Learn ultrasound.
Understand what you see.

Find the liver in transverse and longitudinal planes

Start by orienting yourself in the upper abdomen. The tutorial opens the physiological liver case under Internal Medicine → Liver. The position pictogram shows how the current scan plane relates to the body. Transverse and longitudinal sections offer different views of the same organ volume.

Use small fanning, rocking and rotating movements to explore the liver in three dimensions. Follow a structure across adjacent sections rather than naming it from a single still image. Begin with the labels switched on, then find the same structures again without the colour overlay.

Locate the liver beneath the diaphragm

The liver lies mainly in the right upper abdomen beneath the diaphragm, extending partly into the left upper abdomen. The labelled diaphragm provides a landmark for the upper boundary of the liver and its relationship to the chest.

The liver has important metabolic, synthetic, storage and detoxification functions. For ultrasound orientation, its relationships to vessels and bile ducts are particularly useful. These structures provide landmarks that you can return to as you move through the organ.

Trace the aorta, coeliac trunk and hepatic artery

The tutorial starts the arterial search at the aorta. From there, it identifies the coeliac trunk and the more caudal superior mesenteric artery. Following the common hepatic artery leads towards the proper hepatic artery, which carries oxygenated blood to the liver.

The video also shows the splenic artery and the origin of the gastroduodenal artery. The proper hepatic artery divides into right and left branches. Use these branching relationships as a route map: a smaller vessel becomes easier to identify when you can trace it back to a larger trunk.

Recognise the portal vein and its bifurcation

The portal vein carries nutrient-rich blood from the unpaired abdominal organs to the liver. It is labelled light blue in the tutorial. At the porta hepatis, it branches towards the right and left liver lobes. Rotating the transducer helps bring this branching pattern into view.

The tutorial compares the bifurcation to a leaping deer. The important skill is to follow the vessel continuously, rather than rely on a memorable shape alone. Distinguish portal venous inflow from hepatic venous outflow: both systems are within the liver, but they have different anatomical connections.

Find the hepatic veins and inferior vena cava

Blood leaves the liver through the hepatic veins. The right, middle and left hepatic veins drain into the inferior vena cava. Their converging arrangement forms the hepatic venous star shown in the tutorial.

The video uses an oblique upper abdominal plane with approximately 45 degrees of probe rotation. The anatomical connection matters more than a fixed angle. Locate the venous confluence and adjust the plane until you can follow the vessels as they enter the inferior vena cava.

Identify the gallbladder and common bile duct

The gallbladder lies beneath the liver and stores and concentrates bile. Its cystic duct joins the common hepatic duct to form the common bile duct, or ductus choledochus. This extrahepatic duct carries bile towards the duodenum.

A bile duct is not immediately visible in every plane. The tutorial starts with the gallbladder, then uses changes in probe angle and rotation to explore the surrounding anatomy. An oblique shoulder-to-umbilicus plane is also discussed. Do not identify a dark tubular structure as a duct solely from its appearance; check its anatomical course.

Orient yourself: bladder, uterus and ovaries

The first case shows a normal uterus with unremarkable adnexa. In the transabdominal examination, the filled urinary bladder provides an anterior landmark. The live labels show the relationship between bladder, uterus and the ovaries on either side.

The adnexa include the ovaries and uterine tubes with their associated structures. Practise examining both sides systematically. An overview of normal pelvic anatomy helps you describe the exact location of an abnormal finding later in the examination.

Recognise anatomy without the labels

In the examination mode demonstrated in the video, the learner must display a requested structure, freeze the image and mark the structure. This changes the task from recognising a colour overlay to actively finding your way around the ultrasound image.

Use the same principle when you learn sonography: examine a labelled plane, remove the visual help, find the structure again and explain its relationship to adjacent organs. Check your answer only after you have made your own identification.

Uterine position: anteversion, anteflexion and measurements

The abnormal case starts with a systematic assessment of the uterus. The video describes anteversion and anteflexion: these distinguish the inclination of the uterus relative to the vagina from the bend between its body and cervix. They describe orientation and do not automatically indicate pathology.

The uterus is then measured in three dimensions. Reliable measurements require the appropriate scan planes. Practise setting a clean longitudinal or transverse view before placing the measurement points, rather than measuring an oblique section simply because the organ is visible.

Assess the endometrium and uterine cavity

The tutorial describes a thickened endometrium and measures its thickness. The endometrium is the lining of the uterus. Distinguish it from the surrounding myometrium and relate the measurement to a clearly identified scan plane.

The uterine cavity is then examined systematically. No intrauterine pregnancy is identified in the case shown. This absence alone does not prove ectopic pregnancy: it must be interpreted with the other ultrasound findings, clinical presentation and laboratory results.

Examine the left adnexa and ring-shaped structure

The examination extends to the left adnexal region. The video identifies an abnormal conglomerate between the left ovary and uterus. Closer inspection reveals a cystic finding with a small ring-shaped structure inside.

