Exam #2, study these Flashcards by Daniel R.

Aortic root normal measurements are what?

1.9 - 4.0 cm

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Aortic cusps normal measurement is what?

1.5 - 2.6 cm

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Aortic cusps are measured at the onset of

onset of systole

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

1.9 - 4.0 cm

measured at end systole

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Ao root “motion” reflects the

left atrial dimension

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

normal is greater than 1.6cm

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

normally greater than 70 mm/sec

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

normally no greater than 1cm

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RVd (measurement at LV) normal dimension is

no greater than 3.0cm

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IVS (measurement at LV) normal measurement is

between .6 - 1.1cm

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LVPW (measurement at LV) normal measurement is

between .6 - 1.1cm

Think “small wall”

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LVEDD (measurement at LV) normal measurement is

3.5 - 5.7cm

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LVESD (measurement at LV) normal measurement is

measured at smallest dimension

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Measurement at LV, normal ejection fraction is (EF)

> 55%

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Measurement at LV, normal fractional shortening is (FS)

normally >30%

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

Simpson’s or MOD

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2-d measurements you measure leading edge?

inner edge to inner edge

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RA/RV View aka

tricuspid valve inflow view

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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?

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: