Echo

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maguilar03
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15632
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Echo
Updated:
2010-05-29 14:39:39
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Anatomy Physiology Clinical Indications
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Anatomy, Physiology, and Clinical Indications.
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  1. The American Society of Echocardiography adopted the "leading edge" method of measurement because
    It produces the most consistent and reproducible measurements.
  2. The term basilar area of the ventricle refers to the :

    A.) ventricular myocardium at the apex.
    B.) Ventricular myocardium at the atrioventricular valves.
    C.) Mid segments of the ventricle.
    d.) None of the above.
    B.) Ventricular myocardium at the atrioventricular valves.
    (this multiple choice question has been scrambled)
  3. The infundibulum is related to the area of the right ventricle called the :

    A.) Inflow tract.
    B.) Apical area.
    C.) Subvalvular area.
    D.) Outflow tract.
    D.) Outflow tract.
    (this multiple choice question has been scrambled)
  4. The tree primary branches of the aortic arch include what:
    • Innominate artery.
    • Left common carotid artery.
    • Left subclavian artery.
  5. The term tunica adventitia refers to:
    The outer lining of the arterial wall.
  6. The term tunica intima refers to what:
    The inner lining of the arterial wall.
  7. Dextracardia indicates:
    Heart located in the right side of the chest.
  8. You are asked to pay particular attention to the semilunar valves. These valves are the:

    A.) Aortic and pulmonic valves.
    B.) pulmonic and tricuspid vavles.
    C.) Mitral and tricuspid valves.
    D.) Mitral and aortic valves.
    A.) Aortic and Pulmonic valves.
    (this multiple choice question has been scrambled)
  9. The great vessels of the heart are the:

    A.) Inferior vena cava and superior vena cava.
    B.) Aorta and pulmonary artery.
    C.) Inferior vena cava and subclavian artery.
    D.) Aorta and subclavian artery.
    B.) Aorta and pulmonary artery.
    (this multiple choice question has been scrambled)
  10. In M mode, the structure used to pinpoint end systole for measurement is:

    A.) The R wave of the ECG.
    B.) Maximum anterior motion of the left ventricular posterior wall.
    C.) Maximum posterior motion of the interventricular septum.
    D.) The Q wave of the ECG.
    B.) The R wave denotes the electrical stimulation that initiates systole. The Q wave is not always present and is not an indicator of end systole. Although the septum is at its maximum posterior motion under normal conditions, it is susceptible to electrical aberrations and volume and pressure changes and therefore not consistent for measurement. Only the maximum anterior motion of the left ventricular posterior wall is consistent for end-systolic measurement.
    (this multiple choice question has been scrambled)
  11. The motion of the septum should be evaluated by M mode at the:

    A.) Apical level.
    B.) Midventricular level.
    C.) mitral level.
    D.) Basal level.
    B.) Midventricular level.
    (this multiple choice question has been scrambled)
  12. The coronary sinus returns blood to the left atrium.

    True of False
    False: the coronary sinus is the terminal portion of the great cardiac vein, and it returns blood to the right artium.
  13. The ostium of the coronary arteries may sometimes be visualized in a short-axis two-dimensional echo view at the level of the aortic valves.

    True or False
    True: a narrow opening on the left coronaryh cusp of the av valve at approximately 4 to 5 o'clock may define the ostium (opening) of the left coronary artery.
  14. Since phases of the cardiac cycles are discussed in terms of systole and diastole of the ventricle, what phase would be occurring during atrial filling?

    A.) Insovolumic phase
    B.) Diastole
    C.) Systole
    C.) systole
    (this multiple choice question has been scrambled)
  15. In the ECG cycle, late ventricular filling occurs after the:

    A.) Q wave.
    B.) t wave.
    C.) R wave.
    D.) P wave.
    D.) P wave. The P wave on an ECG is the electrical stimulus that creates the mitral A wave, which coincides with the atrial kick and late diastolic filling.
    (this multiple choice question has been scrambled)
  16. If a patient presents with an early diastolic murmur you would concentrate interest on the: (True or False)

    a.) Aortic valve.
    b.) Mitral valve.
    c.) Tricuspid valve.
    d.) Pulmonic valve.
    • a.) Aortic valve. True
    • b.) Mitral valve. False
    • c.) Tricuspid valve. False
    • d.) Pulmonic valve. True
  17. Which valve would you suspect to be abnormal if auscultation revealed and Austin-Flint murmur?

    A.) Mitral valve.
    B.) Aortic valve.
    C.) Tricuspid valve.
    D.) Pulmonic valve.
    B.) Aortic valve. An Austin-Flint murmur is associated with aortic insufficiency.
    (this multiple choice question has been scrambled)
  18. Most authors consider the major components of the first heart sound to be:

    A.) Closure of the semilunar valves.
    B.) Opening of the semilunar valves.
    C.) Opening of the atrioventricular valves.
    D.) Closure of the atrioventricular valves.
    D.) Closure of the atrioventricular valves.
    (this multiple choice question has been scrambled)
  19. The heart sound most often associated with mitral valve prolapse is:

    A.) Ejection sounds.
    B.) Systolic click.
    C.) Gallop rhythm.
    D.) Opening snap.
    B.) Systolic click. Systolic clicks are among the most important physical findings in patients with mitral valve prolapse. The clicks may be single or multiple and may be brought out by changes in position or by using the Valsalva maneuver.
    (this multiple choice question has been scrambled)
  20. The heart sound associated with mitral and/ or tricuspid stenosis is:

    A.) A friction rub.
    B.) Opening snap.
    C.) Ejection sound.
    D.) Gallop rhythm.
    B.) Opening snap. The sounds are sharp and high- pitched. In isolated mitral stenosis, increasing severity of the lesion causes higher atrial pressures and early opening of the valve. A relatively short interval between the aortic component of the second heart sounds and the opening snap (A2-OS interval) implies severe mitral stenosis. A pericardial knock, which occurs with constrictive pericarditis, is an early diastolic sound that can be confused with an opening snap.
    (this multiple choice question has been scrambled)
  21. Early diastolic murmurs are due to aortic or pulmonic insufficiency.

    True or False.
    True: The severity of regurgitation is often inversely related to the duration of the murmur. With severe regurge, aortic diastolic pressure falls rapidly and may equalize with ventricular pressure relatively early, causing marked reduction of intensity or cessation of the murmur. Aortic insufficiency may also cause a diastolic rumble at the apex- an Austin-Flint murmur. Pulmonary insufficiency due to pulmonary hypertension, there is a large diastolic gradient. The murmur is high- pitched, follows the second heart sound immediately, and continues throughout diastole. In pulmonary insufficiency caused by valvular disease, there is usually a silent period b/w the pulmonic second heart sound and the initiation of the murmur, which is relatively low in frequency.
  22. Myxomas are tumors that can be located either inside or outside the heart.

    True or False.
    False. These tumors are located only intracardially.
  23. Approximately 40% of patients with left atrial myxomas have systemic emboli to the brain or extremities.

    True or False.
    True.
  24. Myxomas occur only in the left atrium.

    True or False.
    False. Myxomas can occur in either atrium, on the mitral valve, or in the ventricles.
  25. Females are affected slightly more often than males.

    True or False.
    True.
  26. Symptoms associated with pericarditis include:

    a.) A severe, sharp pain located precordially that may radiate into the shoulders and neck.
    b.) Ankle swelling.
    c.) Changing positions and taking deep breaths increases the pain.
    d.) The pain is dull and radiates into the jaw.
    a and c
  27. Symptoms noted with mitral valve prolapse syndrome include:

    a.) Palpitations and sharp pain inrelated to exercise.
    b.) Lower back pain and headache.
    c.) Fatigue and dyspnea.
    d.) Palpitations and dizzy spells.
    a, c, and d.
  28. A pseudonym for mitral valve prolapse syndrome is:

    A.) Ebstein's anomaly.
    B.) Prinzmetal angina.
    C.) Crohn's disease.
    D.) Barlow's syndrome.
    D.) Barlow's syndrome.
    (this multiple choice question has been scrambled)
  29. The term trepopnea is the sensation of dyspnea or palpitations, or an uncomfortable feeling that may occur when patients with cardiac diseases lie on their left side.

    True or False.
    True.
  30. The term dyspnea refers to the condition of:
    Difficulty in breathing.
  31. If a patient awakens in the night with shortness of breath, 1 to 2 hours after falling asleep, what disease might be suspected?

    A.) Mitral valve prolapse.
    B.) Angina pectoris.
    C.) Constrictive pericarditis.
    D.) Congestive heart failure.
    D.) Congestive heart failure.
    (this multiple choice question has been scrambled)
  32. Anemia or cyanosis may be a manifestation of serious underlying heart disease.

    True or False
    True.
  33. Heart failure, obstruction of flow by valvular stenosis, and constrictive pericarditis can cause a diminished stroke volume.

    True or False.
    True.
  34. Normal peripheral pulses arrive later than the carotid pulse.

    True or False
    True.
  35. Pulses alternans implies impaired ventricular function and is often present in massive periardial effusion, particularly pericardial tamponade.

