Comprehensive Transthoracic Echocardiogram TTE Flashcards
Using ASE Guidelines and DeWitt Echocardiography (288 cards)
1
Q
According to ASE Guidelines list 2 parameters for measuring the IVS and posterior wall in the parasternal long axis view.
A
-At End diastole or peak R wave,
-largest volume,
-interface of compacted myocardium excluding other inserting structures, -just below MV leaflet tips, same time
-level of LVED dimension, only compacted tissue measured.
2
Q
How does one determine which pulmonic valve cusp is the right posterior cusp in the RVOT view?
A
The right posterior cusp of the PV is easily identified because it is the cusp adjacent to the aortic valve.
3
Q
Define Perpendicular
A
a 90° angle or T
4
Q
Identify which image a sonographer uses to estimate the right atrial pressure. Then explain what finding would indicate a right atrial pressure of 8mmHg.
A
Using the subcostal view the sonographer would assess the IVC. There are two parameters: IVC size and IVC collapsibility.
If one of these is abnormal and the other is normal, the RAP is estimated at 8mmHg.
5
Q
Describe the method to measure the pulmonary artery from the parasternal short axis view.
A
Midway between the PV and the PA bifurcation using and inner edge to inner edge technique at end diastole.
6
Q
When measuring the left ventricular posterior wall care must me made to not include which structure and why?
A
The MV apparatus including chordae tendinae and papillary muscle.
7
Q
Describe the method for measuring leading-edge to leading-edge.
A
The measurement begins at the first depth where the structure is seen and continue until the last depth the structure is seen.
8
Q
In the parasternal long axis view, the __________ is located within the myocardium, while the __________ is posterior to the left atrium and a separate structure.
A
coronary sinus, descending AO
9
Q
The posterior mitral valve leaflet is shaded in which color?
A
yellow
10
Q
Define Compacted Myocardium.
A
The border between the anechoic blood filled chamber and the myocardium once it is dense, excluding any trabeculations.
11
Q
In the PSAX view at the base, what chamber is the most anterior visualized?
A
RV
12
Q
At what point in the cardiac cycle should the aorta be measure?
A
End Diastole
13
Q
In the right ventricular inflow view, the _________ lies between the coronary sinus and the inferior vena cava.
A
eustachian valve
14
Q
The left coronary cusp is outlined in what color?
A
Purple
15
Q
Which measurement is made using inner-edge to inner-edge technique in the PLAX window?
A
LVOT, Annulus
16
Q
Describe laminar flow patters
A
smooth, organized with parabolic velocity profile (slower flow near walls, faster in the center)
17
Q
Describe turbulent flow
A
irregular, chaotic with irregular velocities due to the disordered movement, random directions
18
Q
What view is the RV basal diameter in (for measuring purposes)?
A
Apical RV focus
19
Q
how do you measure the RV basal diameter in Apical RV focused view?
A
end diastole, near TV annulus, compacted myocardium to compacted myocardium from septal wall to lateral wall of the RV
20
Q
What is the normal measurement for the RV basal diameter in women?
A
3.98cm (greater than that is dilated)
21
Q
What view is the IVS (for measuring purposes)?
A
PLAX LV focus view
22
Q
How do you measure the IVS in PLAX?
A
end diastole, leading edge to leading edge, at the interface where the RV cavity meets compacted IVS & where the IVS meets the LV cavity
23
Q
What is the normal measurement for the IVS in women?
A
6-9mm
24
Q
In what view is the LVID (left ventricular internal dimension) for measuring purposes?
A
PLAX
25
How do you measure the LVID (left ventricular internal dimension) in PLAX?
end diastole & end systole, leading edge to leading edge, compacted myocardium of the IVS to the compacted myocardium of the posterior wall, just below the MV leaflets
26
What is the normal measurement for the LVID in women? (end diastole)
LVIDd 38-52mm
27
What is the normal measurement for the LVID in women? (end systole)
LVIDs 22-35mm
28
In what view is the LVPW? (left ventricle posterior wall) for measuring purposes?
PLAX
29
How do you measure the LVPW in PLAX?
end diastole, leading edge to leading edge, compacted posterior wall of the LV cavity to the LVPW to the pericardial interface
30
What is the normal measurement of the LVPW in women?
