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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 |
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What is the innermost layer of the Pericardium? |
Epicardium/Visceral |
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What is the outermost layer of the Heart Muscle? |
Epicardium |
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Which Heart Muscle Layer is watertight to prevent leakage of blood? |
Endocardium |
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What is the Heart doing in Systole? |
Contracting |
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What is the Heart doing in Diastole? |
Relaxing |
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What is the Heart encased in? |
Pericardium |
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What are the 2 main layers of the Pericardium? Which has a double layer? |
Fibrous Pericardium Serous Pericardium (has double layer) -Parietal -Visceral |
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What is the main purpose of the Pericardium? |
Protect the Heart from trauma and infection |
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Which layer of the Pericardium anchors the Heart? |
Fibrous Pericardium |
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What are the layers of the Serous Pericardium? |
Parietal layer Visceral layer |
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Which layer lines the inside of the fibrous Pericardium? |
Parietal layer |
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Which layer adheres to the outside of the Heart and is considered the outermost layer of the Heart wall and muscle? |
Visceral layer (Epicardium) |
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Which layer forms the innermost layer of the Pericardium and the outermost layer of the Heart muscle? |
Epicardium |
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What is the area between the Fibrous and Serous Pericardium called? |
Pericardial Cavity/Space |
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What is the Pericardial Cavity filled with? How much is a normal amount? |
Pericardial Fluid 40 oz is normal |
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What does the Pericardial fluid allow the Heart to do? |
Go into Systole & Diastole |
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Which view shows the Ascending & Descending Aorta? |
SupraSternal Notch View |
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In which view are you able to see the inferior wall of the Heart? |
Apical 2 view |
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Which view gives the same information as the Parasternal Long Axis View? |
Apical 3 (long) View |
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Why is the Apical 3 (long) View better for Doppler vs Parasternal Long View? |
Because the transducer is parallel with blood flow |
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Which view of the Heart shows you coarchtation? |
SupraSternal View |
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Is the IVC Superior or Inferior to the Coronary Sinus? |
IVC is Inferior |
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In which chamber do the Chiari Network and the Thebesian Valve belong? |
Right Atrium |
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What is the muscular ridge that covers from the SVC to the IVC and is associated with the Right Atrium? |
Crista Terminalis |
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What is the measurement for the IVC in Diastole (filling)? |
1.2 - 2.3 cm |
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What does the 'sniff' test indirectly test? |
Right Atrium pressure |
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What is it called when the IVC does not collapse in the 'sniff' test? |
IVC Plethora |
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Where does the Chiari Network cross over? |
Crosses over the Right Atrium (LilyPad) |
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What do you look for in the Right Appendage? |
Blood Clots |
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In Short Axis View (mid-cavity level) the Right Atrium should measure? |
44 mm (4.4 cm) |
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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) |
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What should the Oxygen Saturation be in the Right Atrium? |
75% |
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What should the pressure be in the Right Atrium? |
2 - 8 mmHg (Hg = mercury) |
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What is the length of the Coronary Sinus? |
1 inch (2.54 cm) |
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Which Heart structure has the lowest Oxygen Saturation? |
Coronary Sinus |
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What collects blood from Coronary Veins and empties into the Right Atrium? |
Coronary Sinus |
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Where is the Thebesian Valve located between? |
Between the Coronary Sinus and Right Atrium |
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What is located in the Posterior Atrial-Ventricular Groove (between the LA & LV)? |
Coronary Sinus |
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What is the most anterior chamber? |
Right Ventricle |
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Which chamber is only half the area of the Left Ventricle, but has the same capacity? |
Right Ventricle |
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What is the measurement for the Right Ventricle Free Wall? |
0.5 - 0.8 cm |
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What is the normal measurement of the Right Ventricle in Diastole (filling) (RVOT)? |
1.9 - 2.6 cm (RVOT is measured in M Mode) |
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What is the measurement of the Right Ventricle in the Apical View Mid Cavity? |
3.5 - 4.0 cm |
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What is located at the Tricuspid Valve Apparatus and has criss-crossed muscular bands (trabecualtions)? |
