ECHO: Echo Midterm ch 1-11
overall cardiac function is determined by systolic function a. true b. false
b. false
2D cardiac dimensions of the left ventricle and walls should be acquired ________ A. at the myocardial wall/ cavity interface & wall / pericardium interface b. at oblique angles to the structures c. only if unable to acquire M-mode dimensions d. parallel to the cardiac structure
A. at the myocardial wall/ cavity interface & wall / pericardium interface
the atria are ____ chambers and the ventricles are ____ chambers a. filling/ pumping b. high pressure/ low pressure c. high volume/ low volume d. pumping/ filling
a. filling/ pumping
TEE is contraindicated when the patient ________ a. has a GI bleed b. has a prosthetic mitral valve c. is in the OR d. is post cardiac surgery
a. has a GI bleed
the left heart is a _____ a. high resistance system b. low oxygen saturation system c. low pressure systems d. pulmonary circulation systems
a. high resistance system
The pediatric transducer typically utilized a ___ frequency transducer that provides excellent resolution, while adult transducers utilizes a ___ frequency transducer that provides better depth penetration. a. high/ low b. low/ high
a. high/ low
TEE offers superior imaging over transthoracic echo because it has _______ than most TTE transducers. a. higher frequency range b. increased attenuation c. lower resolution transducer d. lower risk of complication
a. higher frequency range
the _____ is another name for the right ventricular outflow tract a. infundibulum b. moderator band c. trabeculations d. tricuspid apparatus
a. infundibulum
The mitral inflow E wave deceleration time must be measured from the peak E wave all the way down to the baseline because _________ a. it is a measurement of time, not slope b. the E/ e ratio is acquired by retuning to the baseline c. E to A ratio is acquired by returing to the baseline d. E to A time is a diastolic parameter
a. it is a measurement of time, not slope
Typically, the first view acquired is the __________ a. parasternal long axis of the left ventricle ( LAX LV ) b. parasternal long axis of the right ventricular inflow tract (LAX RVIT) c. parasternal long acis of the right ventricular outflow tract ( LAX RVOT) d. zoom the mitral valve and aortic calve
a. parasternal long axis of the left ventricle ( LAX LV )
The entire TEE team is responsible for ________ a. patient education b. gathering materials c. inspecting TEE probe d. ultrasound unit operation
a. patient education
The E-wave peak velocity_____ a. represents the early diastolic LA- LV pressure gradient b. increase with age c. is not affected by changes in LV relaxation d. is equal to the pulmonary vein "a" wave peak velocity
a. represents the early diastolic LA- LV pressure gradient
According to the Intersocietal Accreditation Commission (IAC), the non-imaging CWD probe must be utilized in the assessment of AS from multiple locations, to include the apex, suprasternal notch, and right parasternal border. a. true b. false
a. true
Acquire the end-diastolic and end-systolic left ventricular dimensions. a. true b. false
a. true
Before heading out to the unit for a bedside TEE exam, sonographer needs to collect additional equipment, such as consent form, oropharyngeal anesthesia, bite block, tongue blade, and supplies for a bubble study. a. true b. false
a. true
Doppler echo utilizes ultrasound to record the velocity and direction of the blood flow. a. true b. false
a. true
PWD of the pulmonary venous flow should be acquired ______ a. 3-4 cm into the right or left upper pulmonary vein b. with a decreased sweep speed of 25 mm/s c. with a large sample size of 3-4 cm d. With a small PWD gate, 1-2 cm into the pulmonary vein
With a small PWD gate, 1-2 cm into the pulmonary vein
A normal IVS: PWT ratio = 1.3 : 1 a. true b. false
b. false
Cardiac output=___ a. CI/ BSA B. (EDV-ESV) x HR c. (ESV - EDV) x HR d. SV x CI
B. (EDV-ESV) x HR
Which equation is accurate? A. EF = CO - SV B. EF = [ LVIDd^2 - LVIDs^2 / LVIDd^2] C. EF= [ LVIDV - LVISV/ LVISV ] D. EF= [LVIDV - LVISV/ LVIDV] X 100
D. EF= [LVIDV - LVISV/ LVIDV] X 100
The CFD appearance is based on ___: A. 2D image quality B. blood flow velocity C. color map D. all of the above
D. all of the above
Typically, the transducer is oriented toward the patient's left shoulder during the _______ a. 3C b. LAX LV c. LAX RVIT d. SAX
SAX
The pulmonic valve "a" wave normally equals ________ a. 2.7 mm b. 27 mm c. .27 cm d. 2.7 cm
a. 2.7 mm
E/e' (e prime) ratio ______ a. < 8 usually predicts normal LV filling pressure b. < 14 indicates increased LV filling pressure c. is normally 13-15 d. should not be a mirror image of the mitral inflow
a. < 8 usually predicts normal LV filling pressure
The bulbus cordis can be divided into three parts: the proximal bulbus cordis, conus cordis, and truncus arteriosus. Collectively, they form the a. Apical portion of the right ventricle, ventricular outflow tracts, aorta, pulmonary artery b. descending aorta, left ventricular apex, atrioventricular valves c. left and right pulmonary artery branches, semilunar valves, ventricular outflow tracts d. right and left ventricular inflow tracts, body of the right ventricle, descending aorta
a. Apical portion of the right ventricle, ventricular outflow tracts, aorta, pulmonary artery
What similarities do PWD and CWD share? a. Both are steerable and superimposed on the 2D image b. both have range ambiguity and aliasing when velocity is >2 m/s c. size of doppler gate d. image on the screen
a. Both are steerable and superimposed on the 2D image
the T wave represents a. electrical ventricular diastole or repolarization b. electrical ventricular systole or depolarization c. mechanical isovolumic contraction time d. mechanical ventricular diastole
a. electrical ventricular diastole or repolarization
within the atrioventricular canal, the __ grows and fuse until ultimately the atrioventricular canal is divided and the atrio ventricular valves are formed. a. endocardial cushion b. septum secundum c. sinus venosus d. ventricular bulbar foramen
a. endocardial cushion
From the 5C, the aortic regurgitation CWD waveform is ______ baseline a. above b. below
a. above
List the anatomical order of the mitral valve apparatus a. annulus fibrosus/ leaflets/ chordae tendineae/ antero-lateral papillary muscle & postero-medial /papillary muscle/ left ventricular walls b. annulus fibrosus/ leaflets / papillar muscle/ chordae tendineae/ left ventricular walls c. annulus fibrosus/ papillary muscles/ chordae tendieneae/ left ventricular wall & postero-medial left ventricular wall d. annulus fibrosus. valvular leasflets/ antero-lateral left ventricular wall & postero- medial left ventricular wall/ chordae tendineae
a. annulus fibrosus/ leaflets/ chordae tendineae/ antero-lateral papillary muscle & postero-medial /papillary muscle/ left ventricular walls
The 4C allows us to visualize the ________ wall and _______ wall. a. anterolateral and inferoseptal b. anteroseptal and inferoseptal c. inferior and anterior d. inferolateral and anteroseptal
a. anterolateral and inferoseptal
during systole, there is significant pressure difference across the atrioventricular valves, what is the result a. atrioventricular valves remain closed b. Atrioventricular valves remain open c. blood never flows through a closed valve d. no effect on the atrioventricular valves
a. atrioventricular valves remain closed
the ___ prevents an excessive number of atrial impulses from entering the ventricle and allows atrial systole to reach completion before ventricular systole begins a. av node b. bachmanns bundle c. internodal tracts d. sa node
a. av node
Arteries carry blood ____ the heart while veins carry blood _____ the heart a. away from/toward b. quickly to/slowly from c. toward/ away from d. without oxygen/ with oxygen
a. away from/toward
______ is the arterial pressure exerted on the walls of the systemic circulatory system a. blood pressure b. pulmonary artery pressure c. pulmonary capillary wedge pressure d. systemic circulatory system
a. blood pressure
The ___ is/are directly involved with the rotation and division of the truncus arteriosus a. bulbar ridges b. membranous c. muscular d. outlet
a. bulbar ridges
___ doppler is superimposed, steerable, and measures any velocity making it ideal for performing valve calculations. a. continuous wave b. high- pulsed repetition frequency c. PEDOF d. Plused wave
a. continuous wave
In order to achieve real-time, continuous movement, _____________. a. decreases the depth b. do not utilize the zoom feature c. utilize the largest field of vision possible d. utilize the lowest frame rate possible
a. decreases the depth
the QRS complex represents ____ and is normally_____ seconds a. depolarization / <0.12 b. depolarization / > 0.12 c. mechanical artial systole / > 0.12 d. mechanical ventricular diastole / <12
a. depolarization / <0.12
The indicator that travel down the side of the 2D image represent ___ and each indicator is equal to ___ centimeter. a. depth/ one b. gray scale/ one c. heart structure/ one d. time/ one
a. depth/ one
The majority of the blood in the umbilical vein is dumped into the ___ which connects directly to the IVC a. ductus venosus b. inferior vena cava c. portal system d. superior vena cava
a. ductus venosus
Echo windows are determined by the patient's physique and sometimes the sonographer needed to practice flexibility and patience in order to find the proper window. a. true b. false
a. true
If the patient has a central venous line, use the central venous pressure for the right atrial pressure value in the RVSP/SPAP equation. a. true b. false
a. true
In patients with reduced LVEF, the MV inflow pattern can usually predict elevated left atrial pressure. a. true b. false
a. true
Isovolumic relaxation time begins as soon as mechanical ventricular systole ends a. true b. false
a. true
M-mode is utilized for timing events of the cardiac cycle. a. true b. false
a. true
M-mode produces an ice pick image of the heart and displays it in the form of a time / depth graph. a. true b. false
a. true
Normally, pulsed wave tissue Doppler imaging of the mitral annulus is a mirror image of the mitral inflow waveform. a. true b. false
a. true
Patients who receive conscious sedation require recovery time until awake, alert, gag reflex returns and vitals are stable. a. true b. false
a. true
TAPSE < 17 mm indicates decreased right ventricular function. a. true b. false
a. true
TEE is used as a guide in several situations, such as a transeptal procedure in the cath lab. a. true b. false
a. true
TEE places the patient at an increased risk for complications, such as esophageal trauma/perforation, hoarseness, respiratory distress, sore throat, and dental injuries. a. true b. false
a. true
The 2C and 4C are use to acquire the Biplane Method of Dic Summation measurements. a. true b. false
a. true
The RV is no more then two-thirds the size of the LV, possesses trabeculations, and sometimes a prominent moderator band is noted. a. true b. false
a. true
The SAX is an important view because it is the only view that demonstrates all of the LV walls simultaneously. a. true b. false
a. true
The TEE probe has a flexible, controllable shaft with small, electronically steered ultrasound transducer mounted at the distal tip of the shaft. a. true b. false
a. true
The Valsalva maneuver can unmask abnormal mitral inflow in the presence of a pseudonormal mitral inflow pattern. a. true b. false
a. true
The normal LAVi is 16-34 mL/m^2 a. true b. false
a. true
The normal RV wall thickness is 1-5 mm and often best measured from the subcostal 4C. True or false?
