2 - Introduction to Cardiovascular Imaging Flashcards
What different methods of cardiac imaging are most commonly used?
- X-rays
- Ultrasound
- Nuclear (PET scans)
- Cardiac MRI
- Cardiac CT
- MRI is best used for imaging …….. ………..
- CT is best for imaging ……..
MRI - soft tissues
CT - bone (and solid structures)
To image the major blood vessels of the body a specialised MRI can be used called …
Contrast-enhanced angiography
Where is a group of vessels called the Circle of Willis found?
At the base of the brain
What are the three layers of a blood vessel? Which layer differs between arteries and veins?
- Tunica interna - endothelium
- Tunica media - smooth muscles and elastic fibres
- Tunica externa - connective tissue
Tunica media is thicker in arteries
How is venous return aided in the deep veins?
Deep veins in the periphery (e.g. lower limbs) run through muscles, the rhythmic contractions help to push blood back up to the heart
What are the systolic and diastolic blood pressures in the aorta?
Systolic: 110 - 130
Diastolic: 70 - 80
What are the systolic and diastolic blood pressures in the pulmonary artery?
Systolic: 15 - 25
Diastolic: 8 - 15
What are the systolic and diastolic blood pressures in the right ventricle?
Systolic: 15 - 25
Diastolic: 0 - 8
What are the systolic and diastolic blood pressures in the left ventricle?
Systolic: 110 - 130
Diastolic: 4 - 12
The endothelium of blood vessels can produce nitric oxide (NO), what is it’s function?
Vasodilation
During ventricular ejection the aortic pressure increases from ……. mmHg to ……. mmHg
~ 80 mmHg to 120 mmHg
During ventricular ejection, when the pressure begins to drop the ……… valve closes.
On a curve of aortic pressure over time what feature represents this?
Aortic
Dicrotic notch
What are the first branches of the aorta as it leaves the heart?
The right and left coronary arteries (immediately superior to the aortic valve)
How does the aorta help to convert the pulsatile flow from the heart to a constant flow of blood?
Aorta has some elastic properties (compliance), the stretch helps to overcome the pressure changes
The arch of the aorta forms three main branches, what are they (starting with closest to the heart)?
- Brachiocephalic artery
- Left common carotid artery
- Left subclavian artery
The first main branch of the aortic arch, the brachiocephalic artery, splits almost immediately into what two branches?
- Right subclavian artery
- Right common carotid artery
What is the average cardiac output under resting conditions?
4 - 6 litres/min
What is the average heart rate under resting conditions?
60 - 90 beats per minute
What is the average stroke volume under resting conditions?
55 - 83 ml per beat
In exercise what can cardiac output rise to?
20 - 35 litres/min
In exercise what can heart rate rise to?
150 - 200 bpm
In exercise what can stroke volume rise to?
200 ml per beat
Where are the pectinate muscles found?
In the auricles and right atrial wall
Where are the trabeculae carnae found?
Inside of the ventricle walls
What are the likely explanations for the pericardium showing up as white on a CT scan?
- Fibrosis (scar tissue)
- Inflammation
Three different axis of images can be taken through the heart, which show different orientations of the chambers. What are the three views and what do they show?
- 2 chamber (LA & LV or RA & RV)
- 3 chamber (RA, LA, LV)
- 4 chamber (RA, RV, LA & LV)
In cardiac contraction the …….. of the heart is pulled towards the ……..
Base, apex
What is the most common cause of fibrosis (scar tissue formation) of the cardiac muscle?
Coronary artery disease
What are the two atrioventricular valves?
Tricuspid valve
Mitral valve
What are the two semilunar valves?
Aortic valve
Pulmonary valve
Which valve is always closest to the anterior of the heart?
Pulmonary valve
What is aortic stenosis?
What is bicuspid aortic stenosis?
Narrowing of the aortic valve orifice
2 of the leaflets fuse so the aortic valve only has 2 leaflets instead of 3. Open like a letterbox - reduced opening
What is the name for a heart ultrasound?
This can be taken using a probe in the oesophagus, what is this technique called?
Echocardiogram
Transoesophageal echocardiography
What occurs in mitral valve regurgitation?
Blood from the left ventricle flows back through the mitral valve into the left atrium, instead of into the aorta
What is RCA dominance?
- In 85% of people the right coronary artery (RCA) is dominant as it supplies the inferior aspect of the heart up to the IV septum.
Which parts of the heart are supplied by the right coronary artery?
- Right atrium
- Most of the right ventricle
- Inferior surface of left ventricle
- Posterior portion of IV septum
- SAN
- AVN
Which parts of the heart are supplied by the anterior interventricular (left anterior descending) artery?
- Anterior portion of IV septum
- Parts of right and left ventricles
Which parts of the heart are supplied by the circumflex artery?
- Left atrium
- Parts of the left ventricle
Which cardiac vein follows the same path as the anterior interventricular (left anterior descending) artery?
Great cardiac vein