Right Ventricle Inflow Tract (RVIT) |
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What is the area of the Infundibulum that extends to the pulmonary artery called? |
Right Ventricle Outflow Tract (RVOT) |
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What is the RVOT Oxygen Saturation? |
75% |
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Which is the best View to evaluate Right Ventricle function? |
Apical 4 View |
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Which view is the RVOT seen? |
Parasternal Long Axis View |
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True/False: Valves on the same side of the Heart do not Open or Close at the same time? |
True |
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The valves of the Tricuspid Valve are larger and thinner compared to which Valve? |
Mitral Valve |
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Name the 3 leaflets of the Tricuspid Valve. |
Anterior Septal Posterior aka Inferior/Mural |
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What should the Orifice of the Tricuspid Valve measure? |
7 - 9 cm squared |
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What is the measurement of the Tricuspid Valve in Doppler at the level of the annulus? |
0.3 - 0.7 m/s |
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What is the only view that allows you to see the Posterior Tricuspid Valve Leaflet? |
RVIT View |
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What guards the opening of the IVC at the Right Atrium? |
Eustachian Valve |
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Which Valve is the most anterior? |
Pulmonic Valve |
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What is the most anterior aspect of the Right Ventricle? |
Pulmonic Valve |
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What is the Pulmonic Valve located between? |
Right Ventricle and Pulmonary Artery |
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The Orifice of the Pulmonic Valve should measure greater than? |
greater than 2 cm squared |
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The Pulmonary Valve in Doppler should measure? |
0.6 - 0.9 m/s |
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How many lobes of the lung does the Right Pulmonary Artery feed? |
3 lobes |
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How many lobes of the lung does the Left Pulmonary Artery feed? |
2 lobes |
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What is the most Anterior Vessel of the Heart? |
Pulmonary Artery |
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Where is the Pulmonary Artery located in reference to the Aorta? |
Anterior, Superior and arches to the Left |
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Which Artery carries Deoxygenated blood to the Pulmonary Capillary Bed where Carbon Dioxide turns into Oxygen? |
Pulmonary Artery |
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An indirect estimate of left atrial pressure can be obtained by a catheter called? |
Swan Gantz |
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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 |
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The Systolic Pressure (top#) in the Pulmonary Artery should measure? |
15 - 30 mmHg |
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The Diastolic Pressure (bottom#) in the Pulmonary Artery should measure? |
4 - 12 mmHg |
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Which Chamber forms the right border of the Heart and is Anterior to the Pulmonary Veins? |
Right Atrium |
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Which chamber receives blood flow from the Vena Cavae? (IVC,SVC) |
Right Atrium |
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What is the fenestrated portion of the Eustachian Valve called? |
Chiari Network |
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Which Chamber's Medial Wall is formed by the Interatrial Septum? |
Right Atrium |
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Which Chamber contains the Thebesian Valve? |
Right Atrium |
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Which Chamber contains the Foramen Ovale (aperture of the fetal heart)? |
Right Atrium |
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Which view illustrates a Chiari Network with in the Right Atrium? |
SubCostal 4 Chamber View |
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A collection of veins joined together to form a large vessel that collects blood from the Myocardium of the Heart? |
Coronary Sinus |
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What is located at the Posterior AtrioVentricular Groove? |
Coronary Sinus |
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In Long Axis View, the Apical 4 Chamber view with Posterior Angulation is used to best visualize? |
Coronary Sinus |
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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 |
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True/False: The Right Ventricle does not have the same capacity as the Left Ventricle? |
False (RV has the same capacity as LV) |
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Which Chamber is Triangular in shape and is Heavily Trabeculated and thin walled? |
Right Ventricle |
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Which Chamber has only one wall (anterior/free wall) which pulls inward against the Interventricular Septum? |
Right Ventricle |
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Which Chamber contains the Free Wall, which is functionally part of the left ventricle? |
Right Ventricle |
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Which Chamber has a high surface to volume ratio? |
Right Ventricle |
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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 |
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Which Chamber is considered to have 2 parts? -Anterior Superior Outflow -Posterior Inferior Inflow |
