Practical 4: ULTRASOUND

Question 1

What are the 4 ECHO views of the heart (transthoracic)?

Answer 1

1. Parasternal long axis
2. Parasternal short axis (x4)
3. Apical view
4. Subcostal view

Question 2

What are the 2 ECHO views that allow you to assess the 4 chambers of the heart?

Answer 2

Apical and subcostal 4 chamber views

Question 3

what is the advantage of the subcostal view of the apical view in echocardiography?

Answer 3

in subcostal view the interventricular and interatrial septa can be assessed

Question 4

What are some indications for echo?

Answer 4

Heart murmur w/ symptoms
cardiomyopathy
ischaemic heart disease (known or suspected)
prosthetic valve assessment
surgical planning
hypertension (LV dysfunction)
suspected pericardial disease
Unexplained stroke
infective endocarditis suspected
...etc

Question 5

What is US good for imaging?

Answer 5

Breast, abdo, heart, vasculature, biliary tree, liver, gallbladder, Ao, kidneys…

Question 6

Advantages of US?

Answer 6

Real time imaging
FUNCTIONAL INFORMATION
Cheap
non-ionising
non-invasive
portable

Question 7

Disadvantages of US?

Answer 7

Limited prenetration in obese pts
highly user/operator/interpreter dependent
Poorer resolution than other imaging modalities

Question 8

Why is placing central line preferable on the R to left?

Answer 8

Because need to get to SVC –> shorter route

Question 9

What are some indications for a central line?

Answer 9

Measure central venous pressure in surgery
haemodialysis
emergency venous access
pts lacking peripheral sites for iv ACCESS
PTS REQUIRING MULTIPLE BLOOD PRODUCT INFUSIONS + FLUIDS
Pts needing multiple blood samples
…etc

Question 10

How can US be used in vascular ways?

Answer 10

1. Insertion of central line
2. Identify peripheral veins for cannula insertion
3. Identify arteries for ABG
4. Assess dimensions of vessels for stenosis or aneurysm
5. Assess vessel wall for athersclerosis (thickening between tunica media + adventitia)

Question 11

What two views can yu use to view the heart chambers? What is better at visualising the interventricular/interatrial septa?

Answer 11

apical view

subcostal view (better)

Question 12

What are the four views you get from parasternal short axis view?

Answer 12

1. level of aortic valve
2. level of mitral valve
3. mid-ventricular level
4. apical level