Ultrasound: Skills of carrying out Abdominal Aortic Aneurysm Assessment (AAA)

AAA and Emergency Medicine

Rationale for the Use of Ultrasound in AAA

2 Topics

Answer to a Specific Clinical Question

Clinical Features – presenting symptoms, signs and associated conditions

2 Topics

Presenting Symptoms

Ruptured Aortic Aneurism

3 Topics

The IVC and Aorta

The Normal Abdominal Aorta Ultrasound: Skills of carrying out Abdominal Aortic Aneurysm Assessment

Splenic Vein and Portal Vein

Types of Aortic Aneurysm

Diagnostic Strategies

2 Topics

Key Investigations

When Should a Scan Be Carried Out?

Machine Settings

Positioning the Probe

4 Topics

Transverse Section

Abdominal Aorta

Inferior Vena Cava

Antero-posterior Diameter

Pattern Recognition

2 Topics

The Coeliac Axis and The “Snowman”

Abnormal Aorta Appearances

3 Topics

Antero-posterior Measurement

2 Topics

Clinical Case 1

Clinical Case 2

Ultrasound: Skills of carrying out Abdominal Aortic Aneurysm Assessment (AAA) – Post Test

Ultrasound: Skills of carrying out Abdominal Aortic Aneurysm Assessment (AAA) – Post Test

Ultrasound: Skills of carrying out Abdominal Aortic Aneurysm Assessment (AAA) Ultrasound: Skills of carrying out Abdominal Aortic Aneurysm Assessment (AAA) – Post Test

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Question 1 of 10

1. Question
Which one of the following statements is true with regards to normal aortic anatomy?
- The diameter is measured from outer wall to outer wall
- The aorta lies to the right of the midline
- The maximum external diameter is 3 cm at the bifurcation
- The origin of the superior mesenteric artery (SMA) is 2 cm above the bifurcation
- The aorta bifurcates just above the umbilicus (L4)
Correct

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Question 2 of 10

2. Question
Which one of the following statements is true with regards to the normal ultrasound appearances of the aorta?
- Specular reflection ensures that the anterior and posterior walls are seen best
- There is a gap of approximately 1 cm between aorta and vertebral body
- The SMA arises from the coeliac axis
- The longitudinal view is the first view to obtain
- The right lobe of the liver can obscure the aorta
Correct

Incorrect
Question 3 of 10

3. Question
If you are unable to visualise the aorta by ultrasound in a patient with suspected AAA, which one of the following statements is true?
- An alternative imaging modality such as CT scanning should be used
- Turn the patient over onto their front and scan between the vertebral bodies
- AAA can be excluded as long as a single measurement is taken and is less than 3 cm
- Turning up the power to maximum will ensure an adequate view
- Obtaining adequate doppler flow over the area of the aorta is adequate to exclude an AAA
Correct

Incorrect
Question 4 of 10

4. Question
Detection of an aorta with a diameter of 4 cm on focused ultrasound necessitates which one of the following?
- Careful correlation with the clinical picture
- Immediate laparotomy
- Urgent referral to the vascular surgical team
- Urgent contrast CT of the aorta
- Immediate echocardiogram to exclude aortic dissection
Correct

Incorrect
Question 5 of 10

5. Question
In elderly patients, with back or flank pain and suspected ureteric colic, the primary goal of focused ultrasound is which one of the following?
- To visualise the aorta and exclude AAA
- To assess the renal arteries and their relationship with the aorta
- To look for signs of hydronephrosis
- To assess for free intraperitoneal fluid
- To assess bladder filling
Correct

Incorrect
Question 6 of 10

6. Question
Which one of the following statements is true with regards to abdominal aortic aneurysms?
- The risk of rupture increases with aortic diameter
- Ruptured AAA usually presents with left flank pain
- Elective repair should have a 30-day mortality rate of around 50%
- Emergency repair has a 30-day mortality rate of less than 10%
- Ultrasound is the gold standard test for assessment of a suspected ruptured AAA
Correct

Incorrect
Question 7 of 10

7. Question
In a patient with back pain, which one of the following statements is true?
- Hydronephrosis may be present secondary to compression of the left ureter
- A finding of an aortic diameter of 6 cm confirms rupture
- CT should be requested if the patient is over 55 years old
- AAA is unlikely in the absence of shock
- Ultrasound should always be carried out if the patient is shocked
Correct

Incorrect
Question 8 of 10

8. Question
Clinical features of a ruptured AAA may include all of the following, except?
- Left basal effusion
- Renal failure
- Hydronephrosis
- Tachycardia
- Loin pain
Correct

Incorrect
Question 9 of 10

9. Question
The image is correctly labelled, except for which one of the following?
- Common bile duct
- Liver
- Vertebral body
- Superior mesenteric artery
- Aorta
Correct

Incorrect
Question 10 of 10

10. Question
The image is correctly labelled, except for which one of the following?
- Spinal cord
- IVC
- Aorta
- Superior mesenteric artery
- Liver
Correct

Incorrect

9 Comments

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Dr Ivo Nikolov Kolev September 13, 2023 at 10:06 pm

very good module refreshing my skills for AAA uss

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Mr Md. Showkat Anower September 19, 2023 at 1:47 am

Excellent course for learning.

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Dr Ashfaq Ahmed Khan September 21, 2023 at 9:56 pm

Excellent Session

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Dr Kelly Lewis October 3, 2023 at 12:59 pm

Good revision of AAA and USS thanks.

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Hind Goriel October 5, 2023 at 9:19 am

Very good online learning, bite size learning easy to remember.. Will use as a refence until I master this skill.

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Dr Abdul Manan Babar October 10, 2023 at 12:15 pm

Excellent learning module.

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Dr Mohammed Mousa Hassan December 21, 2023 at 3:36 pm

Thank you for your effort ,highly informative module

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Dr Kayode Kareem Adekitan February 1, 2024 at 6:51 pm

nice read

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Dr Kayode Kareem Adekitan February 1, 2024 at 6:57 pm

easy to follow

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