Principles of 2D and M-Mode Echo (Continued) Flashcards

1
Q

Calculate the reflection co-efficient for the muscle air interface.

A

0.0004 x106 + 1.71x106

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2
Q
A

In echocardiography or medical ultrasound imaging in general, we encounter various types of reflectors, some of which are specular (reflecting waves in a specific direction) and others are non-specular (reflecting waves in multiple directions). Here are some examples:

Specular Reflectors:

Heart valve leaflets: These thin structures within the heart can produce specular reflections due to their smooth surfaces.
Diaphragm: The diaphragm separating the chest and abdominal cavities can produce specular reflections, especially in cases of pleural effusion or pneumothorax.
Bone surfaces: Bone surfaces can act as specular reflectors, particularly when the ultrasound beam encounters cortical bone interfaces.
Non-Specular Reflectors:

Myocardium: The muscular tissue of the heart can produce non-specular reflections due to its irregular structure and varying orientation of muscle fibers.
Blood cells: Within the bloodstream, red blood cells can scatter ultrasound waves in multiple directions, leading to non-specular reflections.
Liver parenchyma: Liver tissue can produce non-specular reflections due to its heterogeneous structure and presence of blood vessels.

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3
Q

What position should the patient typically lay in to obtain the left parasternal views?

A

Correct answer:

left lateral decubitus

Semi-fowler

, Not Selected

right lateral decubitus

, Not Selected

Supine

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4
Q

What structures are visualised in the left parasternal long axis view of the left ventricle?

A

Correct answer:

Left ventricular outflow tract

Left atria

Mitral valve

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5
Q

What left ventricle wall is visualised in the left parasternal long axis view of the left ventricle?

A

Posterior

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6
Q

What anatomical structure is best visualised from the high left parasternal view?

A

Proximal ascending aorta

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7
Q

What normal variants can be seen in the right atria from the right ventricular inflow tract view?

A

Correct answer:

Chiari network

Eustachian valve

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8
Q

What are these: Review
Chiari network:

Moderator band (Septomarginal trabecula)

Atrial appendage

Eustachian valve (Valve of the inferior vena cava)

A

Chiari network: This is a reticulated network of fibers or strands in the right atrium. The Chiari network is a web-like structure of fibers or strands found in the right atrium of the heart, thought to be a remnant of embryonic development, which may play a role in directing blood flow during fetal circulation. In adults, it typically has no significant physiological function but may be observed incidentally during imaging studies or cardiac procedures.

Moderator band (Septomarginal trabecula): This is a muscular band of tissue found in the right ventricle. While not directly visible in the right atrium.
The moderator band, also known as the septomarginal trabecula, is a muscular structure found in the right ventricle of the heart, extending from the interventricular septum to the base of the anterior papillary muscle. It contains the right bundle branch of the cardiac conduction system and helps coordinate ventricular contraction, contributing to efficient pumping of blood from the right ventricle.

Atrial appendage: The right atrial appendage is a small, ear-shaped pouch-like structure extending from the right atrium.
The atrial appendage assists in optimizing atrial function by increasing atrial capacity and aids in preventing blood stasis by serving as a reservoir for blood, thus reducing the risk of clot formation in the atria.

Eustachian valve (Valve of the inferior vena cava): This is a fold of tissue at the opening of the inferior vena cava into the right atrium.
The Eustachian valve is a fold of tissue located at the opening of the inferior vena cava into the right atrium of the heart, directing oxygenated blood towards the foramen ovale during fetal development. In adults, it may have a minimal physiological role, potentially influencing blood flow dynamics in certain clinical conditions such as atrial septal defects.

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9
Q

In the left parasternal long axis view of the left ventricle, the left ventricle should be —————– to the sound beam and be —————– in the sector.

A

–Perpendicular–

–Horizontal–

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10
Q

The interatrial septum can be best visualised in which of the following parasternal views?

A

Parasternal short axis of the aortic valve

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11
Q

Axial resolution is the:

A)Minimum reflector spacing along the axis of an ultrasound beam that results in separate distinguishable echos being displayed

B)Minimum reflector spacing perpendicular to the axis of an ultrasound beam that results in separate distinguishable echos being displayed

C) Ability to accurately image moving structures

D) Smallest variation in echo level that can be distinguished as a shade of grey on B-mode

A

Minimum reflector spacing along the axis of an ultrasound beam that results in separate distinguishable echos being displayed

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12
Q

Lateral resolution is the:

A)Minimum reflector spacing along the axis of an ultrasound beam that results in separate distinguishable echos being displayed

B)Minimum reflector spacing perpendicular to the axis of an ultrasound beam that results in separate distinguishable echos being displayed

C) Ability to accurately image moving structures

D) Smallest variation in echo level that can be distinguished as a shade of grey on B-mode

A

Correct answer:

Minimum reflector spacing perpendicular to the axis of an ultrasound beam that results in separate distinguishable echos being displayed

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13
Q

Contrast resolution is the:

A)Minimum reflector spacing along the axis of an ultrasound beam that results in separate distinguishable echos being displayed

B)Minimum reflector spacing perpendicular to the axis of an ultrasound beam that results in separate distinguishable echos being displayed

C) Ability to accurately image moving structures

D) Smallest variation in echo level that can be distinguished as a shade of grey on B-mode

A

D) Smallest variation in echo level that can be distinguished as a shade of grey on B-mode

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14
Q

Temporal resolution is the:

A)Minimum reflector spacing along the axis of an ultrasound beam that results in separate distinguishable echos being displayed

B)Minimum reflector spacing perpendicular to the axis of an ultrasound beam that results in separate distinguishable echos being displayed

C) Ability to accurately image moving structures

D) Smallest variation in echo level that can be distinguished as a shade of grey on B-mode

A

C) Ability to accurately image moving structures

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15
Q

In order for two reflectors to be displayed as two separate reflectors in the axial plane what must be true?

They must be separated by spatial pulse length

They must be separated by less than one wave length

They must be separated by less than one spatial pulse length

They must be separated by one wave length

A

Answer,
They must be separated by less than one spatial pulse length

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16
Q

Where is the best lateral resolution on the sound beam?

Focal-point

Near-field

, Not Selected

Far-field

, Not Selected

Center of the beam

A

Focal-point

17
Q

Frame rate depends on all of the following EXCEPT:

Propagation speed

, Not Selected

Number of scan lines

, Not Selected

Depth of reflector

Wavelength

A

Correct answer:

Wavelength

18
Q

The increased the frame rate of an image you must:

Increased the sector width

Increased the depth

Decreased the sector width

Decrease the depth

A

Correct answer:

Decreased the sector width

Decrease the depth

19
Q

Which direction do you tilt the probe to see that 5 chamber view from the 4 chamber view?

A)Posterior

B)Anterior

C)Inferior

D)Medially

A

Correct Answer:
Anterior

20
Q

Which septum is visualised in the apical 5 chamber view?

A)Anterior

B)Posterior

C)Lateral

D)Inferior

E)Anterior

A

A)Anterior

21
Q

Which septum and left ventricular wall are visualised in the apical long axis?

A)Anterior septum and inferior wall

B)Anterior septum and posterior wall

C)Inferior septum and posterior wall

D)Inferior septum and inferior wall

A

Correct answer:

Anterior septum and posterior wall

22
Q

In the apical 2 chamber view, the………. wall is visualised on the left hand side of the sector and the………. wall is visualized on the right hand side of the sector.

A

In the apical 2 chamber view, the…..
inferior wall is visualised on the left hand side of the sector and the….
anterior wall is visualized on the right hand side of the sector.

23
Q

What structures are seen in the apical long axis view?

A) Right ventricular inflow tract

B) Mitral valve

C) Left ventricular outflow tract

D) Left atrium

A

Correct answer:

Mitral valve

Correct answer:

Left ventricular outflow tract

Correct answer:

Left atrium

24
Q

In the apical 4 chamber view the ………….
septum and …………….
wall are visualised.

A

In the apical 4 chamber view the
inferior septum and lateral
wall are visualised.

25
Q

Which of the sector orientation below correctly describe the optimal orientation for the apical 4 chamber view?

Top of sector superior, bottom of sector inferior, right of sector left, left of sector right

Top of sector inferior, bottom of sector superior, right of sector left, left of sector right

Top of sector superior, bottom of sector inferior, left of sector left, right of sector right

Top of sector inferior, bottom of sector superior, right of sector left, left of sector right

Top of sector inferior, bottom of sector superior, left of sector left, right of sector right

A

Correct Answer:
Top of sector inferior, bottom of sector superior, right of sector left, left of sector right

26
Q

Which transthoracic echocardiographic view is used to visualise both the anteriorlateral and posteriormedial papillary muscles?

A)Subcostal short axis

B)Subcostal four chamber

C)Parasternal long Axis

D)Apical four chamber

A

Correct Answer:
Subcostal short axis

27
Q

In which view is the interatrial septum best interrogated for atrial septal defects?

A)Right parasternal

B)Subcostal short axis level of the aortic valve

C)Subcostal four chamber

D)Subcostal short axis level of the mitral valve

A

Subcostal four chamber

28
Q

To obtain the subcostal short axis from the subcostal 4 chamber the probe must be rotated:

Clockwise 90 degrees

Clockwise 45 degrees

Counterclockwise 90 degrees

Counterclockwise 45 degrees

Counterclockwise 90 degrees

A

Correct Answer:
Counterclockwise 90 degrees

29
Q

Which of the following are alternatives views that may be useful when standard acoustic windows are not available?

A)Right parasternal

B)Subcostal short axis

C)High left parasternal

D)Selected Answer - Incorrect

E)Suprasternal notch

A

Correct answer:

Right parasternal

30
Q

What is the best patient positioning for the subcostal views?

A) Steep right decubitus

B) Steep left decubitus

C) Semi-fowler

D) Supine with knees bent

A

Supine with knees bent

31
Q

Which of the following are abnormalities that can be detected in the suprasternal notch?

A) Aortic dilatation and dissection

B)Coarctation

C) Thombus

D) Severe left ventricular dysfunction

A

Correct answer: X3

Aortic dilatation and dissection

Correct answer:

Coarctation

Correct answer:

Thombus

32
Q

Which of the following abnormality is best visualised in the right parasternal view?

A)Myxomas

B)Dilated coronary sinus

C)Left ventricular dysfunction

D)Aortic stenosis

A

D)Aortic stenosis

33
Q

The IVC is best visualised using which window?

A)Subcostal

B)Apical

C)Left parasternal

D)Right parasternal

A

A)Subcostal

34
Q

The mechanical index is an indication of the likelihood for:

Faulty transducer

Heating

Cavitation

Faulty scanner

A

Correct answer:

Cavitation

35
Q

The thermal index is an indication of the likelihood for:

Heating

Cavitation

Faulty transducer

Faulty scanner

A

Correct answer:

Heating

36
Q

Means by which ultrasound energy could induce a biological effect include:

Sterilisation

Heating

Mechanical effects other than cavitation

Cavitation

A

Heating

Mechanical effects other than cavitation

Cavitation

37
Q

Two types of cavitation are ___________ and ___________ .

Small bubbles and large bubbles

Absolute and partial

Stable and oscillating

Stable and transient

A

Correct answer:

Stable and transient

38
Q

ALARA translates to:

As long as reasonably allowed

As low as reasonably achievable

As low as reasonably acceptable

As long as resonably acceptable

A

Correct answer:

As low as reasonably achievable