Echo final review Flashcards
The right heart is associated with the __________ and the left heart is associated with the ___________.
pulmonary circulatory system / systemic circulatory system
Of the three germ layers that give rise to all adult tissues and organs, which gives rise to the heart?
mesoderm
The two tubes that eventually fuse to form the heart are referred to as the ________.
endocardial tubes
Blood normally flows from the left ventricle to the
aorta
The pulmonary trunk and aorta are derived from which primitive heart structure?
truncus arteriosus
The earliest organ to form and begin function within the developing human is the ________.
heart
The forceful contraction of the cardiac chambers is ________, and the relaxed phase of the cycle is ________.
systole; diastole
The inferior vena cava is guarded by a fold of tissue called the _____ valve, whereas the coronary sinus is guarded by the _____ valve.
eustachian; thebesian
The most posterior chamber to the left of the sternum is the
left atrium
The point at which the four cardiac chambers meet at the back of the heart forms a cross-shaped area is called
crux
In the __________ view the tricuspid valve insertion is seen closer to the _________ than is the mitral valve insertion.
Apical Four Chamber, apex
The brightest returning echo signal in the heart is from the
Pericardium
The tricuspid valve opens when
right ventricle pressure drops below the right atrial pressure
The semilunar valve that has right coronary, left coronary and noncoronary cusps is the
Aortic
The pericardial sac protects the heart against
Friction
Which primitive area of the heart will give rise to the right ventricle
bulbus cordis
The outflow tract of the right ventricle also is called the
infundibulum
The wall of the aorta bulges slightly at each semilunar cusp to form the
sinus of Valsalva
The greatest muscle mass in the heart is found in the
LV
The right and left coronary arteries arise from the
ascending aorta
The anterior walls and appendages of the atria are made up of projecting muscle bundles that run parallel to one another – these are known as _______
pectinate muscles
________________ follows the anterior interventricular groove down to the apex. It typically supplies 45-55% of the LV and is therefore considered the most critical vessel in terms of myocardial blood supply.
Left anterior descending artery (LAD)
An embryonic remnant, present in about 2-3% of the population. Lies close to IVC in the RA. Appears as a web-like structure with thread like pieces. Characterized by a whip-like motion within the RA
Chiari Network
When the ventricular pressure exceeds the pressure in the atria these valves close preventing the flow of blood from the ventricles into the atria
mitral and tricuspid
What chamber of the heart lies most anterior
RV
The oxygen saturation in the __________ is the lowest in the body
coronary sinus
The moderator band may be visualized traversing the apex of the __________:
RV
The visceral layer of the serous pericardium covers the myocardium and is also known as the ____________
epicardium
The leaflets of the tricuspid valve which are seen in the right ventricular inflow (RVIT) view are the_________
anterior and posterior
The best window to record images and Doppler signals from the arch of the aorta is
suprasternal
The right ventricle pumps blood to the__________ . The left ventricle pumps blood to the ______________.
pulmonary circulation (the lungs); systemic circulation (the head, thorax, abdomen, and extremities).
From the Apical four-chamber view, the transducer is _________________ to obtain the two-chamber view consisting of the LV, MV and LA.
rotated counterclockwise about 90 degrees
Pedoff probe is a type of PW probe. T/F
False
While performing CW Doppler across the aortic valve peak velocity should not exceed:
1.7 m/s
Two-dimensional images are best obtained when the ultrasound beam is directed _____ to the structure of interest. Doppler signals are best obtained when the ultrasound beam is directed _____ to the flow of blood.
perpendicular; parallel
The PW Doppler signal derived from the mitral valve blood flow is best detected in the
apical four chamber view
The greatest advantage of CW Doppler is its ability to accurately measure very high velocities. T/F
True
A sample of CW Doppler of aortic valve is best taken from the apical two chamber view. T/F
True
While performing CW Doppler across the mitral valve peak velocity should not exceed
1.3 m/s
A normal LV Ejection fraction ranges from
53% to 75%
On the LV M-Mode tracing the arrow is pointing to _________
left ventricular internal dimension (end diastole)
It is important to place the ultrasound M-mode cursor perpendicular to the structures of interest. T/F
True
Normal measurement for the left ventricular internal diameter in diastole (LVIDd) according to the ASE is
5.7 cm
________ view is used to measure LVOT diameter during _________
PLAX, mid systole
The difference between end-diastolic volume (EDV) and end-systolic volumes (ESV) is termed ______
stroke volume
The volume of blood pumped by the heart per minute
Cardiac output
Because it is difficult to properly align the M-mode cursor, many measurements are now made with _________ instead of on M-mode.
