Echo final review Flashcards by kamal armstead

The right heart is associated with the __________ and the left heart is associated with the ___________.

pulmonary circulatory system / systemic circulatory system

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Of the three germ layers that give rise to all adult tissues and organs, which gives rise to the heart?

mesoderm

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The two tubes that eventually fuse to form the heart are referred to as the ________.

endocardial tubes

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Blood normally flows from the left ventricle to the

aorta

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The pulmonary trunk and aorta are derived from which primitive heart structure?

truncus arteriosus

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The earliest organ to form and begin function within the developing human is the ________.

heart

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The forceful contraction of the cardiac chambers is ________, and the relaxed phase of the cycle is ________.

systole; diastole

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The inferior vena cava is guarded by a fold of tissue called the _____ valve, whereas the coronary sinus is guarded by the _____ valve.

eustachian; thebesian

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The most posterior chamber to the left of the sternum is the

left atrium

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The point at which the four cardiac chambers meet at the back of the heart forms a cross-shaped area is called

crux

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In the __________ view the tricuspid valve insertion is seen closer to the _________ than is the mitral valve insertion.

Apical Four Chamber, apex

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The brightest returning echo signal in the heart is from the

Pericardium

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The tricuspid valve opens when

right ventricle pressure drops below the right atrial pressure

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The semilunar valve that has right coronary, left coronary and noncoronary cusps is the

Aortic

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The pericardial sac protects the heart against

Friction

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Which primitive area of the heart will give rise to the right ventricle

bulbus cordis

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The outflow tract of the right ventricle also is called the

infundibulum

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The wall of the aorta bulges slightly at each semilunar cusp to form the

sinus of Valsalva

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The greatest muscle mass in the heart is found in the

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The right and left coronary arteries arise from the

ascending aorta

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The anterior walls and appendages of the atria are made up of projecting muscle bundles that run parallel to one another – these are known as _______

pectinate muscles

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________________ follows the anterior interventricular groove down to the apex. It typically supplies 45-55% of the LV and is therefore considered the most critical vessel in terms of myocardial blood supply.

Left anterior descending artery (LAD)

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An embryonic remnant, present in about 2-3% of the population. Lies close to IVC in the RA. Appears as a web-like structure with thread like pieces. Characterized by a whip-like motion within the RA

Chiari Network

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When the ventricular pressure exceeds the pressure in the atria these valves close preventing the flow of blood from the ventricles into the atria

mitral and tricuspid

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What chamber of the heart lies most anterior

The oxygen saturation in the __________ is the lowest in the body

coronary sinus

The moderator band may be visualized traversing the apex of the __________:

The visceral layer of the serous pericardium covers the myocardium and is also known as the ____________

epicardium

The leaflets of the tricuspid valve which are seen in the right ventricular inflow (RVIT) view are the_________

anterior and posterior

The best window to record images and Doppler signals from the arch of the aorta is

suprasternal

The right ventricle pumps blood to the__________ . The left ventricle pumps blood to the ______________.

pulmonary circulation (the lungs); systemic circulation (the head, thorax, abdomen, and extremities).

From the Apical four-chamber view, the transducer is _________________ to obtain the two-chamber view consisting of the LV, MV and LA.

rotated counterclockwise about 90 degrees

Pedoff probe is a type of PW probe. T/F

False

While performing CW Doppler across the aortic valve peak velocity should not exceed:

1.7 m/s

Two-dimensional images are best obtained when the ultrasound beam is directed _____ to the structure of interest. Doppler signals are best obtained when the ultrasound beam is directed _____ to the flow of blood.

perpendicular; parallel

The PW Doppler signal derived from the mitral valve blood flow is best detected in the

apical four chamber view

The greatest advantage of CW Doppler is its ability to accurately measure very high velocities. T/F

True

A sample of CW Doppler of aortic valve is best taken from the apical two chamber view. T/F

True

While performing CW Doppler across the mitral valve peak velocity should not exceed

1.3 m/s

A normal LV Ejection fraction ranges from

53% to 75%

On the LV M-Mode tracing the arrow is pointing to _________

left ventricular internal dimension (end diastole)

It is important to place the ultrasound M-mode cursor perpendicular to the structures of interest. T/F

True

Normal measurement for the left ventricular internal diameter in diastole (LVIDd) according to the ASE is

5.7 cm

________ view is used to measure LVOT diameter during _________

PLAX, mid systole

The difference between end-diastolic volume (EDV) and end-systolic volumes (ESV) is termed ______

stroke volume

The volume of blood pumped by the heart per minute

Cardiac output

Because it is difficult to properly align the M-mode cursor, many measurements are now made with _________ instead of on M-mode.

