Echo A Test 1

Front 1

About how many times thicker is the wall of the left ventricle than the wall of the right ventricle?

Back 1

The left ventricle is 2-3 times thicker

Front 2

What are the extensions (expanded areas) of the atria called?

Back 2

From the outside they are Auricles
From the inside they are called appendages

Front 3

Why do we examine the auricles during ultrasound exams?

Back 3

We are looking for the presence of thrombus

Front 4

Name the 4 valves of the heart.

Back 4

Tricuspid
Mitral
Pulomonic
Aortic

Front 5

What valves of the heart are called semilunar?

Back 5

The pulmonic and aortic

Front 6

What heart valve only has 2 leaflets?

Back 6

Mitral

Front 7

Name the 3 vessels which bring blood into the right atrium.

Back 7

The IVC, SVC and CS

Front 8

What opening exists in the right atrium during fetal life?

Back 8

The formamen ovalle

Front 9

What direction does blood flow through the foramen ovalle in fetal life?

Back 9

Blood flows from the rt atria to the left atria with the assistance of the eustachia valve guiding the flow.

Front 10

After birth what is the foramen ovalle called? And what if it doesnt close after birth?

Back 10

After birth the foramen ovalle closes to become the fossa ovalus. If it doesnt close it is called patent foramen ovalle.

Front 11

What other "bypass" vessel exists before birth?

Back 11

The ductus arteriosus.

Front 12

In what direction does blood flow through the ductus arteriosus during fetal life?

Back 12

Blood flows through the ductus arteriosus from pulmonic valve to the aortic valve.

Front 13

What is the ductus arteriosus called after birth? And what if it doesnt close?

Back 13

After birth the ductus arteriosus closes to form the ligamentum arteriosum. If it doesnt close it is called patent ductus arteriosus

Front 14

What is the purpose of the foramen ovalle and the ductus arteriosum during fetal life?

Back 14

They bypass the lungs.

Front 15

What is the roughness of the myocardium in the lower portions of the ventricles called? What purpose does it serve.

Back 15

These rough surfaces are trabiculae carnea or trabiuculation. They support the heart and strengthen the ventricle walls. They are more prominent in the RT Ventricle.

Front 16

What is the area where the leaflet attaches to the wall called?

Back 16

Annulus

Front 17

Name the leaflets of the tricuspid valve

Back 17

Anterior
Posterior
Septal aka Media

Front 18

Name the leaflets of the mitral valve

Back 18

Anterior
posterior

Front 19

Name the leaflets of the pulmonic valve

Back 19

Anterior
Left
Posterior aka right

Front 20

Name the leaflets of the Aortic valve.

Back 20

RCC
LCC
NCC
cc= coronary cusp

Front 21

In the mitral valve, which leaflet is larger?

Back 21

The anterior leaflet

Front 22

name the three layers of the heart wall, in order from inner most to outer most.

Back 22

Endocardium
Myocardium
Epicardium

Front 23

What is the name of the sac surrounding the heart? Name the 3 layers from inner most to outer most.

Back 23

Pericardium
- Visceral
-parietal
-Fibrous

Front 24

Where is the pericardial cavity located? How much fluid is "normal"?

Back 24

The pericardial cavity is located between the visceral and parietal layers. It contains 5-10 cc of serum

Front 25

Between which layers of the pericardium is there normally some serous fluid? What is its purpose?

Back 25

In the pericardial sac between the visceral and parietal layers there is 5-10 cc of serum. This helps the heart move, it reduces friction and allows the heart to slide with each beat.

Front 26

Which coronary artery branch feeds the right atrium?

Back 26

Rt Coronary artery

Front 27

Which coronary artery feeds the anterio-later wall of the LV?

Back 27

Circumflex

Front 28

Whcih coronoary artery feeds the inferior wall of the LV?

Back 28

The PDA and/or RCA

Front 29

Which coronary artery feeds the right ventricle?

Back 29

The RCA

Front 30

Which coronary artery feeds the Anterior IVS?

Back 30

LAD

Front 31

Which coronary artery feeds the inferior IVS?

Back 31

The PDA

Front 32

Which coronary artery feeds the left atrium?

Back 32

The circumflex

Front 33

Which coronary artery feeds the anterior wall of the LV?

Back 33

The LAD

Front 34

Which coronary artery feeds the Infero-lateral wall of the LV?

Back 34

Circumflex

Front 35

Which Coronary artery feeds the posterior wall of the LV?

Back 35

Circumflex

Front 36

In what percentage does the PDA arise from the RCA? What is this referred to as?

Back 36

in 80-85% the PDA arises from the RCA. This is referred to as Right dominant

Front 37

What is another name from the right ventricular outflow tract (RVOT) and where does it lead?

