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173 Cards in this Set

  • Front
  • Back

What are the different names for the Epicardium?

Serous Membrane


Visceral Membrane


Serous Pericardium


Visceral Serous Membrane



What is the innermost layer of the Pericardium?

Epicardium/Visceral

What is the outermost layer of the Heart Muscle?

Epicardium

Which Heart Muscle Layer is watertight to prevent leakage of blood?

Endocardium

What is the Heart doing in Systole?

Contracting

What is the Heart doing in Diastole?

Relaxing

What is the Heart encased in?

Pericardium

What are the 2 main layers of the Pericardium?


Which has a double layer?

Fibrous Pericardium


Serous Pericardium (has double layer)


-Parietal


-Visceral

What is the main purpose of the Pericardium?

Protect the Heart from trauma and infection

Which layer of the Pericardium anchors the Heart?

Fibrous Pericardium

What are the layers of the Serous Pericardium?

Parietal layer


Visceral layer



Which layer lines the inside of the fibrous Pericardium?

Parietal layer

Which layer adheres to the outside of the Heart and is considered the outermost layer of the Heart wall and muscle?

Visceral layer (Epicardium)

Which layer forms the innermost layer of the Pericardium and the outermost layer of the Heart muscle?

Epicardium

What is the area between the Fibrous and Serous Pericardium called?

Pericardial Cavity/Space

What is the Pericardial Cavity filled with? How much is a normal amount?

Pericardial Fluid


40 oz is normal

What does the Pericardial fluid allow the Heart to do?

Go into Systole & Diastole

Which view shows the Ascending & Descending Aorta?

SupraSternal Notch View

In which view are you able to see the inferior wall of the Heart?

Apical 2 view

Which view gives the same information as the Parasternal Long Axis View?

Apical 3 (long) View

Why is the Apical 3 (long) View better for Doppler vs Parasternal Long View?

Because the transducer is parallel with blood flow

Which view of the Heart shows you coarchtation?

SupraSternal View

Is the IVC Superior or Inferior to the Coronary Sinus?

IVC is Inferior

In which chamber do the Chiari Network and the Thebesian Valve belong?

Right Atrium

What is the muscular ridge that covers from the SVC to the IVC and is associated with the Right Atrium?

Crista Terminalis

What is the measurement for the IVC in Diastole (filling)?

1.2 - 2.3 cm

What does the 'sniff' test indirectly test?

Right Atrium pressure

What is it called when the IVC does not collapse in the 'sniff' test?

IVC Plethora

Where does the Chiari Network cross over?

Crosses over the Right Atrium


(LilyPad)

What do you look for in the Right Appendage?

Blood Clots

In Short Axis View (mid-cavity level) the Right Atrium should measure?

44 mm (4.4 cm)

In Long Axis View: from tricuspid annulus plane to the bottom of the chamber (in a parallel line) the Right Atrium should measure?

53 mm (5.3 cm)

What should the Oxygen Saturation be in the Right Atrium?

75%

What should the pressure be in the Right Atrium?

2 - 8 mmHg




(Hg = mercury)

What is the length of the Coronary Sinus?

1 inch (2.54 cm)

Which Heart structure has the lowest Oxygen Saturation?

Coronary Sinus

What collects blood from Coronary Veins and empties into the Right Atrium?

Coronary Sinus

Where is the Thebesian Valve located between?

Between the Coronary Sinus and Right Atrium

What is located in the Posterior Atrial-Ventricular Groove (between the LA & LV)?

Coronary Sinus

What is the most anterior chamber?

Right Ventricle

Which chamber is only half the area of the Left Ventricle, but has the same capacity?

Right Ventricle

What is the measurement for the Right Ventricle Free Wall?

0.5 - 0.8 cm

What is the normal measurement of the Right Ventricle in Diastole (filling) (RVOT)?

1.9 - 2.6 cm


(RVOT is measured in M Mode)

What is the measurement of the Right Ventricle in the Apical View Mid Cavity?

3.5 - 4.0 cm

What is located at the Tricuspid Valve Apparatus and has criss-crossed muscular bands (trabecualtions)?

Right Ventricle Inflow Tract (RVIT)

What is the area of the Infundibulum that extends to the pulmonary artery called?

Right Ventricle Outflow Tract (RVOT)

What is the RVOT Oxygen Saturation?

75%

Which is the best View to evaluate Right Ventricle function?

Apical 4 View

Which view is the RVOT seen?

Parasternal Long Axis View

True/False:




Valves on the same side of the Heart do not Open or Close at the same time?

True

The valves of the Tricuspid Valve are larger and thinner compared to which Valve?

