ECHO 100 - WEEK ONE Flashcards
What is the normal cardiac chamber pressure and O2 saturation for the RIGHT VENTRICLE?
15-30 mmHg; 1-5 mmHg; 75%
What is the normal cardiac chamber pressure and O2 saturation for the LEFT ATRIUM?
5-12 mm Hg; 98%
What is the normal cardiac chamber pressure and O2 saturation for the LEFT VENTRICLE?
100-140 mm Hg; 5-12 mmHg; 98%
What chamber or vein of the heart has the lowest O2 saturation?
The coronary sinus with 60% oxygen saturation.
What is another term for “anterior” portion of the body?
Ventral
What is another term used for the “posterior” portion of the body?
Dorsal
List the parasternal long axis view anatomy.
Right Ventricle (RV), Right Ventricle Free Wall (RVFW), Interventricular Septum ( IVS), Apex, Left Ventricle (LV)
What is the starting location for the probe when looking for PLAX?
Left second intercostal space at the parasternal border with the dot pointing in the direction of the right shoulder.
Recite blood flow through the heart.
IVC/SVC - RA -Tricuspid Valve - RV - Pulmonary Valve - Left Pulmonary Artery/Right Pulmonary Artery - LUNGS - Left Pulmonary Vein/Right Pulmonary Vein - LA - Mitral Valve - LV - Aortic Valve - Aorta
What is the normal cardiac chamber pressure and O2 saturation for the RIGHT ATRIUM?
1-5 mm Hg; 75%
What does a transthoracic echocardiogram of the heart allow us to study?
The anatomy, motion, blood flow through the heart, and adjacent areas
What are three contraindications for a TTE?
Combative patient, morbidly obese, and those with interstitial air from chest trauma
Hertz is the unit for . . .
Cycles per second
What frequency does cardiac ultrasound use?
2–12 MHz
What are the advantages from a clinical perspective for a TTE?
Requires minimal staffing, minimal equipment, is portable, and provides immediate information
A transducer converts ______to ________ and _________ back to ________.
Converts electrical pulses to sound waves and sound waves back to electrical pulses
What shape does the transducer transmit the ultrasound pulses into the chest in?
Shape of a beam
Ultrasound cannot pass through ________ or __________?
Bone or air
The ultrasound transducer is placed in _____________on the chest wall in order to obtain ___________________ of the cardiac structures, greater vessels and adjacent areas.
Standardize windows, standardized images
TTE cardiac transducers have what range of frequencies?
2.0 to 10 MHz
How does the cardiac sonographer control the transducer frequency?
By attaching the appropriate transducer to the ultrasound unit
What are two benefits of a low-frequency imaging transducer?
Excellent depth penetration, ideal for adult patients
What do we mean when we are talking about resolution?
Clarity, precision
What is the trade-off with the low frequency transducer?
Decreased resolution
What frequency is the transducer that is utilized most frequently on adult patients?
2.0 to 3.5 MHz
When is the 5.0 MHz transducer used?
On small adults or when improved resolution is required
What are the benefits of a high frequency imaging transducer?
Excellent resolution, ideal for pediatric patients
What is the trade-off for a high-frequency transducer?
Decreased depth penetration
What transducer is utilized most frequently on pediatric patient?
Transducer with frequency ranges from 3.5 to 5.0 MHz
What frequency transducer can neonates be scanned with?
7.2 MHz transducer or higher
How is each standardized view of the heart depicted?
By the imaging plane through which it passes
What determines the exact location of each window?
The patients physique
List five windows.
Left parasternal, left apical, subcostal, suprasternal, right parasternal
What is the transducer location for the left parasternal window?
Left sternal border, located at the fourth intercostal space, angled posterior toward the heart
What views do you get with a left parasternal window?
Parasternal long axis (LAX LV, LAX RVIT, and LAX RVOT); parasternal short axis (SAX AP, SAX PM, SAX MV, and SAX BASE)
Where is the transducer location for the left apical window?
Apex, typically located at the point of maximal impulse (PMI), angled superior and medial toward the heart
What views are seen in the left apical window?
Apical 4 chamber (4C), apical 5 chamber (5C), apical 2 chamber (2C), apical 3 chamber (3C)/apical long axis (apical LAX)
Where is the transducer location for the subcostal window?
Sub xiphoid process, located at the bottom of the sternum, angled superior toward the heart
What views do you get with the subcostal window?
Sub costal 4 chamber (subcostal 4C), subcostal short axis (subcostal SAX LV and SAX BASE), subcostal inferior vena cava (subcostal IVC), subcostal descending aorta (SUBCOSTAL DAO)
What is the transducer location for the suprasternal window?