2D imaging

In ___________, the atria and ventricles are out of synch because the atria contract very quickly and irregularly.

atrial fibrillation

____________ is the fraction of the end-diastolic volume that is ejected with each beat.

Ejection fraction

Measurements should be made using the leading edge to leading edge method of measurement. T/F

True

An EF of less than 35% increases the risk of life-threatening irregular heartbeats that can cause sudden cardiac arrest. An implantable cardioverter defibrillator (ICD) may be recommended for these patients. T/F

True

The normal measurement suggested for the diameter of the aortic root in end diastole is up to _______.

3.7 cm

M-mode evaluation of the aortic valve, mitral valve and left ventricle can be done from _______ or _________ representative views.

PLAX, PSAX

What does the "E" point represent on an M-mode of the mitral valve?

end of rapid filling phase

In adults and adolescents, the cavity and wall thickness measurements of the left ventricle should be taken at the level of the ____________

chordae tendinae

The correct equation for fractional shortening is

LVIDd - LVIDs/ LVIDd x 100

It is very important when imaging the left ventricle to have the ultrasound beam transect the walls at a ______ degree angle

An EF of less than 40% may confirm a diagnosis of

heart failure

The amount of resistance that must be overcome by the left ventricle during systole is called

afterload

____________occurs when there is an obstruction within the atrial electrical conduction system, discharge of an ectopic focus for atrial depolarization, only occasional stimulus will penetrate AV node. EKG will show a Saw-tooth pattern.

atrial flutter

Which of the following is the correct sequence of cardiac electrical activity? 1. AV node 2. Bundle of His 3. SA node 4. Purkinje fibers 5. Bundle branches

3,1,2,5,4

The more the myocardium is stretched, the more forceful the contraction

The Frank Starling Law

MV closure is followed by ________ during which all valves are closed and the cardiac muscle depolarizes and starts contracting. LV pressure rises rapidly BUT ventricular volume stays the same (shape changes).

isovolumic contraction

The normal pacemaker site of the heart is the

SA node

__________ is the ability of the cardiac muscle cells to initiate an electrical impulse without being stimulated by a nerve or other source.

automaticity

The 2nd heart sound, S2 (dub) is related to

closure of the aortic and pulmonic valves

On an EKG, ventricular depolarization is represented by the

QRS complex

3 main factors that effect stroke volume include all of the following EXCEPT

Isovolumic relaxation time

________ analyzes how long it takes an impulse to travel from SA node through the internodal pathways from start of atrial depolarization to start of ventricular depolarization.

P-R Interval (PRI)

Cardiac muscles cells ability to initiate an electrical impluse without being stimulated by a nerve or other source is called

automaticity

___________ is a chaotic rhythm in which there are multiple areas exhibiting varying degrees of depolarization and repolarization and an absence of R-waves

Ventricular fibrillation

“Lub” represents the closing of __________________ during ventricular ___________

atrioventricular valves, systole

Parasympathetic stimulation can speed up the conductivity of the impulse. It increases the rate and force of contractions. T/F

False

Approximately 50% of patients become unconscious from this abnormal cardiac rhythm

ventricular tachycardia

The ability of cardiac cells to receive an electrical impulse and transmit it to an adjacent cardiac cell is called

conductivity

Failure of the valve to seal properly (valve may be torn, perforated, affected by rheumatic fever or a failing heart may be enlarged) is called

incompetence

_________________ is a disorder of the heart where blood leaks back from the LV into the LA (through the MV) during systole.

Mitral regurgitation

Vegetations are always found on the _____ side of the valve, so in case of mitral regurgitation caused by vegetations, they are seen on the _____ side of the valve.

low pressure/atrial

Which of the following is associated with severe, acute mitral regurgitation?

pulmonary edema

____________ is still responsible for most of the acquired valvular heart disease in childhood.

Rheumatic fever

The most common cause of mitral regurgitation in elderly patients is

calcified mitral annulus

The smallest vegetation visible echocardiographically measures to be ________

2 mm

The posteromedial papillary muscle has a single blood supply from the RCA and is therefore more likely to become ischemic. T/F

True

A mid or late systolic click with or without a systolic murmur is associated with

mitral valve prolapse

What is considered to be an enlarged LA

> 6.0 cm

Mitral regurgitation happens during diastole. T/F

False

With severe MR, you will see all of these things EXCEPT

vena contracta that measures 0.4 cm

EROA =

2πr2 x Nyquist Limit/ V max

VTI =

stroke distance, stroke distance (cm), Stroke distance, Stroke Distance, RVol/EROA

Always shift the Nyquist limit towards the regurgitant flow. T/F

True

Continuity Equation =

A1 x V1 = A2 x V2, A1xV1 = A2xV2, A1xV1=A2xV2

Which vena contracta value is consist with severe mitral regurgitation?

> 0.7 cm

The most common cause of mitral stenosis is rheumatic fever. T/F

True

According to planimetry, moderate MS measures

1.0-1.5 cm2

The higher the pressure half time the smaller the mitral valve area.

True

Echo final review Flashcards

(96 cards)