27-38mm
31
In what view is the LVOT (for measuring purposes)?
PLAX zoomed/LVOT focused
32
How do you measure the LVOT in PLAX?
mid-systole, inner to inner, approx. 3-10mm from valve, compacted myocardium VS to anterior MV leaflet
33
What is the normal measurement for the LVOT in women?
18-22mm
34
In what view is the AO root (for measuring purposes)?
PLAX zoomed LVOT focused
35
How do you measure the AO root in PLAX?
mid-systole, inner to inner, right coronary & non coronary leaflet insertion points at maximal opening of the valve.
36
What is the normal measurement of the AO root in women?
23 +- 2mm
37
In what view is the ascending aorta (for measuring purposes)?
PLAX
38
ignore
39
In what view is the LA (for measuring purposes?)
PLAX
40
How do you measure the LA in PLAX?
end diastole, leading edge to leading edge, at the level of the SoVA of AO root to PW
41
What is the normal measurement of the LA in women?
27-38mm
42
In what view is the ascending AO (for measuring purposes)?
PLAX
43
How do you measure the ascending AO in PLAX?
end diastole, leading edge to leading edge, at the largest dimension above the AO sinus
44
What is the normal measurement of the ascending AO in women?
27 +- 4mm
45
What are the 3 equations for stroke volume (SV)?
1) SV = EDV-ESV
2) SV (cm ^3) = VTI (cm) x CSA (cm^2)
3) SV (mL) = Pi r ^2 (cm^2) x VTI (cm)
46
Define stroke volume (SV)
The volume of blood ejected by the LV during each contraction
47
What are some clinical applications in which you would use an equation for SV?
-valvular regurgitation
-post physiologic/pharmacologic interventions
-pulmonary to systemic blood flow for patients w/ intracardiac shunts
-cardiac function
-cardiac output
-LV function & volume
-valvular disease
48
Define the Velocity Pressure Relationship - Simplified Bernoulli Equation
Describes the relationship between the velocity of blood flow & the pressure gradient across a stenotic or regurgitant valve. An increase in velocity of a fluid results in a decrease in pressure.
49
What are some clinical applications for the velocity pressure relationship - simplified Bernoulli Equation?
-valvular stenosis
-valvular regurgitation
-artery pressures (pulmonary)
-septal defect
50
What is the Pressure Relationship - Simplified Bernoulli Equation?
ΔP = 4v²
ΔP = 1/2ρv² where ΔP is the pressure difference, ρ is the fluid density, and v is the velocity difference between two points in the flow
51
Define Preload
AKA end-diastolic pressure, the degree of stretch the ventricular myocytes stretch at the end of diastole.
52
What are some circumstances that influence Preload?
-venous return
-diastolic dysfunction
-mitral stenosis
-Anything that prevents blood from easily filling the ventricle.
53
Define Afterload
the resistance the heart must pump against in order to eject blood out of the ventricles
54
What are some circumstances that influence Afterload?
-valve hypertension
-valve stenosis
55
Using a PW Doppler to measure the flow area of the LVOT what view do I need to be in?
A4C or A5C
56
What normal flow pattern is this and in what view?
the flow pattern of a normal LVOT in A5C
57
What is the normal velocity range for the LVOT in A5C for a PW measurement?
0.7 - 1.1m/s
58
Using a PW Doppler to measure the flow area of the ascending AO forward flow through the AO valve, what view do I need to be in?
SSN through LV Apex
59
What normal flow pattern is this and in what view?
the ascending AO forward flow through the AOV, SSN-LV Apex view
60
What is the normal velocity range for the ascending AO forward flow through the AOV for a PW measurement?
(less than) < 2m/s
61
Using a PW Doppler to measure the flow area of the descending AO Thoracic, what view do I need to be in?
SSN, Subcostal
62
What normal flow pattern is this and in what view?
descending AO Thoracic, SSN/Subcostal
63
What is the normal velocity range for the descending AO Thoracic for a PW measurement?
100-140cm/sec
64
Using a PW Doppler to measure the flow area of the descending AO proximal abdominal, what view do I need to be in?
SSN/subcostal
65
What normal flow pattern is this and in what view?
descending AO proximal abdominal
SSN/subcostal
66
What is the normal velocity range for the descending AO proximal abdominal for a PW measurement?
60 - 100cm/sec
67
Using a PW Doppler to measure the flow area of the LV Inflow (mitral) what view do I need to be in?
A3C, A4C, APICAL LAX
68
What normal flow pattern is this and in what view?
LV inflow (mitral), A4C
69
What's the E Wave characteristics for LV Inflow of the A4C view?
-early diastole
-passive filling of the LV
-usually 1cm/sec
70
What's the A Wave characteristics for LV Inflow of the A4C view?
-flow from atrial contraction
-varies by many conditions
71
Using a PW Doppler to measure the flow area of the RVOT & what view do I need to be in?
PLAX, PSAX (AV level), SUB Short-Axis
72
What normal flow pattern is this and in what view?
RVOT, PSAX
73
What is the normal velocity range for the RVOT for a PW measurement?
0.5 - 1.3m/s
74
Using a PW Doppler to measure the flow area of the RVIT Tricuspid TV Inflow & TV regurgitation what view do I need to be in?
A3C
75
What normal flow pattern is this and in what view?
RVIT Tricuspid TV Inflow & TV regurgitation, A3C
76
What is the normal velocity range for the RVIT Tricuspid TV Inflow & TV regurgitation for a PW measurement?
0.3 - 0.7m/s
77
Using a PW Doppler to measure the flow area of the LA Inflow Pulmonary Valve, what view do I need to be in?
A4C
78
What normal flow pattern is this and in what view?
LA Inflow Pulmonary Valve, A4C
79
What is the normal velocity range for the LA Inflow Pulmonary Valve for a PW measurement?
0.5m/s
80
Using a PW Doppler to measure the flow area of the RA Inflow (Hepatic veins) what view do I need to be in?
SSN/Subcostal
81
What normal flow pattern is this and in what view?
RA Inflow (Hepatic veins), Subcostal
82
What is the key factor to obtain accurate color flow doppler and spectral doppler?
Making sure your angle is 0 degrees/ parallel to flow
83
What is the appropriate color Nyquist limit setting for Adult Echos?
60cm/sec
84
What is the appropriate sweep speed setting for measuring elements of time on the spectral doppler graph?
100mm/sec
85
What normal flow pattern is this and in what view?
RVOT, PSAX
86
List some RV characteristics
-thin
-most arteries chamber
-moderator band
-complex crescent shape
87
What is the wall thickness of the RV?
1-5mm
88
When do you measure RVOT?
end-diastole
89
When do you measure the IVS?
end-diastole
90
Which valve has an E & A wave?
Mitral
91
When does the E & A wave happen?
during systole
92
What vessel has an S,D, & A Wave?
Pulmonary valve
93
What is the P Wave?
the atrial kick
94
What 2 structures have similar flow?
Pulmonary valve & IVC
95
Why is the tricuspid the biggest?
because it works at lower pressure
96
Which valve is the biggest?
Tricuspid
97
What 3 things drain into the RA?
-coronary sinus
-IVC
-SVC
98
What 4 things drain into the LA?
-right 7 left pulmonary valves
-Superior & inferior pulmonary valves
99
What is an indication that the IVC is dilated?
RA pressure is too high
100
What does ET mean and when does it happen?
ejection time, during systole
101
When do you measure the AO diameter?
end-diastole
102
When in A2C what do you NOT want to see?
the RV
103
How do you get to A2C?
90 degrees from A4C then turn another 30 degrees
104
What does the arrow reveal?
Moderator band
105
What does the arrow reveal?
LV false tendon
106
In the PLAX LV what 12 things do we document?
-RV wall
-RVOT prox
-IVS
-LVIDd
-LVIDs
-PWT
-LA
-LVOT
-AOV annulus
-SoVa
-Sinotubular junction
-Prox. AAO
107
What 8 structures in the PLAX LV do we measure at End-diastole?
