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Echo 3 > Module 2: Cardiac Situs and the Segmental Approach > Flashcards

Module 2: Cardiac Situs and the Segmental Approach Flashcards

1
Q

what are segments

A
  • the anatomical structures which the cardiovascular system is divided for purpose go evaluation which include the systemic and pulmonary veins, antra, ventricle and great arteries
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2
Q

what are connections

A
  • decreases the anatomical sequence of structures

- venoatrial, atrial-ventricular, ventriclo-arterial

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3
Q

what does concordant mean

A
  • normal sequenctional relationship between the hearts chambers, valve,s and great vessels
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4
Q

what does discordant mean

A
  • refers to an abnormal sequential relationship between chambers, valves, and great vessel
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5
Q

what is commitment

A
  • describes degree of abnormality of flow through valves to ventricles and great vessels
  • if more than 50% of a valve overrides a VSD
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6
Q

what is ambiguous

A
  • used when precise identification of a chamber can not be determined
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7
Q

what are inlet/outlet anomalies

A
  • anomalies of structure and flow into the ventricles or out fo the ventricles
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8
Q

what is the segmental approach to CHD

A
  • systemic approach to defining and charcterizing CHDs
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9
Q

what are the 3 steps to the segmental approach

A
  • visceral atrial situs + atrial connections
  • orientation of the ventricles + connections
  • orientation of the great vessels + connections
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10
Q

what does visceral atrial situs refer to

A
  • position of the atria in relation to the nearby anatomy
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11
Q

what are the three 3 steps to determining visceral atrial situs

A
  • identify which way apex is pointing
  • identify atria
  • relate to surrounding structures
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12
Q

what are the 3 different cardiac situs

A
  • situs solitus
  • situs inversus
  • situs ambiguous
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13
Q

what is situs solitus

A
  • morphologic RA is on the right of morphologic LA
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14
Q

what is situs inversus

A
  • morphologic RA is to the left of the morphologic LA
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15
Q

what is situs ambiguous

A

confident assignment of morphologic left and right atria cannot be made

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16
Q

what does morphologic mean

A
  • has morphologic features of that chamber
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17
Q

what does functional mean

A
  • functional as a different chamber

- LA is functioning as RA due to transposition

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18
Q

what is cardiac position and what are the types

A
  • heart position within chest
  • right (dextroposition)
  • midline (mesopositon)
  • left (levoposition)
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19
Q

what is dextroposition

A
  • most of the heart lies to the right of the sternum
20
Q

what is mesoposition

A
  • the heart lies directly behind the sternum
21
Q

what is levoposition

A
  • most of the heart lies to the left of the sternum (NORMAL)
22
Q

what is cardiac orientation and what are the three types

A
  • apical positon
  • right (dextrocardia)
  • midline (mesocardia)
  • left (levocardia)
23
Q

what is dextrocardia

A
  • the apex points to the right side fo the body
24
Q

what is mesocardia

A
  • apex lies under the sternum
25
Q

what is levocardia

A
  • apex point to the left (normal)
26
Q

how do we determine dextrocardia

A
  • start with transverse subcostal sweep
  • atria and ventricles lie on the left side
  • label chest sides
27
Q

what is the correct term if all organs are mirrored dextro

A
  • dextrocardia situs inversus totalis
28
Q

what three disorders can patients with dextrocardia be prone to

A
  • endocardial cushion defect
  • pulmonary stenosis
  • double outlet RV
29
Q

what does isolated dextrocardia have increased risk of

A
  • ling infection
  • sinus infection
  • pneumonia
30
Q

what arrest eh signs and symptoms of dextrocardia

A
  • breathing difficulties
  • cyanosis
  • fatigue
  • failure to thrive in children
31
Q

what vessels do we evaluate for the venous segment

A
  • hepatic veins
  • IVC
  • SVC
  • coronary sinus
  • pulmonary veins
32
Q

what vessels are interrogated in the vent-atrial connection

A
  • systemic venous return = SVC, IVC

- pulmonary venous return

33
Q

what are the morphologic features of the RA

A
  • eustachian valve
  • venae cavae
  • coronary sinus
  • chiari network
  • RA appendage
34
Q

what are the morphologic features of the LA

A
  • pulmonary veins

- LA appendage

35
Q

how can we tell if there is concordant connection between the atria and ventricle

A
  • MV always associated with LV
  • TV always associated with RV
  • TV more apically attached to the IVS
36
Q

what are the morphologic features of the RV

A
  • crescent shape
  • TV (3 leaflets)
  • large apical trabeculations
  • multiple small papillary muscles
  • moderator band
  • septal leaflet apically displaced
37
Q

what are the morphologic LV

A
  • bullet shapes
  • MV (2 leaflets)
  • two pap muscle
  • fals tendons
  • inlet and outlet valves in continuity
38
Q

what is the crux

A
  • where the atria and ventricles meet at the centre fo the hear
39
Q

what are the different AV connections

A
  • bi-ventricular = one atria connect to both ventricle
  • uni-ventricular = both atria connect to one ventricle
  • common = atria connect to both ventricles through a single multi leaflet structure
40
Q

what can we tell if there is VA concordance

A
  • AV and pV anatomically identical
  • Look for fibrous continuity between AV and mV
  • look for overriding vessels
41
Q

what are the 3 main variations of normal VA connections

A
  • transposed connection of the great arteries TGA
  • double outlet connection
  • single outlet connection
42
Q

what is TGA

A
  • main PA arises from the LV

- aorta arises from the RV

43
Q

what is double outlet connection

A
  • both great arteries arise from a single ventricle almost always the RV
44
Q

what is single outlet connection

A
  • only 1 great artery coming from the ventricle which is overriding or great arteries are fused into a single truncal artery
45
Q

if there are abnormal VA connections how are the ventricles names

A
  • pulmonary ventricle = whichever ventricle pumps to the PV/PA
  • systemic ventricle = ventricle pumps out to the AV/ao
46
Q

what are the defining features o the pulmonary trunk

A
  • bifurcation to the LPA and RPA
47
Q

what are the defining features of the aorta

A
  • coronary arteries

- branches brachiocephalic, LCC, LSC

Echo 3 (4 decks)

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