Mitral Valve

Name the 3 leaflets of the Tricuspid Valve.

Anterior


Septal


Posterior aka Inferior/Mural

What should the Orifice of the Tricuspid Valve measure?

7 - 9 cm squared

What is the measurement of the Tricuspid Valve in Doppler at the level of the annulus?

0.3 - 0.7 m/s

What is the only view that allows you to see the Posterior Tricuspid Valve Leaflet?

RVIT View

What guards the opening of the IVC at the Right Atrium?

Eustachian Valve

Which Valve is the most anterior?

Pulmonic Valve

What is the most anterior aspect of the Right Ventricle?

Pulmonic Valve

What is the Pulmonic Valve located between?

Right Ventricle and Pulmonary Artery

The Orifice of the Pulmonic Valve should measure greater than?

greater than 2 cm squared

The Pulmonary Valve in Doppler should measure?

0.6 - 0.9 m/s

How many lobes of the lung does the Right Pulmonary Artery feed?

3 lobes

How many lobes of the lung does the Left Pulmonary Artery feed?

2 lobes

What is the most Anterior Vessel of the Heart?

Pulmonary Artery

Where is the Pulmonary Artery located in reference to the Aorta?

Anterior, Superior and arches to the Left

Which Artery carries Deoxygenated blood to the Pulmonary Capillary Bed where Carbon Dioxide turns into Oxygen?

Pulmonary Artery

An indirect estimate of left atrial pressure can be obtained by a catheter called?

Swan Gantz

The procedure of wedging a catheter in the Pulmonary Capillary Bed to measure it's pressure, which should be equivalent to the Left Atrial Pressure (10 mmHg), is called?

Pulmonary Capillary Wedge Pressure

The Systolic Pressure (top#) in the Pulmonary Artery should measure?

15 - 30 mmHg

The Diastolic Pressure (bottom#) in the Pulmonary Artery should measure?

4 - 12 mmHg

Which Chamber forms the right border of the Heart and is Anterior to the Pulmonary Veins?

Right Atrium

Which chamber receives blood flow from the Vena Cavae? (IVC,SVC)

Right Atrium

What is the fenestrated portion of the Eustachian Valve called?

Chiari Network

Which Chamber's Medial Wall is formed by the Interatrial Septum?

Right Atrium

Which Chamber contains the Thebesian Valve?

Right Atrium

Which Chamber contains the Foramen Ovale (aperture of the fetal heart)?

Right Atrium

Which view illustrates a Chiari Network with in the Right Atrium?

SubCostal 4 Chamber View

A collection of veins joined together to form a large vessel that collects blood from the Myocardium of the Heart?

Coronary Sinus

What is located at the Posterior AtrioVentricular Groove?

Coronary Sinus

In Long Axis View, the Apical 4 Chamber view with Posterior Angulation is used to best visualize?

Coronary Sinus

Located in the Right Atrium and runs Transversely in the groove between the Left Atrium and Ventricle on the Posterior surface of the Heart?

Coronary Sinus

True/False:




The Right Ventricle does not have the same capacity as the Left Ventricle?

False


(RV has the same capacity as LV)

Which Chamber is Triangular in shape and is Heavily Trabeculated and thin walled?

Right Ventricle

Which Chamber has only one wall (anterior/free wall) which pulls inward against the Interventricular Septum?

Right Ventricle

Which Chamber contains the Free Wall, which is functionally part of the left ventricle?

Right Ventricle

Which Chamber has a high surface to volume ratio?

Right Ventricle

Which Chamber has thin resources (of the pumping chambers) that are spread over a large area, diminishing the force (pressure) that the Chamber Wall can produce?

Right Ventricle

Which Chamber is considered to have 2 parts?




-Anterior Superior Outflow


-Posterior Inferior Inflow

Right Ventricle

Which part of the Right Ventricle is heavily trabeculated and houses the Tricuspid Valve?

Posterior Inferior Inflow portion

Which part of the Right Ventricle is smooth walled and houses the origin of the Pulmonary Trunk?

AnteroSuperior Outflow portion

What are the prominent muscular bands in the Right Ventricle that are between the Inflow and Outflow portions?

Parietal band


Crista Supraventricularis


Septal bands


Moderator bands

What is the band of muscle in the Right Ventricle Apex called?

Moderator bands

What are the names of the leaflets of the Tricuspid Valve?

Anterior leaflet


Septal leaflet


Posterior (Inferior/Mural) leaflet

What are leaflet tips that are drawn into multiple strings called?

Chordae Tendineae

What attaches the leaflet to the Papillary Muscles?

