Probe Selection:
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Linear array transducer
(Small parts/high frequency probe) |
Probe Positioning:
| When the patient is supine, scan along the anterior chest wall in a sagital (longitudinal) plane. | Scan from the anterior axillary line to the lateral sternal border, from the 2nd rib towards the costal margin. |
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Normal Anatomy:
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Rib shadows (R) are visible as bright reflectors with distal shadow.
The Pleura (* *) is a bright echogenic line beneath the ribs. Comet Tail artifacts (> arrows) arise from normal pleura reflecting sound waves. |
Using Video:
| Normal Lung:
+Lung sliding back and forth Note the pleura moves with respect to the ribs +Comet tail artifacts |
Pneumothorax:
NO lung sliding back and forth Note the pleura and ribs move together NO comet tail artifacts |
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Using M-Mode:
M-mode allows documentation of lung sliding with a single image. Superficial soft tissue/muscle does not move much during respirations, and will yield flat lines on M-mode (top half of images below). Normal lung sliding creates a grainy M-mode appearance (left image, bottom). This is referred to as “waves on a beach,” where the smooth soft tissue lines (top half) meet the rough lung lines (bottom half) at the bright white pleural line (center). With pneumothorax, lung sliding is absent- flat lines will be seen above and below the pleura.
| Normal Lung:
Smooth lines above pleural line, grainy below |
Pneumothorax:
Smooth lines above and below pleural line |
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