Question 1

&#10;&#10;-Refer to the figure. What are the structures marked a-d in this normal longitudinal ultrasound of the shoulder?&#10;A) (a) deltoid muscle, (b) subacromial bursa, (c) cancellous bone, (d) synovial fluid&#10;B) (a) subacromial bursa, (b) supraspinatus muscle, (c) cortical bone, (d) articular cartilage&#10;C) (a) subdeltoid bursa, (b) supraspinatus tendon, (c) cancellous, (d) articular capsule&#10;D) (a) deltoid muscle, (b) supraspinatus tendon, (c) cortical bone, (d) articular cartilage

Accepted Answer

The structures identified in a normal longitudinal ultrasound of the shoulder include the deltoid muscle (a), which is superficial and covers the shoulder joint. The supraspinatus tendon (b) is a critical component of the rotator cuff, providing stability and mobility to the shoulder. The cortical bone (c) represents the dense outer surface of bone that provides strength and protection, visible beneath the tendon. Lastly, the articular cartilage (d) is a smooth, white tissue that covers the ends of bones where they come together to form joints, facilitating smooth movement.

Question 2

What are the differences between linear and curvilinear transducers?&#10;A) The linear transducer is often used for abdominopelvic ultrasound&#10;B) The linear transducer displays a field of view wider than the transducer itself&#10;C) The linear transducer is predominantly used for musculoskeletal imaging&#10;D) A curved transducer displays a wider field of view for structures that are close to the transducer

Accepted Answer

Linear transducers are primarily used for imaging superficial structures, making them ideal for musculoskeletal imaging due to their high-frequency waves that provide detailed images of muscles, ligaments, and tendons.

Question 3

High signal intensity in ultrasound images is seen when there is:&#10;A) High absorption of ultrasound&#10;B) Reflection of ultrasound waves tissue off interfaces with similar impedance&#10;AU: Is a word missing here between waves and tissue?&#10;It should read &#34;&#8230;ultrasound waves off tissue&#34;.&#10;C) Scattering of the ultrasound energy&#10;D) Ultrasound is reflected off smooth surfaces

Accepted Answer

High signal intensity in ultrasound images is seen when ultrasound waves are reflected off smooth surfaces, as this results in strong echoes being returned to the transducer.

Question 4

In Doppler ultrasound, a red color indicates:&#10;A) A high velocity of blood flow toward the transducer&#10;B) Irregular blood flow in a tortuous vessel&#10;C) Slow blood flow&#10;D) A small blood vessel

Accepted Answer

In Doppler ultrasound, a red color typically indicates blood flow toward the transducer, with the shade of red often representing the velocity of the flow; brighter red usually signifies higher velocity.

Question 5

Order these tissues from lowest to highest ultrasound signal intensity:&#10;A) Bone, tendon, muscle, hyaline cartilage&#10;B) Hyaline cartilage, bone, tendon, muscle&#10;C) Hyaline cartilage, muscle, tendon, bone&#10;D) Muscle, hyaline cartilage, tendon, bone

Accepted Answer

Ultrasound signal intensity is related to the density and acoustic impedance of tissues. Hyaline cartilage, being the least dense, reflects the least ultrasound signal. Muscle tissue is denser than hyaline cartilage but less dense than tendon or bone. Tendon, being denser than muscle, reflects more ultrasound. Bone, being the most dense, reflects the most ultrasound signal.

Question 6

&#10;&#10;-Refer to the figure. What is the structure between the arrowheads?&#10;A) Muscle&#10;B) Ligament&#10;C) Bursa&#10;D) Subcutaneous fat

Accepted Answer

Ligaments are structures that connect bones to other bones, and the description suggests a connective tissue structure between bones, which fits the definition of a ligament.

Question 7

The scanning planes in musculoskeletal ultrasound can best be described as:&#10;A) Comparable to CT and MRI&#10;B) Transverse, when viewing muscles&#10;C) A direct continuation of the transducer orientation&#10;D) An extended field of view, when looking at a muscle longitudinally

Accepted Answer

The scanning planes in musculoskeletal ultrasound are directly related to the orientation of the transducer, allowing for real-time imaging and adjustments based on the transducer's position.

Question 8

Which is true of the imaging characteristics of an injured tendon?&#10;A) Strains are displayed as increased signal intensity&#10;B) It shows a hyperechoic, parallel fiber pattern&#10;C) Strains show thinning of the tendon&#10;D) The site of a tendon rupture may initially be hypoechoic

Accepted Answer

The answer of Which is true of the imaging characteristics...

Question 9

The advantages of ultrasound imaging include all except:&#10;A) Wide field of view&#10;B) Higher resolution&#10;C) Ability to modify the imaging while it is being done&#10;D) Lower cost

Accepted Answer

Ultrasound imaging has a limited field of view compared to other imaging modalities like CT or MRI, making it less suitable for visualizing large areas in a single image. The other options (B, C, D) are indeed advantages of ultrasound imaging.

Question 10

&#10;&#10;-Refer to the figure. If you compare the longitudinal ultrasound scan of the supraspinatus muscle and tendon (arrowheads) on the right with the normal supraspinatus on the left, what are your findings?&#10;A) Thickened supraspinatus tendon&#10;B) Swollen subacromial bursa&#10;C) Cortical irregularities and a partial tear&#10;D) Hyperechoic focus in the distal tendon

Accepted Answer

The cortical irregularities and a partial tear are indicative of damage or degeneration in the supraspinatus tendon, which can be observed in the ultrasound scan.

Deck 6: Diagnostic Ultrasound