Right Ventricle |
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Which part of the Right Ventricle is heavily trabeculated and houses the Tricuspid Valve? |
Posterior Inferior Inflow portion |
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Which part of the Right Ventricle is smooth walled and houses the origin of the Pulmonary Trunk? |
AnteroSuperior Outflow portion |
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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 |
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What is the band of muscle in the Right Ventricle Apex called? |
Moderator bands |
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What are the names of the leaflets of the Tricuspid Valve? |
Anterior leaflet Septal leaflet Posterior (Inferior/Mural) leaflet |
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What are leaflet tips that are drawn into multiple strings called? |
Chordae Tendineae |
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What attaches the leaflet to the Papillary Muscles? |
Chordae Tendineae |
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Finger-like protuberances arising from the Ventricular Wall that secure the leaflets are called? |
Papillary Muscle |
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What is the other name for the Tricuspid Valve? |
Right AtrioVentricular Valve |
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What closes tightly to prevent the reverse flow of blood when the Right Ventricle contracts? |
Tricuspid Valve |
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What is comprised of strong fibrous tissue and allows blood to flow from the right Atrium into the Right Ventricle? |
Tricuspid Valve |
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What is the most Anterior Valve in the Heart? |
Pulmonic Valve |
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Which Valve has 3 cusps and is the Anterior aspect of the Right Ventricle? |
Pulmonic Valve (Rt, Lft, Anterior) |
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Which is the most Anterior Vessel? |
Pulmonary Artery |
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Which Artery courses Superior and Posterior from the Right Ventricle? |
Pulmonary Artery |
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What is attached to the Anterior Aortic Arch by the Ligamentum Arteriosum? |
Pulmonary Artery Bifurcation |
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Where does the Right Pulmonery Artery pass? |
underneath the Aortic Arch |
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Which Chamber's central oval portion is thin, fibrous and it's Superior Anterior is the Right Atrial Appendage? |
Right Atrium |
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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 |
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What is the most Posterior Chamber? |
Left Atrium |
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Which Chamber is Anterior and Medial to the Left Shoulder? |
Left Atrium |
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The Apex of which Chamber points slightly toward the Anterior Chest Wall? |
Left Ventricle |
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In relation to the Heart position, what structures are considered to be posteriorly? |
IVC Descending Thoracic Aorta Esophagus Spine |
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In relation to the Heart's position, what structures are to the left of it? |
Chest wall Lungs |
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In relation to the Heart's position, What structures are to the right of it? |
Sternum Lungs |
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In relation to the Heart's position, what structures are superior to it? |
Pulmonary Veins Aortic Arch Trachea Clavicles |
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In relation to the position of the Heart, what structure(s) are Inferior to it? |
Diaphragm |
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In relation to the Heart's position, what structure(s) are Anterior to it? |
Chest Wall |
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Which part of the Heart is located near the Second Intercostal Space? |
Base of the Heart |
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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 |
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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) |
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What are the Heart Muscle Layers from Outer to Inner? |
Epicardium - outermost layer Myocardium - center layer Endocardium - inner layer |
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Which layer of the Heart is the Visceral layer of the Serous Pericardium, and covers the Heart and Great Vessels? |
Epicardium |
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Which layer of the Heart contains Myofibrils and is made up of thick, muscular tissue? |
Myocardium |
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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 |
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Which Heart Chamber is located Anterior to the chest and to the right of the sternum? |
Right Atrium |
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Which Chamber of the Heart is located Anterior in the chest and beneath and to the left of the sternum? |
Right Ventricle |
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Which part of the Heart points Anteriorly and is the Inferior margin? |
Apex of the Heart |
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Which Chambers lie anatomically Anterior and near the chest wall on the surface echo image? (AnteroPosterior) |
Right Chambers of the Heart |
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Which chambers of the Heart lie anatomically Posterior, appearing deeper on the surface echo image? |
Left Chambers |
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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 |