-RV wall
-RVOT prox
-IVS
-LVIDd
-PWT
-SoVa
-Sinotubular Junction
-Prox. AAO
108
What 2 structures in the PLAX LV do we measure at End-systole?
-LVIDs
-LA
109
What 2 structures in the PLAX LV do we measure mid-systole?
-LVOT
-AOV annulus
110
What is LVEF?
a measurement of how much blood is pumped out of the LV chamber per contraction or heartbeat
111
What is FS?
a % of the LV size reduction from diastole to systole as measure from the basal segments via M-mode or 2D linear measurements
112
What is the best method of measurement to acquire the LV volume and LVEF?
2D biplane method of disk summation
113
Describe the RV
-thin
-squeezes concentrically during systole
-smaller
-more trabeculated
-complex crescent (triangular) shape
114
What is the most anterior chamber?
The RV
115
What is the RVOT prox normal range?
20 - 30mm
116
RVOT can be measure in what 2 planes?
PLAX & PSAX base
117
What 2 structures are 1:1 ratio in thickness?
the IVS & LVPW
118
What 2 structures are thicker than the RV wall?
the IVS & LVPW
119
When do you acquire the IVS dimension in PLAX?
end-diastole
120
When do you acquire the PWT (posterior wall thickness) in PLAX?
end-diastole
121
what is the normal range in both male and female for the IVS & PWT?
females: 6 - 9mm
males: 6 - 10mm
122
What is the largest chamber?
the LV
123
Where is the LV located?
posterior and lateral to the RV
124
Describe the LV
-longer than RV
-less trabeculated than RV
-may possess false tendon
-ellipsoid in shape
125
What are the normal ranges for LV dimensions for end-diastole?
females: 38 - 52mm
males: 42 - 58mm
126
What are the normal ranges for the LV dimensions for end-systole?
females: 22 - 35mm
males: 25 - 40mm
127
What does the LVOT do?
allows laminar flow from the LV out to the aorta
128
What is the normal range for the LVOT diameter?
18 - 22mm
129
How far do you measure the LVOT from the aortic orifice?
5 - 10mm
130
Where do you measure the LVOT?
inner edge to inner edge of the septal endocardium to the inner edge of the anterior mitral valve leaflet, proximal and parallel to the plane of the AOV
131
What is the AMVL (anterior mitral valve leaflet) part of?
it is continuous with the posterior wall oof the aorta
132
Which is more liable with an unrestricted opening? The AMVL or the PMVL?
AMVL
133
Does the MV prolapse beyond the annular place into the LA?
no
134
What is the most posterior chamber?
the LA
135
Which chamber is the reservoir that receives pulmonary Venus return?
the LA
136
Which chamber is a contractile pump?
the LA
137
Is the LA gender dependent?
yes
138
In PLAX when do you acquire the LA linear dimension?
end-systole
139
Where do you acquire the LA linear dimensions? (how do you measure)
perpendicular to the AO root, at the level of the AO sinuses using the leading edge to leading edge technique
140
Does the PLAX provide the most accurate assessment of the LA size?
no
141
What's another method that could be used to assess the LA size?
LAVi (LA volume index)
142
What 2 structures can be seen within the myocardium of the SAX view?
the coronary sinus & DAO
143
Where is the CS and DAO located in the SAX view?
posterior to the left atrioventricular junction (LA-LV junction)
144
When does the CS diameter narrow?
during atrial contraction
145
In what other planes can the CS be visualized?
the A4C & A2C
146
What is the arrow pointing to?
AMVL continuity
147
In the PLAX plane what 2 AO cusps are visualized?
the RCC & NCC
148
Which AO cusp is not visualized in the PLAX view?
the LCC
149
Are the LVOT and AOV annulus systolic or diastolic measurements?
systolic
150
Do you acquire the AOV annulus during end diastole?
no
151
Which technique do you use to measure the AOV annulus diameter in PLAX?
