CCI flash cards
(495 cards)
0
Q
ASD surgery is mainly considered when the Qp/Qs exceeds? What is Qp/Qs?
A
ASD surgery is mainly considered when the Qp/Qs > 1.5 the size of an atrial septal defect is typically described in terms of the ratio between pulmonary blood flow (Qp) and systolic blood flow (Qs).
1
Q
Sound waves are described as?
A
Longitudinal, mechanical
2
Q
What does each prefix mean ?
Ab, acro, epi, cyan, intra, supra, Brady, peri, leuk, end, auto
A
Ab-away from, acro-extremities, epi-outer, cyan-blue, intra-within, supra-above over, Brady-slow, per-around/about, leuk-white, end-inside, auto-self
3
Q
What is the approximate equivalent of 16 ounces? A.1.5 liter B. 1.0 kiloliter C. 0.5 microliters D. 500 milliliters
A
D. 500 milliliters
4
Q
What is the average speed of sound in soft tissue, bone and air?
A
Soft tissue-1,540 m/s, bone 3,500 m/s, air 330m/s
5
Q
What does each root word mean?
Athro, cardio, hemo, neuro, rhin, thromb, viscer, myco, laparo, path
A
Athro-joint. Cardio-heart. Hemo-blood. Neuro-nerve. Rhin-nose. Thromb-clot. Viscer-organ. Myco-fungus. Laparo-abdomen. Path-disease
6
Q
What is the frequency of ultrasound? What is the frequency of infrasound?
A
Ultrasound is >20,000 hz. Infrasound is <20hz.
7
Q
The label on a large aspirin bottle reads grains. Dr. Jeff feelbetter’s prescription reads aspirin. Grains XV every 4 hours. How many tablets should be tavern according to the dr.?
A
3 tablets should be taken.
8
Q
The RV approximately how many times thinner than the LV?
A
Three
9
Q
What does each suffix mean?
Algia, centsis, desis, ectomoy, itis, ostomy, plasty, Oma, scopy, and megaly.
A
Algia-pain. Centsis-surgical puncture. Desis-surgical Union. Ectomoy-removal. Itis-inflammation. Ostomy-opening into. Plasty-surgical repair. Oma-Tumor. Scopy-view. Megaly-enlargement
10
Q
What is a specular reflector? What is nonspecular reflector?
A
Specular reflector=large smooth structure in comparison to the wavelength like a diaphragm. A nonspecular reflector (also known as Rayleigh scatter) is a smaller reflector like a red blood cell.
11
Q
What are these measurements of? 1. Mm 2. Cc 3. Cm squared
A
Mm=distance. Cc=volume. Cm squared =area
12
Q
What is harmonic imaging? If your harmonic frequency is 6mhz what is the initial transmit frequency?
A
Transmit a certain frequency which is the first harmonic and then processes the next harmonic at twice the frequency. 3mhz because, the first frequency was 3mhz the second higher frequency would be 6mhz.
13
Q
What layer of the heart makes the heart contract? What is the thick middle layer of the heart called?
A
Myocardium
14
Q
How many centimeters are in a meter? How many cubic centimeters in 3.56 cubic meters? What is 3/8 converted to a decimal? How many centimeters are in 2 meters?
A
100,3,560,000, 3/8 is 0.375, centi means hundredth so there are 200 centimeters in 2 meters.
15
Q
Name the two major types of harmonic imaging?
A
Tissue and contrast
16
Q
According to ohms law, resistance is the product of voltage divided by: A. Ergs B. Watts C. Power D. Current E. Ohms
A
D. Current
17
Q
Are these prefixes in increasing order? Micro, centi, milli, deci, kilo, hecto.
What do the prefixes kilo, giga, and mega mean?
A
No, here is the correct increasing order : micro, milli, centi, deci, hecto, kilo.
Kilo=1000, giga = billion, mega=million
18
Q
How many elements does the CW transducer need to operate?
A
Two. One sending and one receiving.
19
Q
What is the name of the valve by the IVC?
A
Eustachian valve
20
Q
How do you convert Fahrenheit to Celsius? How do you convert Celsius to Fahrenheit? Normal oral body temperature is 98.6F, what is the equivalent in Celsius?
A
To convert a Fahrenheit to Celsius, subtract 32 from the Fahrenheit reading and multiply by 5/9. Example : 5/9 (98.6-32)= 37.0. Celsius to Fahrenheit -multiply Celsius reading by 9/5 and add 32. Example : 9/5100 +32= 212.37.0C
21
Q
What is a common murmur heard with mitral valve prolapse?
A
Mid systolic click
22
Q
What is the damping material used for in a transducer? How does damping influence the bandwidth and Q factor?
A
Damping material is placed behind the element to reduce the number of cycles in each pulse. This also increases the bandwidth and decreases the Q factor.
23
Q
A measure of the total opposition to current flow in an alternating current circuit, measured in ohms defines? A. Voltage B. Impedance C. Inductance D. Capacitance
A
B. Impedance
24
What abnormality is often associated with a high pitched friction rub murmur?
Pericarditis
25
What is the decimal form of 44%? 8 is 2 and 1/2% of what number? What is 2/3 divided by 5? What is the product of 2/3, 1/5, 3/6?
44%=.44, 8 is 2.5% of 320, 2/3 divided by 5 is 2/15, the product of 2/3, 1/5, 3/6 is 1/15.
26
What is the Doppler effect?
| What is the Doppler shift?
Effect-change in frequency of sound relative to the movement of the source.
Shift- is the difference between the transmitted and received frequency.
27
Can aliasing occur with normal blood flow using color flow Doppler?
Yes, high velocities can alias
28
What is 40% of 200? What is 1.0 x 10 to the 5th power? If it takes 5 hours to clean 2/3 of a large boat, how long will it take to clean the whole boat?
40% of 200 is 80.
| 1.0 x 10 to the 5th power is 100,000. To clean the whole boat will take 7 1/2 hours.
29
What is a common Murmur heard in patients with constrictive pericarditis?
Pericardial knock
30
A patient with a PDA may have what type of murmur?
Continuous murmur
31
```
The normal range for white blood cell count in adult males (per cubic millimeter) is approximately :
A. 500-1,000
B. 5,000-10,000
C. 10,000-20,000
D. 50,000-100,000
E. 500,000-1,000,000
```
B. The normal range for white blood cell count in adult males (per cubic millimeter) is 5,000-10,000
32
What are three common sense principles of transporting patients?
1. Always get adequate assistance when needed. 2. Use lower body strength (legs) they are strongest. 3. When moving an ambulatory patient from wheelchair to bed - bend knees, and put one foot between the patients legs and the other close to the bed. Turn your body as a unit, not a pivot.
33
What factor involving the wavelength and frequency will improve axial resolution?
Increasing the frequency will decrease the wavelength and improve axial resolution
34
```
A patient is admitted to the cardiac department with the following ABGs : Fi02 = 40%, ph =7.3, pc02 =50, hco3 = 20. According to these blood gases, the patient is in :
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
```
C. Respiratory acidosis - ABG Fi02 = 40% (respiratory) also note the pH is in acidosis range
35
How do you transport patients involving wheelchairs? When entering an elevator with a patient in a wheelchair you should?
Lock big wheels using the wheel locks. The foot rests must be moved aside or removed completely to prevent tripping. Back into the elevator so you can make a quick and safe exit.
36
T/F a mobile mass typically moves into the left atrium during systole and moves to the left ventricle during diastole?
True
37
What is axial resolution? What is lateral resolution?
Axial - able to resolve two closely spaced structures that are parallel to the direction sound is traveling.
Lateral- resolve closely spaced structures that are perpendicular to the beam.
38
List two common findings in a patient with the connective tissue disorder Marfans syndrome. What valvular jet is often observed?
Mitral valve prolapse, aortic dilatation/dissection. MR and AI
39
Ultrasound bio effects are not confirmed below what number?
100 mW/cm2 SPTA (spacial peak temporal average)
40
What are the three main methods of oxygen administration used in a medical setting?
Nasal cannula, nasal prongs, tent.
41
What is stable cavitation? What is transient cavitation?
Expansion and contraction of micro bubbles which may cause tissue damage. Stable is the safe cavitation. Transient is a more violent form which is bad.
42
What is the disease also knows as "aortic arch syndrome" that occurs more in women in Asia and Africa?
Takayasu arteritis also known as pulseless disease is an inflammatory disease with and unknown cause. It affects the aorta, the main blood vessels that attach to it. Inflammation of the aorta and major derivative branches. This inflammation leads to aterial stenosis, thrombosis, and aneurysms.
43
What system is the liver, pancreas, endocrine glands, thymus gland and gallbladder part of?
Digestive system
44
What is TGC and what does it do?
Time gain compensation. It helps to compensate for attenuation of the sound waves.
45
What is the most common mechanical prosthetic valve?
St. Jude (bi-leaflet tilting disc). The design (using two disks, a hinge mechanism, and a low profile) was found to be very durable when constructed of an appropriate material (usually carbon pyrolite) and has enjoyed low thrombogenecity and superior hemodynamics. Of the half dozen or so varieties of the bi -leaflet valve, the st. Jude prostheses has been used most often in aortic and mitral valve replacements. Of the three varieties of the st. Jude prostheses, all are constructed of carbon pyrolite, and have recently been fitted with circular metallic ring below the polyester sewing ring for aid in X-ray visibility.
46
What term would correspond to the list of terms?
| 1. Towards midline 2. Away from midline 3. Close to a location 4. Farther away from the location.
1.medial 2. Distal 3. Proximal 4. Distal
47
```
The major pathway of blood circulation to the brain is through the :
A. Femoral arteries
B. Carotid arteries
C. Coronary arteries
D. Subclavian arteries
E. Pulmonary arteries
```
B. The major pathway of blood circulation to the brain is through the carotid arteries.
48
What is the unit for attenuation? Name three causes of attenuation in soft tissue? Which is the most major cause of attenuation in soft tissue?
