Echo Ultrasound Final

Front 1

What walls does the Lateral Anterior Descending artery feed?

Back 1

Septal
Anterior
Anterior-Septal
Anterior-Lateral

Front 2

What walls does the Left Circumflex Artery feed?

Back 2

Lateral
Inferior-Lateral
Posterior

Front 3

What walls does the Right Coronary Artery feed?

Back 3

Inferior-Septal
Inferior
RVFW

Front 4

What are the standard windows?

Back 4

Left Parasternal Bordere
Left Apical
Right Sternal Border
Suprasternal Notch
Subcostal

Front 5

What is the optimal Doppler signal for CW

Back 5

0/180 degrees

Front 6

Describe 0 degrees.

Back 6

Blood flow travels in the same direction as beam (away from TDX) flow above baseline

Front 7

Describe 180 degrees.

Back 7

Blood flow travels in opposite direction of beam (toward TDX). Flow below baseline

Front 8

Pulse waves: specific locations and lower velocities are__________.

Back 8

<2 m/sec

Front 9

Continuous waves: measures the entire beam and higher velocities will be ________.

Back 9

>2 m/sec

Front 10

What does the IVS run continuous with _______.

Back 10

Aortic Root

Front 11

Atrial depolarization and contraction is represented by what on EKG?

Back 11

P wave

Front 12

What does it mean when the "P" wave is missing?

Back 12

A-fib

Front 13

What are the AKA'S for MVP?

Back 13

Systolic Click Syndrome
Floppy Syndrome or Barrow's Syndrome

Front 14

What is the optimal view for MVP?

Back 14

PSLA

Front 15

How can you get a false positive MVP?

Back 15

PE

Front 16

At what age and sex is MVP more prevalent?

Back 16

Women under 40

Front 17

What is the most common cause of mitral valve stenosis or MS?

Back 17

Rheumatic Fever or RHD

Front 18

The most excellent or best view for MS is _______.

Back 18

PSLAHOW

Front 19

What does the AMLV look like in a patient with MS?

Back 19

Diastolic doming that looks like a "Hockey Stick"
With thicken MVL

Front 20

What happens to the MV orifice with MS?

Back 20

They will be decreased

Front 21

What happens to the E-F slope in a pt with MS?

Back 21

Decreased E-F

Front 22

What will you have to the LA in a pt with MS?

Back 22

LAE (enlargement!

Front 23

What will you happen to the RV in a pt with MS?

Back 23

RVH

Front 24

What happens to the IVS in a pt with MS?

Back 24

Flattens

Front 25

In a pt with MS, the "a" wave will be absent which is a sign of what?

Back 25

PHTN

Front 26

What will the shape of the septum look like in a pt with MS?

Back 26

D shaped septum

Front 27

What type of septal motion will you have in a pt with MS?

Back 27

Paradoxical Septal Motion

Front 28

What happens to the PV in a pt with MS?

Back 28

They will have a mid-systolic closure of PV

Front 29

What are the four things that can cause MR and which one is the primary cause?

Back 29

RHDz, MVP, Prostehetic Valve DysFx, PAP Muscle DysFx

Front 30

What are the three types of MR?

Back 30

Acute
Chronic
Intermittent

Front 31

What can be two of the complications with MR?

Back 31

LVVO (increase preload)
LVH

Front 32

When are the AV valves open and which ones are they?

Back 32

Diastole (TV and MV)

Front 33

When are the semilunar valves open and what are they?

Back 33

Systole (AOV and PV)

Front 34

When are the AV (TV and MV) closed and when are the Semilunar (AOV and PV) closed?

Back 34

AV (TV,MV) Systole
Semilunar (AOV, PV) Diastolic

Front 35

Describe a MS murmer.

Back 35

Diastolic "Rumble" with the opening snap

Front 36

Describe a MR murmur.

Back 36

Holosystolic murmur that radiates to the Avila

Front 37

Describe a MVP murmur.

Back 37

Mid-systolic click with/without a systolic murmur

Front 38

Describe an AS murmur

Back 38

Systolic crescendo murmur

Front 39

Describe an AI murmur.

