<p begin="00:00:07.000" end="00:00:09.879" style="s2">- [Voiceover] A curved or<br />phased array transducer with an</p>
<p begin="00:00:09.879" end="00:00:12.611" style="s2">abdomen exam type is used to perform a</p>
<p begin="00:00:12.611" end="00:00:14.407" style="s2">renal ultrasound exam.</p>
<p begin="00:00:14.407" end="00:00:17.740" style="s2">The kidney should be<br />evaluated in two planes.</p>
<p begin="00:00:17.740" end="00:00:21.151" style="s2">The transducer is placed in<br />a long access orientation</p>
<p begin="00:00:21.151" end="00:00:23.459" style="s2">along the right midaxillary line,</p>
<p begin="00:00:23.459" end="00:00:24.913" style="s2">at the costal margin,</p>
<p begin="00:00:24.913" end="00:00:27.233" style="s2">with the orientation<br />marker directed toward the</p>
<p begin="00:00:27.233" end="00:00:28.487" style="s2">patient's head.</p>
<p begin="00:00:28.487" end="00:00:30.913" style="s2">If it is difficult to<br />visualize the kidney,</p>
<p begin="00:00:30.913" end="00:00:33.981" style="s2">a deep inspiration will move<br />the kidney below the ribs,</p>
<p begin="00:00:33.981" end="00:00:36.044" style="s2">for easier access.</p>
<p begin="00:00:36.044" end="00:00:39.524" style="s2">It may also be necessary to<br />move the transducer proximally</p>
<p begin="00:00:39.524" end="00:00:42.725" style="s2">along the midaxillary line,<br />to visualize the kidneys,</p>
<p begin="00:00:42.725" end="00:00:44.939" style="s2">using an intercostal approach.</p>
<p begin="00:00:44.939" end="00:00:48.233" style="s2">Using this approach will<br />result in rib shadow artifacts</p>
<p begin="00:00:48.233" end="00:00:50.609" style="s2">overlying the ultrasound image.</p>
<p begin="00:00:50.609" end="00:00:53.963" style="s2">Once the kidney is identified,<br />the transducer is slightly</p>
<p begin="00:00:53.963" end="00:00:58.130" style="s2">rotated to adjust for the oblique<br />orientation of the kidney.</p>
<p begin="00:01:04.713" end="00:01:08.435" style="s2">The transducer is swept<br />from anterior to posterior</p>
<p begin="00:01:08.435" end="00:01:10.457" style="s2">to image the kidney parenchyma,</p>
<p begin="00:01:10.457" end="00:01:14.119" style="s2">which will appear hypoechoic<br />when compared to the liver.</p>
<p begin="00:01:14.119" end="00:01:16.892" style="s2">The renal pyramids are<br />triangular in shape,</p>
<p begin="00:01:16.892" end="00:01:19.550" style="s2">and darker than the renal cortex.</p>
<p begin="00:01:19.550" end="00:01:23.140" style="s2">The renal pelvis will appear<br />as bright, hyperechoic echoes</p>
<p begin="00:01:23.140" end="00:01:24.546" style="s2">within the kidney.</p>
<p begin="00:01:24.546" end="00:01:27.247" style="s2">To obtain a transverse access view,</p>
<p begin="00:01:27.247" end="00:01:29.659" style="s2">rotate the transducer 90 degrees,</p>
<p begin="00:01:29.659" end="00:01:31.652" style="s2">from the long access position.</p>
<p begin="00:01:31.652" end="00:01:34.098" style="s2">The kidney appear as a circular structure,</p>
<p begin="00:01:34.098" end="00:01:35.311" style="s2">with a horseshoe shape,</p>
<p begin="00:01:35.311" end="00:01:37.249" style="s2">at the level of the renal pelvis.</p>
<p begin="00:01:37.249" end="00:01:40.994" style="s2">The transducer is swept from<br />the superior to inferior poles,</p>
<p begin="00:01:40.994" end="00:01:43.494" style="s2">to evaluate the entire kidney.</p>