Otto Textbook, Chapter 2, things to consider

Question 1

In diastole the aortic cusps are open or closed…

Answer 1

CLOSED!

Question 1

In diastole the aortic cusps

Question 2

In systole, the aortic cusps are open or closed…

Answer 2

OPEN!

Question 3

In diastole, the mitral valve leaflets are open or closed?

Answer 3

OPEN!

Question 4

In systole, the mitral valve leaflets are open or closed?

Answer 4

CLOSED!

Question 5

In PLAX view, this lies between the the proximal ascending aorta and the superior aspect of the LA but usually is not well seen on transthoracic images.

Answer 5

RIGHT pulmonary artery

Question 6

what is pericardial effusion?

Answer 6

A condition in which extra fluid collects between the heart and the pericardium (the sac around the heart). The extra fluid causes pressure on the heart.

Question 7

this view is particularly useful for recording flow velocities the RV outflow tract and pulmonary artery.

Answer 7

RVOT, right ventricular outflow tract (PLAX)

Question 8

In this PLAX view, you can sometimes see these two important features.

Answer 8

coronary sinus and IVC.

Question 9

To go from PLAX view to SAX view, rotate the transducer how many degrees

Answer 9

90 degrees

Question 10

These nodules normally enlarge with age.

Answer 10

Nodules of Arantius

Question 11

what are the nodules of arantius

Answer 11

nodules (or nodes) of Arantius are thickenings of the tunica intima layer covering the ventricular aspect of the leaflets of the aortic valve, also known as the ventricularis layer. The thickening happens at the point of coaptation of all three leaflets. The shape and size of these growths varies from person to person and with age.

Question 12

when taking high quality electrocardiographic images… these small but normal filaments attached on the ventricular surface of valvular cusps can be easily mistake for pathologic conditions. (pg 42)

Answer 12

Lambl excrescences

Question 13

The central location of this valve illustrates how disease processes can extend from the aortic valve or root into the RV outflow tract, RA, or LA.

Answer 13

Aortic valve

Question 14

A noncircular appearance of the left ventricle in systole (at the papillary muscle SAX view), can indicate what

Answer 14

myocardial disease, such as a myocardial infarction or aneurysm formation, or abnormal septal curvature due to right heart disease.

Question 15

The left ventricle wall is divided into segments… knowing this could be extremely helpful.

Answer 15

divided into anterior (septum and free wall), anterolateral, inferolateral AKA posterior wall, and inferior (free wall and septum). Know these segments… they are consistent descriptors of the location of abnormalities.

The segments are further defined by their location along the length of the ventricle as basal, mid ventricular, or apical.

Question 16

In an APICAL 4-CHAMBER VIEW, the LV will appear foreshortened if

Answer 16

the transducer is not positioned at the true apex. Foreshortening must be distinguished from disease processes, such as chronic aortic regurgitation, which result in increased sphericity of the ventricle and little tapering. The LV should appear as a truncated ellipse with a longer length than width and a tapered but rounded apex.

Question 17

The moderator band traverses what chamber near the apex?

Answer 17

RV

Question 18

From an APICAL 4 CHAMBER VIEW, if you angle the transducer anteriorly you will see these structures in an oblique long view, this view being referred to as an entirely new view.

Answer 18

APICAL 5-CHAMBER VIEW
can see the AORTIC valve and root

Question 19

How to get to a 2-chamber view from a 4-chamber view

Answer 19

rotate counterclockwise about 60 degrees from 4-chamber view

Question 20

To ensure the proper rotation has been made for a 2-chamber view…

Answer 20

angle the transducer posteriorly to intersect both papillary muscles symmetrically. Then slightly angle anteriorly so that neither papillary muscle is seen in its long axis.

Question 21

How to get to a Long Axis-View? AKA 3-chamber view

Answer 21

Rotate 60 degrees from the 2-chamber view (or 120 degrees from 4 chamber)

Looks like a tilted PLAX view

How its different from PLAX, can see LV apex!
But aortic and mitral valves are at greater image depth and have poorer resolution.

Question 22

Positioning of patient for Apical views?

Answer 22

steep left lateral decub position

Question 23

Positioning of patient for Subcostal views?

Answer 23

supine and the legs bent at the knees to relax the abdominal wall

Question 24

patient positioning for suprasternal view?

Answer 24

patient supine and the neck extended. transducer positioned in suprasternal notch or right supraclavicular position to obtain a view of the aortic arch in long and short axis views.