Exam 1 Flashcards
To Rock this Shit! (83 cards)
1
Q
What defines the LVOT.
A
From the free edge of the anterior mitral valve leaflet to the annulus of the Aortic valve.
2
Q
What defines the major axis?
A
The longitudinal centerline of the heart from the apex to the base.
3
Q
What defines the minor axis?
A
The minor axis of the heart is perpendicular to the major axis and is parallel to the base and fiberous skeleton.
4
Q
Regarding the left ventricle, what defines the most basal third?
A
The most basal third of the LV extends from the Atrioventricular Groove to the tip of the papillary muscles.
5
Q
Regarding the left ventricle, what define the middle third?
A
That part of the ventricle that contains the papillary muscles.
6
Q
Regarding the left ventricle, what defines the apical third?
A
The apical third begins at the bad of the papillary muscles and extends to the apex.
7
Q
What is LV Chamber quantification?
A
The part of the exam that determines the Left Ventricular diameter.
8
Q
What is hyperdynamic?
A
Excessive wall motion (EF increased/HR increased)
9
Q
What is Hypokinetic?
A
Mildly decrease wall motion.
10
Q
What is dyskinetic?
A
LV Wall segments contracting ate different times.
11
Q
What is Akinetic?
A
No motion.
12
Q
Regarding the RV, what is normal?
A
Smaller than the LV with apex more basal than the LV apex
13
Q
Regarding the RV, what is Mildy dilated?
A
Enlarged but still less than the LV.
14
Q
Regarding the RV, what is moderately dilated?
A
RV size = LV size.
15
Q
Regarding the RV, what is severely dilated?
A
RV size > LV size.
16
Q
Regarding the RV, what is the normal wall thickness?
A
Wall thickness should not be greater than 0.5 cm.
17
Q
How do we estimate RAP?
What is the view the estimate is based upon?
A
We measure the IVC and determine its inspiratory collapse
18
Q
What is the normal size of the IVC?
What is an acceptable view to measure from?
A
1.7 cm< 1.7 cm is small> 1.7 cm is dilated
19
Q
If IVC is normal and inspiratory collapse is 50%, a what is the estimated RAP?
A
0-5 mmHg
20
Q
If the IVC is greater than 1.7 cm and inspiratory collapse is 50%, what is the estimated RAP?
A
5-10 mmHg
21
Q
If the IVC is less than 1.7 cm with spontaneous inspiratory collapse, what is the estimated RAP?
A
Decreased volume.
22
Q
If the IVC is greater than 1.7 cm and inspiratory collapse is less than 50%, what is the estimated RAP?
A
10-15 mmHg
23
Q
If the IVC is dilated greater than 1.7 cm with no inspiratory collapse, what is the estimated RAP?
A
15-20 mmHg Dilated
24
Q
If the IVC is dilated greater than 1.7 cm and has dilated hepatics with no change on inspiration, what is the estimated RAP?
A
> 20 mmHg
25
What is normal limits of LV diameter for men?
4.2 - 5.9 cm (+0.3) Mild, Mod,
26
What are normal limits of LV for women?
3.9 - 5.3 cm (+0.3) Mild, Mod,
27
What are the normal limits of LV diastolic volume for men?
67 - 155 ml (+22mL) Mild, Mod,
28
What are the normal limits for LV diastolic volume for women?
56 - 104 ml (+12mL) Mil, Mod.
29
What are normal limits for LV systolic volume for men?
22 - 58mL (+11mL) Mild, Mod,
30
What are normal limits for LV systolic volume in women?
19-49ml (+9mL) Mild, Mod,
31
What are the normal limits for D-E excursion?
NL for D-E Excursion are 18-28mm
32
What are the normal limits for EPSS?
Normal limits for EPSS are 2-7mm
33
What are the normal limits for IVS Thickness?
Normal limits for IVS thickness are 0.6-1.1 cm
34
What are the normal limits for PW Thickness?
Normal limits for PW thickness are 0.6-1.1cm
35
What are the normal limits for Ao Root?
Normal limits for Ao Root are 2.0 - 3.7 cm
36
What are the normal limits for ACS?
Normal limits for Aortic Cusp Separation are 1.5 - 2.6 cm
37
What are the normal limits for LA?
Normal limits for the left atrium diameter are 1.9 - 4.0 cm
38
What are the NL Doppler Velocities for the TV?
0.3 - 0.7 m/s
39
What are the NL Doppler Velocities for the PA?
0.5 - 1.3 m/s
40
What are the NL Doppler Velocities for the LVOT?
0.7 - 1.1 m/s
41
Regarding the apical four chamber view, name the right, then left wall segments from apex to base.
Right: apical septal, mid inferoseptal, basal inferoseptal. Left: apical lateral, mid anterolateral, basal anterolateral.
42
Regarding the apical two chamber view, name the right, then left wall segments from apex to base.
Right: apical inferior, mid inferior, basal inferior.Left: apical anterior, mid anterior, basal anterior.
43
Regarding the apical Long Axis (3 chamber) view, name the right, then left wall segments from apex to base.
Right: apical lateral, mid inferolateral, basal anteroseptal.Left: apical anterior, mid anteroseptal, basal anteroseptal.
44
Regarding the IVS in the apical four chamber view, what are the perfusion territories from apex to base.
Apex: LADMid: RCA or LADBasal: RCA
45
Regarding the wall segments of the apical four chamber view, what are the perfusion territories from ride side, apex to base, and left side, apex to base
```
Apical Cap: LAD
Right
Apical Septal: RCA
Mid Inferoseptal: RCA
Basal Inferoseptal: RCA
Left
Apical lateral: LAD or CX
Mid Anterolateral: LAD or CX
Basal Anterolateral: LAD or CX
```
46
Regarding the wall segments of the Apical Two Chamber View, what are the perfusion territories from ride side, apex to base, and left side, apex to base
```
Apical Cap: LAD
Right
Apical Inferior: LAD
Mid Inferior: RCA
Basal Inferior: RCA
Left
Apical Anterior: LAD
Mid Anterior: LAD
Basal Anterior: LAD
```
47
Regarding the wall segments of the Apical Long Axis (Three Chamber View), what are the perfusion territories from ride side, apex to base, and left side, apex to base
```
Apical Cap: LAD
Right (Posterior Wall)
Apical Lateral: LAD
Mid Inferolateral: RCA or CX
Basal Inferolateral: RCA or CX
Left (Interventricular Septum)
Apical Anterior: LAD
Mid Anteroseptal: LAD
Basal Anteroseptal: LAD
Right Ventricular Wall: RCA
```
48
From the Short Axis View, name the Left Ventricular wall segments in clockwise fashion from 12 o'clock at the Basal Level
```
Basal Anterior
Basal Anterolateral
Basal Inferolateral
Basal Inferior
Basal Inferoseptal
Basal Anteroseptal
```
49
From the Short Axis View, name the Left Ventricular wall segments in clockwise fashion from 12 o'clock at the Mid Level
```
Mid Anterior
Mid Anterolateral
Mid Inferolateral
Mid Inferior
Mid Inferoseptal
Mid Anteroseptal
```
50
From the Short Axis View, name the Left Ventricular wall segments in clockwise fashion from 12 o'clock at the Apical Level
Apical Anterior
Apical Lateral
Apical Inferior
Apical Septal
51
From the Short Axis View, name the Left Ventricular wall perfusion territories by segment in clockwise fashion from 12 o'clock at the Apical Level
Apical Anterior: LAD
Apical Lateral: LAD or CX
Apical Inferior: LAD or RCA
Apical Septal: LAD
52
From the Short Axis View, name the Left Ventricular wall perfusion territories by segment in clockwise fashion from 12 o'clock at the Mid Level
```
Mid Anterior: LAD
Mid Anterolateral: LAD or CX
Mid Inferolateral: RCA or CX
Mid Inferior: RCA
Mid Inferoseptal : RCA
Mid Anteroseptal: LAD
```
53
From the Short Axis View, name the Left Ventricular wall perfusion territories by segment in clockwise fashion from 12 o'clock at the Base Level
```
Basal Anterior: LAD
Basal Anterolateral: LAD or CX
Basal Inferolateral: RCA or CX
Basal Inferior: RCA
Basal Inferoseptal: RCA
Basal AnteroSeptal LAD
```
54
Regarding M Mode D-E Measurement, describe the structures and making the measurement.
D-E is a Mitral Valve Measurement of the mitral valve excursion. Place the cursor at the closed point in beginning diastole and measure straight up to the greatest excursion of the anterior leaflet. (Normal Range: 18-28mm)
55
Regarding M Mode EPSS Measurement, describe the structures and making the measurement.
Measuring the End Point Septal Separation during rapid passive filling. Measure the gap between the Mitral valve leaflet and the Left IVS. (Normal Range: 2-7mm)
56
Regarding RVFW Measurement, describe the structures and making the measurement.
