Cardio Vascular

Front 1

How many years does a medical facility keep a patients records for?

Back 1

7 years

Front 2

What are the 2 body types described for an Echocardiogram?

Back 2

1. Pectus Carinatum
2. Pectus Excavatum
   

Front 3

When the sternum is protruding out (convex), this body type is called?

Back 3

Pectus Carinatum

Front 4

When the sternum is depressed (concave), this body type is called?

Back 4

Pectus Excavatum

Front 5

Which chambers are considered the 'Filling Chambers"?

Back 5

Left Atrium and Right Atrium

Front 6

Which chamber receives blood from the lungs?

Back 6

Left Atrium

Front 7

What is the most posterior structure of the Heart?

Back 7

Left Atrium

Front 8

Which chambers are located in the Base of the Heart?

Back 8

Left Atrium and Right Atrium

Front 9

What is the Superior part of the Heart called?

Back 9

Base of the Heart

Front 10

Which vessels carry oxygenated blood directly to the Left Atrium? How many are there?

Back 10

4 Pulmonary Veins

Front 11

Which chamber has striated muscle that extends from the Free Wall to the Left Atrial Appendage?

Back 11

Left Atrium

Front 12

Striated muscle that extends from the Free Wall to the Left Atrial Appendage is called?

Back 12

Pectinate Muscle

Front 13

Protrudes outside of the Heart on either the Left Atrium or Right Atrium?

Back 13

Appendage

Front 14

What happens to a chamber when there is stagnation of blood?

Back 14

Enlarges

Front 15

When there is stagnation of blood or an enlarged chamber, what should we try to rule out?

Back 15

Thrombus (large blood clot)

Front 16

What area should we also look at to see if it is enlarged, if the Left Atrium is enlarged?

Back 16

Left Atrial Appendage (LAA)

Front 17

If the Left Atrium or Left Atrial Appendage or both are enlarged, what should we look for to rule out?

Back 17

Thrombus (large blood clot)

Front 18

Smooth-walled circular sac that lies posterior in the chest is called?

Back 18

Left Atrium

Front 19

Where do the 4 Pulmonary Veins enter the Left Atrium?

Back 19

Either side of the Left Atrium, posteriorly and laterally

Front 20

Which area of the Left Atrium has a small bulge containing small comb-like muscles?

Back 20

Anterior Superior Margin of LA

Front 21

What does the Anterior Superior Margin of the Left Atrium do?

Back 21

Advises the brain of the changes in the circulating volume of fluid in the system

Front 22

What aids in the contractions of the Left Atrium?

Back 22

Left Atrial Appendage

Front 23

When there is pressure or volume overload in the Left Atrium, what aids the LA by taking on some of the pressure/volume overload?

Back 23

Left Atrial Appendage

Front 24

What are the normal dimensions for the Left Atrium?

Back 24

1.9 - 4.0 cm

Front 25

What lies posterior to the Left Atrium?

Back 25

Esophagus

Front 26

What are 3 things that will cause the Left Atrium to enlarge?

Back 26

1. Long term filling pressure problems
2. Diastolic dysfunction
3. Mitral Valve disease (MS or MR)
   

Front 27

How should the Left Atrium be measured?

Back 27

• In 2-D (M-mode may have chamber tilted)
  
• Perpendicular plane to the chamber

• Measure from the Aortic posterior wall to the leading wall (edge) of the Left Atrium

*Not recommended to do in Apical 4 chamber, but if needed, it has a Major Axis and Minor Axis

Front 28

What is measured in the Left Atrium in an Apical 4 chamber view?

Back 28

Volume (Left Atrium)

Front 29

How is the Left Atrium's Volume measured?

Back 29

• Trace the inner border (excluding pulmonary veins) to get an area (looks square)
• Measure in End Systole (gives greatest dimension)
• The Mitral Valve will be closed at end systole
• The machine will calculate a volume
  

Front 30

What is a normal Left Atrium Area?

