercostal Space, midclavicular line, with probe pointed face pointed towards the right scapula Similar location to V4 or V5

 

Identify:

  • Left Ventricle

  • Right Ventricle

  • Left Atria

  • Right Atria

  • Mitral Valve

  • Tricuspid Valve

 

Notes:

For the optimal A4C view the intraventricular septum should be roughly vertical on the screen.  This is a good view to evaluate relative chamber size.  Ensure proper probe orientation during scan, otherwise right and left sides of the heart may be misidentified.  

Screenshot (172)_edited.jpg
A4C unlabled gif.gif

Subcostal Four Chamber
(S4C)

Probe/Preset:

Curvilinear, Phased Array / FAST, Cardiac

Body Plane:

Relative to the Heart

Probe Indicator:

Towards Patient’s Left

 

Depth:

At least 20cm

Location:

Patient Midline, in the epigastric to subxiphoid space.  Approximate 15-20* angle of the probe relative to the patient's skin surface, with probe face angled towards the head 

Identify:

  • Liver

  • Left Ventricle

  • Right Ventricle

  • Mitral Valve

  • Tricuspid Valve

 

Notes:

Good for pericardial effusions, and cardiac activity intra-arrest. This view maybe difficulty to obtain due to patient anatomy. Utilize the liver as an acoustic window to visualize the heart.  Adjust gain and depth to optimize image.

Screenshot (173)_edited.jpg
S4C labeled Gif.gif

Right Upper Quadrant
(RUQ)

Probe/Preset:

Curvilinear, Phased Array/ FAST, Abdominal

 

Body Plane:

Coronal

 

Probe Indicator:

Towards Head

 

Depth:

At least 15cm

 

Location:

Mid axillary to anterior axillary line at the level of the xiphoid scanning posteriorly

Identify:

  • Right kidney

  • Liver

  • Diaphragm

  • Spinal Stripe

 

Notes:

The scan of the RUQ should be dynamic, starting at the interface between the lungs, diaphragm, and liver. Slide the probe towards the feet capturing views Morrison’s Pouch, inferior pole of the kidney and right Pericolic Gutter

Left Upper Quadrant 
(LUQ)

Probe/Preset:

Curvilinear, Phased Array/ FAST, Abdominal

 

Body Plane:

Coronal

 

Probe Indicator:

Towards Head

 

Depth:

At least 15cm

 

Location:

Posterior Axillary line the level of the xiphoid

 

Identify:

  • Left Kidney

  • Diaphragm

  • Spleen

 

Notes:

Scan through the area assessing the around the spleen, splenorenal space, and inferior pole of the kidney

Screenshot (176)_edited.jpg
LUQ Labeled gif.gif

Pelvic Views

Probe/Preset:

Curvilinear / FAST, Abdominal, Bladder

 

Body Plane:

Transverse and Sagittal

Probe Indicator:

  • Transverse: Towards Patient’s Right

  • Sagittal: Towards Head

Depth:

At least 15cm

 

Location:

Patient Midline Superior to the pubic symphysis

 

Identify:

  • Bladder

  • Prostate (male)

  • Uterus/Uterine Stripe (female)

Notes:

Scan through the entire area assessing for the presents of free fluid. The bladder may be difficult to visualize if empty of urine. Small amounts of free fluid in pregnant females are a normal variant. 

Screenshot (179)_edited.jpg
bottom of page