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87 Cards in this Set
- Front
- Back
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What heart chamber makes the diafragmatic surface?
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LV
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What heart chamber makes the sternocostal/anterior surface?
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RV
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What heart chamber makes the inferior margin?
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mostly RV + apical LV
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What heart chamber makes the obtuse margin?
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LV
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What is the dominant artery?
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Artery which supplyes PDA
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Right dominant system
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RCA supplies posterior wall of LV
LCx relatively small (Circumflex branch of left coronary artery) |
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Left dominant system
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LCx supplies post wall of LV
(Circumflex branch of left coronary artery) |
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LCA arises from......
bifurcates in .... |
Arises from Left aortic sinus
Bifurcates in LAD + LCx |
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RCA arises from......
bifurcates in .... supplies.... |
Arises from aortic sinus
Forms PDA (85%), Supplies 50% SA node, 90% AV, Inf & Post surface |
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Coronary sinus (cardiac vein) collects from.....
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Great, middle, small cardiac vein, Post.vein of LV
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What are the roles of pericardium?
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1.Restrict mov.of heart
2.Minimize friction 3.Prevent displacem.of heart 4.Hemodynamic fx |
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When identifying cardiac crux, TV should be more inferior (anatomicaly) than MV ?
TRUE / FALSE |
TRUE
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BP values for pre-hypertension
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120 -139
80 - 89 |
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Pulse Rate
Respiration Rate Temperature in healthy adult |
PR :60-100
RR:12 - 20 T:97.8 - 99 |
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Why steep left lateral decubitus position helps PLAX interogation?
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1. drop the lung away
2. allow heart to fall away 3. maximise intercostal space |
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How do you rotate tx to go from PLAX to PSAX?
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clockwise, 2 o'clock
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What is the other name for PSAX - apical level?
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Para Apical
Apical short axis |
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What is the other name for PSAX - basal level?
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PSAX Apical level
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What is the other name for PSAX -mid level?
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PSAX papillary level
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If moderator band goes across LV it is called....
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false tendon
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What is the only view where you can see the free wall of LV?
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Apical 2
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What is the only view where you can see the Posterior cusp of PV?
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PLAX RVIT
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What view is important to see for px with clotting issues?
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Apical 2 (left atrial appendage)
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what is AKA for Apical 3 ch view?
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Apical long axis
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Where is the tx indicator for SUBCOX 4 ch?
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3 o'clock
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In what view the US beam is orthogonal to interatrial septum?
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SUBCOX long axis
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In what view the US beam is paralele to interatrial septum?
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Apical 4 ch
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How do you rotate tx to go from SUBCOX long axis to short axis
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counterclockwise
12 o'clock |
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What is Eustachian valve?
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Incompetent valve flaap of IVC -remnant from fetal heart
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What is Chiari Network?
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- remnant from fetal heart
- weblike membrane extending from crista terminalis to to the valve of IVC - can be confused with TV vegetation, distinguished because is not attched to TV, has random motions |
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What is Crista terminalis?
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proeminent muscular ridge between IVC and SVC
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What vessels branche from Ao arch?
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Innominate A (brachiocephalic trunck)
Left common carotid Left common subclavian |
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How do you move tx from SSN long axis to short axis?
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clockwise
4 o'clock |
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What is a normal diameter for Ao Arch?
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2.7 +/- 0.3
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Held expiration can optimize SUBCOX image?
True / False |
FALSE
held inspiration DO |
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Which of the following points represents the late diastole motion of AML ?
D, A, E, C |
A point
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LA dimensions are best taken at the widest dimension (QRS onset) .
T / F |
False
that would be on T wave |
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An increased mitral EPSS occurs with:
- Ao valve regurgitation - LV dilatation - Mitral stenosis - All of the above |
All of the above
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M-mode is a good method for systolic function in px with LV inferior wall infarction.
T / F |
False
Inferior wall can only be seen in Apical 2ch |
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A decrease in stroke volume results in increased motion of the Ao root.
T / F |
False
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The C point on the PV M-mode corresponds to:
- max PV opening - RA contraction - onset of RV ejection - end ejection |
- max PV opening
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Eustachian valve
- may also be seen from PLAX-RVIT - is best imaged from Apical 2 ch view |
May also be seen from PLAX-RVIT
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When RV pressure > Pulm pressure
- PV opens - PV closes - TV closes - 2 of the above |
2 of the above
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Pre-ejection mode can be measured with M-mode
T /F |
True
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IVRT occurs:
- after T wave - QRS onset - during PR interval |
After T wave
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The optimal window selection for M-mode interogation is the view in which the beam is ....... to the structure
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orthogonal
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What window is primarly used for M-mode aplications?
