Lesson 4 - M Mode

Question 1

How many frames per second are there for M Mode?

Answer 1

1800

Question 2

What is represented by the X Axis on M Mode?

Answer 2

Time

Question 3

What is represented by the Y Axis on M Mode?

Answer 3

Depth

Question 4

What does a lower sweep speed allow?

Answer 4

To see many waveforms in one image (thickens it up)

Question 5

What does a higher sweep speed do?

Answer 5

Spread out the wave forms (thins it out)

Question 6

If your patient has a high HR, what should you adjust on your M Mode?

Answer 6

Sweep speed - use a higher sweep speed.

Question 7

How do you want your cursor placed?

Answer 7

90 degrees to the structure of interest (perpendicular)

Question 8

Where do you place your cursor for the AoV and LA?

Answer 8

Cursor goes over the aorta and the leaflet tip level, the prayer hands coming together

Question 9

For the AoV and LA, what happens during ventricular systole?

Answer 9

AoV leaflets open (this creates the box shape)
the LA is filling due to atrial diastole, which pushes the aortic root all anterior

Question 10

For the AoV and LA, what happens during ventricular diastole?

Answer 10

AoV leaflets close
LA is contracting during atrial systole, aortic root wall moves posteriorly

Question 11

Where do you place the cursor for the Mitral Valve M mode measurement?

Answer 11

Tips of the mitral valve leaflets

Question 12

What structures do you see during M-Mode of the Mitral Valve?

Answer 12

1. RV free wall
2. RV
3. IVS
4. LV
5. AMVL & PMVL
6. Posterior LV Wall
7. Pericardium

Question 13

AMVL motion has which shaped appearance?

Answer 13

‘M’ appearance

Question 14

PMVL motion has which other shaped appearance?

Answer 14

Blunted ‘W’ shape

Question 15

The MV leaflet has certain points in its motion. Tell me what D, E, F, A, and C are.

Answer 15

D: Diastole onset
E: Early rapid LV filling
F: Filling of LV ends (also known as diastasis)
A: Atrial contraction
C: Closure of MV leaflets

Question 16

What is a B bump?

Answer 16

Signals there is elevated left ventricular end diastolic pressure. Visualized during M mode of the MV.

Question 17

If there is an absence of MV stenosis, what does an increased EPSS indicate?

Answer 17

LV dilation, systolic dysfunction, or Ao regurg

Question 18

In the M-Mode for LV, what structures can be visualized in the graph?

Answer 18

RV free wall
RV
IVS
LV
Posterior LV wall
Pericardium

Question 19

The IVS moves posteriorly and the LV posterior wall moves anterior during Ventricular _________.

Answer 19

Systole

Question 20

During Ventricular Systole, how does the IVS and LV posterior wall move?

Answer 20

IVS moves posteriorly
LV posterior wall moves anteriorly

Question 21

During Ventricular diastole, how does the IVS and LV posterior wall move?

Answer 21

IVS moves anteriorly
LV posterior wall moves posteriorly

Question 22

The IVS moves anteriorly and the LV posterior wall moves posteriorly during Ventricular ________.

Answer 22

Diastole

Question 23

How do the IVS and LV posterior walls shift during ventricular diastole?

Answer 23

IVS - anteriorly
LV posterior wall - posteriorly

Question 24

All M-Mode measurements are taken:
a) leading edge to leading edge
b) inner to inner
c) outer to outer

Answer 24

A. Leading edge to leading edge

Question 25

During M-Mode, when is the aortic root measured?

Answer 25

End-Diastole
(before AV opening)

Question 26

In M-Mode, when is the LA measured?

Answer 26

End-Systole, or the latest diameter of the LA

Question 27

What is the normal range for EPSS at the MV?

Answer 27

2-7mm

Question 28

What are the four measurements for LA in M-Mode?

Answer 28

IVSd - diastole
LVIDd - diastole
LVPWd - diastole
LVIDs - systole

Question 29

When does peak systolic motion of the IVS occur?

Answer 29

Slightly before the peak of systolic motion of the posterior wall.