Back 39

High Pitched "blowing" diastolic murmur at the Left Sternal Border (LSB)

Front 40

Describe a TS murmur.

Back 40

Diastolic "rumble" that varies with respiration and has an opening snap.

Front 41

Describe a TR murmur.

Back 41

Holosystolic murmur that increases with respiration.

Front 42

Describe a severe AI murmur.

Back 42

Low pitched, mid-diastolic "rumble" @apex (aka: Austin Flint Murmur)

Front 43

Describe a PS murmur.

Back 43

Harsh Systolic Ejection murmur. A thrill may also be present.

Front 44

Describe a PI murmur.

Back 44

Low pitched diastolic murmur that may increase with inspiration.

Front 45

Describe the murmur that occurs with PI with PHTN.

Back 45

AHigh pitched blowing diastolic murmur that may be heard (aka: Graham-Steele Murmur)

Front 46

What valves close with the 1st heart sound?

Back 46

MV and TV (AV)

Front 47

What valves close with the 2nd heart sound?

Back 47

AOV and PV (Semilunar)

Front 48

What happens with the 3rd heart sound?

Back 48

Early Ventricular inflow

Front 49

What happens with the 4th heart sound?

Back 49

Atrial Contraction

Front 50

90 % of population is_____

Back 50

Right dominant

Front 51

What are the variables that affect CO (Cardiac Output)?

Back 51

Preload
Afterload
Inotropic Force
Chronotropic Force

Front 52

______ is the filling of the heart during diastole (increased by valvular regurg, VSD's, and fluid overload stress)

Back 52

Preload

Front 53

_______ is the degree of ventricle fiber stretch due to the quantity of blood in the LV prior to contraction.

Back 53

LVEDP = Left Ventricular Diastolic Pressure

Front 54

What is increased by valvular regurge, VSD's, and fluid overload states and occurs during filling of the heart during diastole?

Back 54

Preload

Front 55

_______ is the resistance the heart pump must pump against. Resistance can be inside/outside the heart.

Back 55

Afterload

Front 56

______ is increased by AS, PS, IHISS, HTN, and PHTN.

Back 56

Afterload

Front 57

________is contractible of the heart muscle/force of contraction.

Back 57

Inotropic Force

Front 58

_____ is heart rate/rate of contraction.

Back 58

Chronotropic Force

Front 59

_____occurs when all valves are closed, volume remains constant and ventricle pressure is rising.

Back 59

Isovolumic Contraction

Front 60

_____ occurs when all valves are closed, volume remains constant, ventricle pressure drops, and atrial pressure rises.

Back 60

Isovolumic Contraction

Front 61

________ is when moving blood enters the ventricle during diastole, the greater the QTY of the blood pumped during systole.

Back 61

Frank Starling Principle

Front 62

______ is a period of relaxation/filling phase--"a" kick occurs at the "P" wave. (10-30 % of blood)

Back 62

Diastole

Front 63

________ is the period of contraction---when the blood is ejected from the heart.

Back 63

Systole

Front 64

Name the parts of the Cardiac Conductive System:

Back 64

Sinoatrial Node/ SA Node
Atroventricular Node/AV Node
Bundle of His
Purkinje Fibers

Front 65

______ _____is the primary pacemaker, producing an atrial contraction, and is located on the border of the SVC and RA. PACE = 60-100 BPM.

Back 65

Sinoatrial Node/SA Node

Front 66

______ _______ receives the pulses from the SA, serves as the "Gatekeeper", and prevents excess atrial pulses. It is located on the floor of the RA. PACE = 40 - 60 BPM

Back 66

Atrioventricular Node/ AV Node

Front 67

___ ____ _____ is located at the IVS

Back 67

Bundle of HIs

Front 68

_______ ______is an intricate network that arises from bundles branches and spread through out the ventricles. Pace = 20-40 BPM

Back 68

Purkinje Fibers

Front 69

What is best determined by "EYEBALLING" in 2D?

Back 69

Ejection Fraction

Front 70

Normal Cardiac Values for
TVA =

Back 70

TVA = 7-9 cm squared

Front 71

MVA =

Back 71

MVA = 4-6 cm squared

Front 72

AVA =

Back 72

AVA = >2 cm squared

Front 73

AI by PHT : Mild =
Severe =

Back 73

AI by PHT: Mild > 500 m/sec
and Severe <200 m/sec

Front 74

PS Mild =
Severe =

Back 74

PS Mild = 5-30 mmHG
PS Severe 64 mmHG

Front 75

PHTN: Normal =
Severe =

Back 75

PHTN Normal = 18-25 mmHg
Severe = 64 mmHg

Front 76

Normal MR peak velocity is

Back 76

4-6 m/sec

Front 77

Stress echos can be obtained either through ______/ by ______,

Back 77

Exercise/Pharmacological

Front 78

What do you check for with a stress echo?

Back 78

WMA = wall motion abnormalities

Front 79

Rest ischemic heart disease may appear _______. You can't tell if a person has until you exercise.

Back 79

Normal

Front 80

What are the views pre and post that are used when doing a stress echo?

Back 80

PSLA, PSSA, AP4, and AP2

Front 81

Main protocol used for a stress test?

Back 81

Bruce Protocol

Front 82

With Bruce Protocol in a stress test the grade and speed is increased every _____ mins and images are obtained at _____ and immediate post exercise.

Back 82

3 mins
Rest

Front 83

______ ______ is used when pts can't exercise in where an IV of dobutamine is given to the pt.

Back 83

Pharmacological Stress Test

Front 84

What are the contraindicators or reasons you can't do a pharmacological stress test?

Back 84

IHSS
Sensitivity to Dobutamine

Front 85

In an AOV stenosis (AS) the leaflets will be _____, and does ____open well. Max Velocity > 2m/sec

Back 85

thickened
NOT

Front 86

In an AOV Sclerosis, the AOV is _______, and does not open well, and may or may not become stenotic; has max velocity < 2m/sec

Back 86

thickened

Front 87

What is the most common CMO?

Back 87

Dilated/Congestive

Front 88

What is the least common CMO?

Back 88

Restrictive/Infilrative

Front 89

What is Bernouilli's Equation?
Bernouilli's equation changes velocity to a ______ _____

Back 89

Bernouilli's Equation = 4(V) squared
Velocity to a Pressure Gradient

Front 90

Continuity Equation is

Back 90

(.785)(LVOT)2(V1)/(V2)

Front 91

V1 in the continuity equation represents _______ and use PW.

Back 91

Peak Velocity of LVOT

Front 92

V2 in the continuity equation represents ______ and uses CW.

Back 92

Peak Velocity in the AOV

Front 93

What is the pressure gradient of a severe AS?

Back 93

> 64 mmHg

Front 94

Which valve usually gets RDHZ first?

Back 94

Mitral Valve

Front 95

Who is at high risk for endocarditis?

Back 95

Pt with prosthetic heart valves, with MR, that are IV drug users, Marfan's, PDA, VSD, and pacemaker wires

Front 96

What do you look at when deciding whether a pt has pleural/pericardial effusion?

Back 96

DOA

Front 97

Fluid located above the DOA is a _______ ______

Back 97

Pericardial Effusion

Front 98

Fluid located below the DOA is a _______ ______

Back 98

Pleural Effusion

Front 99

List what you need to do in order to test Diagnostic Fx.

Back 99

E/A ration
E/F Deceleration Time (all the way to baseline)
IVRT (AOV closure to MV opening)
Tissue Doppler
Valsalva maneuver
Pulmonary Venous Inflow (a wave reversal peak velocity)

Front 100

What are the two types of Prosthetic Valves?

Back 100

Bioprosthetic (Tissue)
Mechanical

Front 101

What type of bioprosthetic valve is (self to self)?

Back 101

Auto-graft

Front 102

What type of bioprosthetic valve is (human to human)?

Back 102

Homograft

Front 103

What type of bioprosthetic valve is (animal to human)?

Back 103

Heterograft

Front 104

Which of the Mechanical valves is the ball and cage?

Back 104

Starr-Edwards

Front 105

Which bi-leaflet tilting disc mechanical valve do we use the most?

Back 105

St Jude

Front 106

List the three types of Mechanical valves.

Back 106

Ball and Cage
Single Tilting Disc
Bi-leaflet Tilting Disc