probe maneuver
welcome to mastering and guidelines in ultrasound and echo. today we are going
to talk about probe maneuvers. as we talked before in another lecture the
probe has on the tip of the probe there is a surface we called footprint as you
see here and footprint has to axis: short axis and long axis. sorry!!
in one side of the long axis there is a marker here you will see a circular tip
inside so this is long axis and short axis and marker if we tilt the probe
along the long axis of the footprint we called it heel-toe. toe is the side of
the market and other side is heel it's like that ballet dance you go to
the toe or heel here is the same we called it if you tilted to the toe to
the mark here tilting to the marker it is toeing and heeling. so heel-toe or
Rocking another name they call rocking but heel toe is more accurate because you
see when you are doing for example you want to do something for getting that
image you get I am doing healing or toeing. the next maneuver is fanning if I
tilt the probe along the short axis of the probe.... you call it fanning. this
is fanning. here Fanning to the right Fanning to the left. my right, my
left fanning or you can use the patient as reference of fanning to the right
of patient or to the left of the patient. Fanning. another one is rotation
as you know we can rotate the probe clockwise or counterclockwise. clockwise
counter clockwise and the next one is sliding, when you move the probe in any
direction long axis or short axis your slide or moving the probe. this is
in long axis sliding or short axis sliding.
so you displace the probe completely from that spot and the last one. is
pressing. when I am pressing on tissue here my hand I am pressing down
this is pressing. now let's see what is the effect of this maneuver on image.
and how we can use it for image. Actually one the most important skill you need
for doing study very well, is knowing this always and all the time using this
maneuvers. let's go back to the probe sector. As we talked in another lecture
the ultrasound send sound in a specific pattern that we called it array or
sector. here under vector probe the sector of the image is pie shape as you
see here, and if I hold it on the over the probe you will see something like
that. so on this probe the sector is pi shape and under plate and further to the
long axis of the probe as you see here . in the pattern of the plate pie shape
and parallel to the long axis of the probe let's see when I do
heel-toe what happened to the sector imagine this pencil is cylinder
structures like aorta, or IVC or anything. when I am doing heel
you see what happened to the sector relation the orientation of the this
pencil on the sector. it becomes oblique this way oblique to the right or oblique
to the left, as you see here and so that is very simple maneuver when we have IVS (septum in echo)
in the PLAX in echo you want to make it more horizontal for doing
m-mode or measurement you just need it with this maneuver dependent which angle
is that. just by heel or toe, fix your direction of that structure
here for example IVS. another one you can change the direction of sector. here
imagine at the green side is you see at the right of the image here on this
that green parts is not on the field, I want to show that
spot on the image. I have two options: slide toward that structure or I
just here I do heeling. if you see heeling and start coming to the field
and I can see on the image. so that is the maneuver that helped a lot in the
imaging and optimizing for fanning imagine this is a aorta and we have IVC. I
am putting over the aorta now I want to see IVC just I know anatomically IVC
is at the right side of the aorta, when I see IVC I just fan to the right of
patient or my left and the sector go and cuts that IVC and get
picture from IVC so this is Fanning I do finning. it's very easy and with twisting (rotation)
make it horizontal, transverse of that image or optimizing especially when you
do for example short axis of the left ventricular, just with twisting less or
more make it circular on that spot. I hope you like this lecture and give us
feedback.
have a wonderful time