[05.07] Radiology of the Heart V2.pdf

Deoxygenated blood

What type of blood does the pulmonary artery carry to the lungs?

Oxygenated blood

What type of blood do the pulmonary veins carry back to the heart?

SVC and IVC

What two major vessels carry deoxygenated blood to the right atrium (RA)?

Right atrium (RA)

Which chamber receives deoxygenated blood from the SVC and IVC?

Tricuspid valve (TV)

Which valve does deoxygenated blood pass through to go from the RA to the right ventricle (RV)?

Right ventricle (RV)

Which chamber pumps blood through the pulmonary valve into the main pulmonary artery?

Pulmonary valve (PV)

Which valve does blood pass through from the RV to the pulmonary artery?

Right and left pulmonary arteries

What does the main pulmonary artery split into?

4 pulmonary veins (2 superior, 2 inferior)

How many pulmonary veins carry oxygenated blood back to the left atrium (LA)?

Left atrium (LA)

Which chamber receives oxygenated blood from the pulmonary veins?

Mitral valve (MV)

Which valve does oxygenated blood pass through from the LA to the left ventricle (LV)?

Left ventricle (LV)

Which chamber pumps oxygenated blood through the aortic valve into the aorta?

Aortic valve (AV)

Which valve does blood pass through from the LV into the aorta?

Aorta

What vessel carries oxygenated blood back into the body to oxygenate tissues?

All are tricuspid except the mitral valve

What is the general structure of the heart valves, with one exception?

Bicuspid

How many cusps does the mitral valve have?

Eustachian valve

What structure helps direct blood from systemic circulation into the patent foramen ovale during embryonic years?

Coronary sinus

What structure provides venous drainage of the coronary arteries?

Thebesian veins

What coronary vessels drain directly into the right atrium, bypassing the coronary sinus?

Tricuspid valve and Mitral valve

What two valves comprise the Atrioventricular (AV) Opening?

Vena cordis minimae

What small network of veins opens directly into the lumen of the left atrium?

Sulcus and Crista terminalis

What muscular ridges are present in the right atrium that serve as the junction for the sinus venosus?

Crista terminalis

What structure separates the atrium proper from the pulmonary atrial appendage?

Fossa Ovalis

What is the fetal remnant at the septum in the right atrium?

Remnant of the foramen secundum

What is the fetal remnant at the septum in the left atrium?

Musculi pectinati

What are the prominent muscular ridges along the walls of the right atrium?

Coarse and plentiful

How are the musculi pectinati described in the right atrium?

Finer and few

How are the musculi pectinati described in the left atrium?

Left ventricle

Which ventricular wall is thicker?

Right ventricle

Which ventricular wall is thinner?

Moderator band

What part of the electrical conducting system is seen only in the right ventricle?

Pulmonary infundibulum

What is the smooth area in the right ventricle called?

Aortic vestibule

What is the smooth area in the left ventricle called?

Crescentic

What is the shape of the right ventricle cavity?

Circular

What is the shape of the left ventricle cavity?

Chordae tendineae

What thin, cord-like structures connect the papillary muscles to the valves to prevent prolapse?

Right brachiocephalic artery, Left common carotid artery, Left subclavian artery

What are the three branches of the aorta, from right to left?

Plain radiograph (chest radiograph/chest film)

What is the most commonly requested and least costly diagnostic tool in radiology for cardiac evaluation?

Heart size and silhouette, Enlargement of cardiac chambers, Pulmonary blood flow/markings

What three crucial pieces of information are gathered from chest radiographs in cardiac evaluation?

Posteroanterior (PA) view

What is the basic chest projection used in plain radiography?

Dark (lucent/hypodense)

How does air appear on a plain radiograph?

White (hyperdense)

How do bone and metal implants appear on a plain radiograph?

Right atrium (RA)

What chamber does the blood empty into from the SVC and IVC?

Right ventricle

What chamber does not form a border of the heart on PA view?

Left ventricle (LV)

What chamber is border-forming on the PA view's left side?

Aortic knob, Main pulmonary trunk, Left ventricle (LV)

What three structures form the left cardiac border on PA view, from top to bottom?

SVC, RA, and IVC

What three structures form the right cardiac border on PA view?

Trachea

What structure bifurcates at the carina?

Left atrium (LA)

What chamber sits on top of the carina?

Retrosternal space

What area is normally very black on the lateral view, associated with the right ventricle?

Right ventricle (RV)

What chamber occupies the entire front of the heart on the lateral view?

Left atrium (LA)

What chamber forms the posterosuperior border of the heart on the lateral view?

