CIMT Exam - Scanning Techniques
CIMT Exam - Scanning Techniques
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This video details how ultrasound technology can be used to perform a bilateral examination to evaluate the carotid arteries for CIMT, as well as clinician and patient positioning, and ultrasound transducers orientation.
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<p begin="00:00:08.994" end="00:00:10.703" style="s2">- I'd like to walk you<br />through a demonstration</p>
<p begin="00:00:10.703" end="00:00:13.725" style="s2">of scanning the Carotid Artery for CIMT.</p>
<p begin="00:00:13.725" end="00:00:15.160" style="s2">One of the things that's really important</p>
<p begin="00:00:15.160" end="00:00:18.787" style="s2">is to position yourself as well<br />as the patient comfortably.</p>
<p begin="00:00:18.787" end="00:00:20.470" style="s2">I like to scan from the patient's head,</p>
<p begin="00:00:20.470" end="00:00:23.220" style="s2">but many people like to<br />scan coming from the foot.</p>
<p begin="00:00:23.220" end="00:00:25.665" style="s2">So, when you're scanning<br />from the patient's head,</p>
<p begin="00:00:25.665" end="00:00:27.547" style="s2">you wanna position the height of the table</p>
<p begin="00:00:27.547" end="00:00:29.062" style="s2">so that it's comfortable and you're not</p>
<p begin="00:00:29.062" end="00:00:32.140" style="s2">holding your arms up in<br />an uncomfortable manner.</p>
<p begin="00:00:32.140" end="00:00:33.693" style="s2">You wanna have the patient lying</p>
<p begin="00:00:33.693" end="00:00:36.341" style="s2">with their head turned away from you.</p>
<p begin="00:00:36.341" end="00:00:37.941" style="s2">So, whichever side your scanning,</p>
<p begin="00:00:37.941" end="00:00:39.187" style="s2">have the patient turn their head away.</p>
<p begin="00:00:39.187" end="00:00:41.059" style="s2">So, we like to start this exam</p>
<p begin="00:00:41.059" end="00:00:43.185" style="s2">with a transverse orientation.</p>
<p begin="00:00:43.185" end="00:00:45.075" style="s2">You want to start low in the neck</p>
<p begin="00:00:45.075" end="00:00:47.195" style="s2">with the orientation marker facing toward</p>
<p begin="00:00:47.195" end="00:00:50.573" style="s2">the patient's back down toward the bed.</p>
<p begin="00:00:50.573" end="00:00:53.998" style="s2">Scan up the neck in a<br />transverse orientation.</p>
<p begin="00:00:53.998" end="00:00:56.609" style="s2">The vessel should be nice and round.</p>
<p begin="00:00:56.609" end="00:00:59.026" style="s2">And you'll be able to<br />see the Carotid Artery,</p>
<p begin="00:00:59.026" end="00:01:00.368" style="s2">the thyroid gland.</p>
<p begin="00:01:00.368" end="00:01:04.381" style="s2">And oftentimes, you'll be<br />able to see the Jugular Vein.</p>
<p begin="00:01:04.381" end="00:01:07.580" style="s2">Continue to scan up the<br />neck in a transverse manner</p>
<p begin="00:01:07.580" end="00:01:10.596" style="s2">and when you start to<br />see the vessel get wide,</p>
<p begin="00:01:10.596" end="00:01:11.727" style="s2">then you know you're in the Bulb.</p>
<p begin="00:01:11.727" end="00:01:14.647" style="s2">And you wanna continue through scanning</p>
<p begin="00:01:14.647" end="00:01:18.366" style="s2">to see the internal and the<br />external Carotid Artery.</p>
<p begin="00:01:18.366" end="00:01:21.891" style="s2">You wanna scan the patient<br />from three different angles.</p>
<p begin="00:01:21.891" end="00:01:25.287" style="s2">You wanna scan from the<br />Anterior Aspect of the neck,</p>
