Exam #2, study these

Question 1

Aortic root normal measurements are what?

Answer 1

1.9 - 4.0 cm

Question 2

Aortic cusps normal measurement is what?

Answer 2

1.5 - 2.6 cm

Question 3

Aortic cusps are measured at the onset of

Answer 3

onset of systole

Question 4

left atrial dimension when measuring at the aorta for m-mode… normal measurement is

Answer 4

1.9 - 4.0 cm

measured at end systole

Question 5

Ao root “motion” reflects the

Answer 5

left atrial dimension

Question 6

measurement of D-E excursion.. what is normal? (measurement at MV m-mode)

Answer 6

normal is greater than 1.6cm

Question 7

measurement of E to F slope, what is normal? (measurement at MV m-mode)

Answer 7

normally greater than 70 mm/sec

Question 8

measurement of EPSS, what is normal? (measurement at MV m-mode)

Answer 8

normally no greater than 1cm

Question 9

RVd (measurement at LV) normal dimension is

Answer 9

no greater than 3.0cm

Question 10

IVS (measurement at LV) normal measurement is

Answer 10

between .6 - 1.1cm

Question 11

LVPW (measurement at LV) normal measurement is

Answer 11

between .6 - 1.1cm

Think “small wall”

Question 12

LVEDD (measurement at LV) normal measurement is

Answer 12

3.5 - 5.7cm

Question 13

LVESD (measurement at LV) normal measurement is

Answer 13

measured at smallest dimension

Question 14

Measurement at LV, normal ejection fraction is (EF)

Answer 14

> 55%

Question 15

Measurement at LV, normal fractional shortening is (FS)

Answer 15

normally >30%

Question 16

A more accurate mode of calculating EF and/or chamber dimension volume sizes is

Answer 16

Simpson’s or MOD

Question 17

2-d measurements you measure leading edge?

Answer 17

inner edge to inner edge

Question 18

RA/RV View aka

Answer 18

tricuspid valve inflow view

Question 19

where can the eustachian valve be seen?

Answer 19

sometimes seen at the junction of the IVC and RA

Question 20

To see more of the ascending aorta in a standard PLAX view… do what?

Answer 20

slide the transducer along left sternal border towards neck 1-2 intercostal spaces

Question 21

Color Doppler in PLAX used to detect what pathology

Answer 21

VSD, MV, AoV pathology

Question 22

After 2D evaluation of the SAX views is done, what’s next?

Answer 22

Doppler exam is done next!

Question 23

In SAX, Dopper is used to evaluate what?

Answer 23

PV, TV, AoV, Interatrial septum, portion of IVS

Question 24

PMI stands for

Answer 24

point of maximal impulse, used to palpate where the apex for apical views

Question 25

In Apical 4 chamber view, its best to look first at

Answer 25

the different segments of the ventricles (basal, mid, apical) to help estimate motion. then check overall function

Question 26

Moderator should be seen at the

Answer 26

apex of the Right Ventricle

Question 27

Eustachian valve can be seen where?

Answer 27

RA

Question 28

What structures are seen from an apical 2 chamber view

Answer 28

Left Ventricle (anterior AND inferior wall, and the apex)

Left Atrium

Left Atrial Appendage
(can’t always be seen, lung in the way)

Coronary sinus

Mitral Valve with both leaflets, posterior leaflet to the left of screen, anterior to the right

Question 29

Normal Variants in a five chamber apical view

Answer 29

eustachian valve,
moderator band,
chiari network,
ectopic chordae,
IAS aneurysm

Question 30

what’s the chiari network?

Answer 30

It’s a normal variant NOT to be confused with pathology. Chiari network is a fiber in the right atrium near entrance of the IVC (inferior vena cava)

Question 31

what’s an IAS aneurysm?

Answer 31

Bulge in the IAS that moves to and fro, seen in a 5 chamber apical view, not to be confused with pathology. It is a NORMAL VARIANT.

Question 32

Ectopic chordae are what?

Answer 32

NORMAL VARIANT!
can be seen in a 5-chamber apical view (I think) and are fibrous strands that run from one ventricular wall to another.

Question 33

Apical four chamber, how to view?

Answer 33

LEFT SHOULDER, 3 O CLOCK

Question 34

When thinking of the segments for the different apical views… it’s easier to remember that the only difference is understanding the interplay between which side is the septum side and which side is the lateral side. You can remember this by….

Answer 34

For Long Axis, the “L” in long axis means the “lateral” root is the side on the left side of the screen and the septum part is the other side. AND just remember the mids… they’ll tell you everything.

4 chamber view
mid inferoseptum
mid anterolateral

long axis view
mid inferolateral
mid anteroseptum

the basal views are the same as the mids, and the apical views are the root word of the mids.

Example:
Long axis segments
Apical lateral / Apical septum
Mid inferolateral / Mid anteroseptum
Basal inferolateral / Mid anteroseptum

Question 35

How to view apical 5 chamber?

Answer 35

From apical 4 chamber view (left shoulder, 3 o clock, angle slightly superior or anterior towards chest wall.

Question 36

How to view apical 2-chamber?

Answer 36

rotate transducer 30-45 degrees counterclockwise toward 12 (noon) angle toward right shoulder

Question 37

apical long axis view aka

Answer 37

apical 3 chamber view

Question 38

how to view 3 chamber view (long axis view)

Answer 38

rotate to 11 o clock (from 2 chamber view at noon) toward right shoulder

Question 39

Which apical view is identical to another view of a completely different axis?

Answer 39

Apical 3 chamber view (aptly aka “long axis view”) is identical to the left PLAX view or parasternal long axis view.

Question 40

structures seen of 3 chamber view

Answer 40

LV (IVS, posterior wall, apex)
LA
Aortic valve
Ascending aorta
MV (both leaflets)
RV (small portion)

Question 41

In Color Doppler blood flow that is either red or blue. That denotes what?

Answer 41

Red means blood is traveling toward the probe and blue means away from the probe

Question 42

What Doppler waveform is best for peak velocities?

Answer 42

continuous wave!

Question 43

what doppler eliminates aliasing?

Answer 43

continuous wave!

Question 44

what doppler has no range resolution? why is this an issue

Answer 44

continuous wave has no range resolution… peak velocities could BE ANYWHERE along the cursor line

Question 45

Can make the distinction in determining if you are looking at a continuous wave doppler or pulsed wave doppler… just look at the waves. waveforms in a CW will

Answer 45

HAVE NO WINDOWS!

Question 46

Characteristics of PW doppler

Answer 46

has range resolution
velocities only in the area of the sample gate are recorded
is used to MAP OUT abnormal flow patterns (remember CW can’t tell you where on the cursor the disturbance lies…) so “gate” must be “walked” through the flow disturbance.
Waveforms have an ENVELOPE and a WINDOW!

Question 47

Flow patterns of the MV: