Anatomy & Hemodynamics

Question 0

Which valve is the most anterior?

Answer 0

Pulmonary valve

Question 1

Which valve separates the areas of greatest pressure differences?

Answer 1

Mitral valve

Question 2

Where does the LAD lie?

Answer 2

In the anterior interventricular groove or sulcus

Question 3

Why does the mitral valve have 2 leaflets?

Answer 3

2 cusps for high pressure

Question 4

What is the first standard view on TTE?

Answer 4

Parasternal window long axis view (LAX)

Question 5

Which aortic leaflet is the superior one in the parasternal long axis view?

Answer 5

Right leaflet (RCC). The posterior leaflet is the noncoronary.

Question 6

From the left parasternal window in which of the following are you most likely to get accurate velocity measurements?

Answer 6

Pulmonary artery

Question 7

What is the 2nd standard view in TTE?

Answer 7

RVIT inflow tract

Question 8

Name the tricuspid leaflets seen in RVIT?

Answer 8

Posterior and anterior (L to R)

Question 9

RVIT is only view to what?

Answer 9

RVIT is only standard view in which you see the posterior TV leaflet. If still seeing LV might be septal leaf.

Question 10

Red inflow in the RA on RVIT view would be?

Answer 10

IVC

Question 11

3rd standard view in TTE?

Answer 11

Parasternal short axis (SAX) apex, pap, mv, av levels

Question 12

Where is the LAA on TTE?

Answer 12

Sometimes in the parasternal SAX AoV level. Better seen in apical 2CH

Question 13

What is always on the noncoronary cusps side?

Answer 13

Intra-atrial septum (IAS)

Question 14

The coronary arteries come off the?

Answer 14

Sinuses of valsalva (if not an answer coronary sinuses would be correct)

Question 15

Coronaries come of where ?

Answer 15

They come off above the AoV

Question 16

During which phase do the coronaries fill?

Answer 16

Early diastole (fill throughout diastole but fill most in early)

Question 17

What is the Ao sinotubular junction?

Answer 17

Transition between the sinuses of valsalva and the tubular portion of the ascending aorta

Question 18

What is the Ao sinuses?

Answer 18

The maximal diameter in the sinuses of valsalva

Question 19

How many wall segments?

Answer 19

17

Question 20

What is the structure under the aortic arch?

Answer 20

Right pulmonary artery

Question 21

Name the vessels coming off the aortic arch and most proximal or distal?

Answer 21

Innominate (prox) left carotid and left subclavian (distal)

Question 22

What is aortic coarctation?

Answer 22

The shrinking “rubber band” of the prox descending aorta

Question 23

Where do most aortic coarctation occur?

Answer 23

After the take off of the left subclavian artery, or within the aortic isthmus

Question 24

What cardiac pathology is associated with bicuspid aortic valves?

Answer 24

Coarctation of the aorta

Question 25

Where is the 2nd region to be scanned in standard TTE?

Answer 25

Apical

Question 26

What is the 4th standard view in TTE?

Answer 26

Apical 4CH

Question 27

Where are the pulmonary veins located? Which ones are seen in the apical 4CH view?

Answer 27

R and L upper (superior) pulmonary veins

Question 28

Which other view would give you the same information as the PLAX?

Answer 28

Apical Long axis(3)

Question 29

Which standard 2D TTE view typically allows viewing of the LAA?

Answer 29

Apical 2 CH

Question 30

In apical 2 CH view, the LAA is on what side of heart?

Answer 30

Anterior

Question 31

Where would pleural effusion be located?

Answer 31

Posterior to the DTA

Question 32

Where is the coronary sinus located?

Answer 32

Posterior AV groove / sulcus

Question 33

To visualize the coronary sinus in apical 4 CH view you should tilt the transducer?

Answer 33

Posterior (beam not transducer)

Question 34

Which valve sits at the opening of the coronary sinus?

Answer 34

Thebesian

Question 35

Which valve sits at the opening of the IVC?

Answer 35

Eustachian

Question 36

What portion of the pulmonary venous PW Doppler represents atrial systole?

Answer 36

A wave

Question 37

At what tempature is it unsafe to use a TEE probe?