Describe the location, relationship to the ovary and internal appearance before drawing a conclusion. Can you find the abnormality again in adjacent sections? A precise description separates what the image actually shows from the diagnostic interpretation.

Pouch of Douglas and suspicion of ectopic pregnancy

The case summary combines a thickened endometrium, no visible intrauterine pregnancy, substantial fluid in the pouch of Douglas and an abnormal cystic finding between the left ovary and uterus. The pouch of Douglas lies behind the uterus and is an important location to assess for free fluid.

Together, these findings raise strong suspicion of an ectopic pregnancy in the left uterine tube in this case. An empty uterus or free fluid is not diagnostic on its own. Interpretation requires the overall clinical condition, laboratory findings and appropriately qualified further assessment.

Orient the virtual transvaginal probe

The hand position for a transvaginal case differs from handling a linear or curved transducer on the body surface. The video demonstrates the smartphone’s starting position and alignment before choosing Reset Position. Subsequent movements are interpreted relative to this reference.

Compare your hand position with the pictogram and the displayed pelvic anatomy. Make small, deliberate changes along a single axis. The aim is to connect each change in the image plane with a particular movement rather than alter several axes at the same time.

Fanning through adjacent imaging planes

Fanning moves the handle perpendicular to the long axis of the transducer footprint while keeping the contact location fixed. This axis runs from the marked end to the opposite end of the footprint. The beam moves out of the current imaging plane through adjacent sections.

Watch how controlled fanning changes the structures displayed in the tutorial. Practise this movement on its own, keeping the probe location and rotation constant and avoiding additional rocking.

Rocking to adjust the insonation angle

Rocking moves the handle along the long axis of the transducer footprint, towards its marked or opposite end, while the contact location stays fixed. It redirects the beam within the same imaging plane rather than through adjacent planes.

Use this movement to bring an off-centre structure towards the middle of the image. Start with a small movement and observe the direction in which the structure moves on screen.

Rotate from a transverse to a sagittal view

Rotation turns the transducer around its longitudinal axis. The video demonstrates rotating the smartphone from a transverse orientation towards a sagittal plane. The line in the pictogram helps relate the new scan plane to the body.

An approximately right-angle rotation brings you towards another main anatomical plane when the remaining alignment is appropriate. Try to keep the structure in view as you turn. This connects short- and long-axis appearances of the same anatomy.

Sweeping and sliding: translational movements

Translation changes the transducer’s location. In the tutorial’s Swipe mode, up-and-down gestures control one direction while side-to-side gestures control the other. In realScan mode, the smartphone itself moves through space.

Sliding moves the probe along the long axis of its footprint, towards the marked or opposite end. Keep surface contact, angle and rotation unchanged.

Sweeping moves the probe perpendicular to that long axis, across the short axis of the footprint. Move to a new contact location while keeping the angle and rotation unchanged to acquire adjacent imaging planes.

realScan: transfer movements through space

The realScan demonstration begins by initialising the sensors. The tutorial highlights good lighting and a surface with visual contrast. After briefly moving the device to establish its surroundings, the starting orientation is defined with Reset Position.

You can then reproduce the demonstrated translational movements with the smartphone itself. Compare your movement with the changing ultrasound plane. This lesson focuses on transducer handling; use the separate, newer tutorial for device connection instructions.

airScan: simulate contact loss and compression

The airScan section extends realScan with vertical movement. Reset Position defines a virtual body surface. Raising the smartphone simulates loss of contact; lowering it restores contact with the virtual surface.

Moving further below the reference surface simulates compression. Distinguish the three states: no contact, contact and pressure on virtual tissue. This section explains the movement logic of the simulator; it is not an instruction to apply pressure during a real transvaginal examination.

Choose internal or external control

Internal control uses the movements of the tablet itself. For external control, switch the simulation to the smartphone option. In the iOS example, the selector is at the top right and the option is labelled phone.

This determines which device supplies movements to the simulation. Open Scanbooster Control on the smartphone at the same time. You are setting up a control connection between the apps so the phone can act as the virtual transducer.

Enable Bluetooth on both devices

In the iOS demonstration, swiping down from the top right opens Control Centre, where Bluetooth is enabled. The tutorial then opens Scanbooster Control on the phone and enables Bluetooth there as well.

Separate Bluetooth availability from pairing: the radio connection must be enabled, but the specific smartphone is selected inside Scanbooster. System interfaces may look different in other operating system versions; the app remains the place to establish the connection.

Use the device list or proximity connection

When the phone appears in the tablet’s device list, select it. The newer tutorial also demonstrates an automatic connection by bringing the devices closer together. A blue bar indicates proximity until the connection is established.

If several smartphones are available nearby, select the intended device. Once connected, make a small, deliberate movement of the smartphone and check that the simulator’s scan plane responds.

Android: connect through the app

In the Android section, follow the instructions on the smartphone and enable Bluetooth. On the tablet, switch from internal to external control and select the smartphone from the list.

The closing instruction applies to both platforms: use the pairing mechanisms inside the app, rather than pairing the devices in system settings. After connecting, continue with the separate lesson on fanning, rocking and rotation.