Anatomy, Physiology, & Technique Flashcards by Kaitlyn Yeager

Which echocardiographic window is used in viewing the inferior vena cava?

A. Subcostal
B. Parasternal
C. Suprasternal
D. Apical

Subcostal

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The eustachian valve is seen in which of the following chambers?

A. Right ventricle
B. Right atrium
C. Left atrium
D. Left ventricle

Right atrium

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The area of the aorta between the top of the descending aorta and the arch is called the:

A. Coarctation
B. Sinus
C. Ligamentum
D. Ductus
E. Isthmus

Isthmus

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A patient who has a higher blood pressure in the right arm than in the left arm may have:

A. Patent ductus arteriosus
B. Hypoplastic left heart
C. Aortic insufficiency
D. Coarctation of the aorta

Coarctation of the aorta

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Of the following conditions, which is NOT usually a cause of increased left ventricle mass?

A. Aortic stenosis
B. Mitral valve prolapse
C. Systemic hypertension
D. Aortic insufficiency

Mitral valve prolapse

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Fetal blood oxygenation occurs in the maternal:

A. Lungs
B. Placenta
C. Aorta
D. Heart

Placenta

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During the cardiac cycle, all of these events occur EXCEPT:

A. Ao valve is closed & mitral valve is closed
B. Ao valve is open & mitral valve is closed
C. Ao valve is open & mitral valve is open
D. Ao valve is closed & mitral valve is open

Ao valve is open & mitral valve is open

(they should never be open at the same time)

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When the velocity of blood flow exceeds the Doppler nyquist limit the following occurs:

A. Aliasing
B. Damping
C. Mirroring
D. Contouring

Aliasing

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Doppler views for evaluating the severity of aortic stenosis include:

A. Apical long axis, suprasternal notch, and right sternal border
B. Apical long axis, subcostal short axis, and right sternal border
C. Apical 4 chamber, suprasternal notch, and right sternal border
D. Subcostal 4 chamber, suprasternal notch, and left sternal border

Apical long axis, suprasternal notch, and right sternal border

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The best 2D view for diagnosing mitral valve prolapse is:

A. Subcostal 4 chamber
B. Apical 4 chamber
C. Parasternal short axis
D. Parasternal long axis
E. Any view in which you see mitral prolapse

Parasternal long axis

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A prominent eustachian valve is seen in the right atrium. The eustachian valve is:

A. A normal valve of the superior vena cava commonly seen in the subcostal view
B. A normal valve of the coronary sinus seen in a parasternal short axis
C. The portion of the atrial septum which is patent before birth and did not fuse after delivery
D. A normal valve of the inferior vena cava commonly seen in the subcostal view

A normal valve of the inferior vena cava commonly seen in the subcostal view

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In laminar flow, mean velocity is:

A. Roughly one-quarter maximum velocity
B. Roughly equal to 1/2 maximum velocity
C. Roughly equal to maximum velocity
D. Slightly greater than maximum velocity

Roughly equal to maximum velocity

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In an easy to image adult patient with beautiful pictures, which frequency transducer would you likely want to use?

A. 5.0 MHz
B. 2.0 MHz
C. 1.75 MHz
D. 3.5 MHz

5.0 MHz (better resolution)

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Which is the most anterior cardiac valve in the chest?

A. Pulmonic
B. Aortic
C. Tricuspid
D. Mitral

A. Pulmonic

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Transesophageal echo (TEE) probes generally operate in what frequency range?

A. 5.0 - 10.0 MHz
B. 2.5 - 4.0 MHz
C. 4.0 - 6.0 MHz
D. 5.0 - 7.0 MHz
E. 7.0 - 10.0 MHz

5.0 - 7.0 MHz

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Which of the following choices would NOT be used to correct for pulsed wave Doppler aliasing?

A. Use a higher frequency probe
B. Decrease sample volume depth
C. Use continuous wave
D. Shift the baseline

Use a higher frequency probe

(This would make aliasing worse)

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All of the following are frequencies used in transesophageal echocardiograms (TEE) EXCEPT:

A. 2.5 MHz
B. 7.0 MHz
C. 6.0 MHz
D. 5.0 MHz

2.5 MHz

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On M-mode echocardiography the left ventricular diastolic dimension is measured at:

A. The R-wave
B. The P-wave
C. The start of the QRS
D. End systole

The start of the QRS

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Where is the oxygen saturation the lowest?

