Standard

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

Hours

Propagation of Ultrasound through Tissues

Class

2

Principles of Pulse Echo Imaging

D. Lab

0

Quality Assurance of Ultrasound Instruments      

P. Lab/O.B.I.

0

Elementary Principles

Credit

     

Bioeffects and Safety

 

2

Ultrasound Transducers

 

 

Pulse Echo Instruments

 

 

 

Prerequisite:

DMS 136, DMS 202

Corequisite:

None

 

Course Guide

 

Competency

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

Hours

Class

D.Lab

P.Lab/

O.B.I.

 

 

 

 

Propagation of Ultrasound through Tissues

3

0

0

 

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

3

0

0

 

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

 

 

 

 

Accuracy

 

 

 

Elementary Principles

4

0

0

 

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

3

0

0

 

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

3

0

0

 

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

4

0

0

 

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