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Personal CV > TEE > Flashcards

TEE Flashcards

1
Q

What produces medical ultra sound?

A

-Piezoelectric Crystals

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2
Q

What causes the Piezoelectrical crystals to vibrate?

A

-High frequency alternating electric current

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3
Q

Ultrasound can interact with tissue in what 4 ways?

A
  • Reflection
  • Refraction
  • Scattering
  • Attenuation
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4
Q

What is the trade off when selecting a frequency?

A

-Resolution or depth of penetration

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5
Q

Higher frequencies have what advantage/disadvantage?

A
  • Better resolution

- Less depth of penetration

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6
Q

How does Doppler echocardiography work?

A

-Ultrasound scattered from blood cells measures velocity and direction of blood flow.

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7
Q

Doppler accuracy requires the angle between blood flow and ultrasound to be less than what?

A

20 degrees

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8
Q

Describe M mode

A
  • Pulses of a single, linear beam

- Plotted on a graph

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9
Q

What is M mode useful for?

A
  • Timing of the cardiac cycle

- Detection of high frequency oscillating motion

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10
Q

High frequency detection of oscillating motion of M mode can detect what?

A

-Vibrating vegitation

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11
Q

Describe 2D Mode

A
  • Rapidly moving beam through a plane

- Multiple scan lines displayed simultaneously

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12
Q

What is frame rate?

A

-Number of 2D images displayed per second

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13
Q

What is the frame rate for 2D mode

A

30-60

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14
Q

What does 2D detect?

A

Motion in the heart

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15
Q

What does Pulsed Wave Doppler mode measure?

A

-Velocity and direction of blood in a specific location

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16
Q

Velocity and direction of blood in a specific location is called what?

A

Sample volume

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17
Q

Describe the pulsed wave doppler mode

A
  • One transducer to send and receive signals
  • Limited velocity measurement (1.5-2m/sec)
  • Further from the probe, less velocity it can measure
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18
Q

With a pulsed wave doppler, if the velocity is is above the baseline which way is it moving?

A

toward the transducer

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19
Q

What does continuous wave doppler measure?

A

-velocity and direction along the line of site of the beam

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20
Q

How many transducer does continuous doppler use and what do they do??

A

-2, one for continuously sending and one for continuously receving

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21
Q

What does the pulse wave do that the continuous wave cannot?

A

-Measure depth (range ambiguity)

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22
Q

What problem of PWD does CWD overcome?

A

-No limits on maximum velocity

23
Q

Why use CWD over PWD?

A
  • To measure velocity too high for PWD

- Aortic / Mitral Stenosis

24
Q

Explain Color flow doppler

A
  • Form of PWD

- Superimposes velocity info on 2D image

25
Q

What Mode allows for the location and timing of flow disturbances to easily be seen?

A

Color flow doppler

26
Q

Name the colors in the colors flow mode and what they represent.

A
  • Red = towards transducer
  • Blue = Away from transducer
  • Green = Turbulent flow
27
Q

What is a mosaic pattern seen in color flow doppler?

A
  • Flow with a velocity too high that color flow cannot accurately depict
  • Appears as mixture of red and blue
28
Q

What is a variance map?

A

-When turbulent flow is added to color flow doppler and represented by the color green

29
Q

In color flow doppler when does the image become jerky?

A

Less than 15 frames per second

30
Q

What does tissue doppler do?

A

Measure velocity of tissue motion

31
Q

What 2 modes are forms of PWD and have the same speed limitations?

A
  • Color Flow

- Tissue doppler

32
Q

Most common application for tissue doppler?

A

-Mitral annular motion which assess LV systolic function

33
Q

What are two less common applications for tissue doppler?

A
  • Strain (Tissue deformation)

- Strain rate (rate of deformation)

34
Q

Patient history that contraindicates TEE.

A
  • Dysphagia
  • Odynphagia
  • Mediastinal radiation
  • Upp GI surgery/Bleeding
  • Thoracic Aortic aneurysm
35
Q

Esophageal pathology that contraindicates TEE

A
  • Stricture
  • Tumor
  • Diverticulim
  • Varices
  • Esophagitis
  • Chest trauma
36
Q

Complications of TEE

A
  • Dental injury
  • Laryngeal dysfunction
  • Aspiration
  • ETT displacement
  • Bronchial / Aortic compression in infants
  • GI bleed
  • Phaynx / esophagus perf
37
Q

Transducer frequency is adjusted to provide _______ frequency and _________ depth of penetration.

A

Highest

Adequate

38
Q

Where should the image depth be centered?

A

To the center of the structure being examined

39
Q

Image gain and dynamic range should be adjusted to what?

A
  • Black blood

- Gray tissues

40
Q

What should be adjusted to provide uniform brightness in near and far fields?

A

-Time gain compensation

41
Q

What eliminates background noise?

A

CFD gain

42
Q

Where would the probe be place for a mid-esophageal view?

A

-Posterior to the Left Atrium

43
Q

What can be viewed with ME view?

A

-All cardiac chambers and valves

44
Q

How are transgastric views obtained?

A

-Probe into stomach with view superiorly to heart.

45
Q

What structures are viewed with TG view?

A
  • Both ventricles

- Mitral and tricuspid valves

46
Q

In TG, if you line up view parallel to to flow you can see what 2 things?

A
  • Left ventricular out flow tract

- Aortic valve

47
Q

In the upper esophageal view, where is the probe placed?

A

-Level of the aortic arch

48
Q

What can be examined with UE view?

A
  • Pulmonary artery

- Pulmonic valve

49
Q

What is the normal LV size? and where is it best measured?

A
  • Women < 5.4 cm
  • Men < 6.0 cm
  • ME or TG 2 chamber
50
Q

What is normal thickness for LV wall and where is it best measured?

A
  • < 1.2 cm

- TG mid SAX

51
Q

What is the 2D equivalent of ejection fraction? And what is normal?

A
  • Functional area change

- >0.5

52
Q

Left global function and Functional area change (EF) is best viewed with what?

A

-TG mid SAX

53
Q

Qualitative assessment if LV function is performed how?

A

-Considering all views of LV and estimating ejection fraction

54
Q

What is normal estimated ejection fraction (EEF)

A
  • > 55%

Personal CV (8 decks)

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