Chordae Tendineae

Finger-like protuberances arising from the Ventricular Wall that secure the leaflets are called?

Papillary Muscle

What is the other name for the Tricuspid Valve?

Right AtrioVentricular Valve

What closes tightly to prevent the reverse flow of blood when the Right Ventricle contracts?

Tricuspid Valve

What is comprised of strong fibrous tissue and allows blood to flow from the right Atrium into the Right Ventricle?

Tricuspid Valve

What is the most Anterior Valve in the Heart?

Pulmonic Valve

Which Valve has 3 cusps and is the Anterior aspect of the Right Ventricle?

Pulmonic Valve


(Rt, Lft, Anterior)

Which is the most Anterior Vessel?

Pulmonary Artery

Which Artery courses Superior and Posterior from the Right Ventricle?

Pulmonary Artery

What is attached to the Anterior Aortic Arch by the Ligamentum Arteriosum?

Pulmonary Artery Bifurcation

Where does the Right Pulmonery Artery pass?

underneath the Aortic Arch

Which Chamber's central oval portion is thin, fibrous and it's Superior Anterior is the Right Atrial Appendage?

Right Atrium

Which Chamber has Anterior and Lateral walls that are ridged by fine tubular muscles (Pectinate muscles) and it's Posterior and Medial walls are smooth?

Right Atrium

What is the most Posterior Chamber?

Left Atrium

Which Chamber is Anterior and Medial to the Left Shoulder?

Left Atrium

The Apex of which Chamber points slightly toward the Anterior Chest Wall?

Left Ventricle

In relation to the Heart position, what structures are considered to be posteriorly?

IVC


Descending Thoracic Aorta


Esophagus


Spine

In relation to the Heart's position, what structures are to the left of it?

Chest wall


Lungs

In relation to the Heart's position, What structures are to the right of it?

Sternum


Lungs

In relation to the Heart's position, what structures are superior to it?

Pulmonary Veins


Aortic Arch


Trachea


Clavicles

In relation to the position of the Heart, what structure(s) are Inferior to it?

Diaphragm

In relation to the Heart's position, what structure(s) are Anterior to it?

Chest Wall

Which part of the Heart is located near the Second Intercostal Space?

Base of the Heart

Which part of the Heart is near the Mid-Clavicular line, at approximately the 5th Intercostal Space?




(lead V4 position on a 12 lead ECG)

Apex

What is the direction of the Apex in..




- a Tall patient


- a Short, Heavy patient


- Inspiration


- Expiration

Vertical (tall)


Horizontal (short/heavy)


Vertical (inspiration)


Horizontal (expiration)

What are the Heart Muscle Layers from Outer to Inner?

Epicardium - outermost layer


Myocardium - center layer


Endocardium - inner layer

Which layer of the Heart is the Visceral layer of the Serous Pericardium, and covers the Heart and Great Vessels?

Epicardium

Which layer of the Heart contains Myofibrils and is made up of thick, muscular tissue?

Myocardium

Which layer of the Heart lines the Inner Chambers, Valves, Chordae Tendineae, Papliiary Muscle and is a thin layer of epithelium and connective tissue?

Endocardium

Which Heart Chamber is located Anterior to the chest and to the right of the sternum?

Right Atrium

Which Chamber of the Heart is located Anterior in the chest and beneath and to the left of the sternum?

Right Ventricle

Which part of the Heart points Anteriorly and is the Inferior margin?

Apex of the Heart

Which Chambers lie anatomically Anterior and near the chest wall on the surface echo image?


(AnteroPosterior)

Right Chambers of the Heart

Which chambers of the Heart lie anatomically Posterior, appearing deeper on the surface echo image?

Left Chambers

Contains:




1) Single plate of 4 rings of CT that serves as attachment points for muscular chamber walls.




2) Cardiac Valve Leaflets drawn out from each valve annulus, each composed of the same tissue.

Fibrous Cardiac Skeleton

What are the Transthoracic Echocardiogram standard positions for viewing?

Parasternal (long axis, short axis)


Apical


Subcostal


Suprasternal notch

What are the Transthoracic Echo TTE views?

PLAX


PSAX


Apical (2,3,4,5)


Subcostal


Suprasternal notch

What parts of the Heart are viewed in a PLAX view?

RV


LV


Mitral Valve


LA


Descending Aorta


Aortic Valve


Aortic root


Pericardium


RVIT


RVOT

What is the position of the transducer for the PLAX view?

Transducer: 2-3 in left of sternum. 4th/5th rib interspace




Index: 10 o'clock (toward right shoulder)




*manipulation of the tip of the transducer can obtain the RVIT and PA long axis view

What is the position of the transducer for a PSAX view?

