3
EASy MAPRight Upper Lung
View 3 · probe position C · 2nd ICS, right midclavicular line
Machine setup
- Same sector probe, carried over from the subcostal views.
- Adult Cardiac preset, B-mode, marker upper right.
- Depth stays at 21 cm — the same depth for all six views.
- If image quality is poor, switch to the Adult Lung preset and re-optimize.
- Gain set so the airspaces of the lung parenchyma appear black.
Acquire
- Come off the subcostal position, wipe excess gel from the abdomen, and re-gel the probe.
- Place the probe in the 2nd intercostal space at the right midclavicular line, marker at 12 o'clock.
- Apply gentle pressure and/or slide the probe vertically to get out from under rib shadows.
- Tilt the tail slightly laterally so the beam meets the pleura perpendicularly, allowing for the curve of the chest wall.
- Set gain so the lung airspaces are black; record once you have a clean interspace.
Pitfalls
- Rib shadowing read as pathology — slide or angle, don't guess.
- Too little pressure at the interspace: the pleural line blurs and sliding becomes unreadable.
- Calling B-lines off a single interspace — check the mirror view on the left before you commit.
- Reading the lung before the IVC and heart are done invites premature closure; finish all six views first.
Why the tilt matters
The pleura is a specular reflector — it only returns a clean signal when the beam strikes it square. If you see neither A-lines nor B-lines, the probe-to-pleura angle is off. Recheck orientation and angle before calling the image.
Read it
- A-lines — dry lung; volume is tolerated.
- B-lines — wet lung; the ceiling on volume.
- Lung sliding — shimmering, to-and-fro motion at the pleural line with respiration.
- Neither A- nor B-lines — a technique problem, not a finding. Re-optimize.
If you switch presets
Moving from a cardiac to a lung preset moves the marker indicator to the left of the screen and reverses image orientation. Re-orient before you read the image.
What this view adds
The ceiling on volume. A-lines say the lung is dry and will tolerate fluid; B-lines say it will not. This is the finding that turns a filling decision from a guess into a call.