By Ian Johnston, William Harrop-Griffiths, Leslie Gemmell
Based at the organization of Anesthetists of serious Britain and Ireland's (AAGBI) carrying on with schooling lecture sequence, this clinical-oriented ebook covers the newest advancements in study and the medical software to anesthesia and discomfort control.
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Extra info for AAGBI Core Topics in Anaesthesia 2012
As the ultrasound wave passes through any tissue, some energy is also lost by absorption, and the sound energy is converted to heat. The strength of the returning beam is affected by: resolution and focusing acoustic impedance and reflection refractionscattering speckle attenuation time gain compensation (TGC) artefacts. Resolution The depth of the structure under examination should be at the focal zone. The ultrasound beam is divided into three zones. Initially, the beam diameter reduces in the near or Fresnel zone.
Clearly, this is an area in which close communication between cardiologist, anaesthetist and surgeon is required. The balance of risks will be between life-threatening bleeding and acute stent thrombosis, which both carry a high mortality. Adjunct technology and future developments in coronary stenting Stent design is becoming increasing complex. The stents themselves are increasingly ‘deliverable’ to tortuous arteries, resulting in increased procedural success. Technologies such as optical coherence tomography (OCT) and intravascular ultrasound (IVUS) permit the visualisation of the stents to ensure that deployment is optimised, which decreases the incidence of complications such as acute stent thrombosis and restenosis.
Rayleigh scattering increases in proportion to the fourth power of the frequency. So if a high frequency is used there will be much more scatter and a much brighter image, particularly of blood in superficial vessels. This increase in signal is reduced by attenuation, which is also proportional to frequency and increases as the distance from the transducer increases. The scattering caused by red cells facilitates Doppler shift and colour flow studies. Speckle Speckle is the term given to the spotty texture of an ultrasound image that appears to be made up of many dots of different sizes, shapes and intensities of grey, whereas the tissue should look like one shade of grey.
AAGBI Core Topics in Anaesthesia 2012 by Ian Johnston, William Harrop-Griffiths, Leslie Gemmell