Module 2: Parasternal Anatomy

Question 1

What is the PLAX- TV view structures?

Answer 1

1. RV anterior wall
2. RV
3. IVS
4. Posterior Tricuspid valve
5. Anterior Tricuspid valve
6. Right Atrium
7. Coronary sinus
8. IVC

Question 2

What are some optional structures we will see in PLAX TV view? 4

Answer 2

1.Chair network
2. Eustachian valve
3. SVC
4. Septal TV leaflet

Question 3

What is a tip to get PLAX- RT outflow view (PV)?

Answer 3

Angle towards the patients LT shoulder

Question 4

What are some PLAX - PV visible structures? 3

Answer 4

1. RVOT
2. PV- Pulmonary valve (don’t need to know which cusp is which just need to know that it is a cusp)
3. MPA

Question 5

How do we get a parasternal short axis view (PSAX)?

Answer 5

From the PLAX view rotate the probe 90 degrees clockwise

Question 6

What are the PSAX levels? 6

Answer 6

1. Base of the heart (AV level)
2. Pulmonary artery level
3. MV level
4. LV base level (chordae)
5. LV mid (pap) level
6. LV apex

Question 7

What are some visible structures in PSAX- base level? 8

Answer 7

Visible structures: main focus is the AV. Must see all three leaflets.
1. SVC
2. RA
3. TV
4. RV
5. PV
6. PA
7. AV (RCC, LCC, NCC)
8. LA

Question 8

What are structures we can see in the PSAX- MV level visible structures? 6

Answer 8

1. RV free wall
2. RV chamber
3. IVS
4. AML
5. PML
6. MV annulus

Question 9

What is the PSAX LV base level at?

Answer 9

Level of the chordae tendonae and is mmm below the MV level

Question 10

What view is the most superior portion of the LV in PSAX?

Answer 10

PSAX LV base

Question 11

For a PSAX LV base level if you see MV leaflets you are where?

Answer 11

Too superior in the heart (high)

Question 12

If you see papillary muscles that are attached to the LV wall of the PSAX LV base view, what does this mean?

Answer 12

You are too inferior (low)

Question 13

For the PSAX LV base level you should see what major landmark?

Answer 13

You should see chordae which resemble eye lashes and maybe some floating papillary level

Question 14

What are some structures you will see in the- PSAX- mid (pap) level? 6

Answer 14

1. RV free wall
2. RV chamber
3. IVS
4. Contraction of all LV walls seen simultaneously
5. Papillary muscles (attached to the LV wall)
6. Pericardium

Question 15

How would we start the PSAX -apex level exam?

Answer 15

Start up anterior then slide inferior on the chest.
ideally, this cut plane should be inferior to the paps, so they are not seen

Question 16

What are some structures that are seen at the PSAX-Apex level? What is this view for for? 3

Answer 16

1. All apical level LV walls
2. A silver of the RV
3. Excellent view for pericardial effusions

Question 17

What are the two main branches that originates in the aorta?

Answer 17

The left and right coronary

Question 18

For perfusion territories each wall has a particular what? This does what?

Answer 18

Each wall has a particular artery which perfuses it

Question 19

By knowing the names of all the walls and noticing abnormal movements of the wall we can do what?

Answer 19

Indirectly diagnose ischemia or infarct of a particular artery

Question 20

What does the LAD take care of?

Answer 20

1. Anterior
   A. Anteroseptal
   B. Anterolateral **
2. Apex
3. Septum

Question 21

What does the RCA take care of?

Answer 21

1. Right heart
2. Inferior walls
   A. Inferior
   B. Inferoseptal

Question 22

What does the Circumflex artery take care of?

Answer 22

Lateral heart