Answer 37

40-45c (overheating pick the highest range)

Question 38

At what degrees would you see a 4CH view in TEE?

Answer 38

0 degrees

Question 39

At what degrees would you see the SAX view in TEE?

Answer 39

60 degrees

Question 40

At what degrees would you be able to see the LAA appendage in TEE?

Answer 40

73 degrees (decrease depth)

Question 41

ME?

Answer 41

Mid esophageal (TEE)

Question 42

What degrees at the ME level would you need to see the 4CH view in TEE?

Answer 42

0 degrees

Question 43

What degrees at the ME level would you need to see the 2CH view in TEE?

Answer 43

90 degrees

Question 44

What degrees at the ME level would you need to see the LAX view in TEE?

Answer 44

120 degrees

Question 45

What degrees at the ME level would you need to see the AV SAX view in TEE?

Answer 45

60 degrees

Question 46

What is the normal electrical activation order?

Answer 46

SA node, AV node, Bundle of his, R & L bundle branches and purkinje fibers.

Question 47

Which part of the electrical system has the fastest intrinsic rate?

Answer 47

SA node (pacemaker of heart)

Question 48

What is the pacemaker of the heart?

Answer 48

Sa node

Question 49

What is the absolute refractory state?

Answer 49

That period when a muscle cell is not excitable - from phase 1 until into phase 3, the relative refractory period is during phase 3 and the muscle might contract if the stimulus is strong.

Question 50

What does the P wave on ECG represent?

Answer 50

Atrial systole

Question 51

What does the T wave in ECG represent?

Answer 51

Ventricular diastole (repolarization)

Question 52

What is the P-R interval?

Answer 52

Includes P-R segment (from atrial to ventricular depolarization)

Question 53

What is the QRS complex?

Answer 53

Ventricular systole (depolarization)

Question 54

What is the normal duration for the QRS complex?

Answer 54

0.10 s

Question 55

How long is one small box on ECG in seconds?

Answer 55

0.04 s

Question 56

Normal QRS complex has?

Answer 56

Less than 3 little boxes (less than 0.12 s)

Question 57

What is a normal P-R interval?

Answer 57

Less than 1 big box (less than 0.2 s)

Question 58

Echo findings for preload vs afterload?

Answer 58

Preload - dilation | Afterload- hypertrophy

Question 59

Another name for the RA?

Answer 59

Todaro

Question 60

Where is the chiari network?

Answer 60

RA

Question 61

Acute Ai is ______ because we shift up the starling curve. Chronic ai is _____ when we drop off the end

Answer 61

Hypercontractile, failure

Question 62

Which study does not allow for the calculation of ef?

Answer 62

CXR

Question 63

How does switching to a lower frequency transducer affect aliasing?

Answer 63

Aliasing will occur at higher velocities

Question 64

What does VTI x CSA?

Answer 64

Doppler stroke volume

Question 65

Does venous return increase or decrease with inspiration?

Answer 65

Increase INspration

Question 66

Inhilation of amyl nitrate causes?

Answer 66

Decreased afterload

Question 67

Mitral valve velocity during inspiration?

Answer 67

Decreases

Question 68

What is the normal pressures in the pul artery?

Answer 68

25/10

Question 69

Were is LV pressure the lowest ?

Answer 69

Early diastole

Question 70

Where is the O2 saturation the lowest?

Answer 70

Coronary sinus

Question 71

Best cath technique for LV function?

Answer 71

LV angiogram

Question 72

What is the PCW (pulmonary capillary wedge) measuring?

Answer 72

La pressure

Question 73

Pericardial effusions in 2D can have swing motion & a possible?

Answer 73

Dilated IVC

Question 74

For constrictive pericarditis the m-mode will show?

Answer 74

Thick pericardium & paradoxical septal motion & flat LV posterior wall motion in diastole

Question 75

Constrictive pericarditis in 2D show diastolic dysfunction and?

Answer 75

Dilated IVC without respiration collapse, has prominent E & sm A. Also has respiration variation on mitral PW

Question 76

What increases afterload

Answer 76

Hypertension, AS & PS

Question 77

A pt has a blood pressure of 130/80 and a vsd jet of 5/m sec. What is their right ventricular systolic pressure ?

Answer 77

30 mmhg