a. true
The pulmonary vein S-wave decreases and the D-wave increases when the left atrial pressure increases and left atrial compliance decrease. a. true b. false
a. true
The pulmonary venous outflow into the left atrium is dependent upon the pressure difference between the pulmonary veins and the left atrium. a. true b. false
a. true
The right atrium acts as a reservoir for systemic venous return and assists in right ventricular filling. a. true b. false
a. true
The suprasternal notch is at the base of the neck, just superior to the sternum. a. true b. false
a. true
The umbilical vein is the only vessel to carry enriched blood that has not mixed with depleted blood. a. true b. false
a. true
Tissue Doppler imaging of the mitral annular motion measures the velocity of myocardial movement toward the Doppler cursor as it passes through the sample gate. a. true b. false
a. true
Transnasal echo is useful in those who need continuous visualization of the left ventricle such as those who are critically ill, intubated or post-op. a. true b. false
a. true
When the beam reaches half of its original diameter, the focus is reached; and then beyond that, the far field offers the best resolution. a. true b. false
a. true
While in the operating room, TEE offers vital information pertaining to the ventricular function coming off of cadiopulmonary bypass. a. true b. false
a. true
flow travels from high pressure to low pressure a. true b. false
a. true
left ventricular pressure peaks during mechanical ventricular systole a. true b. false
a. true
mechanical ventricular systole begins as soon as isovolumic contraction time ends a. true b. false
a. true
the left atrial appendage acts as a decompression chamber and is directly affected by the left ventricular function a. true b. false
a. true
the left cornary artery divides into the left anterior descending artery and left circumflex artery. the right coronary artery divides into the acute marginal artery and posterior descending artery. a. true b. false
a. true
the nodules of Arantius are located in the center of the free edge of each cusp, they ensure complete closure of the aortic valve a. true b. false
a. true
the normal mitral valve orifice is 4-8 cm^2 and the normal mitral valve velocity is >2.0 m/s a. true b. false
a. true
the tricuspid valve is the largest cardiac valve with a normal velocity of 0.3- 0.7 m/s and a normal valve orifice of 7-9cm^2 a. true b. false
a. true
while the left atrium is filling and increasing its pressure , the left ventricle is emptying and decreasing its pressure: eventually the left atrial pressure exceeds the left ventricular pressure and the mitral valve opens a. true b. false
a. true
TAPSE is a ____ a) a measure of the peak diastolic longitudinal motion of the TV annular motion b) a simple but good estimate of RV global function c) not angle dependent d) not load dependent
b) a simple but good estimate of RV global function
a normal R-R interval is approx. equal to_- a. <3 small boxes b. 3-5 large boxes c. 3-5 seconds d. 3-5 small boxes
b. 3-5 large boxes
In the adult, normal oxygen saturation in the right hear is ___% and normal oxygen saturation in the left heart is ___% a. 60/ 100 b. 75/ 98 c. 98/ 75 d. 100/60
b. 75/ 98
From a surgical perspective , mitral valve functional abnormalities can occur at _____. a. AMVL, PMVL, antero-lateral commissure, postero-medial commissure, antero-lateral papillary muscle, postero-medial papillary muscle, antero-lateral wall, postero-medial wall b. P1,P2,P3, A1,A2,A3 , antero-lateral commissure, postero-medial commissure c. P1,P2P,P3, A1,A2,A3, antero-lateral papillary muscle, postero-medial papillary muscle d. P1,P2,P3,A1,A2,A3,A4
b. P1,P2,P3, A1,A2,A3 , antero-lateral commissure, postero-medial commissure
Acquire the IVC diameter and inspiratory collapse to complete the _____ calculation. a. aortic stenosis b. RVSP/ SPAP c. pulmonic stenosis d. tricuspid stenosis
b. RVSP/ SPAP
Depleted blood returns to the heart via the a. aorta b. Supeior vena cava c. umbilical arteries d. umbilical vein
b. Supeior vena cava
where/when is the largest normal pressure gradient within the heart a. across the aortic valve during diastole b. across the mitral valve during systole c. across the pulmonic valve during diastole d. across the tricuspid valve during during systole
b. across the mitral valve during systole
blood travels from the aorta to the ____ a. arterioles, arteries, venules, veins b. arteries, arterioles, capillaries, venules, veins c. capillaries, arterioles, venules, veins d. veins, venules, capillaries, arteries, arterioles
b. arteries, arterioles, capillaries, venules, veins
the atrioventricular valves are located between the _____ while the semilunar valves are located between the _____ a. arteries and veins/ ventricles and great vessels b. atria and ventricles/ ventricles and great vessels c. ventricles and great vessels / arteries and veins d. ventricles and great vessels / atria and ventricles
b. atria and ventricles/ ventricles and great vessels
The interventricular sulcus divides the primitive ventricle and a. apical portion of the ventricles b. bulbus cordis c. outflow tract of the right ventricle d. primitive atrium
b. bulbus cordis
____ are responsible for the exchange of nutrients and oxygen with the tissues a. arterioles b. capillaries c. lungs d. venules
b. capillaries
the rate of contration is the a. cardaic output b. chronotropic foce c. inotropic force d. stroke volume
