heart and major vessels Flashcards by Coleen Jones

1) What is dextroversion?
a) Congenital malposition where the heart is positioned on the left side of the thorax and there is a mirror image arrangement of the abdominal viscera
b) Congenital malposition where the heart is positioned on the right side of the thorax but the left ventricle is still in the left sided position.
c) Displacement or congenital malposition where the apex of the heart is positioned more to the right than normal.
d) Congenital malposition where the heart is positioned on the right side of the thorax, there is a mirror image arrangement of the thoracic and abdominal viscera

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2) What is total situs inversus?
a) Congenital malposition where the heart is positioned on the left side of the thorax and there is a mirror image arrangement of the abdominal viscera
b) Congenital malposition where the heart is positioned on the right side of the thorax but the left ventricle is still in the left sided position.
c) Displacement or congenital malposition where the apex of the heart is positioned more to the right than normal.
d) Congenital malposition where the heart is positioned on the right side of the thorax, there is a mirror image arrangement of the thoracic and abdominal viscera

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3) Using the clock face analogy, where is the main pulmonary artery located on a DV projection in a dog?
a) 11-12
b) 12-1
c) 1-2
d) 2-3

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4) Using the clock face analogy, where is the left auricular appendage located on a DV projection in a cat?
a) 9-11
b) 11-1
c) 1-2
d) 2-3

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6) How does the heart look different on a VD compared to a DV (select all that apply)
a) The overall shape and position of the apex is more consistent on a VD
b) You may see a bulge in the position of the main pulmonary artery on a VD
c) The apex is more in the midline in a VD
d) The apex is more to the left in a VD

B, c

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8) True or false, in cats the cardiac silhouette should be no more than 3.5 intercostal spaces in width on the lateral projection?
a) True
b) False

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10) Which disease can lead to enlargement of the aortic arch on a radiograph?
a) Heart worm
b) Sub aortic stenosis
c) Tricuspid dysplasia
d) PDA

B (d??)

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11) Which of the following are false regarding a persistent left cranial vena cava?
a) Is always clinically significant
b) Drains in to the coronary sinus
c) It is very rare
d) It is common in shar peis

a,d

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12) What changes are expected radiographically if a normal PDA is present?
a) Prominence of the aortic arch, main pulmonary artery and left auricle. Enlarge left atrium, enlarged pulmonary arteries
b) Prominence of the aortic arch, main pulmonary artery and left auricle. Enlarge left atrium, enlarged pulmonary vessels (arteries and veins)
c) Reverse D shape, enlarged main pulmonary artery, pleural effusion
d) Ascites, pleural effusion, rounded cardiac silhouette

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13) What is the most common form of pulmonic stenosis?
a) Subvalvular
b) Valvular
c) Supravalvular
d) A and C

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14) Which of the following statements are false regarding tricuspid dysplasia?
a) Ebsteins anomaly is a rare form in which part of the RV is atrialised
b) A holosystolic murmur will be identified over the tricuspid valve
c) End stage cardiac failure is seen as pulmonary oedema
d) The apex is shifted to the right on the DV projection

c,d

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15) Which of the following are radiographic signs of tetralogy of fallot?
a) Enlarged cardiac silhouette, RV enlargement, loss of cranial indentation of the cardiac silhouette, enlarged MPA
b) Enlarged cardiac silhouette, RV enlargement, loss of cranial indentation of the cardiac silhouette, normal to small MPA, Hypovascularisation of the lungs
c) Normal to small cardiac silhouette, LV enlargement, loss of cranial indentation of the cardiac silhouette, normal to small MPA, Hypovascularisation of the lungs
d) Normal to small cardiac silhouette, RV enlargement, loss of cranial indentation of the cardiac silhouette, normal to small MPA, Hypovascularisation of the lungs

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16) Which of the following can help distinguish between a PRAA and another type of vascular ring anomaly?
a) The deviation of the trachea
b) Signs of aspiration pneumonia
c) Whether or not the left margin of the descending aorta is visible
d) Whether or not the right margin of the caudal vena cava is visible

A,C

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17) Which valves are most commonly affected by infective endocarditis?
a) Tricuspid
b) Mitral
c) Aortic
d) Pulmonic

c,b

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18) Which of the following diseases are common causes of pericardial effusion in cats?
a) FIP
b) FeLV
c) Lymphoma
d) Heart base tumours

a,c

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19) What endocrine disease can cause a redundant aorta?
a) Congenital hypothyroidism
b) Addisons
c) Hyperadrenocorticism
d) Diabetes mellitus

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20) Which of the below is not a cause of enlarged pulmonary arteries?
a) Heartworm disease
b) VSD
c) Severe pulmonic stenosis
d) Peripheral arteriovenous fistula

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21) What is the most common congenital cause of pressure overload in cats?
a) ASD
b) VSD
c) PDA
d) Dynamic subaortic stenosis