<p begin="00:01:25.287" end="00:01:27.370" style="s2">it's roughly 2 o'clock.</p>
<p begin="00:01:27.370" end="00:01:30.083" style="s2">Then from the Lateral Aspect of the neck,</p>
<p begin="00:01:30.083" end="00:01:31.930" style="s2">that's probably about 4 o'clock.</p>
<p begin="00:01:31.930" end="00:01:34.757" style="s2">And then from a Posterior<br />Aspect of the neck,</p>
<p begin="00:01:34.757" end="00:01:37.867" style="s2">which is probably about 5 o'clock.</p>
<p begin="00:01:37.867" end="00:01:41.739" style="s2">Three angles, Anterior,<br />Lateral, and Posterior.</p>
<p begin="00:01:41.739" end="00:01:44.828" style="s2">Then, you want to turn the patient's head</p>
<p begin="00:01:44.828" end="00:01:46.995" style="s2">so that it's facing in the other direction</p>
<p begin="00:01:46.995" end="00:01:49.302" style="s2">and you wanna perform the same exam</p>
<p begin="00:01:49.302" end="00:01:52.744" style="s2">from the opposite side of the neck.</p>
<p begin="00:01:52.744" end="00:01:54.106" style="s2">Now, when you're scanning from</p>
<p begin="00:01:54.106" end="00:01:55.378" style="s2">the opposite side of the neck,</p>
<p begin="00:01:55.378" end="00:01:57.343" style="s2">the orientation marker stays</p>
<p begin="00:01:57.343" end="00:02:01.315" style="s2">the same way it was from<br />the opposite direction.</p>
<p begin="00:02:01.315" end="00:02:05.398" style="s2">And you want to scan up<br />again, transverse manner.</p>
<p begin="00:02:08.879" end="00:02:11.333" style="s2">Artery should be nice and round.</p>
<p begin="00:02:11.333" end="00:02:13.466" style="s2">And again, you're looking for</p>
<p begin="00:02:13.466" end="00:02:16.050" style="s2">the widening of the artery wall</p>
<p begin="00:02:16.050" end="00:02:19.463" style="s2">to let you know that you're at the Bulb.</p>
<p begin="00:02:19.463" end="00:02:21.021" style="s2">Scan through the bifurcation of the</p>
<p begin="00:02:21.021" end="00:02:23.520" style="s2">internal and external Carotid Artery.</p>
<p begin="00:02:23.520" end="00:02:26.398" style="s2">And you wanna turn the transducer</p>
<p begin="00:02:26.398" end="00:02:29.348" style="s2">to a longitudinal orientation.</p>
<p begin="00:02:29.348" end="00:02:31.155" style="s2">Again, with the orientation marker</p>
<p begin="00:02:31.155" end="00:02:34.691" style="s2">pointing toward the patient's head.</p>
<p begin="00:02:34.691" end="00:02:38.003" style="s2">And on this side, again, you<br />want to come from three angles.</p>
<p begin="00:02:38.003" end="00:02:42.003" style="s2">From the Anterior approach,<br />roughly 2 o'clock.</p>
<p begin="00:02:42.003" end="00:02:45.721" style="s2">From the Lateral<br />approach, about 4 o'clock.</p>
<p begin="00:02:45.721" end="00:02:49.730" style="s2">And from a Posterior<br />approach, about 5 o'clock.</p>
<p begin="00:02:49.730" end="00:02:52.807" style="s2">So, in summary, the Carotid CIMT Exam</p>
<p begin="00:02:52.807" end="00:02:54.706" style="s2">is a Bilateral Exam.</p>
<p begin="00:02:54.706" end="00:02:55.889" style="s2">You want to be sure to evaluate</p>
<p begin="00:02:55.889" end="00:02:58.018" style="s2">both sides of the patient's neck.</p>
<p begin="00:02:58.018" end="00:03:00.556" style="s2">And you wanna come from as<br />many angles as possible.</p>
<p begin="00:03:00.556" end="00:03:03.965" style="s2">You wanna come from the Anterior approach,</p>
<p begin="00:03:03.965" end="00:03:05.554" style="s2">from the Lateral approach,</p>
<p begin="00:03:05.554" end="00:03:07.282" style="s2">and from the Posterior approach</p>