Left ventricle (LV)

What chamber forms the posteroinferior border of the heart on the lateral view?

Right pulmonary artery

Which pulmonary artery is always lower than the other in the lateral view?

Aorta

What structure is often described as a "candy cane-like" appearance on the lateral view?

Cardiac-Thoracic (CT) ratio

What is the easiest and most widely used method for measuring cardiac size in radiology?

Widest transverse diameter of the heart divided by the widest transverse diameter of the thorax

How is the Cardio-Thoracic (CT) ratio calculated?

0.5 or less (up to 0.53 is allowed)

What is the normal CT ratio for adults?

Approximately 0.65

What is the approximate normal CT ratio for newborns?

Lateral bulging of the right heart border, or elongation of the right heart border exceeding 50% of the mediastinal cardiovascular shadow

What are the signs of Right Atrial (RA) enlargement on PA view?

The bulge of the right atrium exceeds the midline (bisection)

How is RA enlargement confirmed using the imaginary line method on PA view?

Rounding and upliftment of the cardiac apex

What is a sign of Right Ventricular (RV) enlargement on PA view?

Retrosternal fullness

What sign of RV enlargement is seen on the lateral view?

Contact of anterior cardiac border greater than ⅓ of the sternal length

How is retrosternal fullness defined in RV enlargement?

Double density sign

What sign of Left Atrial (LA) enlargement is seen on the PA view?

Enlarged left atrium appearing on the right side

What causes the "double density sign" in LA enlargement?

Upliftment of the left mainstem bronchus

What sign of LA enlargement is seen on PA view regarding the bronchus?

Widening of carina angle (>70 degrees, potentially 90 degrees)

What sign of LA enlargement is seen regarding the tracheal bifurcation?

Prominent posterosuperior cardiac border

What is a sign of LA enlargement on the lateral view?

Posterior displacement and upliftment of the left mainstem bronchus

What sign of LA enlargement is seen on the lateral view regarding the bronchus?

Lateral and downward displacement of the cardiac apex

What is a sign of Left Ventricular (LV) enlargement on PA view?

Posterior displacement of the posterior inferior border of the heart

What is a sign of LV enlargement on the lateral view?

Hoffman-Rigler sign

What sign measures the posterior displacement of the LV border on the lateral view?

Posterior border extends more than 1.8 cm of IVC

What constitutes a positive Hoffman-Rigler sign for LV enlargement?

Left ventricle (LV)

If there is downward displacement of the cardiac apex, which chamber is enlarged?

Right ventricle (RV)

If there is upward or uplifting displacement of the cardiac apex, which chamber is enlarged?

Inner lung zone

Which vertical lung zone has more vessels that are bigger and thicker in caliber?

Outer lung zone

Which vertical lung zone has little-to-no vessels present?

Lower lung zone

Which horizontal lung zone has bigger/thicker vessels due to blood pooling in the upright position?

Base (or Lower lung zone)

What part of the lung is thicker, has more parenchyma, and is a common site for hematogenous metastasis?

Shunts

What condition causes increased lung vascularity (hypervascularity)?

Cyanotic heart disease, pulmonary stenosis, tricuspid atresia, Ebstein anomaly

List two congenital heart diseases observed with decreased lung vascularity (hypovascularity).

Venous congestion

What pattern occurs when vascular structures or vessels seem to converge below the pulmonary arteries?

Mitral regurgitation

Venous congestion is seen in cases of what valve pathology?

Kerley A, Kerley B, Kerley C lines

What three specific lines are signs of venous congestion?

Veins

What pulmonary vessels are incorporated into the interstitium or parenchyma and can only be seen as they approach the left atrium?

Ionizing radiation

What type of radiation does a Cardiac CT scan use?

Black (hypodense)

How does air appear on a CT scan?

White (hyperdense)

How does bone appear on a CT scan?

Contrast

What substance must be administered to visualize cardiac structures or chambers on a CT scan?

Very white

How does contrast appear on a CT scan?

Left arm (upper extremity)

Where is contrast usually given to visualize the SVC in a CT scan?

Lower extremities

Where must contrast be injected to visualize the IVC in a CT scan?

Aortograms

What procedure is a CT scan very useful for, specifically looking for aneurysms of the aorta?

ECG-gated

What process is required when viewing coronary arteries closely with a CT scan due to heart movement?

Femoral vein

Where is contrast given in CT scans for infants?

Radio frequency signals and magnets

What does Cardiac MRI use to acquire images?

Black blood imaging

What MRI technology results in the heart and its contents (blood pool) appearing black?

Soft tissues

Black blood images are primarily used to examine what?