Decibel (dB). Reflection, absorption and scatter. Absorption is the largest form of attenuation in soft tissue. (Conversion of energy into heat)
49
What type of valves is the Hancock? What type of valve is the ionescu-shiley?
They are both prosthetic valves. Hancock - most commonly from the pig, ione from the cow.
50
When a patient is in respiratory distress, what are a few ways in which they could be positioned to help with breathing?
Upright in position (sitting 45 degrees), mid fowlers position (semi setting 30 degrees) reverse trendelenburg (lying down on back, head elevated higher than pelvis).
51
If a patient is in shock, what would be a good position to out them in?
Trendelenburg (lying down with feet elevated above pelvis)
52
Name four acoustic variables?
Temperature, density, particle motion And pressure.
53
What is the advantage and disadvantage of a mechanical valve vs. a bioprosthetic valve?
Mechanical valves typically are more durable but require anticoagulant therapy. Bioprosthetic valves usually don't require anticoagulant ion and have low thrombic risk.
54
In performing CPR on an adult what is the recommended breath to compression ratio? What ratio for a child or infant?
Adult - 15 compressions to 2 breaths, child 5:1
55
T/F a common inflammatory finding with post surgery bioprosthetic valve replacement is they usually are at least 2mm thick?
False
56
What two factors influence propagation speed? Which has the largest effect?
Bulk modulus (stiffness) and density. Stiffness has the largest influence.
57
1. Should IV bags be kept above, at level, or below the level of the IV site? 2. If a patient has a Foley catheter in place, should the bag be placed above, level with, or below the waist?
1. Above infusion site 2. Below the waist
58
At a fat-tissue/ muscle interface approximately what percent of the ultrasound beam would be transmitted? Why?
99%, there is a small acoustic mismatch
59
What type of graft transplant would demonstrate replacing the aortic valve in the heart with another persons aortic valve?
Homographs (or allographs) in which the patient receives a replacement heart valve from a deceased donor. Because the delicate nature of the valve surgeons must be careful to ensure the grave is the proper size and to take the Utmost care during surgery, since it is harder to install than all other forms of tissue valves. In an autograph tissue valve, the tissue is from the bishops the patient receiving the valve replacement. The surgeon can take tissue from a variety of regions, including, but not limited to, the dura mater, pericardium, fascia lata, peritoneum, and vena cava. The tissue is then attached to a synthetic frame, usually of stainless steel, which gives the structure a stronger form and is therefore easier to transplant than a homograph.
60
Approximately how much sound energy would be reflected at a soft tissue (skin)/ air interface? Why?
99%, there is a large acoustic mismatch
61
What is a common sunroom of a patient with endocarditis? What is the "classic" cardiac finding with endocarditis?
Fever/chills. A patient with endocarditis is at risk of vegitations.
62
What is malpractice? What is consent? What is the primary goal of code of ethics?
Malpractice is defined as bad or harmful practice that injures another person. Consent is permission granted by a person voluntarily and in south mind. Code of ethics is to determine what is moral, it is your obligation to do good.
63
Are these sound velocities in order from lowest to highest? Air,fat,blood,muscle,liver,skin, bone?
Yes
64
What side of the mitral and tricuspid valves are vegitations most commonly seen?
Atrial side
65
Why is AC 60hz current (wall current), a ver dangerous current to the heart if you were to get shocked?
It can produce cardiac fibrillation - a life threatening arrhythmia.
66
Staphylococcus aureus is most commonly found in what type of patients? What side of the heart is most effected?
IV drug user. Right side of heart.
67
What is the difference between negligence and liability? What is the purpose of a quality assurance program?
Liability means we are legally responsible for our actions towards patients. Negligence means to not do something we should or do something we should not. QAP purpose it to monitor and help patients receive optimal care.
68
What is the frequency range for clinical imaging?
2-15 MHz
69
As frequency increases, axial resolution will?
Improve
70
Name three guidelines for charting health care records?
1. Records are kept on all clients receiving care or treatment. 2. The chart is considered the property of the facility. 3. Do not chart before the event occurs.
71
Name 3 reasons a pericardial effusion may occur.
Infection, radiation therapy, metastatic disease
72
Name the government agency having the legal responsibility for enforcing proper drug manufacture and clinical use?
Food and drug administration (FDA)
73
What is tamponade?
A moderate to large pericardial fluid build up do to a rapid increase in venous pressure.
74
What unit is dynamic range measured in? What is dynamic range?
Decibels, the range of gray scale between the lowest and the highest magnitude signals the ultrasound system can detect.
75
As frequency increases attenuation will?
Increase
76
How does inspiration effect the mitral and tricuspid valve during a tamponade?
Inspiratory velocity decrease across MV and an increased velocity across TV.
77
When documenting in a computer chart, is it ok to use general non specific statements?
No, avoid using generalizations, use facts. These are things that can be visually observed, felt and heard.
78
If fibrin is seen in an effusion, what may this suggest?
Long standing effusion
79
What are most hospital safety requirements for power cables and electronic equipment like EKG and Echo machines? What is sparks fly when you plug in the machine?
They must be 3 wire conductor, with 3 prong plug. If sparks fly the machine might have been left on.
80
What describes power/area?
Intensity.
81
If a patient feels faint during a blood draw or IV insertion what might help?
Have the patient put there head between there knees.
82
What is pulses paradoxus?
>10mmHg decrease in systolic pressure gradient during inspiration.
83
Which of the following Doppler frequencies 18 MHz, 7mhz, 2mhz, 2.5mhz would result in the shallowest penetration depth?
18 MHz
84
The largest Doppler shift occurs when the beam strikes at what angle?
0 degrees angle
85
What is the best reliable predictor for echo in a tamponade? What is a common way to treat a tamponade?
RV wall diastolic collapse. Pericardial centesis (tap) to drain the fluid.
86
What three factors influence residence to blood flow? What vessel has the greatest influence on total vascular resistance?
Radius of vessel, viscosity if fluid through the vessel and the length of the vessel all determine resistance to flow. Arterioles.
87
```
Which of the following vessels have the greatest influence on total vascular resistance?
A. Veins
B. Venules
C. Arterioloes
D. Capillaries
```
C. Arterioles
88
Describe aliasing? Can aliasing only occur with pulsed Doppler systems?
When the PRF (pulse repitition frequency) is less than twice the Doppler shift frequency. Yes
89
What are the two classic findings (heart sound and m-mode) for constrictive pericarditis?
1. Pericardial knock sound 2. Atrial or Spanish notch on m-mode
90
What are three types of electrical injury involving hands and feet? Which of the three is considered the most deadly?
Foot to foot electric shock,hand to foot, hand to hand. The most deadly route is hand to hand, with a risk of going through the heart.
91
T/F with constrictive pericarditis the diastolic filling is impaired?
True
92
What information does the spectral analysis provide?
Amplitude,time, frequency.
93
What is the reason heart valves open and close? What are the mean intra cardiac pressures (mmHg) for each chamber?
A change in intra cardiac pressure. RA 2-8. RV 15-30/2-8. LV 80 to 130/3-12. LA 2-12. PA15-30/4-12. AO 100-140/60-90
94
What does FFT (fast Fourier transform) do to ultrasound signals?
Converts Doppler signals to analog waveforms.
95
What is an aneroid sphygmomanometer? What is considered the normal value for blood pressure?
It is an inflatable cuff that measures the blood pressure using air or Mercury. Normal value is 120/80.
96
What is pulmonary HTN? What side of the heart does pulmonary HTN effect? What are three things associated with PHTN?
A pulmonary pressure greater than 30 mmHg. Right heart (PHTN is typically secondary to left heart problems). RAE, RVE, TR, dilated IVC.
97
Define the following key terms: asepsis, immunity, sterile, pathogen.
Asepsis- freedom from infection. The methods used by health care workers to prevent spread of microorganisms. Immunity- high level of resistance to certain microorganisms. Sterile- free from all living microorganisms. Pathogen- microorganism that produces disease.
98
T/F with PHTN there is a common finding d-shape "pancaking" of the septum in systole? T/F this is due to both volume overload and high pressure.
True, true
99
What is write magnification? Is this pre or post processing?
It is a zoom feature to increase the size of the structure you want to look at. It is part of preprocessing.
100
Define the following key terms: infection, isolation, reverse isolation.
Infection- invasion and multiplication of microorganisms in the body tissues. Isolation - separation from others (because they may have an infection) and want to prevent the spread of microorganisms. Reverse isolation- protects the patient from microorganisms that may be carried by staff or visitors.
101
What is a common method used to calculate pulmonary artery pressure by Doppler?
Get the TR jet peak velocity and use the modified Bernoulli formula (RSVP = 4xV squared). Then ad 5, 10, 15, 20 to it depending on the IVC size and function. Example : with a peak TR jet of 2.0m/s the RSVP would be 2x2x4=16+5 (IVC) answer : RSVP = 21 mmHg
102
What is pre processing? Name two pre processing functions?
After data is acquired you may use the data before storage in the scan converter. TGC and rejection are both pre processing.
103
The pressure gradient through a tube is inversely proportional to which of the following:
A. Length of the tube
B. Flow rate of fluid
C. Radius of the tube to the fourth power
D. Radius of the tube to the sixteenth power.
C. Radius of the tube to the fourth power.
104
What is a simplified view of the Krebs cycle?
Krebs cycle (citric acid cycle) Is basically many oxidation reductions, involving various acids. During these reactions, O2 and h2 combine and energy is released. The cycle creates energy (ATP), by breaking the bonds in glucose (ADP to ATP). This is import at because ATP is the primary energy storage molecule the heart muscle uses to contract.