<p begin="00:03:07.282" end="00:03:10.282" style="s2">on both sides of the patient's neck.</p>
<p begin="00:00:10.703" end="00:00:13.725" style="s2">of scanning the Carotid Artery for CIMT.</p>
<p begin="00:00:13.725" end="00:00:15.160" style="s2">One of the things that's really important</p>
<p begin="00:00:15.160" end="00:00:18.787" style="s2">is to position yourself as well<br />as the patient comfortably.</p>
<p begin="00:00:18.787" end="00:00:20.470" style="s2">I like to scan from the patient's head,</p>
<p begin="00:00:20.470" end="00:00:23.220" style="s2">but many people like to<br />scan coming from the foot.</p>
<p begin="00:00:23.220" end="00:00:25.665" style="s2">So, when you're scanning<br />from the patient's head,</p>
<p begin="00:00:25.665" end="00:00:27.547" style="s2">you wanna position the height of the table</p>
<p begin="00:00:27.547" end="00:00:29.062" style="s2">so that it's comfortable and you're not</p>
<p begin="00:00:29.062" end="00:00:32.140" style="s2">holding your arms up in<br />an uncomfortable manner.</p>
<p begin="00:00:32.140" end="00:00:33.693" style="s2">You wanna have the patient lying</p>
<p begin="00:00:33.693" end="00:00:36.341" style="s2">with their head turned away from you.</p>
<p begin="00:00:36.341" end="00:00:37.941" style="s2">So, whichever side your scanning,</p>
<p begin="00:00:37.941" end="00:00:39.187" style="s2">have the patient turn their head away.</p>
<p begin="00:00:39.187" end="00:00:41.059" style="s2">So, we like to start this exam</p>
<p begin="00:00:41.059" end="00:00:43.185" style="s2">with a transverse orientation.</p>
<p begin="00:00:43.185" end="00:00:45.075" style="s2">You want to start low in the neck</p>
<p begin="00:00:45.075" end="00:00:47.195" style="s2">with the orientation marker facing toward</p>
<p begin="00:00:47.195" end="00:00:50.573" style="s2">the patient's back down toward the bed.</p>
<p begin="00:00:50.573" end="00:00:53.998" style="s2">Scan up the neck in a<br />transverse orientation.</p>
<p begin="00:00:53.998" end="00:00:56.609" style="s2">The vessel should be nice and round.</p>
<p begin="00:00:56.609" end="00:00:59.026" style="s2">And you'll be able to<br />see the Carotid Artery,</p>
<p begin="00:00:59.026" end="00:01:00.368" style="s2">the thyroid gland.</p>
<p begin="00:01:00.368" end="00:01:04.381" style="s2">And oftentimes, you'll be<br />able to see the Jugular Vein.</p>
<p begin="00:01:04.381" end="00:01:07.580" style="s2">Continue to scan up the<br />neck in a transverse manner</p>
<p begin="00:01:07.580" end="00:01:10.596" style="s2">and when you start to<br />see the vessel get wide,</p>
<p begin="00:01:10.596" end="00:01:11.727" style="s2">then you know you're in the Bulb.</p>
<p begin="00:01:11.727" end="00:01:14.647" style="s2">And you wanna continue through scanning</p>
<p begin="00:01:14.647" end="00:01:18.366" style="s2">to see the internal and the<br />external Carotid Artery.</p>
<p begin="00:01:18.366" end="00:01:21.891" style="s2">You wanna scan the patient<br />from three different angles.</p>
<p begin="00:01:21.891" end="00:01:25.287" style="s2">You wanna scan from the<br />Anterior Aspect of the neck,</p>
<p begin="00:01:25.287" end="00:01:27.370" style="s2">it's roughly 2 o'clock.</p>
<p begin="00:01:27.370" end="00:01:30.083" style="s2">Then from the Lateral Aspect of the neck,</p>
<p begin="00:01:30.083" end="00:01:31.930" style="s2">that's probably about 4 o'clock.</p>
<p begin="00:01:31.930" end="00:01:34.757" style="s2">And then from a Posterior<br />Aspect of the neck,</p>
<p begin="00:01:34.757" end="00:01:37.867" style="s2">which is probably about 5 o'clock.</p>