Back 30

less than (<) 20 cm squared

Front 31

What is the measurement of ejection fractions called?

Back 31

Simpson Rule of Volume

-aka-

Method of Disks

Front 32

Where do you measure in the Left Atrium for the Method of Disks (Simpson Rule of Volume)?

Back 32

From the Posterior wall of the Aorta to the leading edge of the Left Atrial wall (perpendicular line)

Front 33

What is a common reason for Left Atrial Enlargement?

Back 33

Mitral Regurge (back flow)

Front 34

Where do you measure the Left Atrium in M-Mode?

Back 34

from the Posterior wall of the Aorta to the leading edge of the Left Atrium wall (perpendicular line)

*M-Mode may have LA tilted, not good for perpendicular measurement

Front 35

How do you determine if Mitral Valve Regurge is Mild, Moderate or Severe?

Back 35

Doppler the Pulmonary Veins

Front 36

Why should Doppler flow in the Left Atrium be Red in color?

Back 36

• because the Pulmonary Veins are delivering oxygenated blood TO the Left Atrium --> Left Ventricle (towards the transducer index)
  

*the flow is being pushed through in Systole (big push) (big rush of flow)

Front 37

True/False:

The Tricuspid and Mitral Valves are closed in Systole.

Back 37

TRUE

Front 38

How do you Doppler Pulmonary Veins?

Back 38

1. Place cursor approx 1 cm into pulmonary vein
2. Use Pulse Wave Doppler
   

Front 39

What mode gives a sample of ONLY the area where the cursor is placed?

Back 39

Pulsed Wave Doppler

Front 40

On a Pulsed Wave Doppler tracing, what do the AR, A, S, and D wave represent?

Back 40

AR: atrial reversal (kick)

A wave: atrial kick -Atrium is contracting

S wave: systole - LA & RA filling (MV & TV closed)

D wave: diastole

Front 41

Which wave in the Pulsed Wave Doppler tracing is the ONLY wave that is reversed (below the baseline)?

Back 41

A Wave

Front 42

Which Wave, in Pulsed Wave Doppler, represents the pulmonary veins pushing blood into the Left Atrium (MV closed) by a Large Peak above the baseline?

Back 42

S Wave (systole)

Front 43

Which Wave, in Pulsed Wave Doppler, represents Diastole by a Small Peak above the baseline?

Back 43

D Wave (diastole)

Front 44

What should the A, S, and D Waves look like in a normal Doppler scan of the Pulmonary Veins?

Back 44

• S Wave should be larger than D Wave
• D Wave should be smaller than S Wave
• A Wave is the ONLY wave that is reversed and below the baseline
  

Front 45

Which Views should Doppler be done in?

Back 45

4 and 5 chamber views

Front 46

What happens in a SD Reversal of an Abnormal Pulsed Wave Doppler tracing? What does this determine?

Back 46

• S Wave is dampened
• D Wave will be enlarge

*Moderate Mitral Valve Regurge

Front 47

What is happening in a High Resistant Pulmonary System (Pulmonary Hypertension)? What does this determine?

Back 47

• S Wave is reversed and goes below baseline
• Blood from the LA is being pushed back into the lungs through the Pulmonary Veins causing pressure
  
• All of the pressure from the pushing of the blood during Systole is going back into the lungs through the Pulmonary Veins

*Severe Mitral Regurge

Front 48

The Left Atrium is filling up with Pulmonary Venous Flow during?

Back 48

Ventricular Systole

Front 49

Which chamber(s) are 'Filling Chambers' and act as a 'Contractile Pump'?

Back 49

Left Atrium and Right Atrium

Front 50

Which chamber carries 15 - 30% of the Left Ventricle filling (blood)?

Back 50

Left Atrium

Front 51

Which chamber acts as a reservoir for the Left Ventricle?

Back 51

Left Atrium

Front 52

Which chamber collects blood flow from the Pulmonary Veins during Systole?