105
What is post processing? Name one example of post processing?
Using the data (assignment of grey shades) after it was stored in the scan converter. A frozen image
106
What is the normal dimension of the IVC? Does it collapse with inspiration?
1.2 to 2.3 cm.. Yes, it usually has some collapse upon inspiration.
107
What is the main organ responsible for regulating electrolyte and acid base balance in the body?
Kidney
108
What two things are a sound waves wavelength determined by?
The medium and source of sound
109
T/F PHTN is a common cause of left atrial enlargement?
False, PHTN is a right heart problem and usually does not effect the left atrium.
110
What are normal arterial blood gas values?
Normal ABG's would be: PH 7.38-7.44, PC02 40 mmHg, HC03 (bicarbonate) 24mEq/L
111
What are two ways to reduce bio effects on an ultrasound system?
Limit the scan exposure time and reduce the transmit gain.
112
What do you call the memory or computer of the ultrasound machine?
Digital scan converter
113
What is metabolic alkalosis? What is a normal bicarbonate level?
Excessive bicarbonate (HCo3) in the blood. The normal level is 24-28mEq/L.
114
What is the number one cause of dilated cardiomyopathy in the USA? What are other international causes? What type of EF is associated with a dilated cardiomyopathy?
Alcohol is the number one cause. Other causes are infection, AIDS, ischemia. 10-25% EF.
115
What is the number one valvular heart disease? What is the best 2-D view used for diagnosing mitral valve prolapse?
Mitral valve regurgitation is the number one valvular heart disease. Use the parasternal long axis view (3 chamber) for diagnosing MVP.
116
Why is a ultrasound transducer that is cracked considered unsafe?
It may cause electric shock
117
In an emergency situation what body fluids may be considered infectious? How do you disinfect an area after a blood spill?
All fluids may be infectious. After a blood spill put on tour gloves, then use 1 part bleach with 10 parts water.
118
What are five common findings associated with dilated cardiomyopathy? What is a common late complication associated with this type of cardiomyopathy?
Increased EPSS, dilated LV, global hypokinesis with a low EF, decreased aortic root motion, LAE. Risk of systemic emboli or apical thrombus late in course.
119
What is the formula for wavelength?
Wavelength=c/f (speed divided by frequency)
120
Describe the artifact reverberation and name one?
Multiple echoes equally spaced and close to the transducer. Gas bubbles.
121
If your are accidentally exposed to a patients blood, what is the medical responsibility to the healthcare worker?
Post exposure follow up must be made available and blood testing is free of charge.
122
```
In statistics, the most common used measure of variability or dispersion of data is the:
A. Chi square
B. Students t-test
C. Quartile deviation
D. Standard deviation
E. Statistical mean
```
D. Standard deviation
123
What is Chagas' disease?
Cardiomyopathy caused from a parasite bite (more common in South America)
124
If there is a lack of oxygen in the blood stream for anaerobic glycolysis, what is on of the end products?
Lactic acid may build up in the body.
125
What artifact will occur to an object if the propagation speed is less than 1540m/s when scanning?
The object will be placed too far from the transducer.
126
What type of cardiomyopathy may be seen as a bright myocArdium with ground glass appearance? What causes the bright appearance?
Amyloidosis. Starch like deposits of amyloid.
127
Oxidation of glucose is also known as? Why is the process important to the cell?
Cellular respiration. This process produces the cells energy.
128
What are the three major type of cardiomyopathy?
Hypertrophic (with or w/o obstruction), dilated (congestive), restrictive (infiltrative).
129
What type of artifact may sclerotic valves and prosthetic valves produce? What type of artifact is associated with low amplitude signals?
Shadowing artifact
130
What are building blocks of proteins called? What part of a cell stores genetic nucleic acids?
Amino acids, deoxyrubonucleic acid (DNA)
131
What are two classic findings associated with hypertrophic cardiomyopathy using Doppler and m-mode?
Late peak dager shape on Doppler, mid systolic notch of AoV (double diamond appearence) on m-mode.
132
What is considered the audible sound range? Does the Doppler shift occur in this range?
-20 kHz to 20 kHz. Yes
133
The heart rate and respirations are controlled in what part of the brain?
Medulla oblongata
134
What are two ways to improve temporal resolution? Will increasing the frame rate improve temporal resolution?
Decrease image depth, decrease the sector size of your scan. Yes.
135
What effect does the valsalva maneuver have on aortic valve murmurs?
It will increase or accentuate the murmur
136
What does the valsalva maneuver do to intrathoracic pressure? What murmurs will increase during the valsalva maneuver?
The strain phase of the valsalva maneuver increases intrathoracic pressure and will decrease venous return, stroke volume and cardiac output. All murmurs will decrease except for murmurs of hypertrophic obstructive cardiomyopathy and mitral valve prolapse.
137
What is the fresnel zone? What is the Fraunhofer zone?
Fresnel - near field of the sound beam. The region between the transducer face and the focal point.
Fraunhofer - far field. After the focal point where there is beam divergence.
138
What is the main brain stimulus used to control breathing? What nerve controls the breathing by the diaphragm?
The C02 levels in the body is what the brain uses to regulate breathing. The phrenic nerve controls breathing by the diaphragm.
139
T/F the memory of the ultrasound machine uses binary numbers?
True
140
T/F systolic anterior motion (SAM) of the mitral valve is associated with HCM?
True
141
Where is insulin produced? Is the pancreas located in the abdominal cavity?
Pancreas. Yes.
142
Mosaic color may depict what type of blood flow?
Turbulent
143
What does amyl nitrate do to the heart? What murmurs are increased by amyl nitrate and which are decreased?
Amyl nitrate is a vasodilator which causes a decrease in BP and venous return. Murmurs such as AS, AO sclerosis and HOCM are increased. Also a murmur with MVP may be more prevalent, however murmurs MR, AR, and VSD's will typically decrease.
144
What is the simplest carbohydrate group? What are the three classified groups of carbohydrates?
Monosaccharide, the simplest group, and is a single sugar molecule such as glucose or fructose. Disaccharide, polysaccharide, and monosaccharide.
145
Are lipids soluble in water? What are the three major groups of lipids?
No. The three groups are: triglycerides (fats, oils and waxes), phospholipid and steroids.
146
T/F with hypertrophic cardiomyopathy common findings are LVE, LVH and LAE.
False. LVH, LAE, and normal to decreased LV size.
147
What type of transducer can beam steer and focus from a small time delay in the elements firing mechanism?
Sector phased array transducer
148
Describe peak to peak pressure gradient compared to a peak instantaneous pressure gradient. Which is used in Doppler echocardiography?
Peak to peak used in cath, compares the peak systolic right or left ventricular pressure to the peak systolic pulmonary artery or aorta (2 measurements). While peak instantaneous is just one measurement obtaining the instantaneous peak between the 2 chambers and is used in echo.
149
What type of transducer does not have beam steering and produces a rectangle shape?
Linear sequenced array transducer
150
What type of ventricular aneurysm involves only two layers of the heart muscle? What are the two layers?
Pseudoaneurysm. Epicardium and pericardium.
151
In continuous wave ultrasound what is the maximum duty factor value? What is the minimum value?
Maximum is 1 or 100% when the CW is on. Minimum is 0 or 0.0% when CW is off. H
152
T/F A true ventricular aneurysm occurs more frequently than a pseudoanerysm? T/F aneurysm formation is the most complication of an myocardial infarction?
False. True.
153
What are the three parts that make up the respiratory system?
Respiratory system includes the trachea, bronchi and lungs.
154
In the ultrasound beam, where is lateral resolution best? Where is axial resolution best?
Lateral resolution is best at the focus. Axial resolution is best throughout the beams length.
155
T/F True venticular aneurysms have the mouth wider than the body and involve the endo, myo and epicardial ventricular walls?
True
156
What is amarosis fugax? What is syncope?
Temporary loss of sight or blindness in one eye (monocular) caused from decreased blood flow to the retina. Syncope is the medical term for fainting, a sudden, usually temporary, loss of consciousness generally caused by insufficient oxygen in the brain either through cerebral hypoxia or through hypotension, but possibly for other reasons. Typical symptoms progress through dizziness, clamminess of the skin, a dimming of vision or grey out, possible tinnitus, complete loss of vision, weakness of limbs to physical collapse.
157
What does the nervous system consists of?
The paired Vegas nerves, and paired sympathetic chains.
158
What is the name of the most common electronic cardiac transducer?
Sector phased array
159
What is the number one benign cardiac tumor that is made of connective tissue cells?
LA myxoma
160
What body cavity contains the lungs, heart, esophagus, trachea, major blood vessels, endocrine glands nervous system and lymphatics?
Thoracic cavity
161
What dB increase would be considered if the intensity is increased 1000 times greater than the original signal?
30dB
162
What is the number one malignant cardiac tumor?
Sarcoma- it is the most common malignant tumor of the heart, and occurs in the right atrium. Here it can cause right sided heart failure, arrhythmias, pericardial effusion, and cardiac tamponade.
163
What is the most common VSD including adult population?
Perimembraneous VSD
164
What percent does a -3dB loss of original intensity represent?
50% loss of the original intensity.
165
What structure separates the thoracic cavity from the abdominal cavity?
Diaphragm
166
What are the three major types of ASD's? What is the most common ASD?
Sinus venosus (by SVC), primum (by the AV valves), secundum (mid septal area by PFO). Secundum types are most common, approximately 90% of all ASD's are this type.
167
What cavity contains the stomach, gallbladder, pancreas, intestines, liver, spleen, adrenal glands and kidneys?
Abdominal cavity
168
What law is considered the law of refraction? Will refraction occur if there is perpendicular incidence?
