How is the probe placed in the parasternal long view?
Near the sternum, but not too close or too far from it otherwise bone or lung will block your view. The probe is pointed upwards toward the right shoulder.
What structures can you see on the parasternal long view?
Right ventricle, left ventricle, left atrium, mitral valve and aortic valve.
You are trying to get a parasternal long view of a patient's heart while they are lying supine. The view is not as clear as you'd hoped it would be. What can you do to improve your view?
Have the patient roll onto their left side. This gets lung out of the way of the heart.
How is the probe placed in the parasternal short view?
Near the sternum, but not too close or too far from it otherwise bone or lung will block your view. The probe is pointed upwards toward the left shoulder.
Where can the probe be fanned to and from in the parasternal short view?
The apex -> papillary muscles -> mitral valve -> aortic valve at the base of the heart. You just fan the probe, don't move it once you get the view.
What structures can you see on the parasternal short view?
Right ventricle, left ventricle, anterior wall and interventricular septum.
How is the probe placed in the apical 4-chamber view?
The patient is on their left side, the probe at their PMI, with the marker pointed towards the table.
What structures can you see in the apical 4-chamber view?
Right atrium, tricuspid valve, left atrium, mitral valve
How is the probe placed in the subxiphoid view?
Angle AP with the marker pointed towards the patient's left.
What structures do you see in the subxiphoid view?
Right ventricle, left ventricle, mitral valve, tricuspid valve, right atrium and left atrium.
What does this patient have? How would it look in the parasternal long and short views?
Pericardial effusion. In the PSS view you would see dark fluid surrounding the heart. In the PSL view you would see the dark fluid tapering as you get to the defending thoracic aorta (rat tail).
What view is good for imaging swinging of the heart in a pericardial effusion?
Apical-4 chamber view.
What is a poor man's way of assessing ejection fraction?
In the parasternal long view, image the anterior leaflet of the mitral valve. If it slaps against the septum during diastole you have good ejection fraction. If it doesn't you have poor ejection fraction. In the parasternal short view, you can see how far the mitral valve opens and also see sclerosis.
How do the apical 4-chambered view and subxiphoid view demonstrate ejection fraction?
You can image the mitral valve to see if it slaps against the septum.
How can you use m-mode to estimate ejection fraction in the heart?
Put the ultrasound in the PSS view and move the ice pick right over the mitral valve. Turn on m-mode. You will be able to see the peaks and valleys of blood ejected from the left ventricle.
When imaging a heart and looking for regurgitation, what colors indicate what movement of blood through the heart?
Red = blood from atria to ventricles. Blue = blood from ventricles to aorta and pulmonary trunk.