Lung

Set up

  • Probe: Linear
  • Mode: Thoracic/Lung
  • Starting Depth: 
    • 3 cm for evaluation of pleura
    • 10 cm for evaluation of parenchyma

Views (left and right):

  • Lung sliding
  • Anterior chest
  • Posterior chest
  • Mid-axillary line
  • Costophrenic angle

Scanning

  • Lung sliding – Orient the probe with the marker towards the patient’s head on the anterior chest wall (2nd-3rd intercostal space)
  • B-lines, consolidation, pleural effusion – increase depth, and move probe to evaluate midaxillary line, costophrenic angle, and posterior lung fields. Compare both sides.

Normal Lung


Normal lung sliding

B-lines

Pleural Effusion

Free fluid located above  the diaphragm

Consolidation

Pneumothorax

No movement is seen on the pleura

Absence of lung sliding mistaken for pneumothorax

→ Absent lung sliding can also be seen in: right mainstem intubated patients, patients with bullous disease, and severe consolidation.

Missed pneumothorax

→ Pneumothorax will only be seen in the area scanned. The likelihood of identifying a pneumothorax is highest when the anterior and apical areas of the chest are scanned.

Mirror artifact mistaken for lung consolidation

→ A mirror artifact duplicates an image by reflection. Confirm that what appears to be a consolidation is not actually a reflection of the liver or spleen.

Intra-abdominal fluid mistaken for pleural fluid

→ Identify the location of fluid in relation to the diaphragm (above or below) to correctly identify intra-abdominal vs intrathoracic fluid.