into to echo chapter 4 TTE Flashcards
The best 2D images are produced when the transducer is parallel to the structure being imaged.
False
The statement that best describes TTE.
noninvasive study
real-time ultrasound
relatively quick and reliable exam
According to the American Society of Echo (ASE), the current recommendation is to acquire M-mode dimensions rather than 2D dimensions.
False
The ideal Doppler angle is perpendicular to blood flow
False
CWD provides range resolution.
False
How can the sonographer improve temporal resolution?
decrease depth
decrease the number of focal zones
decrease sector width
What can the sonographer adjust to create a high contrast image on a technically difficult study?
dynamic range
A sonographer should never use unconventional windows or views.
False
PWD is subject to range ambiguity.
False
2D echo allows us to visualize the relationship between the heart structures in real time.
True
Aliasing occurs when the velocity is greater than 2 m/sec while using _______________ wave Doppler?
Pulsed
Color flow converts flow frequencies into different colors; its appearance based on the ______________?
Direction of blood flow
Velocity of blood flow
Color map
Continuous wave Doppler detects flow from a specific sample volume, in other words, it has range ambiguity?
False
Echo windows are determined by the patient’s physique and sometimes the Sonographer needs to practice flexibility and patience in order to find the proper window?
True
How can the Sonographer determine which valve’s waveform is displayed on the spectral graph during the PEDOF continuous wave Doppler?
Angle of the PEDOF probe in comparison to the heart
Sound of the recording
Appearance of the waveform
M-mode produces a two-dimensional image of the heart?
False
M-mode produces an “ice-pick” image of the heart and displays it in the form of a time/depth graph.
True
Pediatric transthoracic echo typically utilizes a ________ frequency transducer that provides excellent resolution, while adult transthoracic echo utilizes a _________ frequency transducer that provides better depth penetration?
High/low
The best 2D image is produced when the transducer is perpendicular to the structure being examined.
True
The Cardiac Sonographer can measure the structures within the heart by utilizing the M-mode or the 2D echocardiography images.
True
The indicators that travel down either side of the 2D image represent _____________ and each indicator is equal to __________centimeter?
Depth/one
The PEDOF continuous wave Doppler probe is a “blind” probe; therefore, the Cardiac Sonographer must rely on the _______________?
Position/angle of the probe and the spectral waveform in comparison to the EKG along with skill and practice
The __________ transmits and receives ultrasound pulses that collide with structures, such as the heart walls and valves?
Transducer
Ultrasound is a sound wave with a frequency greater than _______________?
20,000 Hertz
Unconventional views are never accepted.
False
What type of Doppler is superimposed, steerable, and measures any velocity making it ideal for performing valve calculations?
Continuous wave
Which best defines Doppler echo?
Utilizes sound or frequency ultrasound to record the velocity and direction of the blood flow
Provides the best signal when parallel to blood flow
Can be visualized as color flow Doppler or spectral Doppler displayed on a graph
Which of the following is the least utilized trans-thoracic echo window?
Right parasternal
While utilizing color flow Doppler, flow that is traveling toward the transducer is primarily __________ while flow that is traveling away from the transducer is primarily ___________?
Red / blue
Left ventricular ejection fraction (LVEF) is the percentage of the left ventricular size reduction from diastole to systole.
false
Normal end-diastolic right ventricular wall thickness is 6 - 10 mm.
false
Left ventricular dimensions should be acquired perpendicular to the structures, in a straight line, just beyond the tips of the mitral valve leaflets, with the calipers placed at the myocardial wall/cavity interface and the wall/pericardium.
true
Which statement is true regarding the anterior mitral valve leaflet (AMVL) and posterior mitral valve leaflet (PMVL)?
AMVL is more mobile than the PMVL
Dilated coronary sinus can easily be confused with the descending aorta; however, the coronary sinus is located within the __________ and the aorta is a separate structure posterior to the left atrium.
myocardium
In order to locate the LAX RVIT, angle the transducer more lateral and superior from the LAX LV.
false
Choose the tricuspid valve leaflet that is not visualized in the LAX RVIT
medial/septal
Normal embryonic variants known as the eustachian valve and Chiari network may be visible in the right ventricle.
false ( right atrium not ventricle)
Normal LVH serverity scale
Female 6-9 Male 6-10
the main pulmonary artery.
normally smaller than the aorta
T/F The only way to determine the timing of the cardiac cycle is with the EKG.
false
the SAX LV.
demonstrates all of the left ventricular walls simultaneously
T/F End-diastolic and end-systolic left ventricular dimensions can be acquired from the LAX LV.
true
T/F Biplane method of disk summation provides a reliable estimate of left ventricular volume and LVEF.
true
The statement that best describes how to acquire the LVEF.
acquire the end-diastolic volume and end-systolic volume from the 4C and 2C
avoid apical foreshortening
utilize contrast if 2+ connected segments are not well visualized
What is the normal right ventricular wall thickness?
1 - 5 mm
When is end diastole captured?
The left ventricle is at its largest dimension
Choose the normal range for the left ventricular diastolic wall thickness.