Snells law. No.
169
T/F Most ASD's are low velocity with left to right shunting? T/F Longer standing ASD shunts commonly cause RV volume overload?
True. True.
170
What does plasma consist of?
Plasma is 90% water (liquid portion of blood), 8% proteins, nutrients, waste products such as uric acid and creatinine, electrolytes, (various ions such as sodium calcium chloride and bicarbonate), respiratory gases (O2 and C02).
171
What is the most common man made transducer made of?
Lead zirconate titanate (PZT)
172
T/F high velocity VSD jets are typically considered mild?
True, the smaller hole will create a high velocity jet.
173
The frequency of a CW transducer is determined by what factor?
The driving voltage frequency
174
What function do platlets and thrombocytes have?
Platelets and thrombocytes adhere to damaged blood vessel walls and release enzymes that activate hemostasis which stops bleeding.
175
What is in vitro? What is in vivo? What is epidemiology?
Vitro- studies performed in a glass tube. Vivo- performed on animals or plants. Epidemiology is the study of the prevalence of disease.
176
What is persistent left SVC? What is one common echo finding?
Congenital malformation where the last arm drains into the coronary sinus instead of the SVC. A dilated coronary sinus.
177
What is the most common protein and its function? Name a few other proteins and functions?
Albumin. It is produced by the liver and helps to keep osmotic pressure between blood and tissue. Other proteins are hormones, alpha and beta globulins (transport lipids), gamma globulins (antibodies), fibrogen and prothrombin (clotting proteins).
178
What are the main functions of blood? What is anemia? What is erythrocytes?
Transport nutrients, oxygen and hormones, remove metabolic waste and C02, provide immunity through antibodies, maintain body temperature, electrolyte balance and clotting. Anemia is low RBC count and erythrocytes is a high RBC count.
179
What is eisenmengers syndrome? What is a common complication associated with this disorder?
A long standing left to right ASD or VSD the shunt reverses and becomes right to left. Severe pulmonary HTN.
180
What is the basic value of attenuation in soft tissue?
.5-1dB/cm/MHz
181
What are the four blood types? Which is the universal donor?
A, B, AB and O. Type AB is the universal recipient. Type O- is considered the universal donor because it has no antibodies to clump with the antigens of other blood types.
182
What is a common view where the patent ductus arteriosus (PDA) shunt is seen?
Use the PSAX at the aortic level
183
What is thermal index (TI)? What is mechanical index (MI)?
MI- is the potential of cavitation (the higher the MI the larger the potential) TI- estimates temperature rise from ultrasound exposure.
184
Blood and lymph can be checked by chemical tests and coagulation studies. What are the five common tests used for direct examination of blood?
1. Hemoglobin test- measures the oxygen carrying ability of blood. 2. Hematocrit - measures volume of erythrocytes. 3. Sedimentation rates- how long it takes the erythrocytes to settle in the bottom of a container. 4. Blood cell counts (CBC, WBC, RBC) - to evaluate immune disorders and organ function and anemia. 5. Reticulocyte studies- measure the number of immature RBC's.
185
If there is a propagation speed error what might occur?
The echo may be improperly located
186
In which of the following patients would an enteric isolation technique be used?
A. Influenza
B. Draining wounds
C. Respiratory disease
D. Diseases spread by fecal contamination.
D. Diseases spread by fecal contamination.
187
What is ebsteins anomaly? What are three common findings in patients with this anomaly?
Apical displacement of the TV leaflets. TV abnormal, RVVO, ASD.
188
Name the three layers of a vessels wall?
Tunica intima - inner most, media - middle, and adventia - outer layer.
189
What us associated with Huygens principle?
All points on a wave can be considered for secondary smaller waves.
190
What type of aortic dissection is the most common? What is the location?
Type one. Ascending aorta to the aortic arch.
191
T/F With truncus arteriosus the RV has no RV outflow tract and no pulmonic valve?
True
192
What are the arteries that act as controls valves through which blood is metered to the capillaries? What are capillaries and why are they considered Microvessels?
Arterioles. Capillaries are the smallest of a body's blood vessels and are part of the microcirculation. They are only one cell thick. (Microvessels) they connect arterioles and venules, and enable the exchange of water, oxygen, carbon dioxide, and many other nutrient and waste chemical substances between blood and surrounding tissues.
193
What are three other names that lateral resolution may be called? What factor determines lateral resolution?
Transverse, azimuthal, angular. Beam diameter determines lateral resolution.
194
In the PSLAX view what two aortic valve leaflets can be seen? Which leaflet is the closest to the MV in this view?
Right and non coronary. Non coronary.
195
What are three other names axial resolution may be called? What factors determine axial resolution?
Longitudinal, range, depth. Spacial pulse length and the frequency determine axial resolution.
196
What vessel contains deoxygenated blood from peripheral tissue?
Veins.
197
T/F Does the MV have a premature closure when acute severe AI is present? Is the MV effected with loss of sinus rhythm or when a first degree AVB present?
True, true- premature MV closure can occur.
198
What are the three distinct layers of the heart? What is the pericardium?
Epicardium- thin outer layer, myocardium - thick middle muscle, endocardium- inner layer composed of endothelial cells which line the heart valves. Pericardium is the protective sac that surrounds the heart, fibrous parietal and great vessels.
199
What is the function of the matching layer on a transducer?
The matching layer decreases the impedance difference between the piezo crystal and soft tissue. This improves transmission and reception
200
Refraction may often cause artifact known as?
Side lobe artifact.
201
What does fine diastolic flutter of the mitral valve represent on m-mode? What type of murmur is associated with Austin flint?
AI is present. Austin flint murmur is a low pitched diastolic rumble present with severe AI.
202
What is the function of the left atrium and the right atrium? What vessels carry 02 rich blood from the lungs to the left atrium? What three vessels carry C02 to the right atrium?
They both act as a temporary storage chambers so that blood will be readily available for ventricular filling. O2 rich blood enters the left atrium from the four pulmonary veins. Oxygen depleted blood (C02) enters the right atrium from the IVC, SVC and coronary sinus.
203
What are the functions of the left and right ventricles?
The ventricles are the main pumping chambers for the systemic (oxygen rich LV) and (oxygen depleted RV) pulmonary circulation.
204
What is the log of 10,000 equal to?
3
205
Which has a longer ejection time AS or MR?
MR
206
How can AI effect the LV size and wall motion?
LV dilatation, hyperkinesis of the IVS and LV wall.
207
If a patient has chest pain and is given morphine, what effect would it typically have?
It should dull the chest pain and is known for the ability to increase vascular resistance and decrease systemic resistance.
208
What determines the resonant frequency of the transducer?
Crystal thickness
209
Name two mechanisms of bioeffects and describe them?
Thermal - localized heat is produced with ultrasound. Cavitation- small microbubbles are produced as a result of violent agitation.
210
What is the function of a beta blocker? Name four common beta blockers?
Beta blockers slow the sinus rate, depress AV conduction, reduce BP (by blocking part of the sympathetic nervous system). Atenolol, propranolol, labetalol, and metoprolol are four common beta blockers.
211
Which occurs first with AS, LVH or LVE?
LVH
212
Can color shift information be determined by color flow Doppler if blood flow is 90 degrees (perpendicular) to flow?
No, a colorless region may be present.
213
What is the Foramen Ovale and the Ductus Arteriosus function?
Foramen Ovale is a opening across the intratrial septum which allows blood to pass from the RA to the LA while the lungs develop during fetal development. The ductus arteriosus is a connection between the pulmonary trunk and aorta.
214
What murmur typically has a mid systolic upper right sternal border? What murmur has a crescendo decrescendo right sternal S4 sound?
Aortic stenosis murmur. AS murmur.
215
What are three classic symptoms with AS?
Angina pectoris, CHF, syncope.
216
What is the function of calcium channel beta blockers? What are two common Ca++ channel blockers?
Calcium channel blockers block inward movement of calcium to slow impulse conduction (particularly through the AV node). They also relax smooth muscle contraction of the vessels. Diltiazem and verapamil are two common calcium channel blockers.
217
What type of transducer has element that are energized sequentially from inside out and create a circular beam?
Annular array
218
Autorrhythmic activity of the heart can be modified by what branch of the nervous system?
Autonomic nervous system.
219
T/F AS often times may be overestimated if a bad angle or low cardiac output states are present?
False - underestimated.
220
What type of information does color flow Doppler come from?
Multi-gate Pulsed wave Doppler.
221
T/F Low transmit output and high receiver gain is safer than high transmit output low receiver gain?
True
222
What's does the cardiovascular system consist of? What are the three main functions?
The heart, blood vessels and blood. 1. Transport of nutrients, oxygen and metabolic waste removal. 2. Protection by WBC's and antibodies. 3. Regulation of body temperature, fluid PH and H2O content in cells.
223
What is Marfans syndrome? What are some physical abnormalities present with this disorder? What are some common echo findings?
A connective tissue disease. Patients may have long bones and eye problems, MVP, ascending aorta dilatation, and aortic aneurysm.
224
T/F Rheumatic heart disease has been known to effect these three valves with MS, AS and TS?
True
225
What is the propagation of sound inversely proportional to?
The mediums density
226
Where is the highest O2 saturation in the fetal circulation found?
Umbilical vein.
227
T/F As density of the medium increases, the speed increases?
False.
228
Pauses can be seen on an EKG following a PVC or PAC. What are these pauses called? What is an interpolated PVC?
PVC- compensitory pause, PAC - Non-compensitory pause. PVC's that don't have a compensitory pauses are called interpolated PVC's.
229
What are four common findings with TR? Is the LA effected typically with TR?
RAE, RVE (volume overload), flattened septum, vena cava enlargement. No, the LA is not effected.
