Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ KEY IMAGES +++ IVC, transverse ++ Vedio Graphic Jump Location Video 09-01: Transverse view of a normal inferior vena cava In the transverse view the IVC can be seen to collapse during the respiratory cycle in this patient with normal volume status. The hepatic veins can be seen to converge on the IVC at the beginning of the clip. The aorta can be seen to the right, running in front of the spine. Of note is the impressive pulsatility of the IVC, a reminder not to use that to distinguish it from the aorta. Play Video +++ IVC, longitudinal ++ Vedio Graphic Jump Location Video 09-02: Longitudinal view of a normal IVC In the longitudinal view, the IVC can be seen changing from 2 centimeters to an almost complete collapse. The collapsibility should be measured approximately 1 cm distal to the confluence of the hepatic veins, and normal respirations should be used. In this video of the author's IVC, he may have sniffed to exaggerate the effect. Play Video +++ Lung ultrasound, apex—A-lines ++ Vedio Graphic Jump Location Video 09-03: A lines at the apex of normal lungs At the apex of the lung in a patient without any pulmonary edema, the horizontal artifact known as A lines are easily seen repeating 3 times below the bright pleural line. Play Video +++ Internal jugular vein (IJ) assessment ++ Vedio Graphic Jump Location Video 09-04: Longitudinal view of the internal jugular vein In the longitudinal view, the internal jugular takes on a paintbrush (or wine bottle) appearance. The point where the walls come together corresponds to the externally measured jugular venous distension or the invasively measured central venous pressure. The movement is driven by the pressure changes during respiration. Play Video +++ Cardiac ultrasound, parasternal long axis (PLAX) ++ Vedio Graphic Jump Location Video 09-05: Normal parasternal long axis view This patient with pneumonia and mild tachycardia demonstrates a normally sized left atrium, left ventricle, and right ventricular outflow track. The ejection fraction can also be seen to be normal. The observant user will notice the subtle left sided pleural effusion with some atelectatic lung seen in the bottom left corner of the screen. Play Video +++ Cardiac ultrasound, parasternal short axis (PSSA) ++ Vedio Graphic Jump Location Video 09-06: Normal parasternal short axis This video of the heart via the parasternal short axis view at the level of the papillary muscles demonstrates normal ejection fraction anda normal left ventricular end diastolic dimensions. Play Video +++ ACQUISITION TIPS ++ Indications: When history and physical exam do not provide a clear answer to the volume status of ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Download the Access App: iOS | Android Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.