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Parasternal window
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Name 2 disadvantages of M-mode
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1. lack of spatial information
2. Its one dimensional nature, only structures transected by M-mode cursor are displayed |
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Name 2 factors that influence the accuracy of M-mode measurements
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- TX frequency
- inconsistency in measurement |
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The ASE reccomended method for measuring structures by M-mode is to follow the .....
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most continuous echo line
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The m-mode derived ejection fraction that is calculated and quoted by many echo machines is .....
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Teichloz method
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M-mode has far more ..... resolution than other methods
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temporal resolution
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Lack of spatial resolution is a predominant limitation of M-mode
T/F |
True
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Atrial contraction on M-mode will precede the P wave on ECG.
T / F |
False
electric events precede the mechanical ones |
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Great cardiac vein is paralel with LCA.
T / F |
False
LCA forms LAD which is paralel to Great cardiac vein |
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Echo can directly visualize coronary artery disease.
T / F |
False
Angiogram would be the test |
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Endocardial definition of LV apex will be clearer from Apical window than from parasternal window.
T / F |
True
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Where do you find the moderator band?
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RV
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A sinus of Valsava of 39 mm will be considered
- normal - dilated |
Dilated
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A sinus of valsava of 41 mm is considered
- normal - dilated - aneurysmal |
Aneurysmal
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Which of the wall segments can be evaluated from Apical 2 ch view ?
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Septal and inferior wall
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Which tricuspid leaflet is usually predominant ? Why ?
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Anterior. It is the longer and larger
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From what parasternal view can Eustachian valve most likly be seen ?
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PLAX - RVIT
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Aortic valve leaflet identification is best during
- systole - diastole |
Systole
Because a bicuspid valve may appear normal in diastole |
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Foreshortening in Apical view can be adjusted by ....
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Moving an intercostal space lower and more lateral
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Which pulmonic vein is generally not visualised from Apical view?
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Right lower pulmonary vein
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Tilting the tx means....
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Moving up and down the tail of tx
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The coronary sinus is easily visualised from PLAX and can always be visualized.
T / F |
False
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Held inspiration while px is in left decubitus position may improve PLAX.
T / F |
False
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Explain how DA is related to pleural fluid and pericardial effusions.
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Pericardial effusion will appear anterior to DA
while Pleural effusion will appear posterior to DA |
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Which 2 TV leaflets can be seen in PLAX RVIT ?
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Anterior & Posterior TV leaflets
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Why should all 2-D measurements be indexed for the body surface area of the px if possible?
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Absolute measurements without BSA corection can lead to misinterpretations, especially for very small or very large px.
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What view is termed the "circle sausage' view and what does it indicate about normal Ao and PA?
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PSAX - aortic level
AO is transverse PA is in long axis |
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What are nodes of Arantius/ Can they be seen on TTE ?
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Nodes of Arantius are regions of thickening in the middle of the free edge of each cusp of Ao valve.
May be observed when valve is closed |
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Why might IAS appear to bulge slightly from the left to right in PSAX?
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The pressure within LA is slightly higher than in RA.
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Why does drop-out artifact of the IAS occur in PSAX ?
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IAS might not be seen entirely from PSAX - aortic level, it lies almost parallel to the beam
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How can you fix a PSAX basal level image that appears oblique and egg-shaped?
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By moving the tx an intercostal space higher
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AKA of PSAX apical level
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- Para Apical
- Apical short axis |
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Where can you measure RVOT? which edge technique is used?
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PSAX - aortic level
PLAX - RVOT inner edge to inner edge |
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RVOT should be measured during systole or diastole ?
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Systole
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What is a normal dimension for the main pulmonary trunk ?
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1.8 +/- 0.3 cm
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Which leaflets can be visualised from the cardiac crux?
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Septal leaflet of TV and Ant. leaflet of MV
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Why is visualisation of the cardiac crux important ?
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It is important in the assesement of congenital heart lessions
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Anterior MV leaflet is more inferior to the tricuspid septal leaflet and helps distinguish which ventricle is the true LV.
T / F |
FALSE
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Explain what Ebstein's anomaly of TV is.
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TV looks displaced like a sail making an abnormal cardiac crux
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Explain how Ebstien's anomaly of the TV is diagnosed.
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If a displacement index between the insertion points of AMV and STV leaflets is >/= 8 mm/m2
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Explain why LA dimensions in the anterior - posterior plane should not be the only means of assesing LA size.
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2 dimensional measurement is not enaugh to asses a 3 dimension LA
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