<p begin="00:00:14.975" end="00:00:16.658" style="s2">- Once we've done the survey,</p>
<p begin="00:00:16.658" end="00:00:18.355" style="s2">we wanna go back and take measurements</p>
<p begin="00:00:18.355" end="00:00:21.843" style="s2">of the aorta in a transverse<br />view in three levels.</p>
<p begin="00:00:21.843" end="00:00:25.948" style="s2">One level is proximal above the<br />level of the renal arteries,</p>
<p begin="00:00:25.948" end="00:00:29.392" style="s2">the second is just at the<br />level of the renal arteries</p>
<p begin="00:00:29.392" end="00:00:33.356" style="s2">and the third is at the<br />level of the bifurcation.</p>
<p begin="00:00:33.356" end="00:00:36.856" style="s2">We're gonna go back to the epigastric area</p>
<p begin="00:00:40.060" end="00:00:42.810" style="s2">and look for our landmarks again.</p>
<p begin="00:00:44.233" end="00:00:48.862" style="s2">In the middle of the screen<br />we have the aorta pulsating</p>
<p begin="00:00:48.862" end="00:00:52.030" style="s2">to the right of the aorta the IVC</p>
<p begin="00:00:52.030" end="00:00:53.604" style="s2">and anterior to the aorta we have</p>
<p begin="00:00:53.604" end="00:00:56.342" style="s2">the superior mesenteric artery.</p>
<p begin="00:00:56.342" end="00:00:59.175" style="s2">I'm going to freeze the image here</p>
<p begin="00:01:02.657" end="00:01:05.074" style="s2">and perform two measurements.</p>
<p begin="00:01:08.369" end="00:01:12.369" style="s2">Measuring from the outside<br />wall to outside wall,</p>
<p begin="00:01:13.805" end="00:01:16.162" style="s2">so I measure the entire size of the aorta</p>
<p begin="00:01:16.162" end="00:01:19.745" style="s2">and just the residual<br />lumen of an aneurysm.</p>
<p begin="00:01:23.223" end="00:01:27.312" style="s2">I will perform two measurements,<br />anterior to posterior,</p>
<p begin="00:01:27.312" end="00:01:29.639" style="s2">and a transverse measurement.</p>
<p begin="00:01:29.639" end="00:01:33.806" style="s2">From there I'm gonna move<br />a little bit more inferior</p>
<p begin="00:01:39.714" end="00:01:41.169" style="s2">optimizing the image so I can see</p>
<p begin="00:01:41.169" end="00:01:43.669" style="s2">the wall of the aorta clearly.</p>
<p begin="00:01:45.635" end="00:01:48.003" style="s2">I will freeze the image.</p>
<p begin="00:01:48.003" end="00:01:50.908" style="s2">Perform my measurements,<br />the same two views again.</p>
<p begin="00:01:50.908" end="00:01:52.658" style="s2">From the outside wall</p>
<p begin="00:01:54.478" end="00:01:56.145" style="s2">to the outside wall,</p>
<p begin="00:02:00.936" end="00:02:05.103" style="s2">that's the AP measurement and<br />the same for the transverse.</p>
<p begin="00:02:12.280" end="00:02:13.345" style="s2">The measurement is displayed on</p>
<p begin="00:02:13.345" end="00:02:14.925" style="s2">the bottom left of the screen and</p>
<p begin="00:02:14.925" end="00:02:17.380" style="s2">in this case our measurement<br />is 1.36 centimeters</p>
<p begin="00:02:17.380" end="00:02:19.402" style="s2">by 1.69 centimeters.</p>
<p begin="00:02:19.402" end="00:02:23.451" style="s2">So we're looking for a value<br />of over three centimeters</p>
<p begin="00:02:23.451" end="00:02:25.784" style="s2">to be considered aneurysmal.</p>
<p begin="00:02:27.528" end="00:02:30.671" style="s2">I'll keep moving down in a transverse view</p>
<p begin="00:02:30.671" end="00:02:32.671" style="s2">towards the bifurcation.</p>
<p begin="00:02:35.173" end="00:02:37.590" style="s2">Here we see the aorta divide.</p>
<p begin="00:02:39.755" end="00:02:42.694" style="s2">So right before it divides, I want to</p>
<p begin="00:02:42.694" end="00:02:45.777" style="s2">perform my measurement at that point.</p>
<p begin="00:02:48.046" end="00:02:50.525" style="s2">So I will freeze and perform the</p>
<p begin="00:02:50.525" end="00:02:52.858" style="s2">same two measurements again.</p>
<p begin="00:03:00.390" end="00:03:01.223" style="s2">Anterior</p>
<p begin="00:03:04.969" end="00:03:06.219" style="s2">and transverse.</p>
<p begin="00:03:07.245" end="00:03:10.438" style="s2">From outside wall to outside wall.</p>
<p begin="00:03:10.438" end="00:03:12.375" style="s2">And that is the completion<br />of the measurements</p>
<p begin="00:03:12.375" end="00:03:16.125" style="s2">you need to do for the<br />abdominal aortic exam.</p>