Echo Test 1 Study Guide

pericardium

thin sac that houses the heart and root and great vessels

epicardium

outer visceral layer

myocardium

middle muscles contract

endocardium

inner epithelial layer

order of pericardium layers outer to inner

1. fibrous

2. parietal

3. pericardial cavity

4. visceral

superior border of the heart

RA LA

inferior border of the heart

RV

right border of the heart

RA

left border of the heart

LV

anterior border of the heart

RV

posterior border of the heart

LA LV

LCA arises from

left coronary cusp

LAD follows

AV sulcus

LCX follows

coronary sulcus

RCA arises from

right coronary cusp at sinuses

RCA feeds

RA

RV

inf portion LV

portion of IVS

order of blood flow through the heart

1. SVC/IVC

2. RA

3. TV

4. RV

5. PV

6. PulmA

7. Lungs

8. PulmV

9. LA

10. MV

11. LV

12. Ao Valv

13. Ao

14. Body

suprasternal window

suprasternal notch

subcostal window

midline beneath costal margin

apical window

over cardiac window

parasternal window

over area bounded superiorly by left clavicle, medially by sternum, inferiorly by apical region

what does this represent?

atrial depolarization

what does this represent?

ventricular repolarization

what does this represent?

ventricular depolarization

what does this represent?

systole

what does this represent?

diastole

what does this represent?

iso contraction

what does this represent?

iso relax

what is happening to ventricular volume and pressure?

pressure increase

volume decrease

what is happening to ventricular volume and pressure?

pressure is stable

volume increase

which valve is closed during ventricular systole?

AV

Which valve is open after iso relax?

AV

during P wave the ventricles are in

mid-late diastole

during QRS the ventricles are in

systole

during T wave the ventricles are in

early diastole

During Systole the AV valves are ____ and Semilunar valves are _____.

closed, open

During Diastole the AV valves are ____ and Semilunar valves are _____.

closed, open

atrial depolarization is during which wave?

P

ventricular depolarization is during which wave?

QRS

ventricular repolarization is during which wave?

T

stroke volume

amount of blood ejected per beat

stroke volume formula

EDV - ESV

preload

stretch of the heart before it contracts

^ preload = ^ contraction during systole

afterload

the pressure that must be exceeded for LV contraction

contractility

the forcefulness of the contraction

common indications for an echo

enlarged heart, murmur, chest pain, heart failure, shortness of breath, TIA, A fib, Ao disease, Cardiac mass, pericardial disease, congenital heart disease, coronary artery disease

conduction system pathway

1. SA

2. AV

3. Bundle of HIS

4. right and left branches

5. purkinje fibers

SA node location

back of RA near entrance of SVC

AV node location

medial floor of RA

Bundle of HIS location

top of IVS

Purkinje Fibers stimulate

ventricular contraction that emerge from bundle branches and enter myocardium

AV node

delays impulse allowing for ventricular filling

SA node bpm

60-100

AV node bpm

40-60

normal sinus rhythm

60-100 bpm

Uniform shape with one wave in front of every QRS complex

bradycardia

less then 60 bpm

tachycardia

greater than 100 bpm

cardiac output

volume of blood pumped by bpm

ejection fraction

% of blood pumped out of ventricle with each beat

CO=

SV x HR

EF=

(SV/EDV) x 100%

fraction shortening

percentage change in the left ventricular (LV) internal diameter from end-diastole to end-systole

FS=

LVIDd-LIVDs / LVIDd

label LV size M-Mode

1. IVSd

2. PWDd

3. IVSs

4. PWDS

5. LVIDd

6. LVIDs

Doppler =

fd=fr-ft

fd= (2/c)(v)(ft)(cos <)

Acceleration time

Time from onset of flow to peak velocity

Deceleration time

Time from peak flow to end of flow

Pressure Half Time

The time it takes for the peak pressure to drop to half its original value

Velocity Time Integral (VTI)

The distance traveled by the blood cells in one cardiac cycle

VTI formula

trace the flow profile

(CSA lvot)(VTI lvot) = (CSA av)(VTI av)

Tracing the flow profile gives you:

 VTI

 Peak velocity

 Mean velocity

 Peak pressure gradient

 Mean pressure gradient

Adjust ______ to maximize waveform w/o aliasing

scale

Use sweep speed of ____ mm/sec per ASE

100

Adjust _______ to receive adequate signal while reducing noise

sample volume size

Adjust ________ to remove unwanted noise w/o erasing flow info

Wall filter

Spectral Doppler _____ optimized for ability to measure accurately

gain

______ should be positioned to optimize the Doppler signal as large as possible

baseline

PW TDI is routinely used for assessing

LV diastolic function

TDI can be used for

Differentiation between constrictive pericarditis and restrictive cardiomyopathy

myocardial ischemia

resyncing pacemakers

transplant rejection