Back 52

Left Atrium

Front 53

Which chamber is a conduit (passageway) from the lungs to the Left Ventricle?

Back 53

Left Atrium

Front 54

In which 2 views can you view the Left Atrial Appendage (LAA)?

Back 54

Short Axis (aortic level)

Apical 2

Front 55

Which view allows you to see the Posterior Leaflet of the Tricuspid Valve?

Back 55

RVIT

Front 56

When the Left Atrial Appendage is enlarged, what should we look for as a possible cause?

Back 56

Thrombus (blood clots)

Front 57

What area of the Heart compensates for the surface area of the Left Atrium?

Back 57

Left Atrial Appendage

Front 58

What could the enlargement of the Left Atrium or Right Atrium mean?

Back 58

Mitral Stenosis (MS)

Mitral Regurge (MR)

Atrial Fibrilation (A-fib)

Front 59

Why does the Left Ventricle usually have more muscle mass compared to the other chambers?

Back 59

because it has to expel all of the blood into the Systemic System of the body

Front 60

What is the Major purpose of doing an Echocardiogram?

Back 60

to evaluate Left Ventricular function

Front 61

Which chambers are considered the 'Pumping Chambers'?

Back 61

Left Ventricle and Right Ventricle

Front 62

Which chamber is located in the inferior portion of the Heart and has an Apex?

Back 62

Left Ventricle

Front 63

What is an artifact that comes from the chest wall that obscures the view of the Apex called?

Back 63

Reverb aka Ringdown

Front 64

Which chamber is bullet-shaped and smooth walled?

Back 64

Left Ventricle

Front 65

Which chamber has walls that are 1cm in width and are 2-3 times larger than the Right Ventricles?

Back 65

Left Ventricle

Front 66

Which chamber holds 75% of the Hearts mass?

Back 66

Left Ventricle

Front 67

Which part of the Left Ventricle is wider and is formed by the Mitral Valve Ring?

Back 67

Base

Front 68

Which part of the Left Ventricle is smaller?

Back 68

Apex

Front 69

What are the 2 distinctive walls of the Left Ventricle?

Back 69

Lateral -trabeculae

Medial -formed by the Interventricular Septum

Front 70

Name the 2 papillary muscles of the Left Ventricle.

Back 70

Antero-lateral papillary muscle

Postero-medial papillary muscle

Front 71

Name the 2 parts of the Interventricular septum.

Back 71

1. Membraneous
2. Muscular (inlet, trabeculae, outlet)
   

Front 72

Which chamber has thick walls and encircles the blood flow volume ratio (a lot of muscular force in a small area)?

Back 72

Left Ventricle

Front 73

True/False:

The Left ventricle generates more pressure than the Right Ventricle.

Back 73

TRUE

Front 74

The Anterior leaflet of the Mitral Valve is continuous with the?

Back 74

Posterior Aortic Wall

Front 75

The Interventricular Septum is continuous with the?

Back 75

Anterior Aortic Wall

Front 76

What is another name for the Postero Left Ventricular Wall?

Back 76

Infero-Lateral Left Ventricular Wall

Front 77

True/False:

The Interventricular Septum should be the same thickness as the Left Ventricle posterior wall.

Back 77

TRUE

Front 78

What is the normal measurement for the Left Ventricle Posterior Wall thickness (and Interventricular Septum)

Back 78

PW and IVS = 0.6 - 1.1 cm

Front 79

What is the normal measurement for End-Diastole in the Left Ventricle?

Back 79

3.7 - 5.6 cm

Front 80

When does End-Diastole occur?

Back 80

just before the Mitral Valve/Tricuspid Valve close

Front 81

What is the normal measurement for End-Systole in the Left Ventricle?

Back 81

2.0 - 3.8 cm

Front 82

What is occurring during End-Systole in the Left Ventricle?

