Posted: 09/05/07

 R State Standard         £ Institutionally Developed          College: N/A


DMS 210 – Comprehensive Physics Registry Review


Course Description

Provides a review of basic knowledge from previous courses and helps the student prepare for national certification examinations for sonography.   Information concerning test taking skills will also be reviewed.  Topics include physics, patient care, equipment/image manipulation, scanning procedures, bioeffects and safety.  Emphasis will be placed on those items/issues/topics which are part of the certification examination, specifically propagation of ultrasound through tissues, principles of pulse echo imaging, quality assurance of ultrasound instruments, elementary principles, bioeffects and safety, ultrasound transducers and pulse echo instruments.


Competency Areas


Propagation of Ultrasound through Tissues



Principles of Pulse Echo Imaging

D. Lab


Quality Assurance of Ultrasound Instruments      

P. Lab/O.B.I.


Elementary Principles



Bioeffects and Safety



Ultrasound Transducers



Pulse Echo Instruments





DMS 136, DMS 202




Course Guide



After completing this section, the student will be able to:










Propagation of Ultrasound through Tissues





Review the concepts surrounding transmission of sound through tissues to include:

a.       Propagation speed

i.         Stiffness

ii.       Density

b.       Compression and rarefaction

c.       Angle of incidence

       d.   Impedance




Principles of Pulse Echo Imaging





Demonstrate the general concepts regarding the need for and nature of a quality assurance program





Compare and contrast the methods for evaluating Instrument Performance to include:  

a.       Test objects

i.         Phantoms (tissue, Doppler, flow)

ii.       Parameters to Be Evaluated

iii.      Test object

iv.      Dead zone

v.        Axial resolution and lateral resolution (beam width)

vi.      Depth calibration accuracy

vii.     TGC characteristics

viii.   Uniformity

ix.     system sensitivity

b.       Tissue equivalent (mimicking) phantom

i.         Dead zone

ii.       Depth calibration accuracy

iii.      Lateral (horizontal) distance measurement accuracy

iv.      Axial, lateral, and section thickness (elevational) resolution

v.        GC characteristics

vi.      System sensitivity

vii.     Dynamic range

viii.   Contrast resolution

ix.     Lesion detection

c.       Doppler flow, string, or belt phantoms

i.         Maximum depth

ii.       Pulsed Doppler sample volume alignment (gate position accuracy)

iii.      Velocity accuracy

iv.      Color flow penetration

v.        Image congruency test





Organize and plan a Preventive Maintenance program to include:

  1. Cleaning
  2. Disinfecting
  3. Sterilization





Practice standard precautions in regards to equipment cleaning to include:  

  1. Cleaning
  2. Disinfecting
  3. Sterilization





Summarize the details record keeping





Calculate Statistical Indices to include:

  1. Sensitivity/specificity
  2. Negative/positive predictive value









Elementary Principles





Review and discuss the properties of sound to include:

a.       The relationship of wavelength, frequency and propagation speed

b.       The relationship between amplitude, power, pressure and intensity

c.       The factors affecting

i.         Reflection

ii.       Refraction

iii.      Attenuation

iv.      Penetration





Define the various terms associated with sonography





Calculate critical formulas in order to understand their relationships




Bioeffects and Safety





Define Acoustic Output Quantities including :

a.       Pressure

i.         Units (MPa, mmHg)

ii.       Peak pressures (compression, rarefaction)

b.       Power

i.         Units (mW)

c.       Intensity

i.         Units (mW/cm2, W/cm2)

ii.       Spatial and temporal considerations

iii.      Average and peak intensities





Compare and Contrast the Common intensities to include:

a.       SATA

b.       SPTA

c.       SPPA

d.       SPTP





Compare and Contrast the methods for determining intensity, power, pressure to include:

a.       Hydrophones

b.       Radiation Force 





Compare the Intensity and power values for different operating modes





Discuss Acoustic Output Labeling Standards to include:

a. Thermal Index

i. TIS

ii. TIB

iii. TIC

b.   Mechanical index





Define the concepts of prudent use (ALARA)  in reducing acoustic exposure





Discuss the primary Mechanisms of Biologic Effect Production

a.   Cavitation mechanisms: relevant acoustic parameters

b.   Thermal mechanisms: relevant acoustic parameters





Distinguish the details of the various Experimental Biological Effect Studies to include:

a.   Animal studies

b.   In vitro studies

c.       Epidemiologic studies





Recite the key points of the following Guidelines and Regulations regarding ultrasound safety

a.  American Institute of Ultrasound in Medicine (AIUM)

     statements (e.g., mammalian, epidemiology, in vitro)

b.   National Electrical Manufacturers Association (NEMA)

c.   Food and Drug Administration (FDA)