A. Pulmonary vein
B. Coronary sinus
C. Left atrium
D. Pulmonary artery
E. Right atrium

Coronary sinus

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In normal development which is the first to close?

A. Ductus arteriosus
B. Foramen ovale
C. Ventricular septal defect
D. Atrial septal defect

Ductus arteriosus

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All of the following are components of the atrioventricular valves EXCEPT:

A. Chordal web
B. Valve leaflets
C. Chordae tendinae
D. Papillary muscles

Chordal web

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What type of murmur is associated with mitral valve prolapse?

A. A murmur that radiates to the axilla
B. Mid-systolic click with a late systolic murmur
C. Low pitched, diastolic “rumble”
D. Systolic crescendo decrescendo murmur

Mid systolic click with a late systolic murmur

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All of the following arteries originate from the aortic arch in normals EXCEPT:

A. Left carotid
B. Left subclavian
C. Right subclavian
D. Innominate

Right subclavian

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Which cardiac valve lies closest to the apex of the heart?

A. Tricuspid
B. Pulmonic
C. Aortic
D. Mitral

Tricuspid

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Which embryonic aortic arch develops into the transverse arch: A. Fourth B. Second C. Third D. Fifth E. First

Fourth

Which is the most anterior chamber of the heart? A. Left atrium B. Right ventricle C. Right atrium D. Left ventricle

Right ventricle

What is the interventricular septal wall motion in a patient with a left bundle branch block (LBBB)? A. Hyperkinetic B. Dyskinetic C. Akinetic D. Hypokinetic

Dyskinetic septal wall motion abnormalities

In which view is the ultrasound beam most perpendicular to the inter atrial septum? A. Parasternal short axis B. Subcostal 4 chamber C. Apical long axis D. Apical 4 chamber

Subcostal 4 chamber

In fetal circulation the vessel that shunts blood right to left between the pulmonary artery and aorta is the: A. Foramen ovale B. Ligamentum arteriosum C. Ductus arteriosus D. Ductus venosus

Ductus arteriosus

All of the following may result in jugular venous distention EXCEPT: A. Constrictive pericarditis B. Tricuspid stenosis C. Hypovolemia D. Pulmonary hypertension E. Cardiac tamponade

Hypovolemia

Which of the following forms a flap at the level of the Foramen ovale that controls the flow between the right atrium and left atrium? A. Truncus arteriosus B. Septum secundum C. Septum primum D. Bulbous venosus

Septum primum

How do you position a patient for a TEE exam? A. Supine with elevated head B. Trendelenburg C. Supine D. Left lateral decubitus

Left lateral decubitus

The second heart sound involves the: A. Bicuspid valves B. Atrioventricular valves C. Mitral and aortic valves D. Tricuspid and pulmonic valves E. Semilunar valves

Semilunar valves (aortic and pulmonary valves)

What causes a left parasternal friction rub? A. Tamponade B. Rubs are normal findings C. Constrictive pericarditis D. Pericardial effusions E. Pericarditis

Pericarditis

Which of the following carries the electrical impulse from the atria to the ventricles? A. Sinoatrial node B. His bundle C. Atrioventricular node D. Internodal pathways

His bundle

Each of the aortic valve cusps is associated with: A. A coronary vein B. The aortic root C. The ascending aorta D. A sinus of Valsalva

A sinus of Valsalva

The mitral valve apparatus includes all of the following structures EXCEPT: A. Posterior leaflet B. Papillary muscles C. Chordae D. Non coronary cusp E. Anterior leaflet

Non coronary cusp

The resistance against which the left ventricle contracts is referred to as: A. Mean pressure B. Peak pressure C. Preload D. Afterload

Afterload

A saline contrast bubble study is performed during the TEE exam because of its ability to detect: A. Cardiac shunts B. Endocarditis C. Mitral regurgitation D. Pericardial effusion

Cardiac shunts

All of the following are frequencies used in adult chest wall echocardiograms EXCEPT: A. 3.5 MHz B. 2.0 MHz C. 6.0 MHz D. 4.5 MHz E. 2.5 MHz