Back 82

Contraction

Front 83

True/False:

End-Systole is the frame that precedes the Mitral Valve opening when tracing.

Back 83

TRUE

Front 84

In order to be perpendicular for measuring the Left Ventricle, what part of the image do we lose?

Back 84

Apex

Front 85

True/False:

The Left Ventricle has an inflow and an outflow tract.

Back 85

TRUE

Front 86

What parts of the Heart does the LVIT include?

Back 86

Mitral Valve Annulus

Mitral Valve Posterior Leaflet

Chordae Tendineae

Front 87

What parts of the Heart does the LVOT include?

Back 87

Anterior Mitral Valve Leaflet

Interventricular Septum

Left Ventricle Free Wall

Front 88

True/False:

The Interventricular Septum is more CONCAVE (curves inward) from the Left Ventricle, and more CONVEX (bulges outward) to the Right Ventricle.

Back 88

TRUE

Front 89

What is the normal Left Ventricular Systolic Pressure?

Back 89

100-140 mmHg

Front 90

What is the normal Left Ventricular Diastolic Pressure?

Back 90

3-12 mmHg

Front 91

What is the normal Oxygen Saturation of the Left Ventricle?

Back 91

98%

Front 92

What is the normal Left Atrial Pressure?

Back 92

2 -12 mmHg

Front 93

What is the normal Oxygen Saturation for the Left Atrium?

Back 93

98%

Front 94

True/False:

Ejection Fraction and Fractional Shortening should only be obtained in the absence of wall abnormalities.

Back 94

TRUE

Front 95

True/False:

Left Ventricle measurements in M-Mode can be done in PLAX and PSAX.

Back 95

TRUE

Front 96

What formula gives the Systolic performance of the Heart?

Back 96

Ejection Fraction Formula

Front 97

What is the normal Ejection Fraction for the Left Ventricle?

Back 97

55-65%

Front 98

What formula method takes Linear measurements and converts them into Volume measurements?

Back 98

Ejection Fraction Formula

Front 99

Once linear measurements are recorded into the ultrasound machine, it will produce?

Back 99

the Ejection Fraction (volume)

Front 100

What is the Ejection Fraction Formula?

Back 100

Front 101

What is the Fractional Shortening Formula?

Back 101

Front 102

What 2 Methods are used to find the Left Ventricular Systolic Function?

Back 102

Ejection Fraction Formula

Fractional Shortening

Front 103

What are the measurement ranges for the Fractional Shortening Method?

Back 103

Normal: 25 -45

Mild: 20-25

Moderate: 15-20

Severe: <15 (less than)

Front 104

Which Method is used to evaluate the Left Ventricular Volume Function?

Back 104

BiPlane Method of Disks

(Modified Simpson Rule)

Front 105

Which method looks at the Left Ventricular Volume through a summation of multiple views (stacked elliptical views)?

Back 105

BiPlane Method of Disks

(Modified Simpson Rule)

Front 106

In which views can we use the BiPlane Method of Disks to measure the Left Ventricular Volume Function?

Back 106

Apical 4 chamber

Apical 2 chamber

Front 107

How do you perform the BiPlane Method of Disks?

Back 107

• by tracing the Endocardial Border of the Left Ventricle in Diastole and then in Systole
  
• the Ultrasound machine will then calculate the LV Volume from the trace
  

Front 108

What are the steps for tracing the Left Ventricular Volume?

Back 108

1. Zoom in on the LV (Apical 4/ Apical 2)
2. Trace the LV Diastole Endocardial border
3. Roll the trackball to Systole in the same cardiac cycle
4. Trace the LV Systole Endocardial Border

Front 109

Which is the best View to see the Lateral Left Ventricular Wall and the Antero-Lateral Left Ventricular Wall in?

Back 109

4 Chamber

Front 110

In an Apical 4 View, what are the papillary muscles seen in the Left Ventricle called?

