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Echo > Module 1 : Intro Echo and Cardiac Anatomy > Flashcards

Module 1 : Intro Echo and Cardiac Anatomy Flashcards

1
Q

Echo indication

A 
Ischemic heart disease
Valvular disease
Congestive heart failure
Pericardial disease 
Functional capacity
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2
Q

Heart orientation

A

Heart axis is different then body axis

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3
Q

Gross anatomy

A

Dual pump as well as sucks

Pumps through 2 systems in a series like a figure 8

Left heart - systemic system
Right heart - pulmonary system

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4
Q

the cardiovascular system

A

The Left ventricle pumps between 6-8 metric tones of blood in 24 hours (1cm pure muscle)

Left heart - artery- arterioles-capillary bed- venule - Vein- Right heart

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5
Q

Vascular system

A 
Three layers to every vessel
 - tunica adventitia
 - tunica media 
    \+ the layer is thicker in arteries than veins because it has to withstand greater pressure
 - tunica intima : endothelium
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6
Q

Right heart

A 
Contains 
 Right atrium
 Right ventricle
 Pulmonary valve
 Tricuspid valve
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7
Q

Left heart

A 
Contains 
 Left atrium
 Left ventricle
 Aortic valve
 Mitral valve
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8
Q

Cardiac location

A

2/3 of the hearts mass to the left of midline 1/3 to the right or under the sternum

Sits in 4th intercostal spaces

Rests on diaphragm

Lies within the pericardial sac

Surrounded by lungs and pleura

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9
Q

Cardiac shape

A

Cone or pyramid shape

Base - broader upper portion formed by the atria

Apex - blunt formed by LV and RV, points downward anterior and left

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10
Q

Heart divisions / sulci

A

Interventricular sulcus
-runs down the front and around to the back of the heart
- the coronary vessels run through it
- follows path of the interventricular septum
- anteriorly contains
+ left anterior descending artery LAD
+ great cardiac vein
Atrioventricular suculus
- follows path between both ventricles and atria
- anteriorly between atria and Vern tickles
- contains
+ circumflex Artery CXM (left)
+ right coronary artery RCA (right)
+ coronary sinus posteriorly
* where both sulci meet = crux

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11
Q

Great vessels and flow direction

A 
Left heart IN
 - 2 upper (superior) and 2 lower (inferior) pulmonary veins
Left heart OUT
 - aorta
Right heart IN
 - SVC and IVC
Right heart OUT
 - pulmonary artery
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12
Q

Mediastinum

A

Anterior mediastinum - in front of pericardium

Middle mediastinum - contains pericardium and heart

Posterior mediastinum - behind the pericardium

Superior mediastinum - surrounding great vessels

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13
Q

Coronary arteries

A 
Main arteries
 - Left Main Coronary Artery 
    \+ left anterior descending artery LDA
    \+ circumflex Artery 
 - Right Coronary Artery

ONLY FILL DURING DIASTOLE

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14
Q

Cardiac veins

A 
All veins drain into the coronary sinus
 Great - follows LDA
 middle
 Small cardiac veins 
 * Coronary sinus on the back of the heart and drains into the right atrium
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15
Q

Left ventricle

A

The most muscular chamber in the heart

The walls measure 6-10 mm thick

Chamber volume

  • end diastolic = 100ml
  • end systolic = 30ml

Appears as a circle in short axis (cone shape)

Interventricular septum bulges to right due to high LV pressure

LV muscle trabeculated ( bumpy )

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16
Q

Heart muscle layers

A

Endocardium
- innermost layer needs good definition on image
- same echogenicity of myocardium
- thin layer between blood and myocardium
Myocardium
- thickest layer of striated muscle fibers
- LV 6 to 10 mm
- RV 3 to 5mm
- muscle has water in it so doesn’t reflect as well
Epicardium
- also called visceral pericardium and very bright

