Anatomy Pt 1 Flashcards
1
Q
How can you differentiate a waveform obtained from the mitral valve and the tricuspid valve in a normal heart?
A
- Aortic flow can be seen on MV waveform tracing, but pulmonary flow is not seen on TV tracing
2
Q
During embryologic development of the heart, 6 pairs of aortic arches form and atrophy or evolve into different structures. Which one forms the aortic arch?
A
- 4th left
3
Q
What is the difference between the eustachian valve and the Chiari network?
A
- Chiari network is much thinner, delicate, and mobile than the eustachian valve
4
Q
On an EKG, when does ventricular diastole take place?
A
- From the end of the T wave to the onset of the QRS wave
5
Q
What does the pericardial fluid normally drain into?
A
- Lymphatic system
6
Q
What Doppler parameter is an assessment of left atrial function?
A
- A wave velocity on mitral valve Doppler
7
Q
The left ventricular apex is fed by what artery?
A
- Left anterior descending artery
8
Q
How many pairs of aortic arches form during embryologic development of the heart?
A
- 6 pairs
9
Q
What coronary vessel courses through the posterior interventricular groove?
A
- Middle coronary vein
10
Q
What happens to ventricular pressure during the isovolumic contraction period?
A
- Ventricular pressure increases
11
Q
What is the normal range for cardiac stroke volume?
A
- 70 to 100 cc
12
Q
The parasternal long axis view demonstrates what two walls of the left ventricle?
A
- Anteroseptal and inferolateral (posterior)
13
Q
What is the small flap of tissue that protects the opening of the coronary sinus called?
A
- Thebesian valve
14
Q
What cardiac structure are the endocardial cushions involved in forming?
A
- Tricuspid valve
15
Q
The left ventricle outflow to the aorta supplies blood the coronary arteries in ______?
A
- Diastole
(In systole the aortic leaflets are covering the openings into the coronaries
16
Q
What happens volume in the isovolumic relaxation period?
A
- All four chambers maintain a constant volume
17
Q
What happens to pressure in isovolumic relaxation?
What happens to pressure in isovolumic contraction?
A
- Decreases
- Increases
18
Q
What is the segment distal to the origin of the left subclavian to the ligamentum arteriosus?
A
- Aortic isthmus
19
Q
What is the area between the interventricular septum to the anterior annuus and the anterior mitral leaflet to the posterior aortic annulus?
A
- Functional LVOT
20
Q
What extends from the inner edge of the interventricular septum to the leading edge of the anterior MV leaflet?
A
- Anatomic LVOT
21
Q
What is the average normal mitral valve area?
A
- 5 cm2
22
Q
The largest antegrade flow component seen on a Doppler tracing of the hepatic veins is identified during what part of the cardiac cycle?
A
- Early systole
23
Q
Ventricular filling occurs in two phases. _____ of the blood moves into the ventricles during the rapid filling phase and _____ of the blood enters the ventricles during atrial contraction.
A
- 70%, 30%
24
Q
What supplies the interatrial septum with blood?
A
- Right coronary artery
25
What effect does dobutamine have on the left ventricle?
- Increases oxygen demand and left ventricular contractility
26
List the branches in the correct order that originate from the aortic arch
- Right innominate, left carotid, left subclavian
27
In the normal mitral valve leaflet, the _____ leaflet is longer than the _______ leaflet.
- Anterior, posterior
28
What is normal diastolic function of the left ventricle in a 40 year old healthy patient?
Left atrial pressure < ___ mmHg
Left atrial volume index < ___ mL/mm2
S/D ratio > ____
- LAP < 12
- LAVI < 34
- S/D ratio < 1.0
29
Which valve is normally positioned most anterior within the heart/chest?
- Pulmonary valve
30
The posteromedial muscle is supplied by ___ coronary artery(s) and the anterolateral muscle is supplied by ____ coronary artery(s).
- One, two
31
What can you calculate if you know both body surface area and the cardiac output?
- Cardiac index
32
When the right ventricle pressure drops below the right atrial pressure, what happens?
- Tricuspid valve opens
33
What two arteries are direct branches of the left main coronary artery?
- Left anterior descending and left circumflex
34
Where is the coronary sinus located?
- Within the posterior atrioventricular groove
35
What does right dominant coronary circulation indicate?
- The posterior descending artery originates from the right coronary artery
36
If the stroke volume remains constant and the heart rate doubles, what happens to the cardiac output?
- Doubles
37
How many segments is the left ventricle divided into when assessing wall motion at the basal level?
- 6
38
What structure attaches the mitral valve leaflets to the papillary muscles?
- Chordae tendinea
39
What is normal left ventricle systolic pressure?
- Around 120 mmHg
40
What maneuver decreases venous return?
- Valsalva strain
41
While scanning the aortic arch in the suprasternal notch view, you identify a vertical structure to the right of the arch that demonstrates flow moving away from the transducer in systole. What is this?
- Superior vena cava
42
At what point in the cardiac cycle is the left atrium at its greatest dimension?
- End systole
43
There are _____ aortic cusps and _____ sinuses of Valsalva in the aortic root.
- 3, 3
44
Which great vessel connects to the right atrium and drains blood from the uppers extremities, neck, and head?
- Superior vena cava
45
In the PLAX view, the coronary sinus is located _____ to the ______
- Anterior, descending aorta
46
What can the coronary sinus be used to identify for?
