Quiz 9 Flashcards
M-mode directs pulses of a _____, linear bean of ultrasound into the tissues and displays the distance from the transducer of the returning echoes on the ______ of ta graph with signal strength indicated by brightness. The ______ of the graph shows time and motion of the structures is seen as curved lines
single
y axis
x axis
What is M-mode good for:
- precisely timing events within the cardiac cycle
- high temporal resolution (Lots of frames per second)
Velocities going toward the transducer are ____ the baseline of the y axis
above
Velocities going away from the transducer ____the baseline
below
On a color flow doppler what does the color red mean?
flow toward the transucer
On a color flow doppler what does the color blue mean?
Flow going away from a transducer
Some color flow doppler have a variance map that show green; which signifies?
Turbulence (Mosiac)
What are the indication for a TEE in the ASA/SCA guidelines?
- All open hearts
- All thoracic aortic surgical procedures
- Considered in coronary artery bypass graft surgeries
What are the indications for a TEE in the ACC/AHA guidelines?
- vavle repair surgery
- valve replacement surgery with a stentless -xenograft,
- homograft or auto valve
- valve surrgery for infective endocarditis
The ASE/SCA guidelines for performing a comprehensive intraoperative multiplane TEE examination are:
- 20 view
- All chambers
- All vavles
- Thoracic aorta
- Pulmonary Artery
Mid esophageal views are located where and consist of:
-TEE transducer posterior to the left atrium
(With multiplane TEE probe detailed examination of cardiac chambers and valves can be completed in most patients from this window alone)
TG view are located where and consist of:
- Transducer in stomach
- Image plane superior
- Images of the right and left ventricle can be seen
- Mitral valves
- Tricuspid Valves
Views to aligning the doppler beam parallel to flow through the left __________ outflow tract (LVOT) and aortic valve (AV) can be developed from the TG window.
ventricular
TG
Upper esophageal views are located where and consist of:
- transducer at the aortic arch level
- Can be seen in LAX and SAX
- Main pulmonary artery and pulmonary valve can be seen allowing alignment of the Doppler beam parallel to flow in these structures
Left ventricular is viewed at:
- ME two chamber
- ME four chamber
- ME LAX
- TG mid SAX
- TG two chamber views
Left ventricular size is viewed at what approach and what is the size suppose to be?
VIEWED -ME two chamber -TG two chamber Size: 5.4 cm for women < 6 cm for men
LV global function show ejection fraction(FRACTIONAL AREA CHANGE). What is the view approaches?
-TG mid SAX
THIS ONE IS IMPORTANT
Is Fractional Area Change correct when Wall motion abnormalities are present?
NO
Qualitative assessment of LV function is performed by considering all views of the LV and estimating the EF as:
- EEF > 55% = NORMAL
- EEF 45 to 54 % = mildly decreased
- EEF 35 to 44% = moderately decreased
- EEF 25 to 34% = moderately severly decreased
- EEF < 25% severly decreased
Assessment of regional LV function is divided into 17 region or segments. Each segment is rated qualitatively for thickining during systole using the following scale:
1 = (normal) 30% thickening 2 = (Mild hypokinesis) 10 - 30% thickening 3 = (Sever hypokinesis) <10% 4 = (Akinesis) no thickening 5 = (Dyskinesis) Thinning and paradoxical motion during systole
An increase in scale of __ or more in a regional LV function should be considered significant and suggestive of myocardial ischemia.
2
Normal diastolic LV function corresponds with a:
- Positive inflow waves during systole (S wave)
- Positive inflow wave during diastole (D wave)
- Negative wave corresponding to atrial contraction ( A wave)
The mitral valve (MV) is viewed in:
-ME four chamber
-ME mitral commissural
-ME LAX
-TG basal SAX
(WITHOUT THE COLOR FLOW DOPPLER)
Prolapse of the MV is present when a portion of the leaflet moves to the _____ side of the annulus during _______.
Atrial
Systole
Flail is said to be present when a _______ ________ is ruptured and the corresponding segment of the valve leaflet is seen oscillating in the LA during systole.
chordae tendineae
Mitral Stenosis planimetry can be viewed from:
TG basal SAX
Proximal isovelocity surface area (PISA) is most commonly applied to ______ MR and is probably not as accurate for ________ MR
central
eccentic