Inner edge to inner edge
152
Which technique do you use to measure the SoVa, Sinotubular junction & Prox. AAO?
leading edge to leading edge
153
When do you measure the SoVa, Sinotubular junction & Prox. AAO?
end-diastole
154
Where do you point the beam to get the LAX RVIT?
inferior
155
Where are the anterior and posterior tricuspid valves?
between RA & RV
156
Which TV leaflet is not visualized in the PLAX view of the RVIT?
the medial/septal TV
157
What is a normal embryonic remnant located at the junction of the IVC and RA?
the eustachian valve
158
What network is a normal embryonic remnant that originates from either the eustachian valve or the basin valve and may extend too the fossa ovalis?
the Chiari network
159
Is it normal to have a trace to mild TR?
yes
160
Where do you place the gate to acquire TV inflow with the PWD?
between the tips of the TV leaflets in the RVIT
161
Which wave form is this? is it PW or CW?
TV Inflow, PW
162
Which wave form is this? is it PW or CW?
TV & Peak TRV, CW
163
What is used to estimate the RVSP (right ventricular systolic pressure?) & the degree of PH (pulmonary hypertension)?
the peak TRV (TR velocity) & mean RA pressure (RAP)
164
What = SPAP (systolic pulmonary artery pressure)?
RVSP (right ventricular systolic pressure)
165
What is RVSP dependent on?
-age
-weight
-stroke vol.
-BP
166
How do you calculate the RV-RA PG?
using the Bernoulli equation 4V^2 (where V) = peak TRV
167
What does the RAP equal to in patients with a central venous line?
central venous pressure (CVP)
168
What method is used when an increased RAP leads to a dilated IVC w/ diminished inspiratory collapse?
3/8/15 method
169
What is a normal IVC & collapse % upon inspiration/sniff test?
IVC < 2.1cm & collapses > 50% upon inspiration/sniff test
170
What is considered a normal RVSP for the PH scale?
18 - 25mmHg
171
Where do you aim the beam to get the LAX RVOT?
Superior & lateral (toward patient's L shoulder)
172
How would you describe the ROVT anterior wall?
thin
173
What's another name for the conus arteriosus?
Infundibulum
174
How would you describe the infundibulum?
-smooth-walled
-no trabeculations
-funnel shaped
175
Where is the infundibulum located?
part of the RVOT at the entrance of the pulmonary trunk
176
How would you describe the PV cusps?
thin, delicate, pliable
177
Which PV cusp is not visualized from the LAX view of the RVOT?
the anterior PV cusp
178
Which is smaller the AO for the PA?
PA
179
Where does the main Pulmonary Artery splits? and into what?
at the PA bifurcation into the R & L PA
180
Where do you measure to diameter of the PA in the LAX view?
midway between the PV & PA bifurcation
181
What is this M-mode showing?
PV
182
When doing an M-mode of the PV does it show 1 or 2 cusps?
1
183
What does this show?
a normal PV a-wave
184
What does this show?
Absent PV a-wave & flying W which means PH
185
What does the arrow show?
LA Appendage
186
What plane and is it diastole or systole?
PSAX, systole
187
Label including the *
1. Anteritor TV leaflet
2. Medial TV leaflet
3. AOV RCC
4. AOV LCC
5. AOV NCC
6. Right posterior PV cusp
7. Anterior PV cusp
* NCC is always adjacent to the IAS
188
When do you acquire BOTH the proximal and distal RVOT diameter?
end-diastole
189
What does this show and in what plane?
PSAX, Trileaflet AOV
190
Where does the IAS normally bow toward?
the RA
191
Why does the IAS bow toward the RA?
because the LAP (pressure) is slightly greater than the RAP
192
How do you acquire the SAX Basal/MV view?
angling the transducer more lateral/inferior towards the apex from the SAX base
193
What waveform is this and is it PW or CW?
PV & PR, CW
194
What Color Doppler is this of?
RVOT
195
What color doppler is this of?
RVIT
196
What color doppler is this of?
AOV
197
What does this show? In what view? Systole or Diastole?
MV leaflets, PSAX basal/MV view, systole
198
What does this show? In what plane? Systole or Diastole?
MV leaflets, PSAX basal/MV view, diastole
199
Label
1. Anterior MV leaflet
2. Posterior MV leaflet
3. Basal Anteroseptal wall
4. Basal Anterior wall
5. Basal anterolateral wall
6. Basal inferolateral wall
7. Basal inferior wall
8. Basal inferoseptal wall
200
What does this show? In what plane? Systole or Diastole?
