Mod 7 Abnormal Cardiac Chambers

Front 1

how do they start pediatric echo exams?

Back 1

subcostal to see how the heart is lying

Front 2

define levocardia, mesocardia, and dextrocardia

Back 2

levocardia=left=normal
mesocardia=heart midline
dextrocardia=heart to the right

Front 3

w/ congental heart disease, what must the sonographer piece together regarding the heart?

Back 3

chambers
valves
great arteries

Front 4

differntiate btw morphological and functional?

Back 4

MOrphological: form and structure
Functional=job of the organ

Front 5

describe the morphologic right ventricle?

Back 5

-triangular external shape
-thick muscle bundles(course trabeculation)(especially @ apex)
-pap muscles attach to the IVS
-moderator band seprates the RVOT from the rest of the ventricle
-trileaflet valve

Front 6

explain the morphologic left ventricle?

Back 6

-conical shaped
-smoother internal suface w/ fine trabeculation
-2 clearly defined pap muscles
-bileaflet(bicuspid valve)

Front 7

explain the morphogic RA?

Back 7

-drains coronary sinus, IVC, and SVC
-larger appendage than LA
-could drain some or all of PV(anomolous)

Front 8

explain the morphologic LA?

Back 8

-doesn't drain systemic veins
-normally drains pulmonary veins(w/ some exeptions)

Front 9

descibe the morphologic main pulmonary artery?

Back 9

-branch pattern: main trunk w/ rt and lt branches

Front 10

explain the morphologic AO?

Back 10

-coronary arteries(w/ coronary sinus)
-aortic arch w/ arteries to head and neck

Front 11

what are the stable milestones or anatomic relationships of the heart?

Back 11

1. visceroatrial situs:
2. relationship btw ventricles and av valves

Front 12

explain how visceroatrial situs is a stable milestone of the heart?

Back 12

-morphologic LA is on the same side as the gastric bubble
-morphologic RA is on the same side as the liver

Front 13

explain how the relationship btw the ventricles and Av valves is a stable milestone?

Back 13

-MV is always attached to the LV
-TV is always attached to the RV
-exeption: patients w/ AB canal malformations

Front 14

when is the relationship btw the ventricles and AV valves not a stable milestone?

Back 14

with patients w/ AV canal malformations

Front 15

atrioventricular alignment; name and explain the different types?

Back 15

Which atrium opens into which ventricle:
1. AV concordance-RA opens into RV and LA opens into LV(normal)
2. AV disconcordance=RA opens into LV via the MV, and LA opens into RV via RV

Front 16

ventriculararterial alignment; name and explain the different types?

Back 16

ventricle opens into which artery
1. ventriculararterial concordance=RV opens into pulmonary artery, and LV opens into aorta(normal)
2. ventriculararterial disconcordance=transposition, double outlet RV, double outlet LV, truncus arteriosus

Front 17

name and explain the different types of ventriculoarterial discordance

Back 17

-Transposition=RV opens into the Ao and LV opens into the PA
-Double outlet RV=both great arteries originate fromt he RV
-Double outlet LV-both great arteries originate fromt he LV
-Trunkus arteriosus-single great artery

Front 18

explain the segmental approach to congenital heart defects?

Back 18

-compartmentalizes the heart into three main segments; atria, ventricles, and great arteries

Front 19

explain how the 3 segments are assigned?

Back 19

S=solitus(normal visceral and atrial position)
D=normal d-looping of ventricles resulting in AV concordance
S=normal relationship btw great arteries(MPA, and AO)

Front 20

what steps are used determine of all chambers of the heart are in the correct position? (segmental)

Back 20

step one-position of the apex
step two-situs of the atrium
step three-AV relationship
step four-relationship of the great vessels

Front 21

how do you determine if the cardiac postion of the apex is normal?

Back 21

-defined relative to the midline of the thorax
-lie in the rt chest=dextro
-lt chest=levo
-midline=meso

Front 22

how do you determine if the situs of the heart is normal?

Back 22

-determined by the position of the atria because they bear the most consistant relation to the situs of the viscera
-situs solitus=normal or usual
-situs inversus=right to left orientation of unpaired viscera is inverted

Front 23

differntiate btw situs solitus and situs inversus?

Back 23

-situs solitus=normal or usual
-situs inversus=right to left orientation of unpaired viscera is inverted

Front 24

explain levocardia?

Back 24

-heart in the left chest
-morphological RA and RV to right
-morphological LA and LV to left
-aka situs solitus

Front 25

name and explain the 3 causes of dextrocardia

Back 25

1) mechanical:
-shift in mediastinal structures by a space occupying lesion,or underdevloped lungs.
-heart is pushed to the right(dextroposition)
2) situs inversus or mirror image
3)apex of fetus, or baby is opposite to that later in life. (dextroversion)(tilted, but normal chambers)

Front 26

explain levoversion

Back 26

situs inversus w/ apex pointed to the left.

Front 27

explain mesocardia

Back 27

midline arrest of normal cardiac rotation in situs solitus or situs inversusu
-midline of chest

Front 28

what categories can CHD be classified into?

Back 28

1. Holes or defects: at atrial, ventricular or arterial levels
2.Underdevelopment/Absence/Atresia/Hypoplasia of any structure
3. Narrowing: sub - valve, at valve, supravalvular
4. Wrong connections: discorcondance, transposition, inversion, anomalous connection