6.0 MHz

The right atrium receives unoxygenated blood from which of the following EXCEPT: A. Inferior vena cava B. Right pulmonary veins C. Coronary sinus D. Superior vena cava

Right pulmonary veins (connect with the left atrium)

The best Doppler view for evaluating the severity of tricuspid stenosis is: A. Suprasternal long axis of the aorta B. Parasternal long axis C. Apical 4 chamber D. Subcostal 4 chamber

Apical 4 chamber view

The Chiari network is sometimes seen in which of the following chambers: A. Left ventricle B. Right ventricle C. Left atrium D. Right atrium

Right atrium

In patients with severe mitral stenosis, what percent of left ventricular filling might be contributed by atrial systole? A. 70% B. 30% C. 10% D. 50%

50% (Rely on more filling provided by atrial systole) (Compared to 30% in normals)

The left ventricular diastolic pressure is comparable to which of the following pressures? A. Aortic systolic B. Right ventricular systolic C. Mean left atrial D. Right ventricular diastolic

Mean left atrial

When using the PEDOF continuous wave Doppler probe, the cardiac sonographer must rely on the: A. Placement of the cursor on the 2D image B. Valve that is visualized on the screen C. Spectral display in comparison to the EKG D. Size of the Doppler gate

Spectral display in comparison to the EKG

The aortic isthmus is located between the: A. Ascending aorta and aortic arch B. Aortic arch and pulmonary artery C. Brachiocephalic artery and left subclavian artery D. Left subclavian artery and Ligamentum arteriosum

Left subclavian artery and Ligamentum arteriosum

The normal mean left atrial pressure is comparable to which of the following pressures? A. Aortic diastolic B. Left ventricular diastolic C. Left ventricular systolic D. Aortic systolic

Left ventricular diastolic

During this phase of the cardiac cycle, all 4 valves are closed and the pressure increases within the ventricles: A. Isovolumic contraction B. Diastole C. Isovolumic relaxation D. Systole

Isovolumic contraction

Which valve event starts Isovolumic relaxation? A. Mitral closure B. Aortic opening C. Aortic closure D. Mitral opening

Aortic closure

A pericardial effusion will be seen between these 2 cardiac layers: A. Epicardium and myocardium B. Visceral and parietal C. Myocardium and endocardium D. Fibrous and serous

Visceral and parietal

The best Doppler view for evaluating the peak velocity of tricuspid regurgitation is: A. Parasternal long axis B. Subcostal 4 chamber C. Apical 4 chamber D. Parasternal short axis at the mitral level

Apical 4 chamber

Which is the most posterior chamber of the heart? A. Right atrium B. Left atrium C. Right ventricle D. Left ventricle

Left atrium

Which valve directs blood from the inferior vena cava to the Foramen ovale during fetal circulation? A. Eustachian B. Tricuspid C. Thebesian D. Mitral

Eustachian

The best Doppler view for evaluating the severity of pulmonic stenosis is: A. Apical 4 chamber B. Parasternal long axis C. Parasternal short axis view at the base D. Subcostal 4 chamber

Parasternal short axis at the base

The best color Doppler view for evaluating an atrial septal defect is: A. Apical 4 chamber B. Subcostal short axis C. Parasternal short axis D. Subcostal 4 chamber

Subcostal 4 chamber

What percent of left ventricular filling is normally contributed by atrial systole? A. 30% B. 50% C. 70% D. 10%

30%

In a patient with COPD which frequency transducer would most likely result in the best images? A. 3.5 MHz B. 1.75 MHz C. 5.0 MHz D. 2.0 MHz

1.75 MHz

With normal pressures, which valve lesion would have the lowest Doppler velocity? A. Pulmonary regurgitation B. Mitral regurgitation C. Aortic regurgitation D. Tricuspid regurgitation

Pulmonary regurgitation

When transporting a patient with a urinary catheter the bag should always be: A. Above the patients bladder B. Level with the patients heart C. Below the patients heart D. Below the patients bladder

Below the patients bladder

To perform continuous wave Doppler using a PEDOF probe how many piezoelectric crystals are required? A. One B. One hundred and twenty eight C. Sixty four D. Two E. Four

Two (one to transmit and one to receive)