b. chronotropic foce
at 21-23 days, the heart tube is connected to the ___ at the cephalic end and the __ at the caudal end of the embryo. a. bulbus cordis/ sinus venous b. developing aortic arch system/ sinus venosus c. primitive atrium/ primitive ventricle d. sinus venous/ truncus atreriosus
b. developing aortic arch system/ sinus venosus
Increased LAVi predicts patient outcome, usually reflects increased LAP, and is a sign of _______ a. cumulative effect of decreased LV filling pressure b. diastolic dysfunction c. nothin, it is not very accurate d. right atrial pressure severity and chronicity
b. diastolic dysfunction
the EKG detects and records the ___ activity of the heart a. abnormal b. electrical c. mechanical d. normal
b. electrical
the P wave represents a. depolarization b. electrical atrial systole c. electrical ventricular diastole d. mechanical ventricular systole
b. electrical atrial systole
the largest volume in the heart during the cardiac cycle is know as the ___ A. early-diastolic volume b. end-diastolic volume c. end- systolic volume d. rapid early filling
b. end-diastolic volume
what is the sequence of repolarization a. bundle branches to bundle of his b. epicardium to endocardium c. endocardium to epicardium d. myocardium to bundle branches
b. epicardium to endocardium
A good place to start searching for the apical window is at the left sternal border in the 4th intercostal space. a. true b. false
b. false
Acquire the peak TRV from all available views, the calculate the RV diastolic pressure (RVDP). a. true b. false
b. false
Aortic sclerosis always leads to aortic stenosis. a. true b. false
b. false
Continuous wave doppler detects flow from a specific sample volume. a. true b. false
b. false
In order to locate the LAX RVIT, angle the transducer more lateral and superior from the LAX LV. a. true b. false
b. false
M-mode dimensions are recommended over 2D dimensions to avoid capturing oblique angles of the ventricle. a. true b. false
b. false
M-mode produces a two-dimensional graph if the heart. a. true b. false
b. false
Mitral valve planimetry has a low correlation with the anatomical MVA. a. true b. false
b. false
Normal, viable chambers concentrically increase in size during systole a. true b. false
b. false
RV dilatation is reported if the basal diameter is < 41 mm and the mid diameter is < 35 mm. a. true b. false
b. false
The 3C RVIT is very useful view that frequently provides an excellent Doppler angle of the PV. a. true b. false
b. false
The ASE recommends M-mode dimensions, not 2D dimensions. a. true b. false
b. false
The IVC diastolic diameter is best measured from the suprasternal window. a. true b. false
b. false
The LVAi via the Biplane Method of Disks is acquired via LA planimetry of LAX and 4C. a. true b. false
b. false
The TEE probe is an excellent tool to rule out cardiac source of embolus because of its decreased resolution and multiple scanning planes. a. true b. false
b. false
The best 2D image is produced when the transducer is parallel to the structure being examined. a. true b. false
b. false
The interventricular septum stops growing once the atrial walls are no longer expanding a. True b. false
b. false
The left ventricular systolic and diastolic dimensions should be acquired mid chamber at the level of the papillary muscles. a. true b. false
b. false
The majority of the enriched blood that enters the right atrium passes on to the right ventricle and pulmonary artery a. true b. false
b. false
The only way to determine timing of the cardiac cycle is with the EKG A. true b. false
b. false
The right ventricle is the mist anterior chamber, trabeculated, and is larger and more triangular than the left ventricle. a. true b. false
b. false
True or false Prior to week 3, the heart consists of a pair of tubes situated on either side of the midline toward the caudal end of the embryo. a. true b. false
b. false
When the transducer is angled more anterior from the 5C, the 4C is visualized. a. true b. false
b. false
While acquiring the diastolic function parameters, such as the mitral inflow, it is advise that the Doppler sweep speed be decreased from 50 mm/s to 25 mm/s a. true b. false
b. false
a loss of ventricular pressure at the end of diastole allows the semilunar valves to close a. true b. false
b. false
atrial kick completes ventricular emptying, it also creates the fourth heart sound. a. true b. false
b. false
isovolumic contraction time ends as soon as the pressure in the ventricles exceeds the pressure in the atria a. true b. false
b. false
mechanical systole occurs just prior to electrical systole, also known as mechanical-electrical delay a. true b. false
b. false
mechanical ventricular diastole ends once the ventricular pressure exceeds the atrial pressure and the AV valves open a. true b. false
b. false
normally, the atria contract before the ventricles and the ventricles contract from the base to the apex a. true b. false
b. false
once the ventricular pressure exceeds the great vessel pressure, the atrioventricular valves open a. true b. false
b. false
the T wave coincides with electrical atrial systole a. true b. false
b. false
the chiari network is a normal embryologic remnant in the left atrium that appears as a mobile, thin membrane with a whip - like motion, near the entrance of the inferior vena cava a. true b. false
b. false
If the transducer is placed too high during the apical views, ___ may result. a. false postive mitral valve prolapse b. foreshortening c. ablong image of the heart d. pericardial effusion