Index: 2 o'clock (toward left shoulder)




*tilting the probe in this position allows for apical and basal views (ventricle)

What is the transducer placement to obtain a 4 Chamber Apical view?

Index: 3 o'clock (toward left shoulder)




*maximal impulse

What is the transducer position for an Apical 2?

Index: 12 o'clock




90 degrees counterclockwise from Apical 4 (3 o'clock)

What is another name for the Apical 3 Chamber view?

Apical Long Axis

What is the transducer position for an Apical 3?

Index: 9 o'clock




90 degrees counterclockwise rotation from an Apical 2

What Axis view gives the same information as the Parasternal Long view?

Apical Long Axis


(Apical 3)


(9 o'clock)

What is the transducer placement for the subcostal views?

Index: 3 o'clock (toward left shoulder)


SubXyphoid Process


(4 chamber view)




*good view to detect any Pericardial Effusion

What is a good view to detect any Pericardial Effusion?

Subcostal (4 chamber) view

Which view is used to examine for the presence of any dissection or moving flap?

SupraSternal Long Axis

What does the SupraSternal view evaluate?

Aorta


Aortic Arch


Ascending Aorta


Descending Aorta


Right Pulmonary Artery


BrachioCephalic Vessels

Which Axis view extends from the Left Ventricle Apex through the Aortic Valve Plane?

Long Axis View

Which Axis view is perpendicular to the Long Axis view resulting in a circular view of the Left Ventricle?

Short Axis View

Which Axis views are a 60 degree rotation from the Long Axis view, and perpendicular to the Short Axis view?

2 and 4 chamber views

Which Axis view includes both Ventricles and both Atria?

4 Chamber view

Which Axis view includes the Left Ventricle and Left Atrium and sometimes the Atrial Appendage?

2 Chamber view

What is a double sac like structure with 3 layers?

Pericardium

What areas does the Pericardium NOT cover?

-Small patch behind posterior wall of the left Atrium




-Perforations permitting entry/exit of the Vena Cavae, Aorta, Pulmonary Veins (PV)

What is the fluid filled sac that covers all of the Heart and roots of the Great Vessels called?

Pericardium

Which Valve separates the areas of greatest pressure differences?

Mitral Valve

Name the cusps of the Pulmonic Valve.

Anterior


Right


Left

What is the term for having the patient lay on their left side?

Left Lateral DeCube

In Doppler Mode, which direction is Red flowing from the transducer? Which direction is Blue flowing from the transducer?

Red -towards transducer


Blue -away from transducer

True/False:




The Heart is Visceral and can move.

True

Are the Chambers of the Heart considered to be side by side?

No



What does the term 'Near field' mean?

top of the image

What does the term 'Far field' Mean?

bottom of the image

Who is going to PASS this test?

YOU ARE!!

Which Views show the Aortic Valve best?

PLAX


PSAX


Apical long-axis


Anteriorly angulated Apical 4 Chamber

Which Views show the Mitral Valve best?

PLAX


PSAX -Mitral Valve level


Apical 4 Chamber


Apical Long Axis

Which Views show the Pulmonic Valve best?

PSAX -Aortic Valve level


RVOT


SubCostal Short Axis -Aortic Valve level



Which Views show the Tricuspid Valve best?

RVIT


Apical 4


SubCostal 4 Chamber and Short Axis

Which Views show the Left Ventricle best?

PLAX


PSAX


Apical 2


Apical 4


Apical Long Axis


SubCostal 4 Chamber and Short Axis

Which Views show the Left Atrium best?

PLAX


PSAX


Apical 4


Apical 2


Apical Long Axis


SubCostal 4 Chamber

Which Views show the Right Ventricle best?

PLAX (RVOT only)


RVIT


PSAX (MV and LV levels)


Apical 4


SubCostal 4 Chamber

Which Views show the Right Atrium best?

PSAX (Aortic Valve level)


Apical 4


SubCostal 4 Chamber and Short Axis

Which Views show the Aorta, Ascending Arch, and Descending Thoracic Arch best?

PLAX (standard and up an interspace)


SupraSternal notch


ParaSternal with angulation


Modified Apical 2


SubCostal

Which Views show the Interatrial Septum best?

PSAX


SubCostal 4 Chamber

Which Views show the Coronary Sinus best?

PLAX to RVIT (sweep)


Apical 4 -posterior angulation

What is our Class Motto?

"The Blind Leading The Blind"

Who Are We???

The 12 Blind Mice (+ Joel) !!!