The muscle bundles of the appendages are called: A. Pectinate muscles B. False tendons C. Trabeculae tendons D. Ectopic chordae

Pectinate muscles

Right ventricular systolic pressure (RVSP) can be estimated when the patient has: A. Mitral regurgitation B. Tricuspid regurgitation C. Pulmonic regurgitation D. Aortic regurgitation E. Atrial septal defect

Tricuspid regurgitation

The first heart sound involves the: A. Tricuspid and pulmonic valves B. Mitral and aortic valves C. Semilunar valves D. Bicuspid valves E. Atrioventricular

Atrioventricular valves

The pacemaker of the heart is the: A. Internodal pathway B. Atrioventricular node C. Bundle of His D. Sinoatrial node

Sinoatrial node

Which standard 2D transthoracic view typically allows viewing of the left atrial appendage (LAA)? A. Subcostal long axis B. Apical 4 chamber C. Apical 2 chamber D. Parasternal long axis

Apical 2 chamber

Which valve event starts Isovolumic contraction? A. Aortic opening B. Mitral closure C. Mitral opening D. Aortic closure

Mitral closure

Where is the oxygen saturation the highest? A. Pulmonary artery B. Pulmonary vein C. Right ventricle D. Right atrium E. Coronary sinus

Pulmonary vein

The best view for evaluating a patient with suspected coarctation of the aorta is: A. Parasternal long axis of aortic arch B. Parasternal short axis of aortic arch C. Suprasternal long axis of aortic arch D. Suprasternal short axis of aortic arch

Suprasternal long axis of aortic arch

The largest normal cardiac pressure gradient is seen across the: A. Aortic valve during diastole B. Mitral valve during systole C. Tricuspid valve during systole D. Pulmonic valve during diastole

Mitral valve during systole

The closed central portion of the interatrial septum in the adult is called the: A. Ostium primum B. Fossa ovalis C. Foramen ovale D. Thebesian valve

Fossa ovalis

The pressure in the left ventricle at end diastole is referred to as: A. Peak pressure B. Mean pressure C. Preload D. Afterload

Preload

The best position for recording the left ventricular filling waveforms by pulsed Doppler echo is: A. Apical 5 chamber with sample volume in the LVOT B. Apical 4 chamber with sample volume in the left atrium C. Apical 4 chamber with sample volume at mitral valve annulus D. Apical 4 chamber with sample volume at mitral valve leaflet tips

Apical 4 chamber with the sample volume positioned at the mitral valve leaflet tips

Externally where is the left anterior descending coronary artery found? A. Anterior coronary sinus B. Posterior interventricular sulcus C. Atrioventricular sulcus D. Anterior interventricular sulcus

Anterior interventricular sulcus (groove)

Visualization of the lateral wall of the left ventricle is best when the sonographer uses which of the following views? A. Apical 4 chamber B. Parasternal long axis C. Apical long axis D. Apical 2 chamber

Apical 4 chamber

Which valve event ends Isovolumic relaxation? A. Aortic opening B. Mitral opening C. Aortic closure D. Mitral closure

Mitral opening

Which of the following increases left ventricular afterload? A. Mitral regurgitation B. Systemic hypertension C. Pulmonary hypertension D. Atrial septal defect

Systemic hypertension

The moderator band is seen in which of the following chambers: A. Left ventricle B. Left atrium C. Right ventricle D. Right atrium

Right ventricle

On M-mode echo, the late diastolic dip seen on the pulmonic valve is called the: A. B notch B. C notch C. A dip D. B dip

A dip

Color flow Doppler converts flow frequencies into different colors; its appearance is based on all of the following EXCEPT: A. Gray scale map used B. Color map used C. Velocity of blood flow D. Direction of blood flow

Gray scale map used

A patient who has a higher blood pressure in the arms than in the lower extremities may have: A. Aortic stenosis B. Patent ductus arteriosus C. Coarctation of the aorta D. Aortic insufficiency

Coarctation of the aorta

Which of the following has the MOST impact on color Doppler jet size? A. Frame rate B. Doppler gain C. TGC gain D. Wall filter

Doppler gain

Which valve events ends Isovolumic contraction? A. Aortic closure B. Mitral closure C. Aortic opening D. Mitral opening

