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MIDS 197 > Ch 1 Intro > Flashcards

Ch 1 Intro Flashcards

1
Q

The SA node recharges/repolarizes while which chamber refills?

A

While atria refills

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2
Q

The AV node recharges/repolarizes while which chamber refills?

A

While ventricles refill

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3
Q

What is systole + how much of the cardiac cycle does it make up?

A

-Contraction of ventricles
-Begins at mitral valve closure, ends at aortic valve closure
-1/3 of cycle

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4
Q

What is diastole + how much of the cardiac cycle does it make up?

A

-Relaxation of ventricles
-Begins at aortic valve closure, ends at mitral valve closure
-2/3 of cycle

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5
Q

What mechanism causes valves to close?

A

Pressure gradient

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6
Q

What valves are open during diastole?

A

AV valves open, semilunar valves closed (b/c blood filling into ventricles)

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7
Q

What valves are open during systole?

A

Semilunar valves open, AV valves closed (b/c blood pumping out of body)

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8
Q

End of diastole allows for the ventricles to reach their largest or smallest diameter?

A

Largest (b/c filled with blood)

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9
Q

End of systole allows for the ventricles to reach their largest or smallest diameter?

A

Smallest (b/c blood has been pumped out of the ventricles)

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10
Q

What valve separates the biggest pressure differential?

A

Mitral/bicuspid valve

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11
Q

Where blood goes, does pressure increase or decrease?

A

Increases

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12
Q

Which side of the heart has high pressure + which side has low pressure?

A

Left: high (systemic circulation)
Right: low (lungs/pulmonary circulation)

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13
Q

Which chamber has the highest + lowest pressure?

A

RA: lowest
LV: highest

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14
Q

How many pulmonary arteries + veins are there?

A

Arteries: 2
Veins: 4

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15
Q

During what part of the cardiac cycle do the coronary arteries fill?

A

Diastole (b/c they are no longer compressed like in systole)

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16
Q

Which side of heart has highest level of oxygenation?

A

Left b/c has oxygenated blood (right has deoxygenated blood)

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17
Q

Deoxygenated blood returns to the RA via what?

A

SVC + IVC

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18
Q

The coronary arteries come off what structure?

A

Aorta

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19
Q

What do we evaluate during an echocardiogram?

A

-Chambers (size, structure, function)
-Valves (stenosis, regurgitation, area)
-Estimate pressure inside heart
-Recognize issues with other parts of the body via the heart

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20
Q

What is the m/c reason for an echo to be ordered?

A

Heart murmur (extra noise heard during a heartbeat)

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21
Q

Is a TTE or TEE more invasive?

A

TEE b/c goes down esophagus

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22
Q

What is an acoustic window?

A

Probe location that provides access for cardiac imaging

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23
Q

What is an imaging plane?

A

Orthogonal view of the heart (the view/slice we are in)

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24
Q

Differentiate move, translation, tilt, angle + rotate?

A

Move: pick up + move probe to different part of chest

Translation: moving probe across chest while keeping contact with skin

Tilt: rocking probe (heel/toe) within same imaging plane to center structure

Angle: side to side movement of probe from fixed point to view different anatomy

Rotate: twist probe (ex from sag to trv)

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25
Q

4 acoustic window/transducer locations we use?

A

-Parasternal (medial chest)
-Apical (lateral chest)
-Subcostal (stomach)
-Suprasternal (neck)

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26
Q

List the imaging planes/views we do?

A

-Short axis (trv)
-Long axis (sag)
-5,4,3,2 chamber views

27
Q

What are the 3 reference points we use?

A

-Apex vs base
-Lateral vs medial
-Anterior vs posterior

28
Q

Do cardiac sonographers perform TTEs + TEEs?

A

TTEs (imaging through thorax/chest), we only assist the cardiologist with TEEs

29
Q

Are echo exams operator dependent?

A

Yes, highly! The quality of our images is dependent on our skill

30
Q

Where do the 3 ECG leads go?

A

Salt (RA), pepper (LA) + ketchup (left side under ribs)

31
Q

When would we use the pedof blind probe?

A

When dealing with aortic stenosis

32
Q

List 5 emergency indications for an echocardiogram where we could inform the cardiologist asap?

A

-Cardiac arrest (heart stops)
-Pericardial tamponade (too much fluid causing compression of heart)
-Aortic dissection (tear in AO)
-Cardiogenic shock (heart can’t pump enough blood)
-Pulmonary embolism (block in pulmonary arteries)
-Newly decreased ejection fraction
-Thrombus
-New onset arrhythmia

33
Q

What types of doppler do we use to assess the hemodynamics of the heart?

