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Adult Echocardiography 1 > Echo Physics 101 > Flashcards

Echo Physics 101 Flashcards

1
Q

Frank-Starling Principle aka

A

length tension relationship

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2
Q

what is the Frank-Starling Principle

A

force of contraction is greater when the LV muslce is stretched prior to contraction increased by preload

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3
Q

the degree of the stretch of the cells in the ventricular wall is determined by the ___

A

volume of blood within the chamber

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4
Q

more blood to the heart (preload), greater tension, greater forced generated during systole = ____ SV

A

greater

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5
Q

SV

A

stroke volume

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6
Q

what is SV

A

the amount of blood ejected with each beat of the heart

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7
Q

what two ways can stroke volume be calculated and their formulas

A

2d: SV = EDV-ESV
doppler: SV= CSA x VTI

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8
Q

CSA means

A

cross sectional area

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9
Q

VTI means

A

velocity time integral

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10
Q

normal stroke volume at rest

A

50-100mL

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11
Q

what is cardiac output

A

how much blood is pumped out of the heart in one minute

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12
Q

cardiac output formula

A

CO = SV x HR

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13
Q

normal CO

A

4-6L/min

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14
Q

what is cardiac reserve

A

amount of blood the heart is capable of pumping beyond the normal CO of a resting HR

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15
Q

cardiac reserve is____ in athletes, _____ in elderly

A

higher
lower

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16
Q

cardiac index and formula

A

cardiac output indexed to accommodate for body surface area

CI = CO/BSA

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17
Q

SV = blood pumped to heart per ___

A

beat

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18
Q

CO = blood pumped from the ventricle in ____

A

one minute

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19
Q

chronotropic force

A

heart rate

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20
Q

increased HR = ____ the LV filling time (diastole)

A

decrease

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21
Q

SNS increases ____ and ____

A

chronotropic force
inotropic force

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22
Q

SNS _____ HR

A

increases

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23
Q

SNS ____ chronotropic force/HR

A

decreases

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24
Q

preload is what

A

the amount of blood in the ventricle at end-diastole (volume load delivered to ventricle)

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25
Q

increased preload = _____ EDV/SV/CO

A

increased

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26
Q

decreased HR = ____ diastole time, ____ filling time, _____ preload

A

increased x3

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27
Q

increased HR = ____ diastole time, ____ filling time, _____ preload

A

decreased x3

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28
Q

preload factors (2)

A

filling time
venous return

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29
Q

increased venous return = _____ preload

A

increased

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30
Q

3 causes of increased venous return

A

increased blood volume/venous pressure
Decreased intrathoracic pressure

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31
Q

decreased intrathoracic pressure = _____ venous return

A

increased

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32
Q

what decreases intrathoracic pressure

A

breathing = diaphragm moves down

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33
Q

inspiration ______ VR to heart

34
Q

standing ____ VR

A

decreases (gravity pulls down to legs)

35
Q

squatting _____ VR

A

increases (squeezes blood to heart)

36
Q

valsalva maneuver ____ VR and ____

A

decreases
SV

37
Q

valsalva ____ intrathoracic pressures

38
Q

is afterload opposite to preload

39
Q

what is afterload

A

resistance to ventricular emptying (pressure LV has to squeeze against)

40
Q

increased afterload = ____ SV/CO

41
Q

what affects afterload (3)

A

hypertension
viscosity of blood
valvular stenosis

42
Q

Law of Laplace and formula

A

tension in walls depends on 1. pressure of its contents, 2. radius

Wall tension = cavity pressure (r) / wall thickness x 2

43
Q

contracility AKA (2)

A

inotropic force, force-velocity relationship

44
Q

contracility is the ______ of ____ at a given preload and afterload

A

force
contraction

45
Q

is contracility related to the Frank-Starling mechanism

46
Q

____ force of contraction = increased SV

47
Q

SNS _____ contracility

48
Q

negative inotropic response = LV cannot _____ due to ____

A

contract enough
structural disorganization (disease)

49
Q

positive inotropic response

A

medications can make it easier for the heart to contract by altering the sympathetic nervous system

50
Q

length-tension relationship
vs
force-velocity relationship

A

frank-starling principle (preload)
vs
inotropic force/contracility/afterload

51
Q

increased preload = _____ tension = ____ SV

A

increased x2

52
Q

increased afterload = ____ stroke volume/CO

53
Q

bernoulli principle formula

54
Q

what is bernoulli’s principle used to measure in echo

A

measur pressure gradients

55
Q

what angle does pressure gradient measurements need

56
Q

pressure gradients may be underestimated due to (3)

A

incorrect doppler angles
viscous friction from blood hitting walls (stenosis = >10mm)
increased proximal velocity (>1.2m/sec)

57
Q

20 degree offset from flow diretion = ___ underestimation of blood flow velocity

58
Q

systolic pressure in the PA = systolic pressure in the ____ (assuming there is no blockage in the outlfow)

59
Q

SPAP = RVSP (what does it mean)

A

systolic pulmonary artery pressure = right ventricular systolic pressure

60
Q

TR pressure gradient is the ____ between the RV and RA pressure during systole

A

difference

61
Q

TRpg formula (and what equation it originally came from)

A

TRpg = 4TRmax vel

came from bernoullis

62
Q

pressure in RV = add the pressure in the ___ to the ____

A

RA
TR pressure gradient

63
Q

RVSP formula (not with a four)

A

RVSP = TR Δpress +RA press

64
Q

RVSP formula (with a four)

A

RVSP = 4(peak TR vel)^2 +RAP

65
Q

normal RVSP

66
Q

we use ____ and _____ to come up with our rap estimates

A

IVE diameter
collapsibilty

67
Q

IVC ≤21mm
≥

70
Q

> 21mm
<50%

+RAP =
vs
RVSP SPAP

71
Q

flow rate at any given point must remain _____

72
Q

velocities at a narrowing _____ than the velocities before or after the narrowing

73
Q

stroke volume must remain constant at any _____

A

2 points in the heart

74
Q

all 4 valves should have the same ___ in the absence of a shunt or regurgitation

75
Q

SV = (formula)

A

SV = CSA x VTI

76
Q

CSA = (formula)

A

CSA = 0.785 x diameter^2

77
Q

SV must be the same throughout the LVOT and the ___

78
Q

AVA = (formula)

A

AVA= (A1 x V1)/V2

79
Q

AVA stands for

A

aortic valve area

80
Q

2 most important principles/equations in echo principles

A

Bernoulli’s
continuity rule

Adult Echocardiography 1 (17 decks)

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