Aortic opening

The coronary sinus receives deoxygenated blood from all of the following veins EXCEPT: A. Posterior cardiac B. Great cardiac C. Small cardiac D. Middle cardiac

Posterior cardiac

On M-mode echo, late diastolic dip seen on the pulmonic valve is caused by: A. Elevated LVEDP B. Ventricular contraction C. Atrial contraction D. High pulmonary pressures

Atrial contraction

On M-mode echo the left atrial dimension is measured at: A. The start of the QRS B. P-wave C. End systole D. End diastole

End systole

The right ventricle is composed of an inflow tract and an outflow tract. What is another name for the right ventricular outflow tract? A. Infundibulum B. Moderator band C. Papillary muscles D. Trabeculations

Infundibulum

Which of the following can be seen on echo and is considered a normal remnant of fetal circulation? A. Patent ductus arteriosus B. Moderator band C. Atrial septal defect D. Eustachian valve

Eustachian valve

From the left parasternal position which of the following are you most likely to get accurate velocity measurements? A. Pulmonary artery B. Mitral regurgitation C. Aortic stenosis D. Left ventricular outflow tract

Pulmonary artery

The central opening of the interatrial septum during fetal circulation is called the: A. Foramen ovale B. Thebesian valve C. Ostium primum D. Chiari network

Foramen ovale

The reason for using ultrasound gel on the transducer is to: A. Keep the air out B. Help the transducer slide C. Protect the patients skin D. Conduct electricity

Keep the air out

The best Doppler view for evaluating the severity of mitral stenosis is: A. Apical 4 chamber B. Suprasternal long axis C. Subcostal 4 chamber D. Parasternal short axis E. Parasternal long axis

Apical 4 chamber

All of the following are indications for TEE EXCEPT: A. Evaluate mitral regurgitation B. Suspicion for endocarditis C. Rule out apical mural thrombus D. Rule out embolic source E. Evaluate left atrial mass

Rule out apical mural thrombus (TEE has difficulty visualizing the true LV apex)

Name the vessels coming off the transverse aortic arch in order from right to left: A. Right carotid, left subclavian, right subclavian B. Innominate, right carotid, left subclavian C. Right carotid, right subclavian, left subclavian D. Innominate, left carotid, left subclavian

Innominate, left carotid, left subclavian

The best 2D view for evaluating a patient with a suspected patient ductus arteriosus is: A. Parasternal short axis B. Suprasternal short axis C. Suprasternal long axis D. Parasternal long axis E. Subcostal 4 chamber

Parasternal short axis of aorta

What can you do to minimize ghosting in color Doppler? A. Increase gain B. Roll the patient C. Increase wall filter D. Decrease sector size 3. Change transducers

Increase wall filter

What percentage of left ventricular filling normally occurs in the first third of diastole? A. 30% B. 50% C. 70% D. 10%

70%

The anterior and apical wall of the left ventricle is supplied by which coronary artery? A. Right coronary artery B. Left anterior descending C. Left circumflex D. Acute marginal

Left anterior descending

Adult chest wall echo probes generally operate in what frequency range? A. 5.0 -7.0 MHz B. 2.0 - 4.0 MHz C. 4.0 - 6.0 MHz D. 7.0 - 10.0 MHz E. 5.0 - 10.0 MHz

2.5 - 4.0 MHz

All of the following are frequencies used in TEE EXCEPT: A. 2.5 MHz B. 6.0 MHz C. 5.0 MHz D. 7.0 MHz

2.5 MHz

In normal development which is the last to close? A. Ductus arteriosus B. Foramen ovale C. Atrial septal defect D. Ventricular septal defect

Foramen ovale

At which temperature range is unsafe to use a TEE probe? A. 30-40º C B. 25-30º C C. 40-45º C D. 20-25º C

40-45º C

Which is the most posterior cardiac valve in the chest? A. Pulmonic B. Tricuspid C. Mitral D. Aortic

Mitral

Early diastole allows for passive filling of the ventricles, it also creates the: A. First heart sound B. Second heart sound C. Third heart sound D. Fourth heart sound

Third heart sound

On M-mode echo, the left atrial dimension is measured at: A. The start of the QRS B. End systole C. The P-wave D. End diastole

End systole

Anatomy, Physiology, & Technique Flashcards

(105 cards)