PE

Question 1

What are the layers of the heart from outer to inner?

Answer 1

1. Fibrous pericardium
2. Serous parietal pericardium
3. Pericardial space
4. Visceral pericardium (epicardium)

Question 2

What is heart layer that is the smooth wall of a cavity called?

Answer 2

Serous parietal layer

Question 3

What is the heart layer that is smooth toward the Organ called?

Answer 3

Visceral layer (epicardium)

Question 4

What is the heart layer that is the thick outer sack called?

Answer 4

Fibrous pericardium

Question 5

What is another name for the visceral layer of the heart?

Answer 5

Epicardium

Question 6

List the layers of the heart from inner to outer

Answer 6

1. Visceral pericardium (epicardium)
2. Pericardial space
3. Serous parietal pericardium
4. Fibrous pericardium

Question 7

The epicardial layer of the heart is also known as?

Answer 7

Visceral layer

Question 8

What are some ideologies of a pericardial effusion?

Answer 8

-idiopathic
-infection
-TB
-Uremia
-autoimmune/inflammatory diseases
-Neoplastic disease ( abnormal tissue)
-MI
-Post cardiac surgery
-Trauma
-Radiation

Question 9

What is neoplastic disease?

Answer 9

Abnormal tissue

Question 10

What is the pathophysiology of a pericardial effusion?

Answer 10

1-pericarditis occurs
2. Extra fluid secretes into the pericardial space
3. heart try’s to expand to compensate for extra fluid

Question 11

What are some physical signs of a pericardial effusion?

Answer 11

-positional angina
-Dyspena
-Distended neck veins
- friction rub murmur
-pulses paradoxus

Question 12

What is the murmur associated with a pericardial effusion?

Answer 12

Friction rub

Question 13

What is the pulses paradoxes change for PE?

Answer 13

A decrease of <10mmhg of the systolic BP with inspiration

Question 14

What is the biggest echo sign of a PE?

Answer 14

Echo free space between the visceral and parietal pericardium

Question 15

With a PE always perform a ____ valve to ____ sweep in m-mode.

Answer 15

Aortic to LV

Question 16

Isolated interior echo free spaces are indicative of?

Answer 16

Most likely a epicardial (visceral) fat pad not an effusion

Question 17

True or false- Loculated effusions are common

Answer 17

False they’re rare

Question 18

Loculated effusions are ___ except in what 2 cases?

Answer 18

Rare ; post cardiac surgery and metastatic disease

Question 19

What is commonly seen in long-standing effusion or effusion from metastatic disease?

Answer 19

Fibrin strands

Question 20

With PE what should you do with your Doppler?

Answer 20

Check for respiratory variation in flow across all valves

Question 21

A respiratory variation of _____ indicates possible ____

Answer 21

> 25% ; tamponade

Question 22

In what cardiac cycle do you measure a PE?

Answer 22

End diastole

Question 23

What is the measurement of a small pericardial effusion?

Answer 23

<1cm posteriorly

Question 24

What is the measurement of a medium sized pericardial effusion?

Answer 24

1-2cm anterior and posterior

Question 25

What is the measurement for a large pericardial effusion?

Answer 25

>2cm surrounding the heart

Question 26

Pericardial effusion may be seen _____ to the left atrium in the____sinus

Answer 26

Posterior ; and oblique

Question 27

Where is the oblique sinus?

Answer 27

Posterior to the left atrium between two sets of pulmonary veins

Question 28

A pericardial effusion can often be seen in patients with? 1. Aortic stenosis 2. Atrial flutter 3. Myocardial infarction 4. Renal failure

Answer 28

4. Renal failure

Question 29

What is the pericardial effusion grading criteria for small medium and large?

Answer 29

Small PE = <1cm Moderate PE= 1-2cm Severe PE= >2cm