Discuss the Electrical and Mechanical Hazards of ultrasound examinations

a.       Patient susceptibility to electrical hazard

  1. Equipment components which could present a hazard




Ultrasound Transducers





Define and discuss the concept of the piezoelectric effect





Define Curie point





Compare various piezoelectric materials





Discuss the construction and characteristics of ultrasound transducers to include:

a.       Thickness resonance of crystal

b.       Operating (resonance) frequency

i.         Crystal thickness

ii.       Speed of sound in crystal material

c.       Frequency characteristics (spectrum)

i.         Bandwidth

(1)     Quality factor

(2)     Effect of damping

ii.       Multi-Hertz

(1)     Harmonics

d.       Damping

e.       Matching layer





Discuss sound beam formation





Compare and contrast transducer Arrays and Image





Appearance based on the following items

a.       Mechanical and/or electronic construction

b.       Multiple element construction

                                 i.      Linear array

                               ii.      Curved array

                              iii.      Annular array

                              iv.      Multi-dimensional array

       c.    Multiple element operation

                                 i.      Sequenced

                               ii.      Phased

                              iii.      Annular 

                              iv.      Vector

                                v.      Multi-dimensional





Evaluate transducer care and maintenance




Pulse Echo Instruments





Review the critical factor s affecting Pulse Echo Instruments





Analyze the following dynamic factors in the role of hemodynamics:

a.       Energy gradient

b.       Effects of viscosity, friction, inertia

c.       Pressure/flow relationships

d.       Velocity

e.       Steady flow vs. pulsatile flow

f.         Laminar versus turbulent flow

g.       Effects of stenosis on flow characteristics

h.       Venous resistance

i.         Hydrostatic pressure

j.         Pressure/volume relationship

k.       Effects of respiration (phasicity)





Discuss the Doppler Effect as it relates to the sampling of red blood cell movement





Analyze the Doppler equation and the factors influencing the magnitude of the Doppler shift frequency





List the Range of the Doppler shift frequency





Discuss the effects of beam angle, transmitted frequency, flow velocity, and flow direction on Doppler velocities





Compare and contrast Continuous wave and pulsed wave Dopplers listing the advantages and disadvantages of each





Discuss Aliasing and the  Nyquist criteria including Range ambiguity





Identify and diagram Doppler Instrumentation to include:

  1. Receiver
  2. Demodulater
  3. Wall filter for clutter rejection
  4. Directional devices





Define the basic principles and instrumentation associated with Duplex ultrasound and Spectral analysis





Discuss the effect of

  1. Direction
  2. Velocity
  3. Duration
  4. Character
  5. Magnitude





Fast Fourier transform (FFT)





Discuss the usefulness of pulsatility and resistive indices





Describe the Basic Principles of Color Flow Imaging to include:  

  1. Sampling methods
  2. Display of Doppler information
  3. Reflector direction
  4. Average velocity
  5. Velocity variance
  6. Advantages and limitations





Diagram and define Instrumentation issues including

  1. Autocorrelation
  2. Time domain processing
  3. Color field size and frame rate

                                 i.      Ensemble length (packet size, pulse packet)

                               ii.      Line density

                              iii.      Maximum

d.   Color maps, assignment, or coding

    i.   Hue

    ii.   Saturation

                    iii. Luminance (significance, brightness, intensity)





Define and analyze Doppler Artifacts

  1. Compare and contrast the properties, advantages and limitations of  Color Power (Energy) Mode





Suggested Resources


Davies. Physics Registry Review Book and CD-Rom


Edelman, S. (2006). Understanding Ultrasound Physics. (2nd ed.) ESP, Inc. ISBN-13: 978-0-9626-4444-3


Gulfcoast. Ultrasound Physics Registry Review and CD-Rom


Hedrick, W. (2005). Ultrasound Physics and Instrumentation. (4th ed.) St. Louis: Mosby. ISBN-10: 0-323-03212-5


Kremkau, F.W. (2006). Diagnostic Ultrasound: Principles and Protocols, (6th ed.) W.B.  Saunders. ISBN: 0-7216-7143-8


Miele, F. (2006). Ultrasound Physics and Instrumentation. Forney, Tx: Miele Enterprises


Mosby’s Pocket Dictionary of Medicine, Nursing & Health Professions. (5th ed.) Elsevier. ISBN-13: 978-0-323-03943-7


Taber’s Cyclopedic Dictionary. (20th ed) F. A. Davis. ISBN-13: 978-0-8036-1207-5


Tempkin. (2007) Utrasound Scanning, Principles and Protocols. (2nd ed.) Elsevier. ISBN-13-9780-7216-0636-1


Zagzabski, J. (1997). Essentials of Ultrasound Physics. St. Louis. Mosby: ISBN-10: 0-8151-9852-3