b. foreshortening
____ increase afterload a. atrial septal defect b. hypertension c. mitral regurgitation d. pulmonic regurgitation
b. hypertension
If the patient has LVEF: e' (lateral wall) = 6 cm/s E/e' (lateral wall)= 12 LAVi = 36 mL/m^2 and peak TRV is 2.7 m/s report _______ a. abnormal diastolic function b. inconclusive diastolic function c. insufficient data d. normal diastolic function
b. inconclusive diastolic function
the sympathetic nervous system _____ the heart rate as part of the fight or flight response, while the parasympathetic nervous system____ the heart rate via the vagus nerve a. decrease/ increase b. increase/ decrease
b. increase/ decrease
the apex is positioned ______ a. anterior, rotates inferior, with a rightward direction b. inferior, rotates interior, with a leftward direction c. superior, rotates posterior, with a rightward direction d. superior, rotates inferior, with a leftward direction
b. inferior, rotates interior, with a leftward direction
The sonographer's duties during a TEE exam include ______ a. administer conscious sedation b. inspected the shaft of the TEE probe for cracks, tears and signs of damage c. operate the TEE probe during the exam d. start the IV
b. inspected the shaft of the TEE probe for cracks, tears and signs of damage
the force of contraction is the a. chronotropic force b. intropic force c. length- tension relationship d. preload
b. intropic force
during___ all four valves are closed and the ventricular pressure increases a. diastole b. isovolumic contraction c. isovolumic relaxation d. systole
b. isovolumic contraction
Left ventricular outflow tract obstruction (LVOTO) typically has a ______ a. early peaking dagger shape systolic jet b. late peaking systolic jet c. rounded, high velocity waveform because there is increased velocity d. very low velocity waveform because there is decreased flow
b. late peaking systolic jet
the aortic arch branches include the brachiocephalic artery, left common carotid artery and _____ a. innominate artery b. left subclavian artery c. ligamentum arteriosum d. right common carotid artery
b. left subclavian artery
End diastole is captured when the _________ a. aortic valve just opened b. left ventricle is at it largest dimensions c. left ventricle is at the smallest dimensions d. mitral valve just opened
b. left ventricle is at it largest dimensions
the normal mean left atrial pressure is comparable to the __ a. aorta systolic pressure b. left ventricular diastolic pressure c. pulmonary artery systolic pressure d. all of above
b. left ventricular diastolic pressure
During the contrast bubble study, the mircobubbles are seen as they enter the right heart and a negative contrast area is immediately detected in the right ventricle; what is the most likely the diagnosis? a. abscess of the interventricular septum b. left-to- right ventricular shunt c. right-to-left ventricular shunt d. tricuspid regurgitation
b. left-to- right ventricular shunt
The remnant of the ductus arteriosus is called the a. fossa ovalis b. ligamentum arteriosum c. ligamentum venosum d. patent ducts arteriosus
b. ligamentum arteriosum
The Cardiologist's duties during the TEE exam include _______ a. clean and disinfect the probe post exam b. manipulate the probe and acquire the windows and views c. operate the suction device d. operate the ultrasound unit during the exam
b. manipulate the probe and acquire the windows and views
The ___ interventricular septum forms where the secondary interventricular foramen was once located a. inlet b. membranous c. muscular d. outlet
b. membranous
What is an example of a TEE window? a. inferior esopageal b. midesophageal c. mid-gastric d. upper transthoracic
b. midesophageal
increase preload a. aortic stenosis b. mitral regurgitation c. pulmonary hypertension d. pulmonic stenosis
b. mitral regurgitation
choose the statement that best describes the right ventricle a. large, muscular pumping chamber b. most anterior chamber in the heart c. most posterior chamber in the heart d. normal right ventricular systolic pressure= mean right atrial pressure
b. most anterior chamber in the heart
The _______ TEE probe is utilized in most labs today. a. biplane b. multiplane c. single plane d. transnasal
b. multiplane
during early diastole, there is a small pressure difference in the diastolic pressures across the atrioventricular valves, what is the result a. blood can flow from low pressure to high pressure b. passive filling from the atria into the ventricles c. valves are forced closed d. valves are forced open
b. passive filling from the atria into the ventricles
While performing an echo on a premature baby, what two findings are to be expected? a. patent duct arteriosus and atrial septal defect b. patent ductus arteriosus and patent foramen ovale c. patent foramen ovale and atrial septal defect d. patent foramen ovale and ventricular septal defect
b. patent ductus arteriosus and patent foramen ovale
The PEDOF probe is a non-imaging probe; therefore, the sonographer must rely on the ___. a. placement of the cursor on the 2D image b. position and angle of the probe and waveform in comparison to the EKG c. size of the doppler gate d. image on the screen
b. position and angle of the probe and waveform in comparison to the EKG
