Echo-B ~ Part 1
18. At normal heart rates, atrial systole accounts for approximately ____ % of ventricular filling.
10 - 15 %
3. The left atrium receives blood from:
4 PULMONIC VEINS These four pulmonic veins carry oxygenated blood from the lungs back to the left side of the heart to be pumped to the systemic circulation. Note that in this case, veins are carrying oxygenated blood.
1. The chordae tendinae and papillary muscles prevent the valves from prolapsing back into the:
ATRIA The chordae tendinae and papillary muscles prevent valves from prolapsing back into the atria in systole. During systole, ventricular pressure increases. This means that the ventricular surface of the AV valves is pushed toward the atria.
46. The electrical P wave on an EKG indicates that the:
ATRIA HAVE BEEN DEPOLARIZED Atrial contraction has occurred - a corresponding A wave will be seen on the m-mode and Doppler tracings of the AV valves.
14. Functions of the cardiac skeleton include all of the following except: -valve support -electrical separation of the atria and the ventricles -support for myocardial contraction -attachment for the chordae tendinae
ATTACHMENT FOR THE CHODAE TENDINAE The cardiac skeleton provides support for cardiac valve attachment, electrically separates the atria and the ventricles, and gives the myocardium something to contract against. The chordae tendinae attach to the papillary muscles and the free edges of the valve leaflets.
27. The electrical impulse generated at the SA node can only travel from the atria to the ventricles by way of the
AV NODE The cardiac skeleton prevents the impulse from traveling from the atria to the ventricles elsewhere.
22. Which statement is true? -The inferior border of the heart is formed entirely by the right ventricle. -The right border of the heart is also known as the obtuse margin. -Both the LV and LA contribute to the left border of the heart. -The atria do not form any of the superior border of the heart.
BOTH THE LV AND LA CONTRIBUTE TO THE LEFT BORDER OF THE HEART. The inferior border of the heart is formed by the right ventricle and a portion of the left ventricle. The right border of the heart is also known as the acute margin. The atria do form a superior border of the heart.
2. The branches of the aortic arch are:
BRACHIOCEPHALIC, LEFT COMMON CAROTID, LEFT SUBCLAVIAN
11. The two main branches of the left coronary artery are the:
CIRCUMFLEX AND LEFT ANTERIOR DESCENDING
28. Which structure is found in the left anterior atrioventricular groove?
CIRCUMFLEX CORONARY ARTERY The circumflex coronary artery is a branch of the left coronary artery. It travels in the left anterior atrioventricular groove supplying the lateral wall of the left ventricle. The left anterior descending coronary artery travels between the right and left ventricles in the anterior interventricular groove. The coronary sinus runs in the posterior left atrioventricular groove. The descending aorta travels behind the left atrium.
12. The myocardium receives its blood supply directly from the ________. This blood returns to the right atrium from the _______.
CORONARY ARTERIES; CORONARY SINUS The myocardium receives its blood supply directly from the coronary arteries. Deoxygenated blood returns to the right atrium from the coronary sinus.
17. The right atrium is the receiving chamber for the:
CORONARY VENOUS CIRCULATION, INFERIOR VENA CAVA, SUPERIOR VENA CAVA coronary venous circulation via the coronary sinus, vena cavas from the systemic circulation
50. A patient's pulmonary artery pressure is 40/8. This is considered to be
ELEVATED (PHTN)
13. The lining of the heart is the:
ENDOCARDIUM The endocardium covers the inner aspect of the cardiac chambers and covers the valves. The tunica intima lines the vessels.
33. What is located in the central portion of the interatrial septum?
FOSSA OVALIS (the foramen ovale in the fetal circulation)
69. The electrical impulse produced by the heart's conduction system is carried from the atria to the ventricles via the bundles of His.
False It's carried from the atria to the ventricles via the atrioventricular (AV) node.
67. The stroke volume of the right ventricle is lower than that of the left ventricle due to the shorter distance through the pulmonary circulation.
False The stroke volume of the RV is equal to that of the LV unless a shunt is present.
44. In which of the following situations would it be acceptable to use the Valsalva maneuver? -hypertrophic cardiomyopathy -recent MI -severe mitral insufficiency -severe aortic stenosis
HYPERTROPHIC CARDIOMYOPATHY Valsalva maneuver is used to increase the LVOT gradient in hcm. It is contraindicated in the other listed conditions.
24. The portion of the membranous interventricular septum that is located adjacent to the tricuspid septal leaflet is known as the ______ IVS.
INLET ivs
19. Opening and closing of the cardiac valves is accomplished by:
INTRACARDIAC PRESSURE CHANGES Valves open when the pressure proximal to the valve exceeds the pressure distal to the valve. They close when the distal pressure exceeds the proximal pressure.
45. The semilunar valves open at the end of
ISOVOLUMIC CONTRACTION During this period, the aortic and pulmonic valves are closed and ventricular pressure is rising. When ventricular pressure exceeds the pressure in the great vessels, the semilunar valves open and rapid ejection begins.
39. The first stage of diastole is:
ISOVOLUMIC RELAXATION
47. All four valves are closed and ventricular pressure is decreasing. This phase of the cardiac cycle is:
ISOVOLUMIC RELAXATION
30. Which statement best describes the crux of the heart?
IT IS LOCATED AT THE INTERSECTION OF THE POSTERIOR INTERVENTRICULAR GROOVE AND THE POSTERIOR PART OF THE ATRIOVENTRICULAR GROOVE.
42. Which coronary artery supplies the cardiac apex in most patients?
LAD
41. The structure found in the anterior interventricular groove is the:
LAD The left anterior descending artery runs in the anterior iv groove.
32. Which of the following will increase the systemic venous return? -amyl nitrate -suddenly standing up -expiration -laying down from a standing position
LAYING DOWN FROM A STANDING POSITION The other maneuvers listed will decrease systemic venous return.
10. In a standing position, the apex of the heart points toward the:
LEFT HAND
16. Which of the following is located between the anterior mitral leaflet and the IVS?
LEFT VENTRICULAR OUTFLOW TRACT
37. Which of the following is the right coronary artery least likely to supply? -LV anterior wall -LV inferior wall -inferior IVS -RV free wall
LV ANTERIOR WALL The RCA gives off the posterior descending branch that runs in the posterior interventricular groove. It feeds the inferior IVS, inferior LV free wall and the RV free wall.
7. The systemic side of the heart pumps:
OXYGENATED BLOOD TO THE TISSUES The systemic side of the heart pumps oxygenated blood to the tissues. The systemic side of the heart is the left heart. It pumps the oxygenated blood that has the returned from the lungs to the systemic circulation. The systemic circulation supplies most of the body's organs and tissues.
26. The abbreviation PDA is used to refer to
PATENT DUCTUS ARTERIOSUS This is a congenital condition is which the fetal ductus arteriosus fails to close at birth.
20. When considering a short axis section of the left ventricle at the level of the mitral valve, which of the following is least likely to be used to describe the right ventricular free wall? -inferior -anterior -posterior -middle
POSTERIOR The right ventricular free wall can be described as having inferior, middle and anterior segments (it is adjacent to the inferior and anterior portions of the LV free walls). The posterior wall is composed of only the left ventricle.
29. Which statement is false? -LV wall thickness is greater than RV wall thickness. -Oxygen saturation is higher in the pulmonary veins than in the pulmonary artery. -Right heart pressures are lower than left heart pressures. -Pulmonary vascular resistance is higher than systemic vascular resistance.
PULMONARY VASCULAR RESISTANCE IS HIGHER THAN SYSTEMIC VASCULAR RESISTANCE. Pulmonary vascular resistance is lower largely due to the length of the circuit meaning the the right ventricle generates lower pressures and has thinner walls than the left ventricle.
38. Which of the following is/are associated with the posterior wall of the left atrium? -left atrial appendage -pulmonic veins -fossa ovalis -Eustachian valve
PULMONIC VEINS The four pulmonic veins enter the posterior LA
25. Ventricular depolarization results in the ______ on the EKG tracing.
QRS complex
5. The moderator band is located in the:
RIGHT VENTRICLE The moderator band is located in the apex of the right ventricle. This band is one of the trabeculations of the right ventricle and is a landmark used in echocardiography that helps to differentiate the right ventricle from the left.
4. The pulmonary and systemic circuits are:
SEPARATE AND IN SERIES WITH EACH OTHER This means that blood travels from one system into the other and back again.
35. In the normal heart, the tissue that determines the heart rate is the:
SINO-ATRIAL NODE
9. Three outpouchings are found at the origin of the ascending aorta. These are known as _______ and two of them give rise to the ________.
SINUSES OF VALSALVA; OSTIA OF THE CORONARY ARTERIES The coronary sinus is part of the heart's venous system and is found in the left atrioventricular groove. It drains into the right atrium.
23. Which of the following terms is used when a valve opening is narrowest?
STENOSIS
21. Which of the following statements is incorrect? -The leaflets of the cardiac valves are supported by valve annuli. -Electrical separation of the atria and ventricles is a function of the cardiac skeleton. -The muscular IVS contributes directly to the emptying of the right ventricle. -The right and left atria share a common wall.
THE MUSCULAR IVS CONTRIBUTES DIRECTLY TO THE EMPTYING OF THE RIGHT VENTRICLE. The muscular IVS contracts with the left ventricular free wall to empty the left ventricle. Only the right ventricular free wall contributes to the emptying of the right ventricle. In cases of a right ventricular volume overload the IVS moves opposite the direction (paradoxical motion) to aid in emptying the RV.
8. Pressure in the pulmonary artery is normally much lower than the pressure in the aorta because:
THE OVERALL RESISTANCE OF THE PULMONARY CIRCULATION IS LOWER THAN THAT OF THE SYSTEMIC CIRCULATION. This means that it is easier to pump blood to the pulmonary circulation. The right ventricular myocardium is thinner, but this is a result of the lower pressure that the right ventricle must generate.
49. Which structures divide the left ventricle into basal, mid and apical segments?
THE PAPILLARY MUSCLES
43. In the sixteen segment model used to describe the walls of the left ventricle, which statement is TRUE? -In the mid ventricle, the posterior wall lies between the inferior and lateral walls. -The anterior interventricular septum forms part of the left ventricular free wall. -The apex of the heart is subdivided into six segments. -At the level of the mitral valve, the anterior and inferior walls are adjacent.
THE POSTERIOR WALL LIES BETWEEN THE INFERIOR AND LATERAL WALLS IN THE MID LEFT VENTRICLE.
34. Which cardiac valve is located closest to the apex of the heart?
TRICUSPID The tricuspid annulus is slightly more inferior than the mitral annulus.
31. The right ventricular inlet valve is the _____ valve and the left ventricular outlet valve is the _____ valve.
TRICUSPID; AORTA
15. How many papillary muscles are associated with the mitral valve and what are their names?
TWO; POSTEROMEDIAL AND ANTEROLATERAL
40. Amyl nitrate may be used for all of the following except: -increase systemic venous return -enhancement of mitral valve prolapse -vasodilation -increases in lvot obstruction in HCM
USED FOR ALL EXCEPT INCREASE VENOUS RETURN
36. From apex to base, the ventricles are divided into three regions. Which of the following is not considered one of these regions? -valvular -basal -mid -apical
VALVULAR
48. The epicardium is also known as:
VISCERAL PERICARDIUM
6. The pericardial space is a potential space located between the ________ and the _________.
VISCERAL PERICARDIUM; PARIETAL PERICARDIUM The pericardial space is a potential space is a potential space located between the visceral pericardium (epicardium) and the parietal pericardium. Pericardial effusions collect in the pericardial space.
56. Arteries carry oxygenated blood; veins carry deoxygenated blood.
false Although most arteries carry oxygenated blood, the pulmonary artery and umbilical arteries carry deoxygenated blood. The pulmonic veins and umbilical vein carry oxygenated blood.
65. The right border of the heart is formed by the right atrium and is also known as the obtuse margin.
false It is known as the acute margin.
73. Lambl's excrescences are unique to the right heart valves.
false Lambl's excrescences are found on the aortic valve.
66. The functional LVOT is much smaller than the anatomic LVOT.
false The functional LVOT is much larger than the anatomic LVOT.
74. The myocardium and systemic circulation receives their blood supply during systole.
false The myocardium receives its blood supply during diastole; the systemic circulation receives its blood supply during systole.
60. The right atrial appendage extends from the postero-lateral aspect of the right atrium.
false The raa extends from the anterior and inferior aspect of the right atrium.
59. The nodules of Arantius are associated with the atrioventricular valves.
false aortic valve
53. Normal pulmonary artery pressure is 100/80.
false Normal pulmonary arterial pressure is 15-30 mmHg systolic and 4-12 mmHg diastolic.
52. Structures found in the anterior interventricular groove include the left anterior descending coronary artery and great cardiac vein.
true
54. The terms conus arteriosus and infundibulum refer to the RVOT.
true
55. The abbreviation FVI is used to refer to the flow velocity integral.
true
57. Arteries carry blood away from the heart; veins carry blood toward the heart.
true
58. The coronary sulcus contains the right coronary artery.
true
61. The arterioles determine the body's metabolic needs.
true
62. Normal heart rate is 60-100 beats per minute.
true
63. Myocardial thickness of the left ventricle and interventricular septum is greater than that of the right ventricular free wall.
true
64. The purpose of dividing the left ventricle into named segments is to allow an accurate description of the location of wall motion abnormalities.
true
68. Diastasis may also be referred to as the conduit phase of ventricular filling.
true
70. The property of every myocardial cell that allows it to produce an impulse is known as automaticity.
true
71. 85-90% of ventricular filling occurs during early rapid filling.
true
72. In the normal patient, aortic systolic and diastolic pressure will be the same as the peripheral systemic blood pressure.
true
75. Blood in the coronary sinus has the lowest oxygen saturation in the body.
true
True/False 51. Subepicardial fat may be mistaken for a pericardial effusion.
true
