C10: Apical And Other Views

Question 1

Where do you place the probe when scanning on the apical window (with reference to the apex)

Answer 1

The point of maximal impulse

Question 2

Which leaflets or the MV are seen in the 2 chamber view?

Answer 2

PML and AML

Question 3

Can you get an ejection fraction from tracing the endocardium?

Answer 3

Yes

Question 4

Can you sometimes see the coronary sinus in the 2 chamber view?

Answer 4

Yes

Question 5

Do you have to see both cusps of the AO valve in the apical 3 chamber view? What about the AO sinus?

Answer 5

Yes, you must see both

You must see the AO sinus

Question 6

Can you sometimes see the pulmonary veins in the apical 3 chamber view?

Answer 6

Yes

Question 7

Which pap muscle is sometimes seen. In the apical 3 chamber view?

Answer 7

Inferolateral pap muscles

Question 8

Why do we do the long axis measurements in PLAX instead of PSAX?

Answer 8

Because we are perpendicular to the structures and we are crossing fewer scan lines when we measure which makes it more accurate

Question 9

Where should the probe be placed when scanning in the subcostal window?

Answer 9

2 cm inferior to the xiphoid process… probe should be rotated at 3 o’clock

Question 10

What conditions can make the subcostal view difficult?

Answer 10

Cirrhosis and calcifications can make it hard to see the heart

Question 11

Can you sometimes see the SVC in the 4 chamber subcostal view?

Answer 11

Yes

Question 12

In which view can you best see an atrial shunt?

Why

Answer 12

Subcostal 4 chamber

We’re perpendicular with our beam

Question 13

What % of the population has an atrial shunt?

Answer 13

5%

Question 14

Which branches off the AO are seeing in the suprasternal notch?

Answer 14

1) First more anterior branch: brachiocephalic
2) left common carotid artery
3) let subclavian

Question 15

Which pulmonary artery do we see in the SSN view?

Answer 15

RPA

Question 16

Where is your probe marker pointing for the apical 4 chamber window?

Answer 16

2 or 3 o’clock

Question 17

How do you angle the probe to go from 4 chamber to 5 CH view?
What’s the 5th chamber?

Answer 17

Angle probe more anterior or superior

The AO

Question 18

What AO valves are we seeing in apical 5CH view?

Answer 18

R&L coronary cusps

Question 19

Which other structures of the AO are seen?

Answer 19

Prox AO including the sinus of valsalva

Question 20

How do you move the probe to go from apical 4CH view to 2CH view

Answer 20

Rotate to ~12oclock until the RV disappears

Question 21

What’s it called when you cut of the LV apex?

Answer 21

Forshortening

Question 22

Which struct are sometimes seen in the A2CH view?

Answer 22

1+ pulmonary veins

left atrial appendage

Question 23

If you saw the coronary sinus in the A2CH view, where would the be

Answer 23

@ approximately the level of the MV annulus on the L of the screen (they’re posterior to the LA)

Question 24

How do you move the probe to go from A4CH vie to A3CH/long axis view?

Answer 24

Rotate so marker is pointing to R shoulder

Question 25

Where is probe marker pointing in the subcostal window?

Answer 25

Marker is pointing towards you

Question 26

Where is probe maker for subcostal IVC view? How do we change out angle from subcostal 4CH?

Answer 26

~12:30

Angle inferior

Question 27

What structure in the liver must you get when imaging the IVC view?

Answer 27

Hepatic vein

Question 28

Where is marker facing when imaging in the SSN? View?

Answer 28

1-2 o’clock

Question 29

When looking at wall motion of the LV in the apical 4CH view, how should we change the depth

Answer 29

Reduce it