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What are the Transthoracic Echocardiogram standard positions for viewing? |
Parasternal (long axis, short axis) Apical Subcostal Suprasternal notch |
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What are the Transthoracic Echo TTE views? |
PLAX PSAX Apical (2,3,4,5) Subcostal Suprasternal notch |
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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 |
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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 |
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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) |
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What is the transducer placement to obtain a 4 Chamber Apical view? |
Index: 3 o'clock (toward left shoulder) *maximal impulse |
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What is the transducer position for an Apical 2? |
Index: 12 o'clock 90 degrees counterclockwise from Apical 4 (3 o'clock) |
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What is another name for the Apical 3 Chamber view? |
Apical Long Axis |
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What is the transducer position for an Apical 3? |
Index: 9 o'clock 90 degrees counterclockwise rotation from an Apical 2 |
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What Axis view gives the same information as the Parasternal Long view? |
Apical Long Axis (Apical 3) (9 o'clock) |
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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 |
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What is a good view to detect any Pericardial Effusion? |
Subcostal (4 chamber) view |
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Which view is used to examine for the presence of any dissection or moving flap? |
SupraSternal Long Axis |
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What does the SupraSternal view evaluate? |
Aorta Aortic Arch Ascending Aorta Descending Aorta Right Pulmonary Artery BrachioCephalic Vessels |
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Which Axis view extends from the Left Ventricle Apex through the Aortic Valve Plane? |
Long Axis View |
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Which Axis view is perpendicular to the Long Axis view resulting in a circular view of the Left Ventricle? |
Short Axis View |
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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 |
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Which Axis view includes both Ventricles and both Atria? |
4 Chamber view |
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Which Axis view includes the Left Ventricle and Left Atrium and sometimes the Atrial Appendage? |
2 Chamber view |
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What is a double sac like structure with 3 layers? |
Pericardium |
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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) |
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What is the fluid filled sac that covers all of the Heart and roots of the Great Vessels called? |
Pericardium |
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Which Valve separates the areas of greatest pressure differences? |
Mitral Valve |
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Name the cusps of the Pulmonic Valve. |
Anterior Right Left |
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What is the term for having the patient lay on their left side? |
Left Lateral DeCube |
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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 |
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True/False: The Heart is Visceral and can move. |
True |
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Are the Chambers of the Heart considered to be side by side? |
No |
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What does the term 'Near field' mean? |
top of the image |
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What does the term 'Far field' Mean? |
bottom of the image |
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Who is going to PASS this test? |
YOU ARE!! |
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Which Views show the Aortic Valve best? |
PLAX PSAX Apical long-axis Anteriorly angulated Apical 4 Chamber |
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Which Views show the Mitral Valve best? |
PLAX PSAX -Mitral Valve level Apical 4 Chamber Apical Long Axis |
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Which Views show the Pulmonic Valve best? |
PSAX -Aortic Valve level RVOT SubCostal Short Axis -Aortic Valve level |
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Which Views show the Tricuspid Valve best? |
RVIT Apical 4 SubCostal 4 Chamber and Short Axis |
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Which Views show the Left Ventricle best? |
PLAX PSAX Apical 2 Apical 4 Apical Long Axis SubCostal 4 Chamber and Short Axis |
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Which Views show the Left Atrium best? |
PLAX PSAX Apical 4 Apical 2 Apical Long Axis SubCostal 4 Chamber |
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Which Views show the Right Ventricle best? |
PLAX (RVOT only) RVIT PSAX (MV and LV levels) Apical 4 SubCostal 4 Chamber |
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Which Views show the Right Atrium best? |
PSAX (Aortic Valve level) Apical 4 SubCostal 4 Chamber and Short Axis |
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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 |
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Which Views show the Interatrial Septum best? |
PSAX SubCostal 4 Chamber |
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Which Views show the Coronary Sinus best? |
PLAX to RVIT (sweep) Apical 4 -posterior angulation |
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What is our Class Motto? |
"The Blind Leading The Blind" |
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Who Are We??? |
The 12 Blind Mice (+ Joel) !!! |