Back 37

The RVOT is aka Infundibulum and it leads to the pulmonic valve/artery

Front 38

The leaflets, annulus, chordae tendenae, papillary muscles and heart walls at the point of the papillary muscle orgin are all collectively known as what/

Back 38

Valve apparatus

Front 39

Damage to any part of the valve apparatus can lead to what?

Back 39

Damage to any part of the valve apparatus can lead to regurge

Front 40

Name the 3 vessels that drain the heart tissue. And where do they drain into.

Back 40

The great cardiac vein drains the LAD & circumflex
The small cardiac vein drains the RCA and the Middle cardiac vein drains the PDA.

All these are drained back into the Coronary sinus and into the rt atrium

Front 41

Average or normal blood pressure for the Right atrium

Back 41

2-8 (avg 6)

Front 42

Avg or normal blood pressure in the Left atrium

Back 42

2-12 (avg 10)

Front 43

Ave or normal blood pressure in the right Ventricle

Back 43

25/5
systole/diastole

Front 44

Ave or normal blood pressure in the left ventricle

Back 44

120/7
systole/diastole

Front 45

Avg or normal blood pressure in the Main pulmonary artery

Back 45

25/10
systole/diastole

Front 46

Ave of normal blood pressure in the aorta

Back 46

120/80
systole/diastole

Front 47

Normal O2 levels in IVC

Back 47

72%

Front 48

Normal O2 levels in SVC

Back 48

78%

Front 49

Normal O2 level in CS

Back 49

60%
**lowest in body

Front 50

Normal O2 in right atrium

Back 50

75%

Front 51

Normal O2 levels in Right ventricle

Back 51

75%

Front 52

Normal O2 Levels in Pulmonary arteries

Back 52

75%

Front 53

Normal O2 levels in Pulmonary veins

Back 53

98%

Front 54

Normal O2 level in Lt atrium

Back 54

98%

Front 55

Normal O2 level in Left ventricle

Back 55

98%

Front 56

Normal O2 level in aorta

Back 56

98%

Front 57

What are the 2 nodes that conduct electrical impulses throughout the heart muslces?

Back 57

SA node and AV node

Front 58

Do the SA Node and AV node send impulses at the same time?

Back 58

No, the SA node sets the rhythm of the pulse. AV node sets the rhythm of the contractions. The delay in the AV node allows the atrium to fully drain and the ventricle to become full.

Front 59

Name the 3 normal variances sometimes seen in the Rt Atrium.

Back 59

Chiari network
crista terminalis
Prominent eustachia valve

Front 60

Name the normal varient seen in the RT Ventricle

Back 60

Moderator band

Front 61

Name the normal varient seen in the Left Ventricle

Back 61

False tendon aka ectopic chordae aka chordal web

Front 62

Name the normal varient seen in the left atrium

Back 62

NONE

Front 63

Does the blood flow into the coronary arteries during diastole or systole? Why?

Back 63

During diastole. When the base of the aorta is expanded and The blood is trying to get back into the LV but the aortic valves are closed.

Front 64

Where do the coronary arteries originate?

Back 64

The sinus of valsalva in the aortic root

Front 65

Does flow into the atria during systole or diastole? Why?

Back 65

Blood flow into the atria is constant so it occurs both at systole and diastole because there is no valves from the IVC, SVC or CS.

Front 66

Name and describe the 4 stages of diastole and what the AV valves are doing in each.

Back 66

IVRT - End of Systole. AV valves prepare to open
Early diastole - MV opens and 70% of blood is ejected into LV
Mid diastole - Partial closure of the MV. 0-10% of blood is ejected
Atrial contraction/late diastole - remaining 20-30% of blood is ejected.

Front 67

In m-mode what does the horizontal axis represent?

Back 67

Time

Front 68

In m-mode what does the vertical axis represent?

Back 68

Depth

Front 69

In m-mode what does the Z axis represent

Back 69

Amplitude or strength of the dot. Brightness indicates fibrous tissue.

Front 70

Is velocity indicated in M-mode display?

Back 70

No, velocity is not indicated in M-mode

Front 71

When is the Aortic valve open?

Back 71

Systole

Front 72

When is the aortic valve closed?

Back 72

Diastole

Front 73

When is the mitral valve open?

Back 73

Diastole

Front 74

When is the mitral valve closed?

Back 74

Systole

Front 75

When is the left ventrical expanded?

Back 75

Diastole

Front 76

When does the left ventricle contract?

Back 76

Systole

Front 77

What two measurements are used to obtain the Ejection Fraction (EF)?

Back 77

LV diameter in diastole and in systole.

Front 78

What is normal EF?

Back 78

55-75%

Front 79

When do you measure the Aortic root diameter?

Back 79

In end diastole (leading edge to leading edge)

Front 80

When do you measure the Aortic valve leaflet seperation?