230
What are the basic four heart sounds?
S1 - Closure of mitral and tricuspid valves (systolic contraction), S2 - Closure of the aortic and pulmonic valves (dicrotic notch), S3 - Rapid filling of blood into the left ventricle, S4 - Atria contracting, pushing blood into the LV and RV (final rush of blood).
231
What are three common findings with stenotic valves?
Thickened leaflets, valvular dimming, reduced cusp separation
232
What will happen to the speed of sound through tissue if the stiffness of the medium increases?
The speed will increase.
233
Name one thing you can do to increase the frame rate?
Decrease the size of the image sector.
234
What is a common chronotropic drug and a common inotropic drug?
Chronotropic=atropine, Inotropic=dobutamine
235
What type of flow is AI and PI? Are these typically seen above or below the baseline with Doppler interrogation?
Diastolic flow. Seen typically above the baseline.
236
If the blood travels away from the transducer the Doppler shift will be?
Negative Doppler shift.
237
What is a false positive test? What is a false negative test?
FP= a positive test, but the patient does not have the disease state. FN= the test shows a negative result, but they really have a diseases state that has been missed.
238
What type of flow is MR and TR?
Systolic flow.
239
What are the inherent fire rates of the SA, AV and perkinje fibers?
SA=60-100, AV=40-60, perkinje=20-40 beats per minute.
240
What are two common early stage findings with MR? What are three late stage findings?
LAE, LVE. Late- RVE, RVH, HTN.
241
What artifact is typical of multi-element transducers?
Grating lobe artifact.
242
What are six common findings with mitral stenosis? Is the LV commonly effected by mitral stenosis?
LAE, HTN, RAE, RVE, LA thrombus, A-Fib. No, the LV is not usually effected unless MR is present.
243
What effect does the valsalva maneuver have on the cardiovascular system?
Decreases venous return.
244
What function on the ultrasound machine would eliminate smaller amplitude voltages produced by weaker echos to reduce unwanted noise?
Reject function.
245
List four findings with AS? Why is there sometimes post stenotic dilatation of the aortic valve with AS? Is the RV usually effected with AS?
LVH then LVE, LAE, decreased LV contractility. Post dilatation may occur because of the high pressure/velocity jet hitting the aortic walls. No effect on RV.
246
What effect is there on the cardiovascular system with isometric exercise? (Sustained handgrip type of exercise).
Increased peripheral resistance, CO, BP, HR are some of the effects.
247
What transducer will avoid aliasing better? 2.5 MHz or 3.5 MHz?
2.5 MHz.
248
How many weeks does it take for the heart to be completely formed?
Seven
249
T/F AI may effect the great vessels and sometimes cause aortic dilatation? What are three common findings with AI?
False. LVE, LAE, hyper dynamic LV.
250
What percentage of time is a pulsed ultrasound system receiving sound?
99.9%
251
In the fetal heart what does the Bulbus Cordes form?
LV and RV.
252
Looking at the monitor, approximately how many shades of gray can the organic human eyeball see?
One hundred.
253
What equation should be used to determine AVA? Does AI effect this equation for an accurate peak velocity? What value is considered severe aortic stenosis?
Continuity of flow equation A2=A1xV1/V2. AI I does not effect the V1/V2 equation. <.7 cm2 is severe.
254
A 97 year old female is scheduled for a TEE. As a perioperative measure, his doctor has given him 25mg of demoral. Upon entry to the lab, his breathing is shallow and he is unresponsive. After notifying the cardiologist, which of the following medications WOULD be MOST useful for counteracting the effects of the narcotic given? A. Versed. B. Narcan. C. Oxygen. D. Valium. E. Verapamil
B. Narcan
255
A change in direction of a sound beam at a interface with two different impedances is called?
Refraction
256
What heart valve is located most superior? On m-mode what abnormality is a common finding with a deep "a" dip of the posterior leaflet >7mm?
Pulmonic. Pulmonic stenosis.
257
What is pectus carinatum?
A protrusion of the chest over the sternum which gives the chest a bowed-out appearance.
258
What are three common findings with PS? T/F The LV and LA are typically effected with pulmonic stenosis? T/F The most common cause of PS is congenital (non-RHD)?
RVH then RVE over time, also possible RAE. False. True.
259
What determines the brightness of an echo signal?
Amplitude.
260
In relation to the EKG what normally occurs with the S2 murmur?
End of T wave.
261
What is the unit of frequency?
Hz
262
Where is a common area a PDA can be viewed from in 2D?
PSAX aortic valve level.
263
Can respiratory inspiration cause a delay in the interval between aortic and pulmonic valve closure?
Yes
264
How does PI effect the RV? T/F The very most common cause of PI is valvular ring dilitation?
RVE with paradoxyl septal motion, possible fine diastolic flutter of the TV leaflets. True.
265
The time it takes for one cycle to occur is called?
Period.
266
(In statistics) What is the greatest common variability of data? What is the statistical mean of 1, 2, 3?
The greatest common variability of data is the "standard deviation". Mean is the average, so the answer is 2.
267
T/F Wavelength increases as frequency increases?
False.
268
What are three causes of TR? T/F Carcinoid Is a TV disease were the valves are thickened and fixed in a closed position?
RHD, carcinoid syndrome, ebsteins anomally. False - fixed in an open position.
269
Name two common radioisotopes used in nuclear myocardial scan?
Thallium 201, Technetium (99m Tc) referred to as Sestamibi.
270
What are three common findings with ASD's?
PA enlargement, RAE, RVE.
271
What does a sound wave carry?
Energy.
272
How many cycles are there in one second in a 7 MHz transducer?
Seven million
273
What are two common findings with VSD's? What is a classic m-mode finding with ASD's? Which direction is the blood flow across the VSD usually?
LAE, LVE, RVVO. Left to right (higher pressure to lower)
274
What is one of the most common protocols used during the treadmill exam?
Bruce protocol
275
Is attenuation higher in soft tissue or bone?
Soft tissue.
276
T/F Aortic coarctation is strongly associated with bicuspid aortic valve?
True.
277
The SA and AVB node receive oxygenated blood from which coronary artery?
Right (RCA)
278
T/F A decreased EPS separation of the MV (m-mode) is usually associated with an increased ejection fraction?
False.
279
What is the crux of the heart?
Where all four heart chambers come together.
280
What term is used to describe when pressure changes a crystals shape from electric voltage hitting it?
Piezoelectric effect.
281
What is automaticity?
The ability of the heart to start and maintain rhythmic activity without the use of the nervous system.
282
What is the bandwidth?
A range of frequencies that occur with a pulse of sound
283
If standing, venous return and ventricular filling will?
Decrease.
284
If there is high O2 sats in the IVC, what abnormality may be present?
ASD
285
What type of modality is 2D imaging?
B mode
286
```
Splitting of S2 is best heard at the?
A. Apex
B. Third left intercostal space
C. Fourth left intercostal space.
D. Second right intercostal space.
```
B. Third left intercostal space
287
Is color flow angle dependent?
Yes
288
T/F On pulsed wave Doppler an an E/A ratio of 2:1 is a normal diastolic value?
False 1.0-1.5 to 1 ratio is normal.
289
What type of EKG signal is produced when the heart depolarizes toward a positive electrode?
R wave
290
Name the two basic ways to focus the ultrasound beam?
Mechanical and electronic
291
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What are the five wall motion assignments? What do the segments define in regard to function of wall motion? T/F number 1 is normal so 2 would be akinetic? Hung kinda mmniichbtk
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The five wall motion segments define the wall motion of the heart as follows: 1. Normal=no obvious abnormality 2. Hypokinetic = lower than normal movement 3. Akinetic = no movement 4. Diskinesis = opposite motion 5. Aneurysmal = a tear or ripping of wall. False-segment 2 represents hypokinesis.
292
What effect does inspiration have on preload? What effect does the valsalva maneuver have on venous return and BP?
Inspiration results in increased preload and increased RV stroke volume. The valsalva maneuver (bearing down) causes decreased BP and and decreased venous return.
293
T/F Doming of a valve is usually caused by valvular regurgitation rather than valvular stenosis?
False - valvular doming is associated with stenosis rather than regurgitation. Valve thickening, decreased leaflet excursion and Doming (tethering) may all occur in valvular stenosis.
294
What is the formula Z=ps used to describe?
Acoustic impedance
295
Which cardiac valve is the first to open and the last one to close in ventricular systole?
Pulmonic valve
296
High frequency transducers will have what type of wavelength and penetration?
Short wavelength and poor depth of penetration.
297
How does poiseuilles law demonstrate the changes in pressure related to the radius of a blood vessel? Which factor had the largest effect on resistance to laminar flow through vessel?
Inversely proportional to the 4th power. The vessels radius.
298
With a PDA what side of the heart is usually effected? What are four common findings with a PDA?
Left. LAE, LVH, LVVO, dilated pulmonary artery.
299
Vagal stimulation of the heart will?
Decrease the SA node rate
300
What happens when a annular array transducer malfunctions?
There will be a horizontal blank space on the CRT.
301
Which would endocarditis most likely cause, PI or PS?
PIKA
302
Name three things that ultrasound systems require periodic testing?
Depth calibration, axial resolution, lateral resolution.
303
What does stimulation of the sympathetic nervous system have on the heart?
It decreases the AV conduction time, which will increase heart rate and contractility.
304
What type of aneurysm is kawasakis disease?
Coronary artery aneurysm
305
What is primary hypertension? What is the cause of PHTN? What are four major risk factors that can develop with high BP?
An increase in peripheral vascular resistance (usually - BP >140/90) The etiology of most HTN is unknown. Risk factors include heart attack, stroke, heart and kidney failure.
306
What is the number one cause of Ischemia? What is Ischemia? What is CHF?
