Exam #2, study these Flashcards
Aortic root normal measurements are what?
1.9 - 4.0 cm
Aortic cusps normal measurement is what?
1.5 - 2.6 cm
Aortic cusps are measured at the onset of
onset of systole
left atrial dimension when measuring at the aorta for m-mode… normal measurement is
1.9 - 4.0 cm
measured at end systole
Ao root “motion” reflects the
left atrial dimension
measurement of D-E excursion.. what is normal? (measurement at MV m-mode)
normal is greater than 1.6cm
measurement of E to F slope, what is normal? (measurement at MV m-mode)
normally greater than 70 mm/sec
measurement of EPSS, what is normal? (measurement at MV m-mode)
normally no greater than 1cm
RVd (measurement at LV) normal dimension is
no greater than 3.0cm
IVS (measurement at LV) normal measurement is
between .6 - 1.1cm
LVPW (measurement at LV) normal measurement is
between .6 - 1.1cm
Think “small wall”
LVEDD (measurement at LV) normal measurement is
3.5 - 5.7cm
LVESD (measurement at LV) normal measurement is
measured at smallest dimension
Measurement at LV, normal ejection fraction is (EF)
> 55%
Measurement at LV, normal fractional shortening is (FS)
normally >30%
A more accurate mode of calculating EF and/or chamber dimension volume sizes is
Simpson’s or MOD
2-d measurements you measure leading edge?
inner edge to inner edge
RA/RV View aka
tricuspid valve inflow view
where can the eustachian valve be seen?
sometimes seen at the junction of the IVC and RA
To see more of the ascending aorta in a standard PLAX view… do what?
slide the transducer along left sternal border towards neck 1-2 intercostal spaces
Color Doppler in PLAX used to detect what pathology
VSD, MV, AoV pathology
After 2D evaluation of the SAX views is done, what’s next?
Doppler exam is done next!
In SAX, Dopper is used to evaluate what?
PV, TV, AoV, Interatrial septum, portion of IVS
PMI stands for
point of maximal impulse, used to palpate where the apex for apical views
In Apical 4 chamber view, its best to look first at
the different segments of the ventricles (basal, mid, apical) to help estimate motion. then check overall function
Moderator should be seen at the
apex of the Right Ventricle
Eustachian valve can be seen where?
RA
What structures are seen from an apical 2 chamber view
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
Normal Variants in a five chamber apical view
eustachian valve,
moderator band,
chiari network,
ectopic chordae,
IAS aneurysm
what’s the chiari network?
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)
what’s an IAS aneurysm?
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.
Ectopic chordae are what?
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.
Apical four chamber, how to view?
LEFT SHOULDER, 3 O CLOCK
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….
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
How to view apical 5 chamber?
From apical 4 chamber view (left shoulder, 3 o clock, angle slightly superior or anterior towards chest wall.
How to view apical 2-chamber?
rotate transducer 30-45 degrees counterclockwise toward 12 (noon) angle toward right shoulder
apical long axis view aka
apical 3 chamber view
how to view 3 chamber view (long axis view)
rotate to 11 o clock (from 2 chamber view at noon) toward right shoulder
Which apical view is identical to another view of a completely different axis?
Apical 3 chamber view (aptly aka “long axis view”) is identical to the left PLAX view or parasternal long axis view.
structures seen of 3 chamber view
LV (IVS, posterior wall, apex)
LA
Aortic valve
Ascending aorta
MV (both leaflets)
RV (small portion)
In Color Doppler blood flow that is either red or blue. That denotes what?
Red means blood is traveling toward the probe and blue means away from the probe
What Doppler waveform is best for peak velocities?
continuous wave!
what doppler eliminates aliasing?
continuous wave!
what doppler has no range resolution? why is this an issue
continuous wave has no range resolution… peak velocities could BE ANYWHERE along the cursor line
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
HAVE NO WINDOWS!
Characteristics of PW doppler
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!
Flow patterns of the MV:
