Parasternal View Powerpoint

Question 1

4 types of Doppler

Answer 1

Color flow Dopper, Pulsed Wave (PW) doppler, Continuous Wave (CW) doppler, Tissue Doppler

Question 2

Don’t confuse tissue colorization with color flow Doppler

Answer 2

tissue colorization just changes the color of the tissue so that you can detect variations more easily

Question 3

M-mode stands for

Answer 3

motion mode

Question 4

EKG leads go where

Answer 4

Left upper chest
Right upper chest
Left or right lower chest

Question 5

PLAX view, index is towards what time (clock)

Answer 5

10 o clock!

Question 6

For M-mode at the AO level, the cursor is placed so it transects…

Answer 6

RV
AO
LA

Question 7

In the M-mode measurement at AO, end systole for the left atrium is the largest opening that you can measure. In a separate M-mode measurement for LVESD or “left ventricular end systolic diameter” you are going to measure at the

Answer 7

smallest dimension.

Question 8

In the M-mode measurement for the LV, select your package and begin measuring but make sure you are over a

Answer 8

Q wave! (EXCEPT FOR ONE, and that is gonna be the LVIDs aka LVESD (left ventricular inner dimension systole or left ventricular end systolic diameter - same thing). This measurement is taken at the smallest dimension. It should occur right after the Q wave.

Question 9

Define Ejection Fraction

Answer 9

The fraction or % of LV diastolic volume that is ejected in systole. Volumes are calculated using diameter measurements and can be inaccurate.

Question 10

Define Fractional shortening

Answer 10

This is a rough measurement of LV systolic fx using LV dimensions rather than volumes. Can reduce magnification of error.

Question 11

Define Stroke volume

Answer 11

The volume of blood ejected with each heart beat and is reported in cc or ml (the same thing)

Question 12

Define cardiac output

Answer 12

The volume of blood pumped by the heart per minute and is reported in L/min (liters per minute).

Question 13

Cardiac Output equation

Answer 13

SV x BPM (stroke volume multiplied by beats per minute)

Answer is in Liters per minute

Question 14

LVEDD and LVESD when measuring at the LV (3rd M-mode viewing), should be measured

Answer 14

ON THE SAME BEAT

Question 15

In LV M-mode measurement, to measure for the chordae tendineae, measure right outside the

Answer 15

MV valve leaflets.

Question 16

In 2D measurements, end-diastole can be defined as

Answer 16

the onset of the QRS complex, the frame after the mitral valve closes or the frame in the cardiac cycle in which the cardiac chamber dimension is LARGEST

END-SYSTOLE IS…
the frame preceding the MV opening or the time in the cardiac cycle when the chamber dimension is the smallest.

Question 17

In 2D measurements, end-systole can be defined as

Answer 17

the frame preceding the MV opening or the time in the cardiac cycle when the chamber dimension is the smallest.

END DIASTOLE IS…
the onset of the QRS complex, the frame after the mitral valve closes or the frame in the cardiac cycle in which the cardiac chamber dimension is LARGEST

Question 18

To obtain a Right Atrium / Right Ventricular Inflow View, angle towards the _________ where you can find…

Answer 18

UMBILICUS (textbook)
Or right hip (seen it online)

you can fine more anterior heart structures here. Three notable ones are the right atrium, right ventricle, and tricuspid valve.

Question 19

Structures seen in the RA/RV view

Answer 19

the RA, RV, and tricuspid valve (TV)

Question 20

For a RVOT view, what should you do?

Answer 20

From standard 10 o clock PLAX position, angle transducer superior and lateral.

ANGLE TOWARD LEFT SHOULDER!!!

Question 21

RVOT allows you to assess what?

Answer 21

the pulmonary artery and allows for pulmonic valve assessment

Question 22

In Parasternal Short Axis Views (SAX) rotate the index how and angle the probe in what direction, beam being directed toward what?

Answer 22

rotate 90 degrees clockwise, index will be at one o clock. Angle the probe inferior and lateral. Beam should be directed toward the LV apex.

Question 23

In SAX views, to obtain the different levels, you may need to…

Answer 23

SLIDE AN INTERCOSTAL SPACE

Question 24

To obtain SAX papillary muscle view…

Answer 24

angle toward base of patient’s heart or towards right shoulder.
This is “mushroom”
It is the LV surrounded by the round papillary muscle.

Question 25

To obtain SAX mitral valve level view…

Answer 25

obtain papillary muscle view “mushroom” and continue to angle towards base of heart and stop when you see “fish mouth.”

Anterior and posterior mitral valve leaflets can be seen. Identify them

Question 26

To obtain SAX aortic valve level view…

Answer 26

obtain papillary view, then fish mouth view, from fish mouth view - tilt transducer towards the right shoulder to obtain a SAX at the base or at aortic valve level.

Question 27

Can M-mode be performed in SAX?

Answer 27

Yes! Structures must be perpendicular though.

Question 28

RA/RV inflow view… think this!

Answer 28

Belly Button

Question 29

If Tracy asks this question… “If I saw something at the base of the Mitral Valve, what would it be?”

Answer 29

Coronary Sinus

Question 30

For a view of the Ascending Aorta in PLAX…

Answer 30

Get a good view of the butt cheeks, or the RCC and NCC of the aortic valve… then just slide up a rib or two!

Question 31

Once you’ve rotated to one o clock from PLAX to SAX view…

Answer 31

angle towards the apex.

Question 32

To view the SAX aorta view… do this

Answer 32

slide away from the sternum and angle medially

Question 33

Anteroseptal wall is the current nomenclature for what well-known structure?

Answer 33

IVS
Interventricular Septum!

Question 34

Color doppler in the parasternal LAX view used primarily to detect what pathology

Answer 34

a VSD

OR

MV and AoV pathology