Atlas of Endoscopic Ultrasonography

Video 1.8starts distally at the end of the anal canal. The internal and external sphincters are shown, and residual stool is present in the rectum. Moving proximally, the vagina and urethra are shown, followed by the cervix and bladder.

Video 1.9starts with a sagittal plane through the pelvis with the body facing the left. The prostate, rectum, anal canal, and bladder are identified. The plane is rotated, and the seminal vesicles and internal anal sphincter are labeled. The coccyx and sacrum are apparent at the start and end of the video but are unlabeled.

Video 1.10starts with a sagittal plane through the pelvis with the body facing the left and slightly face down. The anal canal, rectum, uterus, and bladder are identified. Stool is present in the rectal vault. The plane is rotated, and towards the end of the video the internal anal sphincter (IS) and external anal sphincter (ES) are identified.

Video 1.11shows models of some of the main arteries that are visualized during endosonography. A close‐up view shows the celiac artery with its branches (hepatic, splenic, and left gastric arteries). The gastroduodenal and pancreaticoduodenal arteries are shown coming off the hepatic artery. The internal and external iliac arteries are then identified, followed by identification of the arteries associated with the aortic arch (left subclavian, left carotid, brachiocephalic) and the branches of the brachiocephalic (right subclavian and right carotid). Various organs are then placed in the model starting with the esophagus, then pancreas, stomach, and duodenum.

Some of the major veins visualized during endosonography are shown. At first, the vena cava and right atrium are identified, after which, the renal veins and azygos veins are added. The portal system with the portal vein, SMV, splenic vein, and inferior mesenteric vein (not labeled) are placed in blue. The systemic veins are then colored and removed. The pancreas is placed on the portal vein and its branches, showing how the head runs parallel to the SMV and the tail runs parallel to the splenic vein.

Extratracheal anatomy is similar to extraesophageal anatomy and many of the structures seen in the extratracheal spaces are the same as what is seen in the extraesophageal spaces. The endoluminal views of the trachea are oriented so that the membranous trachea is inferior and is splayed wider than the cartilaginous trachea at the level of the carina, putting the right mainstem bronchus (RMB) to the right and the left mainstem bronchus (LMB) to the left ( Figure 1.9). As one goes right the bronchus immediately branches superiorly towards the right upper lobe (RUL), and continues straight as bronchus intermedius (BI) ( Figure 1.10), which then branches towards the right middle lobe (RML) and right lower lobe (RLL) of the lung ( Figure 1.11).

Going left from the carina, one goes down the relatively long left mainstem bronchus until it branches towards the left upper lobe (LUL) and left lower lobe (LLL) of the lung ( Figure 1.12). An overview of the bronchial tree is shown in Figure 1.13.

Video 1.13starts with the cervical trachea. All images are in a linear array orientation as endobronchial ultrasound (EBUS) is exclusively linear. The esophagus is inferior and the brachiocephalic artery and vein are superior. The video begins with rotation of the image plane. The superior part of the plane moves left and the inferior part moves right. This moves the esophagus out of view and brings the left subclavian artery and left carotid artery into the inferior part of the image. Eventually, the esophagus is seen in the superior part of the image and, with continued motion, the esophagus again appears inferior to the trachea. At this point, the image plane moves caudally to the carina. The right pulmonary artery, brachiocephalic artery (BA), and left brachiocephalic vein (LBV) are labeled. The plane is again rotated to splay the right (RMB) and left (LMB) mainstem bronchi apart. The plane is then moved to better visualize the right mainstem bronchus, showing the branch to the right upper lobe (RUL), the azygos arch (AzArch), the bronchus intermedius (BI). This same plane shows the relation of the aortic arch (AoArch) and left pulmonary artery to the left mainstem bronchus (LMB). As the plane goes down the right mainstem bronchus/bronchus intermedius (RMB) towards its next bifurcation, the azygos arch (AzAr), right pulmonary artery (RPA), and right pulmonary vein (RPV) are shown.

Figure 1.9 Endobronchial view of the carina, showing the right (RMB) and left (LMB) mainstem bronchi.

Figure 1.10 Endobronchial view of the first branch of the right mainstem bronchus towards the right upper lobe (RUL) and the bronchus intermedius (BI).

Figure 1.11 Endobronchial view of the bifurcation of the bronchus intermedius towards the right middle lobe (RML) and the right lower lobe (RLL).

Figure 1.12 Endobronchial view of bifurcation of the left mainstem bronchus towards the left upper lobe (LUL) and left lower lobe (LLL).

The plane is brought back to the carina to visualize the left mainstem bronchus (LMB), and the azygos arch (AzAr), aortic arch (AoAr), left pulmonary artery (LPA), and vein (LPV) are identified. The branching to the left upper lobe (LUL) and left lower lobe (LLL) are shown, and the aorta (Ao) and left pulmonary artery are labeled.

Figure 1.13 A Visible Human Model of the bronchial tree.

Video 1.1 Esophageal‐related models and cross‐sectional anatomy: radial orientation.

Video 1.2 Esophageal‐related models and cross‐sectional anatomy: linear orientation.

Video 1.3 Gastric‐related models and cross‐sectional anatomy: radial orientation.

Video 1.4 Gastric‐related models and cross‐sectional anatomy: linear orientation.

Video 1.5 Duodenal‐related models and cross‐sectional anatomy: radial orientation.

Video 1.6 Duodenal‐related models and cross‐sectional anatomy: linear orientation.

Video 1.7 Male rectum‐related models and cross‐sectional anatomy: radial orientation.

Video 1.8 Male rectum‐related cross‐sectional anatomy: linear orientation.

Video 1.9 Female rectum‐related cross‐sectional anatomy: radial orientation.