A

-Color doppler (qualitative)

Spectral doppler: quantitative
-Pulse wave
-Continuous wave

34
Q

What 3 questions do pt’s often have?

A

-Length of exam
-Positioning of pt
-Timing of results

35
Q

What is 2D B-Mode imaging?

A

Real time cross sectional images of heart achieved by repeated multiple u/s scan lines being compiled into a 2D image

36
Q

Quality of 2D B-Mode images depend on what 4 factors?

A

-Selecting correct probe pre set
-Depth
-Frequency
-Frame rate gains

37
Q

Can we assess the heart quantitatively or qualitatively with 2D B-Mode imaging?

A

Both!

Quantitative: numbers, is measurable
Qualitative: characteristics not expressed by #s

38
Q

Can we do measurements offline or does it have to be done on the u/s machine?

A

Either!

39
Q

What is M-Mode imaging?

A

-Motion mode
-Single narrow beam of u/s repeated multiple times
-Tracing of depth on y-axis + x-axis

40
Q

Advantage + disadvantage of M-Mode imaging?

A

Advantage: high frame rate to evaluate ventricular motion + opening/closing of valves

Disadvantage: hard to interpret b/c cursor must be perpendicular

41
Q

Can we assess the heart quantitatively or qualitatively with CD?

A

Qualitatively - shows direction of flow with respect to the probe (BART)

42
Q

Is CD a form of pulse wave doppler?

A

Yes

43
Q

What can CD detect?

A

-Abnormal backwards flow of valves
-Turbulent flow at obstructions
-Shunts (hole in heart)

44
Q

Can we assess the heart quantitatively or qualitatively with pulse wave doppler?

A

Quantitatively

45
Q

What does PW doppler show on u/s?

A

Direction + velocity of flow with respect to time in 1 location, through 1 SPECIFIC location

(flow above baseline: towards probe
below baseline: away from probe)

46
Q

What is PW doppler used for?

A

To evaluate flow at a specific location

47
Q

Is PW doppler subject to aliasing?

A

Yes

48
Q

Is PW doppler best for low or high flow states?

A

Low

49
Q

Can we assess the heart quantitatively or qualitatively with continuous wave doppler?

A

Quantitatively

50
Q

What does CW doppler show on u/s?

A

Shows direction + velocity of flow with respect to time in 1 location, can NOT localize a specific location

(flow above baseline: towards probe
below baseline: away from probe)

51
Q

What is CW doppler used for?

A

To measure differences in pressure from 1 side of a tight valve to the other side

52
Q

Does sampling occur along the entire cursor line with CW doppler?

A

Yes

53
Q

List 3 conditions affecting image quality?

A

-Increased probe distance from hrt (adipose tissue)
-Decreased u/s penetration (scar tissue)
-Air containing tissues b/w probe + hrt (chronic lung disease, recent cardiac surgery)

54
Q

What do we report on after an exam?

A

-Size of chambers
-Valves
-Presence/degree of valve stenosis + regurgitation
-Function of ventricles
-Size/dilation of AO root + ascending AO
-Presence of pericardial fluid
-Technical quality of exam
-Segmental wall motion abnormalities
-BP + HR
-Height + weight for body surface area (BSA)

55
Q

What is endocarditits?

A

Bacterial growth inside heart

56
Q

Where is the lubricating fluid in heart?

A

B/w the epicardium + pericardium

57
Q

Name of indentation found in the center of a normal interatrial septum?

A

Fossa ovalis

58
Q

Name the coronary artery that runs adjacent/beside the middle cardiac vein?

A

Right posterior descending artery

(aka posterior interventricular artery)

59
Q

What does the right coronary artery divide into?

A

-Right posterior descending (posterior side of heart)
-Right marginal (anterior side of heart)

60
Q

Name the coronary artery that runs adjacent to the small cardiac vein?

A

Right marginal artery

61
Q

Name the coronary artery that runs adjacent to the great cardiac vein?

A

LAD - left anterior descending

(aka anterior interventricular artery)

62
Q

What does the left coronary artery divide into?

A

-LAD
-Left circumflex

63
Q

On an ECG, systole occurs during which wave forms?

A

Peak of R wave to end of T wave

64
Q

On an ECG, diastole occurs during which wave forms?

A

End of T wave to peak of R wave

MIDS 197 (15 decks)

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