in the embryo, the left ventricle communicates with the right ventricle via a. foramen ovale and ventricular bulbar foramen b. primary interventricular foramen and secondary interventricular foramen c. secondary ventricular foramen and trabecular interventricular septum d. ventricular septal defect and foramen ovale
b. primary interventricular foramen and secondary interventricular foramen
Persistent feral circulation is the result of a. hypertension and persistent left to tight shunting across PFO and PDA b. pulmonary hypertension and persistent right to left shunting across the PFO and PDA c. pulmonary hypertension and systemic hypertension d. systemic hypertension, fossa ovalis and ductus venosum
b. pulmonary hypertension and persistent right to left shunting across the PFO and PDA
In most labs, flow traveling toward the transducer is ___, and flow traveling away from the transducer is ___ a. blue/ red b. red/blue
b. red/blue
By the end of week ___, the major development of the heart is complete a. three b. seven c. ten d. thirteen
b. seven
one large box on the EKG paper represents a. 0.02 seconds b. 0.04 seconds c. 0.2 seconds d. 0.4 seconds
c. 0.2 seconds
the new American Heart Association BP guidelines state that State 1 hypertension= ____ mmHg a. <120/80 b. 120- 140 / <80 c. 130-139 / 80-89 d. 140+ / 90+
c. 130-139 / 80-89
A peak velocity > ______ indicates aortic stenosis, and the peak velocity mean pressure gradient and aortic valve area should be acquired. a. 1 m/s b. 1.7 m/s c. 2.6 m/s d. 26 m/s
c. 2.6 m/s
The normal left ventricular internal dimension diastole for women is ________ a. 3.78 - 5.82 mm b. 21.6 - 34.8 mm c. 37.8 - 52.2 mm d. 42.0 - 58.4 mm
c. 37.8 - 52.2 mm
The umbilical artery O2 sat is approx a. 38% b. 48% c. 58% d.69%
c. 58%
The normal left ventricular diastolic wall thickness is _______ a. 0.6 - 1.2 cm ( women) b. 6- 12 mm ( women) c. 6 - 10 mm (men) d. 1.0 - 1.3 mm ( men)
c. 6 - 10 mm (men)
pulmonary artery pressure ____ mmHg at rest signifies pulmonary hypertension a. > 2-8 b. >15 c. >25 d. >30
c. >25
The mitral inflow provides critical information pertaining to diastolic function, to include ______ a. a wave decleration time b. e peak velocity c. E to A ratio d. E wave duration
c. E to A ratio
Correct order of flow a. aorta, common iliac arteries, umbilical arteries, placenta, internal iliac arteries b. placenta, portal system, umbilical vein, inferior vena cava, ductus venosus, right atrium c. Right atrium, foramen ovale, left atrium, left ventricle, aorta d. right atrium, right ventricle, aorta, ductus arteriosus, pulmonary
c. Right atrium, foramen ovale, left atrium, left ventricle, aorta
The diastolic function parameters include ______ a. CWD of the mitral inflow b. CWD of the pulmonary venous inflow c. TDI of the mitral annular motion d. LA linear dimensioin
c. TDI of the mitral annular motion
each aortic valve cusp is associated with a. aortic root b. ascending aorta c. a sinus of valsava d. coronary veins
c. a sinus of valsava
The _______ and _______ tricuspid valve leaflets are visualized in the LAX RVIT a. anterior/ inferior b. anterior/ medial c. anterior/posterior d. medial/ posterior
c. anterior/posterior
what is the sequence of depolarization a. bundle branches to bundle of his b. epicardium to endocardium and apex to base c. endocardium to epicardium and apex to base d. endocardium to epicardium and base to apex
c. endocardium to epicardium and apex to base
List the heart wall sequence from the inner layer to the outer layer a. endocardium, fibrous pericardium, myocardium, pericardial space b. endocardium, myocardium, fibrous pericardium, serous pericardium c. endocardium, myocardium, serous pericardium, fibrous pericardium d. myocardium, fibrous pericardium, parietal layer, endocardium
c. endocardium, myocardium, serous pericardium, fibrous pericardium
the ___ is the normal embryologic remnant at the junction of the inferior vena vaca and the right atrium a. atrial septal defect b. ductus arteriosum c. eustachian valve d. pantent ducts arteriosus
c. eustachian valve
Ultimately, the left ___ aortic arch forms the definitive aortic arch. a. first b. third c. fourth d. sixth
c. fourth
Usually, the best parasternal views are acquired when the patient is positioned __________ a. at a 45- degree angle b. flat on their back c. in the left lateral decubitus d. in the right lateral decubitus
c. in the left lateral decubitus
What causes the foramen ovale to close? a. decreased left atrial pressure b. decreased right atrial pressure c. increased left atrial pressure d. increased right atrial pressure
c. increased left atrial pressure
the base of the heart is positioned___ a. inferior, rotates inferior, with a rightward direction b. inferior, rotates anterior, with a leftward direction c. inferior, rotates posterior, with a rightward direction d. superior, rotates inferior, with a leftward direction
c. inferior, rotates posterior, with a rightward direction
____ is the longer the interval between heartbeats, the stronger the contraction required to pump the blood out a. force-velocity relationship b. frank-starling law c. interval-strength relationship d. left ventricular end diastolic pressure
c. interval-strength relationship
the great cardiac vein travels along the ______ collects blood from the anterior myocardium and drains into the coronary sinus a. anterior cardiac veins b. circumflex artery c. left anterior descending artery d. left main artery
c. left anterior descending artery
Choose the statement that best describes the left ventricular a. normal left ventricular diastolic pressure = aortic systolic pressure b. left ventricular chamber dimension never varies with the cardiac cycle c. left ventricular outflow tract consists of AMVL, IVS and Lv free wall d. left ventricular pressure is apprx 3 times greater than the right pressure
c. left ventricular outflow tract consists of AMVL, IVS and Lv free wall
choose the statement that best describes the intracardiac pressures a. mean left atrial pressure= left ventricular end systolic pressure b. left ventricular end diastolic pressure= systemic arterial pressure c. mean right atrial pressure= right ventricular end diastolic pressure d. right ventricular diastolic pressure= systolic pulmonic artery pressure
c. mean right atrial pressure= right ventricular end diastolic pressure
The trabecular interventricular septum is known as the ___ in the adult heart a. inlet interventricular septum b. membranous septum c. muscular septum d. oulet interventricular septum
c. muscular septum
In the LAX, one can differentiate between the coronary sinus and descending aorta because the coronary sinus is seen within the ______; whereas the aorta is a separate structure posterior to the left atrium a. endocardium b. left atrium c. myocardium d. pericardium
c. myocardium
the _____ is the main pumping mechanism of the heart a. endocardium b. epicardium c. myocardium d. pericardium
c. myocardium
choose the statement that best describes the pulmonic valve a. has four pocket-like cusps: anterior, posterior(right and left). and inferior b. normal peak velocity is >2 m/s c. normal pulmonic valve velocity < normal aortic valve velocity d. RV pumps oxygenated blood through the PV and PA
c. normal pulmonic valve velocity < normal aortic valve velocity
Perforations develop in the septum primum resulting in the __ a. foramen ovale b. ostium primum c. ostium secundum d. ventricular bulbar foramen
c. ostium secundum
If the patient presents with a neurological event due to embolus, and a right-to-left shunt is present during the bubble study, one can assume the patent had a deep vein thrombosis with _________. a. infective endocarditis b. left atrial appendage clot c. paradoxical embolism d. ventricular clot at apex
c. paradoxical embolism
Utilize the LAX AO to measure the _______ dimensions a. end-systolic proximal AAO b. end - systolic sinuses of valsalva c. peak- systolic AOV annulus d. peak - systolic sinotubular junction
c. peak- systolic AOV annulus
the heart is enclosed in the ____ , a fluid filled sac that protects it against infection and trauma a. myocardium b. pericardial effusion c. pericardium d. thoracic cavity
c. pericardium
the volume of blood in the heart at end-distole is the ___ a. afterload b. blood pressure c. preload d. resistance
c. preload
The left and right ventricles are the result of trabecular expansions from two chambers within the bulboventricular loop, what are they? a. atrioventricular canal and primitive ventricle b. bulbus cordis and truncus arteriosus c. primitive ventricle and bulbus cordis d. truncus arteriosus and primitive atrium
c. primitive ventricle and bulbus cordis
the right heart is associated with the ______ and the left heart us associated with the _____ a. arterial system/venous system b. oxygenated blood/deoxygenated blood c. pulmonary circulation system/systemic circulatory system d. systemic circulatory system/pulmonary circulatory system
c. pulmonary circulation system/systemic circulatory system
Aliasing occurs when the velocity is > 2 m/s while using ___ doppler. a. contiuous wave b. PEDOF c. pulsed d. spectral
c. pulsed
During early diastole, the left ventricular pressure is at its lowest and the ventricles experience ______. a. decrease filling b. decreased pressure c. rapid filling d. second heart sound
c. rapid filling
___ increase the venous return, stroke volume and cardiac output a. bearing down Valsalva, inspiration and squatting b. expiration, inspiration, squatting and bearing down c. releasing after valsalva, inspiration and squatting d. standing, expiration, squatting and amyl nitrite inhalation
c. releasing after valsalva, inspiration and squatting
The primitive atrium will divide into the a. apical portion of the right ventricle b. apical portion of the left ventricle c. right and left atria d. right and left ventricles
c. right and left atria
While estimating the RVSP from the peak TRV, the IVC diameter and inspiratory collapse are used to estimate the ______ a. left atrial pressure b.LVEDP c. right atrial pressure d. right ventricular diastolic pressure
c. right atrial pressure
The omniplane TEE probe's array rotation button permits the Cardiologist to _______. a. angle the distal tip right and left b. flex and retroflex the distal tip of the probe c. rotate the ultrasound beam from 0 to 180 degrees d. switch between planes with the two connectors
c. rotate the ultrasound beam from 0 to 180 degrees
Acquire the peak TRV and calculate the ______ a. diastolic pulmonary artery pressure b. pulmonary vein pressure c. systolic pulmonary artery pressure d. tricuspid pressure half- time
c. systolic pulmonary artery pressure
The ____________ transmits and receives ultrasound pulses that collide with structures, such as the heart walls and valves. a. matching layer b. near field c. transducer d. ultrasound unit monitor
c. transducer
ultrasound is a sound wave with a frequency of greater than a. 20 Hertz b. 200 Hertz c. 2,000 Hertz d. 20,000 Hertz