Measure the RV Anterior Wall thickness at Diastole. Measure from the epicardium to the endocardium of the anterior wall of the RV. (Normal Range: 0.5-0.8 cm)
57
Regarding RV Diameter Measurement, describe the structures and making the measurement.
Measure the endo to endocardial diameter of the Right Ventricle during peak diastole. (Normal Range: 0.9-2.6cm)
58
Regarding IVS Measurement, describe the structures and making the measurement.
Measure the endo to endo thickness of the IVS at peak distole. (Normal Range: 0.6-1.1 cm)
59
Regarding LVIDD Measurement, describe the structures and making the measurement.
Measure the internal dimension of the Left Ventricle during Diastole. Endo to Endo (Normal Range: 3.7-5.6 cm)
60
Regarding LVESD Measurement, describe the structures and making the measurement.
Measure the internal dimension of the Left Ventricle during systole. Endo to Endo (Normal Range: 2.0-3.8)
61
Regarding LVPW Measurement, describe the structures and making the measurement.
Measure the thickness of the posterior wall from the endocardium to the epicardium during diastole. (Normal Range 0.6-1.1 cm)
62
Regarding Ao Diameter Measurement, describe the structures and making the measurement.
From the Parasternal Long Axis View, get a good perpendicular shot of the Ao Root and place the cursor at the anulus. get a good sequence of valve cycles where both cusps are showing. Measure leading edge to leading edge at the anulus at the onset of QRS.(Normal Range 2.0-3.7 cm)
63
Regarding ACS Measurement, describe the structures and making the measurement.
From the Parasternal Long Axis View, get a good perpendicular shot of the Ao Root and place the cursor at the anulus. get a good sequence of valve cycles where both cusps are showing. Measure Aortic Cusp Separation at onset of Systole. (Normal Range 1.5 - 2.6 cm)
64
Regarding LA Measurement, describe the structures and making the measurement.
From the Parasternal Long Axis View, get a good perpendicular shot of the Ao Root and place the cursor at the anulus. get a good sequence of valve cycles where both cusps are showing. Measure the diameter of the LA and End Diastole. Use the Leading Edge to Leading Edge technique. (Normal Range: 1.9 - 4.0 cm)
65
Regarding the M Mode of the Tricuspid Valve, what event is indicated by point E' ?
This is End Systole/Beginning Diastole.
66
Regarding the M Mode of the Tricuspid Valve, what event is indicated by point F?
This marks the Beginning of Atrial Contraction
67
Regarding the M Mode of the Tricuspid Valve, what event is indicated by point A (a-dip)?
This is a normal result of Atrial Contraction. This may be lost by patients with Pulmonary Hypertesion.
68
Regarding the M Mode of the Tricuspid Valve, what event is indicated by point B?
Pulmonary Valve Opens and Systole begins.
69
Regarding the M Mode of the Tricuspid Valve, what event is indicated by point C?
This is full PPVL excursion during systole.
70
Regarding the M Mode of the Tricuspid Valve, what event is indicated by point D?
Marks the end of Diastole and PV valve closure begins.
71
What are the NL Doppler Velocities for Pulmonary Vein Flow?
0.4 -0.7 m/s
72
What is the NL Length of the RV
7.1 - 7.9 cm
+5 Mild : 8.0 -8.5
+5, +5 Moderate 8.6 - 9.1
Severe: 9.2
73
What is the NL Doppler Velocity for the MV?
1.3 - 1.6 m/s
74
What does point E represent on the MV doppler profile?
Rapid passive filling 1.3 - 1.6 m/s
75
what does point a represent on the MV doppler profile?
A Kick 0.4 - 0.6 m/s
76
What does the MV Decel Time represent?
from peak velocity to A kick 150- 240ms
77
What is the E/A Ratio
The ratio of passive filling to Atrial contribution.
| An indexless number. Better than 1 for young adults. Can reverse for older people 50-60 y.o.
78
When sampling the LVOT which click do you want to hear and what's the NL Velocity?
Closing Click and the velocity is 0.7 - 1.1 m/s
79
When sampling the Ao which click do you want to hear and what's the NL Velocity?
Opening Click and the NL Velocities are 1.0 -1.7 m/s
80
When sampling the RVOT and PA which click do you want to hear and what's the NL Velocity?
Closing Click and the NL velocities are 0.5 - 1.3 m/s
81
How is respiration related to TV doppler velocities?
Inspiration will increase volume which will increase velocities
82
What is the TV Decel Time?
200ms
83
What is the ejection fraction equation?
| EF%
LVED3-LVSD3/LVED3 X 100 = EF%