2D imaging
In ___________, the atria and ventricles are out of synch because the atria contract very quickly and irregularly.
atrial fibrillation
____________ is the fraction of the end-diastolic volume that is ejected with each beat.
Ejection fraction
Measurements should be made using the leading edge to leading edge method of measurement. T/F
True
An EF of less than 35% increases the risk of life-threatening irregular heartbeats that can cause sudden cardiac arrest. An implantable cardioverter defibrillator (ICD) may be recommended for these patients. T/F
True
The normal measurement suggested for the diameter of the aortic root in end diastole is up to _______.
3.7 cm
M-mode evaluation of the aortic valve, mitral valve and left ventricle can be done from _______ or _________ representative views.
PLAX, PSAX
What does the “E” point represent on an M-mode of the mitral valve?
end of rapid filling phase
In adults and adolescents, the cavity and wall thickness measurements of the left ventricle should be taken at the level of the ____________
chordae tendinae
The correct equation for fractional shortening is
LVIDd - LVIDs/ LVIDd x 100
It is very important when imaging the left ventricle to have the ultrasound beam transect the walls at a ______ degree angle
90
An EF of less than 40% may confirm a diagnosis of
heart failure
The amount of resistance that must be overcome by the left ventricle during systole is called
afterload
____________occurs when there is an obstruction within the atrial electrical conduction system, discharge of an ectopic focus for atrial depolarization, only occasional stimulus will penetrate AV node. EKG will show a Saw-tooth pattern.
atrial flutter
Which of the following is the correct sequence of cardiac electrical activity?
- AV node
- Bundle of His
- SA node
- Purkinje fibers
- Bundle branches
3,1,2,5,4
The more the myocardium is stretched, the more forceful the contraction
The Frank Starling Law
MV closure is followed by ________ during which all valves are closed and the cardiac muscle depolarizes and starts contracting. LV pressure rises rapidly BUT ventricular volume stays the same (shape changes).
isovolumic contraction
The normal pacemaker site of the heart is the
SA node
__________ is the ability of the cardiac muscle cells to initiate an electrical impulse without being stimulated by a nerve or other source.
automaticity
The 2nd heart sound, S2 (dub) is related to
closure of the aortic and pulmonic valves
On an EKG, ventricular depolarization is represented by the
QRS complex
3 main factors that effect stroke volume include all of the following EXCEPT
Isovolumic relaxation time
________ analyzes how long it takes an impulse to travel from SA node through the internodal pathways from start of atrial depolarization to start of ventricular depolarization.
P-R Interval (PRI)
Cardiac muscles cells ability to initiate an electrical impluse without being stimulated by a nerve or other source is called
automaticity
___________ is a chaotic rhythm in which there are multiple areas exhibiting varying degrees of depolarization and repolarization and an absence of R-waves
Ventricular fibrillation
“Lub” represents the closing of __________________ during ventricular ___________
atrioventricular valves, systole
Parasympathetic stimulation can speed up the conductivity of the impulse. It increases the rate and force of contractions. T/F
False
Approximately 50% of patients become unconscious from this abnormal cardiac rhythm
ventricular tachycardia
The ability of cardiac cells to receive an electrical impulse and transmit it to an adjacent cardiac cell is called
conductivity
Failure of the valve to seal properly (valve may be torn, perforated, affected by rheumatic fever or a failing heart may be enlarged) is called
incompetence
_________________ is a disorder of the heart where blood leaks back from the LV into the LA (through the MV) during systole.
Mitral regurgitation
Vegetations are always found on the _____ side of the valve, so in case of mitral regurgitation caused by vegetations, they are seen on the _____ side of the valve.
low pressure/atrial
Which of the following is associated with severe, acute mitral regurgitation?
pulmonary edema
____________ is still responsible for most of the acquired valvular heart disease in childhood.
Rheumatic fever
The most common cause of mitral regurgitation in elderly patients is
calcified mitral annulus
The smallest vegetation visible echocardiographically measures to be ________
2 mm
The posteromedial papillary muscle has a single blood supply from the RCA and is therefore more likely to become ischemic. T/F
True
A mid or late systolic click with or without a systolic murmur is associated with
mitral valve prolapse
What is considered to be an enlarged LA
> 6.0 cm
Mitral regurgitation happens during diastole. T/F
False
With severe MR, you will see all of these things EXCEPT
vena contracta that measures 0.4 cm
EROA =
2πr2 x Nyquist Limit/ V max
VTI =
stroke distance, stroke distance (cm), Stroke distance, Stroke Distance, RVol/EROA
Always shift the Nyquist limit towards the regurgitant flow. T/F
True
Continuity Equation =
A1 x V1 = A2 x V2, A1xV1 = A2xV2, A1xV1=A2xV2
Which vena contracta value is consist with severe mitral regurgitation?
> 0.7 cm
The most common cause of mitral stenosis is rheumatic fever. T/F
True
According to planimetry, moderate MS measures
1.0-1.5 cm2
The higher the pressure half time the smaller the mitral valve area.
True