Atherosclerosis. Lack of oxygen to the myocardium. The hearts inability to meet metabolic demands of the body.
307
What ratio does maximum amplitude to minimum amplitude describe?
Dynamic range.
308
What is blood pressure? What is pulse pressure?
Force of the blood against the walls of the arteries. The systolic is when the heart contracts and is the highest number, the lowest number is in diastole when the heart relaxes. Normal pressure is 120/80. Pulse pressure is the difference between the top number and the bottom number.
309
What is Dressler's syndrome?
A post MI pericardial effusion
310
What is temporal resolution? What type of frame rate will help improve temporal resolution?
Being able to determine the position of a moving structure at any given time on the ultrasound system. Higher frame rates improve temporal resolution.
311
Name a common test object used in quality assurance and its purpose?
AIUM 100mm test object -used to evaluate resolution and range performance. (Non-attenuation)
312
What are the two most common congenital abnormalities found in adults?
Atrial septal defect (ASD) and bicuspid aortic valve are the two most common congenital abnormalities found in adults. However, the most common congenital cardiac anomaly is ventricular septal defect which is involved in 20%-30% of all congenital defects.
313
Which percent stenosis is considered to be significant coronary artery disease?
70%
314
T/F Blood flow toward the transducer is above the baseline?
True
315
1. Which of the following coronary arteries provide blood to the anterior wall of the left ventricle? 2. Which to the right ventricle? Which to the inferior septal walls in a right dominant system?
1. LAD (left anterior descending) 2. Right coronary 3. Posterior descending.
316
What is the number one cause of mitral stenosis? What is considered a significant stenosis? What three measurements should you get in a MS study?
Rheumatic heart disease. <1cm2. MVA, P1/2T, PAP.
317
What is contrast commonly used for in an echo study? Where is peripheral contrast appear first?
To determine LV function, also helpful in ASD, TR and VSD studies. Appears in the RA first.
318
What is the Absolute or Effective refractory period of the heart?
When the heart is unable to respond to electrical impulses.
319
With a stenosis, What location is there a typically the most turbulent blood flow?
Distal to the stenosis
320
```
During the holding phase of the valsalva maneuver, which of the following occurs?
A. Increased cardiac output
B. Decreased intrathoracic pressure
C. Increased venous return to the heart
D. Decreased venous return to the heart.
```
D. Decreased venous flow to the heart
321
T/F Plural effusion is commonly difficult to see in the presence of RVH?
True
322
What EKG findings may be present with a patient with the electrolyte disorder hypokalemia?
Peaked P waves (lead 2) and long QT interval, large U waves, also flat T waves.
323
Will color flow Doppler provide peak velocity blood flow information?
No, average velocity.
324
(On a treadmill) What is the hearts largest response to myocardial work and increased oxygen demand?
The heart adapts to work by vasodilation of the myocardial arteroles.
325
In the 2 chamber apical view what 2 LV walls are seen? In the four chamber apical view what LV walls are seen?
2CH-Inferior septal and anterior walls. 4CH-Anterior lateral and septal.
326
What type of Doppler uses autocorrelation?
Color flow Doppler
327
If a person is walking, what is the main mechanism responsible to returning the venous blood to the heart?
Skeletal Muscle
328
What is the curie point? In performing TEE echoes you must keep all transducers sterilized, should you use autoclaving for this?
A temperature 300-400 degrees C that will cause the piezoelectric crystals to permanently lose effectiveness. No.
329
What type of MI involves the right ventricle?
Inferior MI
330
Coronary artery perfusion occurs from?
Epicardium to endocardium
331
What does a darker color shade represent during aliasing? What does the color black represent?
Lower frequency shifts will exhibit darker shades of color. Black represents no Doppler shift (zero baseline)
332
What vessel in the body contains the largest volume of blood?
Veins and venules
333
Name three functions that effect the frame rate of color gain ?
Sector size, color size box, PRF
334
What is hibernating myocardium? What is stunned myocardium?
A living myocardial muscle that is nonfunctioning because of chronic ischemia-perfusion may restore function. Ischemic muscle that is reperfused but still not functioning.
335
Which method is the most common right heart cath method used for predicting cardiac output? Which the most accurate method? What is cardiac output?
Thermodilution. Fick. Cardiac output is the amount of blood pumped out of the heart per minute (SVxHR), normal range is 4-8LPM
336
Cyanosis is often seen in what types of congenital abnormality?
Eisenmenges syndrome, and a number of congenital heart defects including atrial septal defects, ventricular septal defects, patent ductus arteriosus, and more complex types of cyanotic heart disease.
337
How are each of the following units used in ultrasound? Area, circumference, time, volume.
Area-distance squared
Circumference- length or distance (inches or millimeters)
Time- seconds milliseconds (ms) or microseconds,
Volume - cubic units (cc)
338
What is the amount of blood pumped out of the heart per beat called? What is normal range? Is the stroke volume of the LV equal to that of the RV?
Stoke volume (EDV-ESV). The normal range is 70cc-100cc. Yes.
339
In a vessel, what is the number that determines when turbulent flow will occur?
Reynolds number (number greater than 2000)
340
List three findings with post operative cardiac patients?
Paradoxyl septal motion, pericardial effusion, atrial enlargement in some cases.
341
What equation helps to keep the proper depth of a reflection?
Range equation
342
How many pulses does it take to equal one scan line on the image frame?
One
343
Peak instantaneous pressure gradient for a patient with aortic stenosis of 4.0 m/s is?
64mmHg
344
What are the normal left and right heart oxygen saturation levels?
Right heart sats are 70% and the left heart sats are 98%.
345
(In comparing the systemic circulation to the pulmonary circulation) Which has the higher pressure, higher resistance, higher oxygen content, thicker ventricular and vessel walls and lower C02 level?
Systemic circulation
346
What are the two major components of demodulation?
Rectification, smoothing
347
What is the B notch seen on the M mode? What does this indicate?
It is the small notch between the AC point on the mitral valve m-mode, caused from prolongation of the AC interval. Indicates elevated LV diastolic pressure.
348
How do the stenotic aortic and pulmonic valves effect the ventricle chamber first?
Ventricular pressure overload.
349
Name the components of the pulmonary circulation?
RV, main pulmonary artery and branches, pulmonary capillaries, pulmonary veins.
350
What is CRT? What format does CRT write on?
TV screen or computer screen (cathode ray tube), writes in a faster scan format up to 60HZ or 60 frames per minute.
351
Frequency and wavelength are inversely related, what does this mean?
As frequency increases wavelength decreases. As frequency decreases wavelength increases.
352
How does a regurgitant mitral and tricuspid valve first effect the atrial chambers?
MR first creates volume overload of the left heart and TR creates overload of the right heart.
353
Name three components of the systemic circulation?
LV, aorta, systemic capillary network, cerebral, peripheral and abdominal veins, SVC and IVC.
354
How does MS and TS effect the atria first?
MS creates pressure overload of the left atrium and TS creates pressure overload of the RA.
355
The length of myocardial fibril stretch prior to its next contraction is called? What 3 factors influence this?
Preload, LV preload occurs only during ventricular diastole and the 3 measurements that evaluate LV preload are resting fiber length, end diastolic volume and end diastolic pressure.
356
What's does the term BART stand for in ultrasound?
This is the standard direction of blood flow in orientation to the transducer. (Blue-away red-towards)
357
How does AI and PI effect the ventricle first?
Ventricular overload.
358
The resistance (pressure build up) the ventricles face as they eject blood is called? Blood pressure is mainly determined by? Increasing the _____ will cause a decrease in cardiac output.
Afterload, afterload, afterload causes a decrease in CO due to the increase in resistance.
359
With acoustic exposure, what type of ultrasound has the highest intensity levels?
Pulsed wave and color flow Doppler have the highest intensities. m-mode and 2D imaging have the lowest intensities.
360
80 mm is the same as how many centimeters?
8cm
361
Depolarization of the ventricle occurs with the onset of which EKG complex?
QRS
362
Loud S1, opening snap and late diastolic murmur often represent?
Rheumatic mitral stenosis.
363
2 meters per second (m/s) can be written as how many cm per second?
200cm/s
364
What effect does isometric handgrip excercise have on the mitral valve?
Increases the murmur and regurgitation
365
When do the mitral and tricuspid valves close and open in relation to the EKG? Why do they open and close?
MV and TV close with the onset of the QRS. The LV and RV pressure has exceeded the LA and RA pressure. The MV and TV open at the end of the T wave when LV and RV pressure falls below LA and RA pressure.
366
Describe the mitral valve prolapse murmur? Is the 2-D 4 chamber view a good view to determine the presence of MVP?
A MVP murmur is a mid-systolic and late systolic murmur at cardiac apex. NO, MVP may be falsely diagnosed in the 4 chamber.
367
What are the 4 phases of the action potential curve?
Phase 0-1: Cardiac cell repaid depolarization (sodium rapidly enters cell and potassium leaves)
Phase 1: Ealry rapid re polarization (K+ reeneters cel Na+ leaves)
Phase 2: Plateau phase (consides w/ the ST segment and is cardiac contraction)
Phase 3: Final rapid repolarization (Na+ and caa++ out, while k+ returns to cell)
Phase 4: resting.
368
PSAX at the apex of the heart can be seen contracting in what direction?
Counter clockwise
369
What will improve temporal resolution?
Increase the number of images per second (increase PRF - by decreasing the depth)
370
When do the aortic and pulmonic valves open and close? Why?
In early ventricular systole the aortic and pulmonic valves open as the Left and Right ventricle pressures exceed the aortic and pulmonic pressure. They close when the pressure in the ventricles fall below the aortic and pulmonic pressure.
371
(T/F) Does the TV open before the MV? Does the MV close before the TV?