<p begin="00:01:37.867" end="00:01:41.739" style="s2">Three angles, Anterior,<br />Lateral, and Posterior.</p>
<p begin="00:01:41.739" end="00:01:44.828" style="s2">Then, you want to turn the patient's head</p>
<p begin="00:01:44.828" end="00:01:46.995" style="s2">so that it's facing in the other direction</p>
<p begin="00:01:46.995" end="00:01:49.302" style="s2">and you wanna perform the same exam</p>
<p begin="00:01:49.302" end="00:01:52.744" style="s2">from the opposite side of the neck.</p>
<p begin="00:01:52.744" end="00:01:54.106" style="s2">Now, when you're scanning from</p>
<p begin="00:01:54.106" end="00:01:55.378" style="s2">the opposite side of the neck,</p>
<p begin="00:01:55.378" end="00:01:57.343" style="s2">the orientation marker stays</p>
<p begin="00:01:57.343" end="00:02:01.315" style="s2">the same way it was from<br />the opposite direction.</p>
<p begin="00:02:01.315" end="00:02:05.398" style="s2">And you want to scan up<br />again, transverse manner.</p>
<p begin="00:02:08.879" end="00:02:11.333" style="s2">Artery should be nice and round.</p>
<p begin="00:02:11.333" end="00:02:13.466" style="s2">And again, you're looking for</p>
<p begin="00:02:13.466" end="00:02:16.050" style="s2">the widening of the artery wall</p>
<p begin="00:02:16.050" end="00:02:19.463" style="s2">to let you know that you're at the Bulb.</p>
<p begin="00:02:19.463" end="00:02:21.021" style="s2">Scan through the bifurcation of the</p>
<p begin="00:02:21.021" end="00:02:23.520" style="s2">internal and external Carotid Artery.</p>
<p begin="00:02:23.520" end="00:02:26.398" style="s2">And you wanna turn the transducer</p>
<p begin="00:02:26.398" end="00:02:29.348" style="s2">to a longitudinal orientation.</p>
<p begin="00:02:29.348" end="00:02:31.155" style="s2">Again, with the orientation marker</p>
<p begin="00:02:31.155" end="00:02:34.691" style="s2">pointing toward the patient's head.</p>
<p begin="00:02:34.691" end="00:02:38.003" style="s2">And on this side, again, you<br />want to come from three angles.</p>
<p begin="00:02:38.003" end="00:02:42.003" style="s2">From the Anterior approach,<br />roughly 2 o'clock.</p>
<p begin="00:02:42.003" end="00:02:45.721" style="s2">From the Lateral<br />approach, about 4 o'clock.</p>
<p begin="00:02:45.721" end="00:02:49.730" style="s2">And from a Posterior<br />approach, about 5 o'clock.</p>
<p begin="00:02:49.730" end="00:02:52.807" style="s2">So, in summary, the Carotid CIMT Exam</p>
<p begin="00:02:52.807" end="00:02:54.706" style="s2">is a Bilateral Exam.</p>
<p begin="00:02:54.706" end="00:02:55.889" style="s2">You want to be sure to evaluate</p>
<p begin="00:02:55.889" end="00:02:58.018" style="s2">both sides of the patient's neck.</p>
<p begin="00:02:58.018" end="00:03:00.556" style="s2">And you wanna come from as<br />many angles as possible.</p>
<p begin="00:03:00.556" end="00:03:03.965" style="s2">You wanna come from the Anterior approach,</p>
<p begin="00:03:03.965" end="00:03:05.554" style="s2">from the Lateral approach,</p>
<p begin="00:03:05.554" end="00:03:07.282" style="s2">and from the Posterior approach</p>
<p begin="00:03:07.282" end="00:03:10.282" style="s2">on both sides of the patient's neck.</p>
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https://youtube.com/watch?v=n7VD-KjeO-g
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This video details how ultrasound technology can be used to perform a bilateral examination to evaluate the carotid arteries for CIMT, as well as clinician and patient positioning, and ultrasound transducers orientation.