Suprasternal notch, located at the top of the sternum, angled inferior toward the aortic arch
What are the views found in the suprasternal window?
Suprasternal long axis (SUPRASTERNAL LAX), suprasternal short axis (SUPRASTERNAL SAX)
What position is the patient placed in for the right parasternal window?
Right lateral decubitus position
What is the transducer location for the right parasternal window?
Right sternal border, approximately at the fourth intercostal space, angled medial toward the heart
What does LAX stand for?
Long axis
What does LPA stand for?
Left pulmonary artery
What does RPA stand for?
Right pulmonary artery
What does SAX stand for?
Short axis
How does the SAX imaging planes slice the heart?
At right angles to the longest axis of the heart
What does the SAX imaging planes provide cross-sectional views of?
Base (SAX BASE), mid ventricular region (SAX MID), Apex (SAX APEX)
What type of views does the SAX imaging planes provide?
Cross sectional views
How does the LAX imaging planes slice the heart?
Parallel to the longest axis of the heart
What does the LAX imaging planes provide?
Elongated views of the heart
What views do you see with the LAX 2C imaging plane?
LV, LA
What views do you see with the LAX 4C imaging plane?
All four chambers
What views do you see with the LAX 3C imaging plane?
Left heart with the aortic valve and a portion of the right ventricle
What are the 2D imaging planes?
LAX, SAX
What are the standard TTE windows in a frontal view?
Suprasternal, right parasternal, left parasternal, subcostal, apical
What are the standard TTE windows in a lateral view?
Subcostal, parasternal, apical, suprasternal
How many echo modalities are there that provide information about the heart?
Three
List the three Echo modalities that provide information about the heart.
2-D echo, M-Mode, and Doppler echocardiography (to include color flow Doppler and spectral Doppler)
What does 2-D echo produce?
A black-and-white, real time, moving image of the heart and adjacent area
What does 2-D echo allow us to do?
Visualize the relationship between the heart structures
How is the optimal 2-D image produced?
When the transducer is perpendicular 90° to the structures being imaged
The perpendicular position is considered to be…
On axis
In a 2-D echo: LAX LV view, what does each dot represent?
1 cm
The depth and the focus are determined by the…
Sonographer
In order to be on axis the heart has to be…
Perpendicular to the transducer
What does off-axis mean?
The heart is not perpendicular to the transducer
Where do you start to acquire the parasternal long axis of the left ventricle (LAX LV)?
In the left parasternal border at approximately the 4th ICS
Which chambers are visualized in the parasternal LAX LV?
Right ventricle, left ventricle, left atrium
What valves are visualized in the parasternal LAX LV?
Aortic and mitral valves
What walls are visualized in the LAX LV?
Right ventricular free wall, interventricular septum, left ventricular posterior wall
What is the left ventricular posterior wall also known as?
Inferolateral wall
What vessel is visualized in the long axis?
The aortic root and sometimes the ascending aorta
What vessels are visualized in the short axis (LAX LV)?
Descending aorta and coronary sinus
How is the parasternal long axis of the right ventricular inflow track (LAX RVIT) acquired?
Angle the transducer more medial and inferior from the LAX LV
Which chambers are visualized in the LAX RVIT?
Right ventricle, right atrium
What valve is visualized in the LAX RVIT?
Tricuspid valve
How was the parasternal long axis of the right ventricular outflow tract (LAX RVOT) acquired?
Angle the transducer more superior and lateral from the LAX LV
What chamber or chambers is visualized in the LAX RVOT?
Right ventricle
What valve or valves is visualized in the LAX RVOT?
Pulmonic valve
What vessel or vessels is visualize(d) in the long axis LAX RVOT?
Pulmonary artery and pulmonary bifurcation
How do you acquire the parasternal short axis (SAX) views?
rotate the transducer approximately 90° clockwise from the LAX LV and then sweep across the long axis of the heart
What short axis or cross-sectional views does the parasternal SAX view provide?
SAX AP, SAX PM, SAX MV, SAX BASE
What does SAX AP stand for?
Short axis apex
What does SAX MV stand for?
Short exes mitral valve
What does SAX PM stand for?
Short axis papillary muscles
What chambers are visualized in the parasternal short axis (SAX)?
RA, RV, LA, LV
What valves are visualized in the parasternal short axis (SAX)?
Mitral, aortic, Pulmonic, tricuspid
What walls are visualized in the parasternal short axis (SAX)?
Septal wall, Anteroseptal wall, anterior wall, anterolateral wall, lateral wall, inferolateral wall, inferior wall, and inferoseptal wall
What are the views of SAX?
SAX AP, SAX PM, SAX MV, SAX BASE