True. True.
372
Anterior clear space is seen between the epicardium and myocardium, what is the most likely?
Fat tissue (adipose tissue)
373
What is the muscle bundle that attaches from the RV free wall to the IVS?
Moderator band.
374
Which semilunar valve opens first? Which semilunar valve closes first?
Pulmonic, aortic.
375
What is the subpulmonic area of the RV?
Infundibulum.
376
What vessel has the lowest O2 saturation?
Coronary sinus.
377
How does tricuspid regurgitation affect the right atrium? How does it effect the the right ventricle?
Tricuspid regurgitation may cause right atrial enlargement due to volume overload. The right ventricle may become dilated and present hyperdynamic wall motion.
378
What is the sequence of cardiac conduction?
SA node - Internodal tracts - AV node (RA muscle then To the LA muscle) - His bundle - R and L bundle branches (left has 2 sections the anterior and posterior) - perkinje fibers.
379
How do the layers of the heart muscle depolarize when ventricular depolarization occurs? Coronary artery perfusion occurs from?
Endocardium to epicardium. Epicardium to endocardium.
380
Where is the tricuspid valve located? Name the three tricuspid valve leaflet (cusps) in relation to the right ventricle?
The tricuspid valve is located between the right atrium and right ventricle. The cusps are Anterior, posterior, and medial septal.
381
```
Sound travels though tissue at approximately:
A. 154.0 m/s
B. 1,540.0 m/s
C. 15,400 m/s
D. 154,000 m/s
```
B. 1,540 m/s
382
What is the medical term for headaches?
Cephalagia
383
What pulmonic valve normally seen on m mode? What is the most common cause of pulmonic stenosis?
The posterior pulmonic valve is usually seen on m mode. Congenital abnormality is the most common cause of pulmonic stenosis.
384
An incision into the gallbladder is named?
Cholecystotomy
385
What 2D view is best for visualizing tricuspid regurgitation? What are two main echo findings with chronic tricuspid regurgitation?
Apical four chamber is the best for visualizing tricuspid regurgitation. Findings with chronic tricuspid regurgitation are right ventricular volume overload and right ventricular dilitation.
386
Breakdown of fat is called?
Lipolysis
387
T/F Aortic valve peak velocities can often be detected from the apical four chamber view?
False. (Five chamber view)
388
A common word for sternum is?
Breast bone.
389
T/F Mapping is one of the most common used methods of quantitating the severity of a regurgitant jet?
True
390
What is "under the skin" referred to?
Hypodermic or subcutaneous.
391
What is 4v squared?
The modified Bernoulli equation.
392
T/F Congenital bicuspid mitral valve typically has a larger anterior leaflet and a smaller posterior leaflet?
True
393
What does the word stetho mean?
Chest
394
Before a medical procedure a patient should sign an informed consent. What are two general principles concerning informed consents?
1. Consent forms must be signed by the patient prior to preoperative medication administration (such as Demerol). 2. A patient that sign an informed consent - protects the medical staff from claims of unauthorized procedures.
395
Describe parachute MV? The mitral valve consists of two valve leaflets (anterior and posterior), what other structures are part of the MV apparatus?
Parachute MV is the abnormal condition in which the LV papillary muscles are closer than normal or fused to create a single papillary muscle. The other structures of the normal MV include the LV walls, mitral annulus and papillary muscles.
396
What is a common ventricular finding with infundibular pulmonic stenosis?
Hypertrophied portion of the RV outflow tract.
397
What is the function of the spleen? What is the function of the hepatic veins?
The spleen filters plasma and dead RBC's and store blood. The hepatic veins drain directly into the IVC to drain deoxygenated blood from liver.
398
A 89 year old male with jugular venous distention and a pericardial knock; What might be the diagnosis?
Constrictive pericarditis
399
Breaches of patients confidence may result in what law suit?
Libel and slander
400
22 year old female seen in the ER with a severe ripping feeling; What might be two possible diagnosis?
MI or aortic dissection.
401
Performing treatment without the patients informed consent, the physician runs a risk of suit for?
Assault and battery
402
In the PSAX - what wall can be seen at the top of the screen? Which is at the bottom?
The top is the anterior wall. The bottom is the inferior wall.
403
What statute generally protects a physician from civil liability in cases of rendering emergency care if done with a good faith and due caution?
Good Samaritan statues
404
What chamber is the lateral wall seen in?
Four chamber
405
What is the factor you multiply red blood cells by if you are doing a RBC count? What is considered a normal white blood count? What would a WBC of count of 22,000 indicate?
Multiply buy 10,000 for a RBC count. 5,000-10,000 is a normal WBC count. WBC of 22,000 indicates a systemic infection.
406
```
Which of the following is most influenced by distance from the face of the transducer?
A. Frequency
B. Wavelength
C. Axial resolution
D. Lateral resolution
E. Medium
F. Nyquist limit.
```
D. Lateral resolution
407
In RBC blood transfusions, what blood type is the universal donor? What is the universal acceptor? What blood types are compatible for the universal receptor?
O- is the universal donor and they can only receive type O-. AB+ is the universal acceptor and they can receive A+,A-,B+,B-,O+,O-,
AB+,AB-
408
What coronary artery delivers blood to the anterior and anterior septal wall of the heart?
Left.
409
What coronary artery usually supplies the anterior lateral and inferior lateral wall?
Circumflex (left)
410
What percentage is the normal right side heart pressure compared to that of the left side heart pressure?
Right heart is approximately 20% of the left heart.
411
What artery supplies the RV apex and the RV free wall?
Right
412
What is the most common diagnostic modality used in a chest X-ray? Name two possible cardiac related findings in X-rays? Is X-ray able to detect coronary artery disease?
PA and lateral. Cardiomegaly and increased pulmonary vascularity are two findings seen on X-ray that may indicate cardiac abnormalities are present. No, there are no specific findings for CAD on X-ray.
413
What is the first downward deflection on the EKG that follows the P wave? What does the QRS complex consist of? What does the QRS represent? What is the normal time duration for the QRS complex?
Q wave, the QRS consists of the Q wave, the R wave, and the S wave. It is produced by the ventricular depolarization and is associated with ventricular contraction. .06 to .12 seconds is the normal duration.
414
What percent of patients have a right dominant coronary artery supply? What does this mean? What 2-D view is best for visualizing the coronary arteries?
80-90%. This means the right coronary artery supplies the crux and the posterior descending artery. (PDCA-determines dominance). Parasternal short axis at the AoV level.
415
In mitral stenosis what is considered a severe p1/2 time and what is a severe MVA?
>220 p1/2time and MVA <1.0cm2
416
What are the largest white blood cells called ?
Monocytes.
417
What are the neurons that carry impulses toward the brain or spinal cord?
Afferent neurons
418
What is the normal thickness of the IVSd?
7-11 mm
419
What is the basic description of right heart catherization? Are all of the following pressures measured in a right heart cath? RA, RV systolic, RV end diastolic, systolic pulm artery, end- diastolic pulm artery, mean and pulm artery wedge pressure.
A catheter is inserted in a femoral antecubital vein and advanced to the SVC, IVC, RA, RV and main PA to obtain pressures and oxygen saturation levels. Yes
420
What is the only artery that carries deoxygenated blood?
The pulmonary artery.
421
What is present in the blood that causes red blood cells to appear red?
Oxyhemoglobin
422
What normally causes the patent Foramen Ovale (PFO) to close after birth? What is is called when the PFO remains open after birth? What view is best for evaluating a patient with this anomaly?
Higher LA pressure. Patent ductus arteriosus (PDA). The parasternal short axis view at the basal level is the best view for detecting the PDA. Usually blood flows in a left to right direction from the aorta to the pulmonary artery during diastole.
423
What are three basic divisions of the heart?
Basal, Mid, apical
424
What nerves regulate the heartbeat? What happens when the parasympathetic nervous system is stimulated?
Sympathetic and parasympathetic nerves. There will be a decrease in HR if the parasympathetic nervous system is stimulated.
425
Lying on the stomach is referred to as?
Prone position.
426
```
If the relative output of an ultrasound instrument is calibrated in decibels and the sonographer increases the output by 50 dB, how many times will the beam intensity increase?
A. 2
B. 100
C. 100,000
D. 1,000,000
```
C. 100,000
427
What is CAD directly associated with?
Restricted blood flow to the heart muscle
428
What does the isles of langerhans produce?
Insulin
429
T/F Pericardial effusions are commonly present with chronic renal failure?
True
430
What is a condition in which the heart is unable to pump adequate amounts of blood to tissues and organs?
Cardiac failure.
431
What do the following abbreviations mean? Qid, STAT.
Qid- medication given four times a day. STAT - immediately.
432
What do the following medications do? Analgesics, antibiotics.
Analgesics - relieve pain, antibiotics fight infection.
433
Disinfectants destroy?
Bacteria.
434
What is another name for the RV outflow tract?
Infundibulum
435
Describe ebsteins anomaly an what echo view is best to asses this?
A congenital defect where one or more of the tricuspid valves are displaced. The apical four chamber view or the subcostal view is best for viewing this tricuspid abnormality.
436
The polarized state of the heart is considered the?
Resting state.
437
Upon viewing the echo screen and observing the EKG - When does the aortic valve open in relation to the EKG?
Aortic valve opens at the end of the QRS complex.
438
Where does V1 go when placing an electrode on the patients chest?
4th intercostal space down from the right clavicle.
439
T/F The most amount of ventricular filling occurs in a phase of diastole called "active filling"?
False, the passive (rapid) stage of diastolic filling accounts to approx 70% of filling? "Active filling" is when atrial contraction (a-kick) occurs, there is approx 30% of the remaining ventricular filling.
440
What precordial ECG lead is placed 5th intercostal down mid -axillary?