PM, PSAX, mid systole
201
What does this show? In what plane?
Apex, PSAX
202
What is SALI an acronym for?
the LV walls
Septal
Anterior
Lateral
Inferior
203
Label
1. anterior TV leaflet
2. medial TV leaflet
3. anterior MV leaflet
4. posterior MV leaflet
5. basal inferoseptal wall
6. mid inferoseptal wall
7. apical septal wall
8. apical cap
9. apical lateral wall
10. mid anterolateral wall
11. basal anterolateral wall
12. IAS
13. MV
14. TV
15. PV4
16. IVS
204
Label
1. basal inferior wall
2. mid inferior wall
3. apical inferior wall
4. apical cap
5. apical anterior wall
6. mid anterior wall
7. basal anterior wall
8. LAA
9. PV4
10. DAO
205
what does TAPSE stand for?
Tricuspid
Annular
Plane
Systolic
Excursion
206
What does TAPSE provide?
a simple but good estimate of global RV systolic function
207
How does TAPSE measure?
measures the longitudinal systolic performance of the RV wall.
208
Is TAPSE angle dependent?
yes
209
What does this M-mode depict?
TAPSE
210
Where do you put the cursor to acquire TAPSE?
through the RV & RA through the lateral TV annulus, the cursor should be perpendicular to the annulus and parallel to the movement
211
What do you measure TAPSE on the M-mode image?
the peak systolic longitudinal motion of the TV annular motion from end diastole to end systole
212
What is different about the RV compared to the LV?
-RV chamber is no more than 2/3s the size of the LV
-has more trabeculations
-has a moderator band
213
What does this image show and in what window?
prominent moderator band, A4C
214
Do you need to compare RV size with LV size? if so, when?
yes, always
215
What does this image show? what window?
RV linear dimensions:
basal (blue)
mid (red)
longitudinal (yellow)
A4C RV focused
216
What is the normal range for the RAV (RA volume)?
females: 21 +- 6mL/m^2
males: 25 +- 7mL/m^2
217
When do you measure the RA single plane?
end-systole
218
What is the normal range for the RA area for single plane?
< 18cm^2
219
What does this image show?
Single-plane RAV-RA area (red) Major (yellow)
220
What does this image show?
RA area (red) major (yellow) minor (blue)
221
What is this equation and what is it used for?
single plane volume, ONLY for RA
222
What is the arrow showing?
ICD wire in RA
223
What is the arrow pointing at?
dilated CS
224
What does the LV form?
the apex
225
What is the Biplane Method of Disk?
measures the LVEF. provides an estimate of the LV volume through a process of dividing the cavity into multiple disks with equal height.
226
What is the number of disks determined (in the biplane method of disks)?
determined by the length of the cavity and the disk volumes
227
What are the disk volumes determined by (in the biplane method of disks)?
determined by the length and width of each disk
228
What does this image depict?
biplane method of disks
229
What does the blue and red depict?
EDV & ESV (blue) LV length (red)
230
Where do you acquire the LV dimensions for the biplane method of disks?
the calipers placed at the interface between the compacted (solid, homogenous wall separate from the trabeculated) and noncompacted myocardium
231
What is the equation for the LAVi (LA volume index)
LAVi = LAV/BSA
232
What is the equation for the LVEF%?
LVEF% = (EDV - ESV) / EDV x 100
233
What does this image show? is it PW or CW?
MV Inflow, PW
234
What does this image show? What kind of Doppler?
MV Annulus, Tissue Doppler Imaging (TDI)
235
What does this image show? is it PW or CW?
PV4, PW
236
What does this image show? Diastole or Systole? End?
A5C, end-systole
237
What does this image show? What window?
Zoom AOV & LVOT, A5C
238
When should you calculate peak velocity, mean PG, and AOV area (AVA)? (hint* A5C)
-suspected of AO stenosis
-if patient has undergone an AOV repair/replacement w/ a prosthetic valve
239
What is the normal range of the LVOT in the A5C?
0.8 - 1m/s
240
If LVOT peak velocity is > 2m/s what does this indicate?