Back 80

Early systole (inner to inner)

Front 81

When do you measure the LV diameter

Back 81

End of systole. Outer to inner

Front 82

Why do you measure the Aortic valve section?

Back 82

To check for dilation

Front 83

What are the 3 measurement for the Mitral valve in m-mode?

Back 83

D to E
E to F
EPSS (E to IVS)

Front 84

Why do we measure the mitral valve?

Back 84

To check for dilation and prescence of stenosis

Front 85

What are the 7 measurements of the LV and when are they measured?

Back 85

1) RVID(d)
2) IVS(d)
3) LVID(d)
4) LVPW(d)

5) IVS(s)
6) LVID(s)
7) LVPW(s)

Front 86

Why do we measure the IVS and PW?

Back 86

To check for thickness

Front 87

Why do we measure RVID and LVID?

Back 87

To check for dilation

Front 88

The pulmonary artery connects between ______

Back 88

The RT Atrium and the lungs

Front 89

The pulmonary veins connect between _____

Back 89

The lungs and LT Atrium

Front 90

Name the 2 papillary muscles of the LV

Back 90

Anteriolateral and posteriormedial

Front 91

Name the 4 sections of the first part of the aorta

Back 91

1) aortis annulus
2) sinus of valsalva
3) sino-tubular junction
4) ascending aorta

Front 92

How many coronary arteries do we have?

Back 92

Two

Front 93

The RCA supplies what?

Back 93

The rt atrium and Rt Ventricle

Front 94

The PDA supplies what part of the heart?

Back 94

The inferior septum, inferior wall of both ventricles

Front 95

The Left Main Coronary artery is divided intow what vessels?

Back 95

The LAD and Circumflex

Front 96

What part of the heart does the LAD supply?

Back 96

The LV anterior wall, the anterior IVS and the Apex of LV

Front 97

What part of the heart does the Circumflex supply?

Back 97

THe lateral side of the LV (which includes the anterio-lateral or inferio lateral walls also known as posterior walls) and the LT atrium.

Front 98

Name the differences between the RT Ventricle and the Left (right side differences)

Back 98

-3 Papillary muscles
- ejects to pulmonary valve
- triburculation is prominent
-triangular shape
- normal varient = moderator band

Front 99

Name the differences between Lt Ventricle and Rt Ventricle (Left side differences)

Back 99

- Bigger
- wall is 2-3 times thicker
- 2 papillary muscles
- Apex is formed
- Higher O2 level
-Higher pressures
- Ejects to systemic system
- Shape: bullet/eliptical
- Normal varient = false tendon aka ectopic chordae aka chordal web

Front 100

Name the 3 layers of the heart wall

Back 100

Endocardium
myocardium
epicardium

Front 101

Name the 3 cusps of the aortic valve. Which angle are all 3 seen?

Back 101

RCC
NCC
LCC

** all three seen in short axis at the aortic level

Front 102

Name the 3 brances of the aortic arch

Back 102

-Brachiocephalic
- LCCA
- L Sub clavian

Front 103

The right atrium receives deoxygenated blood from ....

Back 103

IVC
SVC
CS

Front 104

Name the 4 parts of the IVS according to congenital abnormalities

Back 104

Trabecular (muscular)
Membranous/perimembranous
Inlet
Outlet (aka Subpulmonic/supracristal)

Front 105

What are the components of the AV valves?

Back 105

Attached by annulus. located Between atria and ventricles
tricuspid has 3 cusps
Mitral has 2 cusps
cusps are attached to chordae tendinae which are attached to papillary muscles which are attached to ventricle walls

Front 106

Define Fossa ovalis

Back 106

The remenant of the foreman ovalle. A hole between the atria during fetal life to bypass lungs.

Front 107

Define Pericardium

Back 107

The sac surrounding the heart to protect from surrounding tissue. Acts as a lubricant. Pressure is low to allow heart to expand.

Front 108

What is a shunt

Back 108

An opening from left to right ventricle

Front 109

What unit is pressure measured in?

Back 109

mmHg
millimeters of mercury

Front 110

Define Ligamentum arteriosum

Back 110

Remenant of ductus arteriosum. The vessel connecting pulmonary artery to aorta in fetal life.

Front 111

Define Sinoatrial node.

Back 111

SA node is the pacemaker of the heart. it supplies myocardium with electrical impulses. It sets the rhythm of the heart. It is located at the top Rt atrium and sends impulses across the interatrial septum to the LT Atria and to the AV node. Normal rate is 60-90 beats/min

Front 112

Describe the conductive system of the heart.

Back 112

SA node to AV node (internodal pathway) to the bundle of hiss (located at IVS) down to the LT and RT branches and then into the Pinkumje fibers

Front 113

What is the normal rate of the AV node?

Back 113

40-60 beats/min