V 6
441
What would you consider a heart rhythm that is regular and a heart rate of 98.6 BPM?
Sinus rhythm
442
Which patients are at higher risk of infective endocarditis?
1. Arrhythmia
2. CAD
3. Aneurysmal pericardium
4. Valvular disease
4. Valvular heart disease and prosthetic heart valves increase the risk for infective endocarditis.
443
What is pectus excavatum?
A condition in which the "breast bone" (sternum) appears sunken in the chest, concave.
444
What is the most common type of right ventricular outflow obstruction? Name three types of RV obstruction?
At the valvular level is the most common type of RVO obstruction. Two other less common types may be subvalvular and supra valvular.
445
```
A ventricular wall motion abnormality that is reversible with nitroglycerin is associated with:
A. Pericarditis
B. Myocardial fibrosis
C. Myocardial ischemia
D. Myocardial infarction
E. Stunned myocardium
```
Myocardial ischemia
446
An extension cord running under the patients bed is likely to produce?
AC interference.
447
What is the most reliable m mode finding for pulmonary hypertension?
Notching or flying W appearance due to mid systolic closure of the pulmonary valve
448
What is the name of the most common restrictive cardiomyopathy in which a thickened bright shiny myocardium is present.
Amyloidosis
449
Where is the U wave on the EKG?
A small U wave may sometimes be seen between the T wave and the P wave.
450
What does the T wave represent?
Repolarization of the ventricles.
451
What is the name of the hypertrophy describing an interatrial septum that has a primary appearance of a "dumbbell shaped" (thick septum but thin at the level of the fossa ovalis)?
Lipomatous hypertrophy
452
What is the normal EKG paper speed?
25mm per second
453
What structure has the lowest oxygen saturation level of nay structure in the body? What is the normal oxygen (02) saturation for the right heart? What is the normal O2 saturation level of the normal left heart? Do the pulmonary veins have a high oxygen saturation level?
The coronary sinus has the lowest O2 saturation in the body. Right heart
454
What is the name of the hypertrophy describing an interatrial septum that has a primary appearance of a "dumbbell shaped" (thick septum but thin at the level of the fossa ovalis)?
Lipomatous hypertrophy
455
What is the normal EKG paper speed?
25mm per second
456
What structure has the lowest oxygen saturation level of nay structure in the body? What is the normal oxygen (02) saturation for the right heart? What is the normal O2 saturation level of the normal left heart? Do the pulmonary veins have a high oxygen saturation level?
The coronary sinus has the lowest O2 saturation in the body. Right heart chamber saturation is normally around 75%. Left heart saturation is normally around 98%. Yes, the pulmonary veins have the highest 02 sat level.
457
What sensors are used for a 2 lead ECG?
R-arm (negative) and L-leg (positive) electrode placement.
458
When do the aortic and pulmonic valves open and close? Why?
In early ventricular systole the aortic and pulmonic valves open as the left and right ventricle pressures exceed the aortic and pulmonic pressure. They close when the pressure in the ventricles fall below the aortic and pulmonic pressure.
459
How many grades of murmurs are there? What is the least intense murmur? What is the strongest murmur?
Six grades, the weakest would be 1/6, the strongest would be 6/6. A moderately loud murmur would be 3/6.
460
What are four reasons a patient may have a wandering baseline EKG?
Bad prep, bad sensor, oily skin, movement.
461
What is Ejection Fraction? What is the normal value? Name three things Ejection Fraction (EF) can determine?
The percentage of blood pumped out of the LV during systole. Normal percentage is 60-75%. Overall heart function, Cardiac output, wall motion.
462
What percent is the normal arterial 02 saturation level? (Sa02)
93-98%
463
How many pulmonary veins are there? How do the pulmonary veins connect to the systemic circulation? What echo view is the best for viewing the pulmonary veins?
There are 4 pulmonary veins. The oxygenated blood leaves the lungs through the pulmonary veins p, which returns it to the left heart, completing the pulmonary cycle. This blood then enters the left atrium, which pumps it through the bicuspid valve (mitral valve), into the left ventricle. The blood is then ejected through the aortic valve and distributed to the body through the systemic circulation. Four chamber view.
464
What is ejection fraction? What is the normal value?
The percentage of blood pumped out of the LV during systole. Normal percentage is 60-75%.
465
Is dobutamine a pharmacological agent that is considered a positive inotrope and chronotrope?
Yes
466
What three vessels arise from the arch of the aorta? Which is the first artery that arises from the aortic arch?
The three arteries are the brachiocephalic artery (Innominate artery), left common carotid artery and left subclavian artery. The brachiocephalic artery is the first large branch of the aortic valve.
467
How many pulmonary arteries are there? Does the pulmonary artery bifurcate? Describe the flow of blood through the pulmonary artery. What is the normal mean flow velocity across the pulmonic valve?
There is one main pulmonary artery. Yes, it does bifurcate - from the right ventricle, blood is pumped through the pulmonic (semilunar valve) into the main pulmonary artery. This blood enters the two pulmonary arteries (and bifurcates one for each lung) and travels through the lungs. 0.7 m/s is the average pulmonic flow velocity.
468
Is adenosine considered a coronary vasodilator?
Yes
469
What is inotrope? What is chronotrope?
Inotrope - increases the contractility of heart. Chronotrope - increase the pacemaker firing rate of heart.
470
When evaluating the heart from different echo views, it is important to look for abnormalities. List several common questions you should keep in mind when you image?
Is there evidence of an effusion? Mitral, aortic, tricuspid or pulmonic valve disease? LV, RV or septal wall thickness? Any chamber size enlargement or masses? Segmental wall motion abnormalities or decreased LV function? Color flow and Doppler velocities normal?
471
```
Difficulty in determining echocardiographic signs of tamponade may occur in the presence of:
A. Right pleural effusion
B. Systemic hypertension.
C. Left ventricular dysfunction
D. Right ventricular hypertrophy
E. Infundibular stenosis
F. Coronary sinus dilatation
```
D. Right ventricular hypertrophy
472
What will nitrates (nitro) do to smooth muscle? Will this effect after load? Why should you keep nitro in a dark bottle out of direct light?
Vasodilates smooth muscle. Yes, this will decrease after load. Light will degrade the effect of the nitro.
473
In statistics, what is the most commonly occurring value out of many numbers?
Mode: example: Out of the numbers 1,2,7,5,5,3,5,9 the mode would be 5 because It occurs the most.
474
Is it possible for a medication or lab specimen to slowly lose its potency, or simply deteriorate as a result of aging?
Yes
475
What is the refractory period?
The time that immediately follows a stimulus to the cardiac muscle and will not respond to new stimulus.
476
What is PAW? What does it reflect?
Pulmonary artery wedge pressure. It reflects the LA and LV end diastolic pressure which is usually (3-8mmhg)
477
What are 2 ways to determine severity of AI?
2 ways to determine the severity of aortic regurgitation - look for the p1/2 time slope and also the vena contracta.
478
What effect does the valsalva maneuver (sustained bearing down) have on the cardiovascular system?
Decreased blood pressure and decreased venous return
479
What does inspiration have on the cardiovascular system?
Increases the right atrial venous return and the hearts stroke volume.
480
Why is it common for moderate AI to eventually cause left atrial enlargement?
Moderate AI will cause LV volume overload, (then LVH over time) the LA enlargement is also common due to volume of back flow blood.
481
What abnormality is primarily seen with HCM?
Thickened ventricular walls, increased LV mass and raised ventricular diastolic pressure. There are 2 types of HCM - either obstructive (HOCM) which van cause syncope and has been known to cause sudden death. Also non-obstructive (HCM). Use of the valsalva maneuver may help provoke obstruction.
482
What ion enters the heart in systole to make the heart contract?
Ca++
483
What is the voltage of a resting cardiac muscle cell?
-90mv
484
What are the three main coronary arteries? When does coronary blood flow occur?
RCA, LAD, Circumflex. Diastole
485
What is streptokinase? What is heparin?
Streptokinase is a thrombocytes do dissolves clots. Heparin blocks clot formation, (blood thinner), so clots won't get larger.
486
During isovolumic contraction which cardiac valves are open? During isovolumic relaxation what valves are closed?
The four valves (MV, TV, AOV, PV) are closed during both of the isometric stages.
487
What is the first thing you should do according to the American heart association if an adult patient collapses and is unresponsive?
Activate the local emergency medical services number.
488
What is the most common life threatening complication of myocardial infarction?
Cardiac arrhythmias
489
What is the normal cardiac valves function in regard to the direction of blood flow? In the case of a stenotic area of a vessel or valve, where typically is the highest velocity of blood flow found?
One way or unidirectional flow. Proximal to the stenotic area is where the highest velocity will be found.
490
Describe how cardiac muscle contracts when sarcoplasmic reticulum releases calcium?
Myosin cross bridges form, then the calcium released by sarcoplasmic reticulum binds to troponin molecules in the actin helix this causes contraction.
491
Name 2 other common names for the obstructive variant of hypertrophic cardiomyopathy (HOCM)?
The obstructive variant of HCM, hypertrophic obstructive cardiomyopathy (HOCM) has also historically been known as idiopathic hypertrophic subaortic stenosis (IHSS) and asymmetric septal hypertrophy. (ASH)
492
Name three things chest pain or angina may be caused by?
Embolus, tissue hypoxia, plaque
493
What is the first mechanical event in the cardiac cycle? What is the name for the amount of blood pumped from the ventricles in a solo systolic event? Why is CO/HR called?
Ventricular systole, stroke volume. Stroke volume= CO/HR
494
Name three things ejection fraction (EF) can determine? What is considered a normal EF?
Overall heart function, cardiac output, wall motion. Normal EF is usually >60%.