LVOTO
241
If LVOTO is present what do you need to switch PW to and acquire?
CW and acquire the peak velocity and PG
242
What does this image show? What window?
LA, MV, LV, LVOT, AOV in A5C
243
What does this image show? What window?
Focus AOV & IVRT, A5C
244
What does this image show? PW or CW?
AOV, CW
245
What does this image show? PW or CW?
IVRT, CW
246
What does this image show? PW or CW?
AR & AS, CW
247
What does this image show? What window?
Gate LVOT, A5C
248
What does this image show? PW or CW?
LVOT, PW
249
What does this image show? PW or CW?
LVOTO, CW
250
What does the LAA act as?
a decompression chamber
251
What does the LAA decompression chamber do?
helps decrease LAP whenever elevated or during normal LV systole
252
What does this image depict? In what window? systole or diastole?
A2C, systole
253
What is the arrow showing, what window?
LAA & PV4 in A2C
254
What does this image show? What window?
DAO, A2C
255
How do you get to A2C?
rotate transducer ~60 - 90 degrees counter clockwise from the A4C
256
How do you get to A3C?
rotate transducer ~30 - 60 degrees counter clockwise from A2C
257
What's another name for the A3C?
Apical LAX
258
What does this image show? What window? diastole or systole?
LA, MV, LV, LVOT, AOV, AO root, A3C, systole
259
What does this image show? What window?
LA, MV, LV, LVOT, AOV, AO root, A3C
260
Label
1. basal inferolateral wall
2. mid inferolateral wall
3. apical lateral wall
4. apical cap
5. apical septal wall
6. mid anteroseptal wall
7. basal anteroseotal wall
261
Which direction do you angle the beam to get A3C RVIT?
medial and inferior from the A3C
262
What is the A3C useful for the RVIT?
it yields the optimal doppler angle and absolute peak TRV for the RVSP calculation
263
What does this image depict? In what window?
A3C, OFF-AXIS
264
What does this image depict? In what window?
RVIT, A3C
265
What does this image depict? In what window?
TR, A3C
266
What does this image show? PW or CW? from what window?
TV & PEAK TRV, A3C, CW
267
Why are subcostal views vital to the pediatric and adult echos exam?
because they provide visualization anterior and posterior to the heart and lay out the relationship between the heart and surrounding structures
268
What does this image depict? In what window?
RV wall thickness, SUB 4C
269
What does this image depict? In what window?
RV, Sub 4C
270
What does this image depict? In what window?
lipomatous hypertrophy of the IAS (LHIS)
271
What does the arrow show? In what window?
Chiari network, sub 4c
272
lipomatous hypertrophy of the IAS (LHIS)?
a fatty infiltration of the IAS sparring the fossa ovalis giving it s dumb-bell shape
273
How do you get to a Sub SAX Window?
rotate transducer ~60 - 90 counter clockwise from the SUB 4C
274
What's another name for Sub SAX?
Subcostal short axis
275
What views from the SUB SAX are similar to the left PSAX?
- the base
- MV
- LV
276
What window is occasionally the only window with quality images particularly with patients with Chronic Obstructive Pulmonary Disease? (COPD)
SUB SAX
277
What angle does the transducer need to go in order to get the subcostal inferior vena cava?
more medial from the SUB SAX BASE
278
In addition to the IVC who other structures can be seen from the SUB IVC view?
liver
hepatic vein
SVC
RVIT
279
What view would I use to check the hepatic vein for dilation?
SUB IVC
280
What does the "sniff test" do?
helps visualize the collapse of the IVC by estimating the mean RAP
281
What structure should be acquired always but especially those with abdominal pain?
the DAO
282
What does the DAO need to be evaluated?
to see if there is any indication of AO dissectioon
283
What should the general diameter of the DAO be?
< 3cm
284
What structures can be view in the SUPRA LAX window?
-AAO
-AO arch with branches
-thoracic DAO
285
What is the normal velocity of the AAO?
< 2m/s
286
What is the normal velocity of the thoracic DAO?
< 2m/s
287
What structures can be seen in the SUPRA SAX window?
-AO arch
-RPA
-SVC
-L/R innominate vein
-PV4
288