17
Q

The pericardium

A 
Fibrous pericardium 
 - outermost layer
 - prevents over distention of the heart
 - stiff
Serous pericardium 
 - 2 layers between 20-50 ml of fluid resides
 - parietal layer
 - visceral layer
    \+ epicardium
18
Q

Pericardial fluid

A

Normal 20 - 50ml
Too. UCB fluid compresses the heart
- may be acute or chronic
+ depends on rate of accumulation

19
Q

The right heart

A

Crescent shaped
Curves all the way around the left heart
Wall thickness <5mm
RV inflow at 45’ angle compared to RV outflow

20
Q

Right atrial structures

A 
IVC
SVC
Coronary sinus 
Tricuspid valve
Right atrial appendage (auricle)
21
Q

SVC and IVC

A 
SVC
 - drains all vessels above the heart
 - drains into the superior portion of the RA
IVC 
 - drains vessels below the diaphragm 
 - drains into inferior RA
22
Q

Aorta

A 
Segments
 - ascending
    \+ going toward head
 - arch
    \+ 1st branch to 3rd branch
 - descending 
    \+ above diaphragm 
    \+ after 3rd branch 
    \+ below diaphragm
  • can’t see all three segments on same image
23
Q

The right ventricle

A

Tricuspid valve
Pulmonary valve
Anterior papillary muscle (moderator band)
Infundibulum (smooth muscle ridge between RVOT and LVOT)

24
Q

Left atrium

A

4 pulmonary veins

  • Right Upper Pulmonary Vein (RUPV)
  • Left Upper Pulmonary Vein (LUPV)
  • Right Lower Pulmonary Vein (RLPV)
  • Left Lower Pulmonary Vein (LLPV)

LA appendage also on LA
- common site of thrombus formation

LA mostly made up of Pulmonary connections

25
Q

The aortic valve

A 
Right coronary cusp (RCC)
 - faces toward the RV
 - origin of the right coronary artery 
 - straight up 
Left Coronary Cusp (LCC)
  -Faces the pulmonary artery 
 - origin of the left main coronary artery
Non-coronary Cusp (NCC)
 - faces the interatrial septum 
 - no coronary artery associated with it
26
Q

AV parts

A

Crown snapped annulus ( edge of cusps)

Coaptation zone - cusps overlap slightly

Aortic Sinus - (bulge)

Aortic root continuous with the IV septum

27
Q

Mitral valve apparatus

A

AML - anterior mitral leaflet

PML - posterior mitral leaflet

Chordae tendinae

Papillary muscles

  • posteromedial
  • anterolateral

Annulus

28
Q

Scallops of the mitral valve

A
  • Anterior Mitral Leaflet
    +A1, A2, A3
    + numbered lateral to medial (septum side)
  • Posterior Mitral Leaflet
    + P1, P2, P3
    + numbered lateral to medial
    + posterior scallops named first then correspond to anterior scallops
29
Q

The tricuspid valve leaflets

A 
- Anterior
   \+ faces toward the transducer in the parasternal window 
- Posterior
   \+ facing RV free wall
- Septal
   \+ faces IV septum
30
Q

Tricuspid valve attachments

A
  • leaflets are connected to 2 papillary muscles with chordae tendinae
  • the MODERATOR BAND connects the pap muscles
31
Q

The pulmonary valve

A
  • structurally similar to AV ( different rotation)
  • abnormalities tend to be congenital rather than acquired
  • 3 cusps
    + anterior
    +left
    + right
32
Q

The interventricular septum

A
  • divides right and left ventricles
  • part of cardiac crux
  • high pressure in LV pushes septum toward the RV
33
Q

2 parts of IV septum

A

Membranous septum
- most common site of ventricular septal defect (VSD)
- thin
Muscular septum
-less common site of VSD
-most of the thickness of IVS belongs to LV

34
Q

Interatrial septum

A 
3 segments
 - septum primum
    \+ very bottom
 - septum secoundum
    \+ very top
 - foramen ovale 
    \+ covering flap
  • structures this way so in fetus blood could get to left side of the heart

Echo (19 decks)

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