Echo final

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Pulmonic Regurgitation permits backward

Diastolic blood flow traveling from the PA, through the PV into the RV

A strong indication for mitral valve stenosis on two-dimensional echocardiography is an anterior mitral valve leaflet that exhibits:

Diastolic doming

Aortic insufficiency/regurgitation is the results of an incompetent AOV that permits backward

Diastolic flow from the aorta to the LV

Mitral stenosis is associated with what type of murmur?

Diastolic rumble

Severe aortic regurg creates a _____________ called the ____________ murmur

Diastolic rumble, austin flint

Mitral valve stenosis impedes __________blood flow traveling from the ___________ into the ________

Diastolic, left atrium, left ventricle

What would you expect to see on the M-mode of an 11 year old with bicuspid aortic stenosis?

Eccentric closure

Increased E-F is present when mitral stenosis is present

False

The left ventricle can be seen in the SAX Aorta view

False

The pedof probe is designed for the acquisition of the CW Doppler but has low sensitivity

False

The right atrium can be seen in the PSLAX view?

False

to acquire doppler of the pulmonary vein you would use CW. T/F

False

Calcific/Rheumatic Aortic stenosis presents on an M-mode with decreased aortic cusp separation (ACS)= 2.6-3.5

False ( = less than 1.5 cm )

The AVA is calculated by measuring the RVOT diameter , LVOT velocity and the aortic valve velocity

False - measures LVOT diameter

Atrioventricular valves are open during systole T/F

False - open during diastole

An MR jet that extends just beyond the mitral valve leaflets is

Grade 1

When pulmonary hypertension is present a high pitched blowing diastolic murmur is called a____________ murmur.

Graham steele

When severe tricuspid regurgitation is suspected, enlargement may be noted in the:

IVC SVC Hepatic veins

Increased LAVi indicates

Left atrial filling pressure in the absence of MV disease Possible diastolic dysfunction The outcome of heart failure

What does LAVi stand for?

Left atrial volume index

The most common location for beginning the adult echocardiographic examination is:

Left parasternal

Complications that can occur with AS are;

Left ventricular pressure overload left ventricular hyperthrophy infective endocarditis

Reasons LA enlargement can occur despite a normal LV diastolic function

MV disease Bradycardia

Where should the PW gate be placed to obtain MV flow?

MV leaflet tips

When obtaining the PSLAX view what anatomy do we see in this view?

MV,LA,LV

Causes of MVP include

Marfans syndrome Hereditary factors A&B

_______________ is the most common heart problem associated with MVP

Mitral regurgitation

Name two views where we could evaluate the aortic valve

PSLAX, SAX AO

Which spectral Doppler is used to assess normal specific atrioventricular valvular inflow?

PW

When measuring flow through the MV, we measure normal flow, using ____________, at the MV __________.

PW, leaflet tips

To provoke MVP the tech can have the patient ___________

Perform valsalva maneuver

Causes of TR

Pulmonary stenosis Rheumatic fever TV infection Ebstein's anomaly

Possible two-dimensional echocardiographic findings for valvular pulmonic stenosis include all the following EXCEPT:

Pulmonic valve prolapse

The apical 5 chamber shows the anatomy of the

RV, RA, TV, LA, LV, MV, AV

Tricuspid regurgitation is leakage of blood backwards from the ______into the ________during_____.

RV,RA,Systole

To calculate the RVSP you would:

TR max = RAP

The right ventricle can be seen in the SAX Aorta view

TRUE

Which spectral Doppler measurement is obtained to calculate the mitral valve mean pressure gradient?

Trace the E and A wave

Aortic insufficiency is the result of an incompetent valve that permits backward diastolic flow from the Aortic valve into the left ventricle

True

Ar murmur is a high pitched blowing diastolic decrescendo murmur T/F

True

Mitral stenosis creates turbulent diastolic flow

True

PW Doppler advantage is that it is precise to flow using the sample gate

True

The left atrium can be seen in the SAX Aorta view

True

diastolic doming of the anterior mitral valve leaflet creates a "hockey stick" appearance with Mitral stenosis

True

What does an E/e' >14 indicate?

abnormal LV filling pressure

Pulmonic stenosis as seen on Doppler echo from the parasternal window appears _____________ the base line during _______________.

above/diastole

The resistance to ejection of blood encountered by the contracting ventricle is called

afterload

Which of the following is not a limitation of continuous wave Doppler?

aliasing

Several windows should be utilized when acquiring the aortic valve Doppler waveform, to include the

all of the above -apical window -suprasternal window -right parasternal window

a diastolic flutter of the anterior mitral valve leaflet can be caused from

aortic regurgitation

The E-F slope of the M-mode of the anterior mitral valve leaflet in mitral valve stenosis is:

decreased

Utilizing CW Doppler, tricuspid stenosis will have a ______ E-F slope

decreased

In the SAX view of the mitral valve, tracing the opening of the mitral valve with mitral stenosis it will present a

decreased MVA

Aortic regurgitation creates a high pitched

diastolic blowing

TS murmur

diastolic rumble that varies with respiration and has an opening snap

spectral Doppler measure flow velocity and

direction of flow

M-mode bicuspid AS presents

eccetric closure

Trace the LA during

end ventricular systole

A complication of mitral stenosis is increased cardiac output

false

aortic stenosis creates a turbulent diastolic color flow that travels from the aorta into the left ventricle

false

aortic regurgitation

flow of blood backward from the aorta into the heart; caused by a weak heart valve

AI murmur

high-pitched, blowing, diastolic decrescendo murmur at the left sternal border

Mitral regurgitation creates a ______________ murmur

holosystolic blowing

TR Murmur

holosystolic murmur that increases with respiration

Complications with mitral regurgitation results in

left atrial enlargment pilmonary hypertension possible left atrial thrombus answer: all of the above

MVP murmur presents as a

mid systolic click

The most common cause of mitral stenosis is

mitral regurgitation

When acquiring the LA length freeze the image prior to the _________ opening

mitral valve

tricuspid stenosis

narrowing, thickening or obstruction of the TV that impeded Diastolic flow.

What does an E/e' <8 indicate?

normal LV filling pressure

Excellent two-dimensional views for imaging the tricuspid valve include all the following EXCEPT:

parasternal long-axis view

The best two-dimensional view for determining mitral valve area is the:

parasternal short-axis view

In most cases if the AMVL prolapses there is a ___________ direct jet

posterior

The volume or pressure that exists in the ventricle at end-diastole is called:

preload

the semilunar valves are open in

systole

on M-mode mitral valve prolapse creates a

systolic dip

A reason LA measurements may be inaccurate may be due to suboptimal views

true

Mitral stenosis can eventually cause pulmonary hypertension

true

aortic regurgitation is possible with stenosis

true

in order to acquire a pressure gradient, one can utilize the modified Bernoulli's equation.

true

you measure aortic regurgitation using the pressure half time method (PHT)

true

aortic insufficiency (AI)

when failure of a valve to close completely allows blood to move backward ( diastolic)

on M-mode, pulmonic stenosis presents an increased depth of

"a" wave

which of the following represents the formula for calculating the mitral valve area (MVA)?

220/PHT (pressure half time)

How far should you place the pw Doppler gate into the pulmonary veins

1-2cm

TVA=

190/PHT ( pressure half time)

When tracing the LA use the _________ chamber and the ___________chamber view

4 chamber and 2 chamber view

To acquire mitral valve velocity in a normal mitral valve, you would use the _______ view, using _________ doppler at the ___________ of the mitral valve leaflets

4 chamber, PW tips

continuity equation

785xLVOT2

with serve mitral stenosis, the MVA is _____________ cm squared

<1.0

Normal peak velocity for the mitral valve flow is

<1.3m/sec

severe aortic stenosis peak velocity is

>4.0 m/s

AI treatments

AOV repair/replacement

Name a treatment for AS

AOV replacement

Normal MV inflow antegrade or retrograde?

Antegrade

The best view to obtain the MV velocity is the

Apical 4 chamber view

What view could you use to evaluate stenosis?

Apical 5CH, Apical 3CH

The best view to obtain spectral Doppler of the mitral valve is the

Apical view

The murmur associated with severe aortic insufficiency is:

Austin Flint murmur

Mitral regurgitation is

Backflow of blood into the left atrium

Tricuspid regurgitation

Backflow of blood through incompetent tricuspid valve into RA during Systole

Which Doppler signal is used to calculate the tricuspid valve mean pressure gradient?

CW

Which spectral Doppler is used to assess valvular regurgitation?

CW

which spectral Doppler is used to assess valvular stenosis

CW

When pulmonic stenosis is detected using Doppler, you should use ___________ and ______________ the wave form.

CW/Trace

The flow convergence method can be used to estimate the MR volume. This method is also called

PISA

When MR is present you should look at your 2D image and evaluate

Mitral valve apparatus Left atrium Both a&b

Mitral stenosis is

Narrowing, thickening of the hearts mitral valve

Atrioventricular regurgitant blood flow will appear on which side of the spectral doppler baseline?

Retrograde

Causes of TS

Rheumatic fever ( most common) Ebstein's anomaly Carcinoid Heart Disease

Name 2 views you could use to evaluate pulmonic regurgitation

SAX AO, RVOT

Name 2 views where the Tricuspid valve is visualized

SUBCOSTAL 4CH, APICAL 5CH

Grade 4+ MR, is indicative of

Severe MR

on a 2D echo, AS may present;

Thickened cusps left ventricular hypertrophy both A&B

Pulmonic stenosis is not that common in the adult. Which od the following 2D echo findings would indicated pulmonic stenosis?

Thickening of the pulmonic leaflets with systolic doming

When measuring spectral Doppler Aortic stenosis you:

Trace the AV waveform

aortic stenosis

calcification of aortic valve cusps that restricts forward flow of blood during systole

3 s&s of AS

chest pain,syncope,heart failure

What type of Doppler is NOT considered spectral Doppler?

color Doppler

what type of aortic stenosis originates at the aortic valve cusps?

congenital


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