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23) What is the most common ASD?
a) Sinus venosus- high
b) Ostium secondum- mid
c) Ostium primum- low
d) Endocardial cushion defect- low

b, some authors think foramen ovale

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22) What causes closure of the ductus arteriosus by constriction of the smooth muscle?
a) Increased arterial oxygen tension causing prostaglandin release
b) Increased arterial oxygen tension causing inhibition of prostaglandin release
c) Decreased arterial oxygen tension causing prostaglandin release
d) Decreased arterial oxygen tension causing inhibition of prostaglandin release

24) What is going on in this first pass radionucleotide angiogram?
a) Left to right shunting
b) Right to left shunting
c) Normal
d) Non-diagnostic

25) What is the most common congenital defect in cats?
a) ASD
b) VSD
c) Pulmonic stenosis
d) Mitral valve dysplasia

26) What are the features of tetralogy of fallot?
a) Aortic stenosis, right ventricular hypertrophy, subaortic VSD, dextroposition of the aorta
b) Pulmonic stenosis, right ventricular hypertrophy, ASD, dextroposition of the aorta
c) Pulmonic stenosis, right ventricular hypertrophy, subaortic VSD, right ventricular outflow tract obstruction, dextroposition of the aorta, underperfusion of the pulmonary vessels
d) Pulmonic stenosis, subaortic VSD, dextroposition of the aorta, enlarged pulmonary veins

2) What are the radiographic findings for cor triatrium dexter?
a) Soft tissue opacity bulge between 9-11 o clock on the DV and lateral projections, dilation of the CdVC, hepatomegaly, possible peritoneal effusion
b) Left atrial dilatation, enlarged pulmonary veins, possible interstitial to alveolar lung pattern
c) Right sided cardiac enlargement, dilation of the MPA with tortuous pulmonary arteries
d) Generalized cardiomegaly, pleural and peritoneal effusion

4) What radiographic signs would not be excepted in a cat with RCM and signs of heart failure? a) Left atrial enlargement b) Right atrial enlargement c) Enlarged pulmonary veins d) Pulmonary infiltrate

5) True or false, a thrombus within the left atrium or left auricular appendage is more common with RCM that other cardiomyopathies in cats? a) True b) False

a- check when read chapter again

6) DCM in cats is associated with what? a) Hyperthyroidism b) Thiamine deficiency c) Taurine deficiency d) Breed predisposition in maine coons

7) How many valve leaflets are there in the tricuspid and mitral valves? a) 2 in mitral valve, 3 in tricuspid b) 2 in both c) 3 in both d) 2 in both in dogs, 2 in mitral and 3 in tricuspid in cats

7) B. 2 leaflets, but more cusps! tricuspid- 2 cusps but can have 2, 4 or 5 in some cases in dogs. Mitral- Miller's says division is indistinct. 2 leaflets. dyce says the same as human anatomy in the basic anatomy section and isn't specific in the dog and cat section.

8) A small breed dog with myxomatous mitral valve disease stage C has a fractional shortening of the left ventricle of 35% noted on echocardiography. What does this mean? a) This would be deemed normal for the disease process b) This is hyperdynamic due to regurgitation through the valve c) This is hypomotile and points towards reduced myocardial contractility d) I cannot evaluate without specific breed information

c. with severe MVD they are normally hypermotile with FS of >50%

11) Jugular venous distension is not always a feature of which cause of right sided heart failure? a) Pericardial effusion b) Tricuspid dysplasia c) Pulmonic stenosis d) Cor triatrium dexter

12) What is the most common heart base mass? a) Haemangiosarcoma b) Chemodectoma c) Ectopic thyroid carcinoma d) Myxoma

13) At what larval stage do lungworm larvae migrate through the liver to the right side of the heart? a) L2 b) L3 c) L4 d) L5

Which echo positions are best for Doppler assessment of the heart?

Left apical, cranial and subcostal

The right ventricular internal diameter should be equal what in a normal dog?

1/3 the left ventricular internal diameter

How much should the left ventricular size decrease by in systole compared to diastole

30-40% but in big dogs it could be 22-25. In cats 40%

When is end diastole on both the qrs complex and in imaging the heart?

Onset of the qrs complex and the frame following mitral valve closure

When is end systole in terms of the qrs complex and the echo images?

At the end of the t wave, before mitral valve opening and when the left ventricular internal diameter is smallest

Atrial contraction contributes what percentage to the final volume of the ventricle?

10-20%. Left ventricle in particular 15-30%

Is diastolic dysfunction the main case of heart failure in dogs, or cats?

Cats. It contributes in dogs with dcm

How many pulmonary veins enter the left atrium? 2 3-5 5-8 6

5-8, usually 7.

La ao greater than what value in dogs is abnormal?

1.6

Name the aortic cusps.

Left coronary, right coronary, non coronary

How do you measure la ao?

What is the modified Bernoulli equation to work out a pressure difference?

4x velocity squared 4V^2

How can you tell and measure pulmonary hypertension

What other heart problem can occur commonly with aortic stenosis? Malformation of the aortic arch Arrhythmias Vsd

Arrhythmias due to reduced perfusion of the left ventricle. Can also develop mitral insufficiency

Shunting of blood in tetralogy of fallot is usually which direction?

Right to left

What is a normal e/a wave ratio in cats?

More than 1