d. 20,000 Hertz
Approx ___ % of the popculation have a right dominant coronary artery system a. 7 b.8 c.58 d. 85
d. 85
___ doppler is used to measure blood flow from a specific site that is < 2 m/s. a. continuous wave b. high- pulsed repetition frequency c. PEDOF d. Plused wave
d. Plused wave
TEE is recommended for _______ a. Technically limited patients b. Trauma patients c. Valve repair/replacement d. all of above
d. all of above
Ultimately, the sinus venosus forms the _____ a. posterior portions of the atria b. pulmonary veins c. superior and inferior vena cava d. all of above
d. all of above
systolic and diastolic function are dependent upon ____ a. wall thickening and motion b. chamber size c. left ventricular end diastolic pressure d. all of above
d. all of above
the right atrium receives deoxygenated blood from the ___ a. coronary sinus b. inferior vena cava c. superior vena cava d. all of above
d. all of above
The right atrial single plane area-length volume is _______ a. Acquired from the 4C with emphasis on the right heart b. Includes the RA area via planimetry c. Includes the RA major dimension d. all of the above
d. all of the above
transthoracic echocardiogram is an ___ a. non- invasive study that allows us to examine the heart, valves, and great vessels b. relative quickly and reliable exam c. ultrasound of the heart d. all of the above
d. all of the above
another name for decreased wall motion is ____ wall motion a. akinetic b .dyskinetiic c. hyperkinectic d. hypokinetic
d. hypokinetic
The main pulmonary artery _____ a. gives rise to the coronary arteries b. is best visualized from the LAX RVIT c. is normally 4 cm wide x 6 cm long d. is normally smaller than the aorta
d. is normally smaller than the aorta
the aortic isthums is located between the ___ a. ascending aorta and aortic arch b. aortic arch and pulmonary artery c. brachiocephalic artery and left subclavian artery d. left subclavian artery and ligamentum arteriosum
d. left subclavian artery and ligamentum arteriosum
______ is the degree of fiber strech due to the quantity of blood in the chamber prior to contraction. a. force- velocity relationship b. frank-starling law c. interval-strength relationship d. left ventricular end diastolic pressure
d. left ventricular end diastolic pressure
If the patient has normal LVEF: TDI e' (lateral wall) = 15 cm/s E/e' (average lateral and septal wall) = 10 LAVi = 28 mL/m^2 peak TRV = 2.4 m/s report ______ a. abnormal diastolic function b. inclusive diastolic function c. insufficient data d. normal diastolic function
d. normal diastolic function
In the fetus, the ___ is responsible for the exchange of oxygen, carbon dioxide, nutrients, and waste products? a. kidney b. liver c. lungs d. placenta
d. placenta
the coronary sinus is positioned along the _____ a. anterior atrioventricular groove b. great cardiac vein c. middle cardiac vein d. posterior atrioventricular groove
d. posterior atrioventricular groove
The left atrium is the most _____ chamber to the heart, a reservoir for pulmonary venous return, and a contractile pump the delivers ____ of the left ventricular filling a. anterior/ 20-30% b. inferior/ 15-30% c. medial/ 22.5% d. posterior/ 15- 30%
d. posterior/ 15- 30%
fluid overload increases ____ and pressure overload increase_____ a. afterload/preload b. afterload / BP c. hyperyrophy/ dilation d. preload/ afterload
d. preload/ afterload
the heart ability to spontaneaously depolarize at periodic intervals without an external stimulus is known as the a. conduction system b. electrical-mechaical delay c. long refractory period d. property of automaticity
d. property of automaticity
According to the ASE, left ventricular diastolic dysfunction is usually the result of impaired LV ______ and increased LV chamber ______, which increase cardiac filling pressures. a. ejection fraction/ filling b. function/ size c. pressure/ volume d. relaxation/ stiffness
d. relaxation/ stiffness
the ___ is the primary pacemaker in the heart; it is located at the boarder of the a. av node/ superior vena cava and right atrium b. av node/ inferior vena cava, right atrium c. sa nose/ inferior vena cava and right atrium d. sa node/ superior ve cava and right atrium
d. sa node/ superior ve cava and right atrium
The interatrial septum is formed by the septum primum and septum secundum; a remnant of the ___ forms a flap at the level of the foramen ovale that controls the flow between the right atrium and left atrium a. left venous valve b. septum primum c. septum secundum d. septum spurium
d. septum spurium
The bubble study is performed during the TEE exam because of its ability to detect _____ a. endocarditis b. pericardial effusion c. regurgitation d. shunts
d. shunts
The sinus venosus and primitive atrium communicate via the a. foramen ovale b. ostium primum c. ostium scendum d. sinoatrial orifice
d. sinoatrial orifice
during___ the atrioventricular valses are closed, the semilunar valves are open and the blood is ejected into the aorta and pulmonary artery a. diastole b .isovolumic contraction c. isovolumic relation d. systole
d. systole
The primary right ventricular diastolic function parameters include _______ a. LAVi and LAP b. linear dimensions c. TDI of PV annulus d. tricuspid inflow E/A and DT
d. tricuspid inflow E/A and DT
Early in development, the __ is the only great vessel leaving the heart a. aorta truncus b. bulbus venosus c. pulomanry truncus d. truncus arteriosus
d. truncus arteriosus