6 - 10 mm (male)
T/F BP does not affect the CFD jet size.
false
Which of the following ensures proper orientation of the anatomy?
transducer indicator
Choose the statement that best describes the left ventricular outflow tract (LVOT) dimension.
measure within 5 - 10 mm of the aortic valve orifice
normal mid-systolic diameter = 18 - 22 mm
zoom in and optimize the blood tissue interface
T/F Left ventricular size is not gender dependent.
False
Choose the statement that best describes the initial LAX LV.
acquire at an increased depth
include the entire cardiac structure and surroundings
rule out extracardiac abnormalities
Typically, the transducer indicator is toward the patient’s right shoulder during the SAX.
false
T/F Mitral valve planimetry has a low correlation with the anatomic mitral valve area.
false
T/F A good place to start searching for the apical window is along the left sternal border at the 4th intercostal space.
false
T/F
According to the ASE, M-mode dimensions are recommended over 2D dimensions to avoid capturing oblique angles of the ventricle.
T/F Postprocessing zoom is the best type of zoom.
False
T/F M-mode has superior temporal resolution making it an excellent tool for timing events of the cardiac cycle.
true
T/F According to the American Society of Echocardiography (ASE), the current recommendation is to acquire M-mode dimensions rather than 2D dimensions.
false
T/F Spectral Doppler of the mitral valve is always indicated from the LAX LV due to the excellent Doppler angle
false
T/F inferior vena cava diameter and collapsibility index can be assessed via 2D echo or M-mode.
true
T/F SUB DAO and SUPRA LAX help rule out dilatation of the aorta.
true
When is end diastole captured?
left ventricle is at largest dimension
The statement that best supports the SAX LV.
demonstrates all of the left ventricular walls simultaneously
Choose the walls best visualized from the 4C.
anterolateral, apical, and inferoseptal
T/F End-diastolic and end-systolic left ventricular dimensions can be acquired from the LAX LV.
true
How is the 2C acquired?
rotate 60 - 90 degrees counter clockwise from the 4C
Descending aorta can be seen from the 2C as a separate structure, anterior to the left atrium.
false
T/F A sonographer can use the central venous pressure or the inferior vena cava diameter and inspiratory collapse to estimate the mean right atrial pressure (RAP).
true
T/F Acquire the inferior vena cava diameter at rest, during normal respiration, ~ 1 - 2 cm distal to the left atrium
false
If the inferior vena cava diameter = 1.7 cm and collapses < 50% upon inspiration, then according to the 3/8/15 method, the mean RAP estimate = __________.
8 mmHg
T/FThe only way to determine the timing of the cardiac cycle is with the EKG.
false
T/F Typically, the transducer indicator is toward the patient’s right shoulder during the SAX
false
T/F Interatrial septum bows slightly toward the left atrium because the right atrial pressure is slightly greater.
false
Choose the statement that represents the left atrial appendage.
decompression chamber
filling and emptying are directly related to left ventricular function
prone to thrombus
T/F 3C RVIT is a very useful view that frequently yields the peak tricuspid regurgitation velocity.
true
T/F Mitral valve planimetry has a low correlation with the anatomic mitral valve area
false
T/F Aortic valve non-coronary cusp is adjacent to the interatrial septum in the SAX BASE.
true
A potentially lethal complication of acute DVT is which one of the following?
Pulmonary embolism
The innominate artery divides into the ___________ and ___________ arteries.
right common carotid; right subclavian
Risk factors for deep-vein thrombosis (DVT) include all of the following
oral contraceptive use.
orthopedic surgery.
pregnancy.
In an apical four-chamber view a rounded apex indicates that the image is:
Foreshortened
What is largely responsible for aortic root movement?
LA filling
A fibrous strand that extends from one ventricular wall to another most likely represents (primarily the left ventricle)
An ectopic chordae
An ejection fraction of 65% would be considered normal.
True
A Bubble Study uses agitated saline and can be useful for:
Detection of atrial septal defects/ASD
Detection of ventricular septal defects/VSD
Detection of patent ductus arteriosus/PDA
Detection of patent foramen ovale/PFO
Detection of a persistent left SVC (PLSVC)
Which view has a “mushroom-like” appearance?
Parasternal short axis at the papillary muscle
LV end systole
Female 22-35mm Male 25-40mm
LA end systole
female 27-38mm male 30-40mm
LAX AO end diastole SOV
Female 30 + 3mm Male 34 + 3mm
LAX AO end diastole STJ
Female 26 + 3mm Male 29 + 3mm
LAX end diastole Prox AAO
Female 27+4mm Male 30+4 mm
LAX LV end diastole RV wall
1-5mm
LAX LV end diastole RVOT
20-30mm
LAX LV end diastole IVS
Female 6-9mm Male 6-10mm
LVEF%=
LVIDV-LVISD/LVIDV x 100
LVIDd normal range
Female 38-52mm Male 42-58mm
LVIDs normal range
Female 22-35mm Male 25-40mm
the IVS and ____ are the same thickness
LVPW left ventricular posterior wall
IVS and LVPW end diastolic normal range
Female 6-9mm Male 6-10mm
SAX coronary sinus normal range
4-10mm
LA linear dimensions normal range
Female 27-38mm Male 30-40mm
IVC diameter normal range at rest
1.2-2.1 cm
what is the frequency for TEE
3-10 MHz
what TEE probe is the best
Omniplane