- Differentiate between pleural effusions and pericardial effusions
47
The early heart tube normally loops _____ and to the ______.
- Anterior, right
48
What demonstrates the relationship between venous return and stroke volume?
- Frank Starling Law (Starling's Law)
49
Which coronary artery usually supplies blood to the posteromedial papillary muscle?
- Right coronary artery
50
What describes the isovolumic contraction period? In terms of what happens to pressure and volume.
- Volume is constant in all four chambers but the pressure in the ventricles increases
51
Which fetal shunt usually closes first after birth?
- Ductus arteriosus
52
What is the normal response to exercise testing performed to assess diastolic function of the left ventricle?
- Both the E and E' velocities should increase with no change in E/E' ratio
53
By what gestational age is the primitive heart tube formed?
- Day 23
54
When the pressure in the left atrium exceeds the pressure in the left ventricle, which valve opens?
- Mitral valve
55
What kind of flow is described by blood moving in layers with the highest velocity in the center of the vessel?
- Parabolic laminar flow
56
What fetal structure allows blood flow shunting between the pulmonary artery and aorta?
- Ductus arteriosus
57
What is considered an abnormal change in the left ventricular inflow seen in patients over 60 years of age?
- E/A ratio over 2.0
58
According to the ASE guidelines, the top normal left ventricular wall thickness in a male is ______ and the top normal wall thickness in a female is ____.
- Male 1.0 cm
- Female 0.9 cm
59
Correctly describe the movement of blood from left atrium into the left ventricle in the rapid filling phase.
- Atrial pressure increases, mitral valve opens and blood is pulled into the left ventricle due to the rapidly relaxing ventricle
60
Which component of blood holds the hemoglobin?
- Red blood cells
61
Define systole.
- From mitral valve closure to aortic valve closure
62
At what point in the cardiac cycle is the right ventricle at its smallest dimension?
- End systole
63
When is the left ventricular pressure the lowest?
- Onset of diastole
64
What two left ventricular walls are seen on an apical 4 chamber view?
- Inferoseptal and anterolateral
65
Which ventricle has direct attachments to chordae tendineae?
- Right ventricle
66
When congenital heart disease is suspected in an adult, how do you differentiate the aorta from the pulmonary artery?
- The PA bifurcates and the aorta gives rise to three branches
67
What is the normal left ventricular response to exercise?
- Reduced end systolic volume/dimension
- Increased LV EF%
- Increased LV wall thickness
68
How many papillary muscles are in the right and left ventricle?
- RV has 3 papillary muscles, LV has 2
69
What does the S1 heart sound correspond with?
- Atrioventricular valve closure (MV/TV)
70
What are small fibrous nodular areas that are normally identified on the central part of the aortic cusps?
- Nodules of Arantius
71
Which tricuspid valve leaflets are evaluated in PLAX of the right ventricle?
- Anterior and posterior
72
What is the anatomy of the tricuspid valve?
- It is composed of an anterior, posterior, and medial leaflet
73
What is the equation for stroke volume?
CSA x VTI = Stroke Volume
74
In most patients, the left anterior descending artery is a branch of the _____ and the posterior descending artery is a branch of _____.
- Left coronary artery, right coronary artery
75
At what point in the cardiac cycle is the left ventricle at its greatest dimension?
- End diastole
76
What cardiac wall segments are fed by the left anterior descending coronary artery?
- Anteroseptal
- Left ventricular apex
- Anterior
77
What does the right ventricular systolic pressure measurement estimate?
- Pulmonary artery pressure which is used to assess pulmonary hypertension
78
How does Doppler evaluation demonstrate that the pulmonary vascular resistance is normally lower than resistance in the systemic vascular system?
- The flow through the aortic valve reach es a peak velocity faster than the flow through the pulmonary valve
79
When does the mitral valve normally close as related to an EKG tracing in a patient with normal sinus rhythm?
- 60 ms after the start of the QRS wave
80
What coronary vessel courses through the anterior interventricular groove?
- Left anterior descending artery
81
Where is the basal wall segment of the left ventricle?
- Between the atrioventricular groove and the tip of the papillary muscle
82
What can be used to decrease venous return to the heart and increase heart rate?
- Valsalva maneuver
- At onset, venous return decreases. Upon release, venous return increases.
83
What heart sound marks the start of systole?
- S1
84
What two factors mainly control blood flow volume changes?
- Cardiac function and peripheral resistance
85
What heart sound marks the start of diastole?
- S2
86
What does the S2 heart sound correspond with?
- Semilunar valve closure (AV/PV)
87
What does preload refer to?
- Amount of blood entering the heart
88
What are heart failure, mitral stenosis, and mitral regurgitation associated with?
- Increasing preload
89
What does afterload refer to?
- The amount of resistance as the heart ejects blood
90
What are aortic stenosis, aortic coarctatoin, and systemic HTN associated with?
- Increased afterload
91
What is the average normal aortic valve area?
- 3 to 4 cm2
92
What is the visceral layer of the pericardium referred to?
- Epicardium
93
When doe the majority of pulmonary venous flow enter into the left atrium?
- Early systole
94
What effect will getting out of bed and standing up have on the venous return?
- Decrease venous return
95
What facilitates the contraction of the atrial appendage?
- Pectinate muscle in the walls of the appendages
