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MD3001 > intro to echocardiography > Flashcards

intro to echocardiography Flashcards

1
Q

LO?

A

Understand the basics of Echocardiography.
Understand the different cardiac windows used in echocardiography and relate the images seen to the underlying cardiac anatomy and physiology.
Have a basic understanding of the use of Echocardiography in assessment in the context of the Cardiology Clinic.
Have a basic understanding of the role of Echocardiography in Point of Care Ultrasound.

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2
Q

what is the first exam of choice for evaluating heart structure?

A

echocardiograpghy

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3
Q

what are the advantages of echocardiography?

A
  • low cost
  • low distress to patients
  • provides a detailed picture of the hearts structure
  • highly available
  • no ionising radiation
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4
Q

what are the disadvantages of echocardiography?

A
  • highly user dependant
  • it is only 2D imaging
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5
Q

how do they work?

A

sound waves bounce of different parts of the heart ‘echos’ which will appear as pictures on the sonograpghers computer.

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6
Q

what is an echocardiography?

A

‘- echo’ is the use of ultrasound to examine the heart.
- non invase diagnostic procedure

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7
Q

how quickly can an echo be done and does it distress patients?

A

Compared with other imaging techniques,echocardiographymay be done quickly, with the least trouble and distress to the patient, and provides speedy clinically relevant data at comparatively low cost.

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8
Q

what type of info does echocardiograogh give?

A

-cardiac structure
- containing the size and shape of cardiac chambers
- function and morphology of the cardiac valves
- systolic and diastolic function and intra cardiac haemodynamics.

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9
Q

main type of echo?

A

Trans-thoracic echocardiography (TTE)

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10
Q

advanced types of echo?

A
  • Trans-oesophageal echocardiography
  • Stress echocardiography
  • Contrast echocardiography
  • 3D echocardiography
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11
Q

what is echogenicity?

A

Echogenicity of the tissue refers tothe ability to reflect or transmit ultrasound waves in the context of surrounding tissues

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12
Q

what is:
1) hyper echoic
2) hypo echoic
3) anechoic

A

1) white on screen (bone and air)
2) gray on screen (soft tissue)
3) black on the screen (fluid and blood)

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13
Q

what type of probe do we use in echo?

A

phased array probe

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14
Q

what are the main types of probe?

A
  • linear array probe
  • curved array probe
  • phased array probe
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15
Q

linear array probes?

A
  • images of flat superficial surfaces
  • high frequency sound will not penetrate deep into tissue, so high frequency probes (like this one) will only be used for superficial structures.
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16
Q

curved array probes?

A
  • end-liminal scanning
  • general abdomen and obstetrical scanning
  • the images for this one will always have a curved superficial surface
17
Q

phased array probe?

A
  • every element in the array will participate in the formation of each transmitted pulse
  • the sound beams are steered at varying angles from one side of the transducer to the other = producing a sector image format.
  • thi probe is smaller and can scan in areas where acoustic access is limited, like between the ribs.
18
Q

describe probe and image orientation?

A
  • must be properly orientated to accurately identify the structures
  • probe orientation marker should be on the right side of the patient
  • therefore the orientation marker on the left side of the monitor will show the cephalad end during a longitudinal scan or the right side during a transverse scan.
19
Q

what is the typical frequency range for an adult echo?

A

1-5 MHz

20
Q

location of the 4 valves?

A
21
Q

what is an imaging window?

A

An imaging window refers to an anatomic position on the patient’s body where an ultrasound transducer is placed to visualize specific structures.

22
Q

what are the imaging windows for echo?

A

For Transthoracic Ecchocardiography (TTE) there are three standard imaging windows.
1. Parasternal. (long and short axis)
2. Apical.
3. Subcostal.

23
Q

what are the 4 probe manipulation manoeuvres?

A
  • pressure
  • allighnmnet
  • rotation
  • tiliting
24
Q

parasternal long axis?

A
  • transducer is placed in 3rd-4th intercostal space
  • orientation marker should be put towards the patients right shoulder
  • depth 12-16cm
  • for assessment of a pericardial and pleural effusion use a depth of 20-24cm
25
Q

what is the m mode?

A

The m-mode is designed to document and analyze tissue motion.
This mode is particularly important in studying cardiac valve and wall motion and in documenting foetal heart rate and activity.

26
Q

parasternal short axis- mitral valve level?

A
  • from the parasternal long axis view, rotate the transducer 90 degrees clockwise
  • transducer orientation marker is pointing towards the patients left shoulder
  • transducer is perpendicular to the chest wall
  • depth is 12-16cm
27
Q

apical four - chamber (A4C) view?

A
  • the transducer is placed on the apical impulse
  • tilt the face of the transducer up until the ultrasound beam cuts through the long axis of the heart
  • transducer orientation marker is at 3 o’clock
  • -depth is 14-18cm
28
Q

apical five chamber (A5C)

A
  • from the apical 4 chamber view, tilt the face of the transducer slightly upward until the aortic valve appears
  • transducer orientation marker is at 3 o’clock
  • depth 14-18cm
29
Q

subcostal 4 chambers

A
  • patient is supine
  • transducer is placed 2-3 cm below the xyphoid process
  • direct the transducer towards the patients chin/left shoulder
  • transducer orientation marker is at 3 o’clock
  • hold the transducer palm down to facilitate cephalic angulation of the ultrasound beam
  • depth is 16-24 cm
30
Q

subcostal inferno vena cava?

A
  • from subcostal four chamber view, rotate the transducer 9- degrees counter clockwise always keeping the right atrium on the screen
  • transducer orientation marker is at 12 o’clock
  • depth 16-24 cm
  • it is important to see the IVC merging into the RA, this will confirm that you are not visulaing the aorta.
31
Q

basic echo in resuscitation?

A

in normal echo we use multiple views and techniques ut in resuscitation we are only using it to answer yes or no questions.

32
Q

what are you looking for in basic echo in resuscitation?

A

What are we looking for?
In the shocked, dyspnoeic, or arrested patient it looks for (or rules out):
Pericardial effusion (with or without signs of tamponade)
An enlarged RV (with or without hypokinesis and paradoxical septal motion)
LV size, in conjunction with IVC (eg small LV suggests hypovolaemia)
LV systolic function (rough estimate only)

33
Q

transoesophageal echo?

A

If it’s difficult to get a clear picture of a patient’s heart with a standard echocardiogram or if there is reason to see the heart and valves in more detail, a transesophageal echocardiogram can be performed.
this goes down the throat so have to take this into consideration for the patient.

MD3001 (56 decks)

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