Back 110

Postero papillary muscles

Antero papillary muscles

Front 111

In Left PLAX, what section of the RVOT, RV wall, IVS and LV Wall can be seen clearly?

Back 111

Antero RVOT
RV Free Wall
Antero IVS
Basal Inferior Lateral LV Wall (posterior LV wall)

Front 112

In an Apical 4 at the papillary level, name the walls of the LV in clockwise order starting from the Septum.

Back 112

1. Infero-Septal Wall
2. Antero-Septal Wall
3. Anterior LV Wall
4. Antero-Lateral Wall
   
5. Antero-Lateral Papillary Muscle
6. Infero-Lateral Wall
   
7. Inferior LV Wall
8. Postero-Medial Papillary Muscle

...and back to the Infero Septal..

Front 113

True/False:

In an Apical 4, the Base is closest to the Mitral Valve.

Back 113

TRUE

Front 114

In an Apical 4 at the Basal level, name the walls of the LV in clockwise order starting from the Apex.

Back 114

1. Apex (Apical)
2. Apical-Lateral
3. Mid-Lateral
4. Basal-Lateral
5. Basal Septal
6. Mid Septal
7. Apical-Septal

...and back to the Apex..

Front 115

True/False:

The Right Ventricle is seen in the Left Ventricular Short Axis View.

Back 115

TRUE

Front 116

In the Left Ventricular Short Axis View (at the papillary level), Which walls are seen of the RIGHT Ventricle?

Back 116

Anterior RV Wall
Lateral RV Wall
Inferior RV Wall

Front 117

True/False:

In PLAX and PSAX views, the dimensions are the same for the Left Ventricle.

Back 117

TRUE

Front 118

What does a 2 Chamber view HAVE to include to be considered a good view?

Back 118

Pulmonary Veins

Front 119

Which view is the ONLY one that shows the Inferior Left Ventricular Wall?

Back 119

Apical 2

Front 120

In which views can you see the Left Atrial Appendage?

Back 120

Apical 2

PSAX (aortic level)

Front 121

What are the 2 vessels that feed the Inferior Wall of the Left Ventricle?

Back 121

Posterior Descending Artery (PDA)

Right Coronary Artery (RCA)

Front 122

Which View gives the same information as the PLAX?

Back 122

PSAX

Apical long (3)

Front 123

Another name for the Posterior Left Ventricular Wall is?

Back 123

Inferior-Lateral Wall

Front 124

What are the dimensions for a normal Left Ventricle in Diastole?

Back 124

3.7 - 5.6 cm

Front 125

In an Apical 3 (long) View, which 2 main walls can you see of the LV?

Back 125

Anterior IVS

Inferior Lateral LV Wall

Front 126

What are the normal dimensions for the Left Ventricle in Systole?

Back 126

2.0 - 3.8 cm

Front 127

What is the normal dimension of the Left Atrium's DIAMETER?

Back 127

Diameter: 1.9 - 4.0 cm (19-40 mm)

Front 128

What is the normal dimension of the Left Atrium's MAJOR AXIS?

Back 128

Major Axis: 4.1 - 6.1 cm (41 - 61 mm)

Front 129

What is the normal AREA dimension of the Left Atrium?

Back 129

Area: < 20 cm squared

Front 130

What is the normal VOLUME dimension of the Left Atrium?

Back 130

Volume: 22 - 58 ml

Front 131

What are the DIAMETER dimensions of a Severely Dilated Left Atrium?

Back 131

Diameter: > 5.2 cm (52 mm)

Front 132

What are the dimensions of a Severely Dilated Left Atrium's MAJOR AXIS?

Back 132

Major Axis: > 7.7 cm (77 mm)

Front 133

What are the AREA dimensions of a Severely Dilated Left Atrium?

Back 133

Area: > 4.4 cm (44 mm)

Front 134

What is the VOLUME dimensions of a Severely Dilated Left Atrium?

Back 134

Volume: > 7.9 cm (79 mm)