    True or False.
    True.
  36. Aortic regurge and carotid atherosclerosis cause a large stroke volume, wide pulse pressure, and lowered peripheral resistance with resultant bounding hyperkinetic pulses.

    True or False.
    True.
  37. Which of the following signs are indicative but not diagnostic of heart disease?

    a.) Sharp chest pains.
    b.) Cyanosis.
    c.) Clubbing.
    d.) Obesity.
    e.) all of the above.
    e.) all of the above. They may all be indicators of cardiac disease but are not specifically diagnostic.
  38. Which of the following is most likely to cause a decease in cardiac output?

    A.) Hypertension.
    B.) Hyperemia.
    C.) Decrease in left ventricular stroke volume.
    D.) A decrease in peripheral resistance.
    E.) Increase in heart rate.
    C.) Decrease in left ventricular stroke volume. Left ventricular stroke volume is directly related to cardiac output. Therefore and decrease in left ventricular stroke volume will reduce cardiac output. Conversely, and increase in left ventricular stroke volume will raise cardiac output.
    (this multiple choice question has been scrambled)
  39. A decrease in left ventricular contractility secondary to acute myocardial infarction will:

    A.) Decrease cardiac output (Q) by decreasing pressure (delta P).
    B.) Decrease delta P with no effect on cardiac output (Q).
    C.) Increase velocity of flow in the aorta.
    D.) Increase cardiac output (Q) by increasing resistance (R).
    A.) Left ventricular contractility will decrease delta P and in doing so will reduce cardiac output.
    (this multiple choice question has been scrambled)
  40. If all other factors remain constant, you would expect a reduction in vessel diameter to:

    A.) Decrease viscosity.
    B.) Decrease kinetic energy.
    C.) Increase velocity.
    D.) Decrease the likelihood of turbulence.
    E.) Increase flow.
    C.) Increase velocity. A reduction in vessel diameter increases velocity within the constricted segment. A reduction in vessel diameter also increases the likelihood of turbulence, and if the diameter is sufficiently reduced, flow will be reduced (critical stenosis).
    (this multiple choice question has been scrambled)
  41. Which one of the following is most likely to cause turbulent flow of blood in the aorta?

    A.) An increase in cardiac output from 5 L/min to 20 L/min.
    B.) An increase in arterial pressure of 5 mm Hg.
    C.) A decrease in cardiac output to one-half of normal.
    D.) A hypertensive episode.
    E.) An increase in hematocrit.
    A.) An increse in cardiac output from 5 L/min to 20 L/min.
    (this multiple choice question has been scrambled)
  42. Which of the following are characteristics of turbulent flow?

    a.) It can be predicted by Reynold's number.
    b.) It is responsible for murmurs, bruits and thrills.
    c.) It increases pressure downstream.
    d.) It occurs where there are abrupt variations in vessel diameter.
    e.) It is affected by velocity.
    All of the above except for c.
  43. During and experiment, a laboratory animal suddenly develops 2:1 heart block, effectively reducing heart rate by one-half. Which ONE of the following responses would account for pressure being maintained at the same level as before the heart block?
    A.) Peripheral resistance doubled.
    B.) Arteriovenous shunting.
    C.) Peripheral resistance decreased by one-half.
    D.) Massive vasodilatation of the arterial sphincters.
    E.) Peripheral resistance unchanged.
    A.) See the analogy to Ohm's law. Cardiac output and pressure are governed not by how much blood the heart can put out in a given period but rather by how much blood the peripheral vessels are capable of accepting. With cardiac output halved and peripheral resistance doubled, pressure remains the same.
    (this multiple choice question has been scrambled)
  44. A subject has a cardiac output of 5 L/min at a heart rate of 75 beats/ min. If stroke volume remains constant, what will be the effect of an increase in heart rate to 150 beats per minute?

    A.) Cardiac output would triple.
    B.) Cardiac output would increase to 25 L/min.
    C.) Cardiac output would increase to 10 L/min.
    D.) Cardiac output would increase to 22.5 L/min.
    E.) Nothing; cardiac output is independent of heart rate.
    C.) Cardiac output would increase to 10 L/min.
    (this multiple choice question has been scrambled)
  45. Which ONE of the following statements is True regarding the term blood pressure?

    A.) It is constant throughout the cardiac cycle.
    B.) It represents and can be used interchangeably with flow.
    C.) It is the same as hydrostatic pressure.
    D.) It is reported in cm H2O unless otherwise specified.
    E.) It represents the force exerted by the blood against any unit area of the vessel wall.
    E.) It represents the force exerted by the blood against any unit area of the vessel wall.
    (this multiple choice question has been scrambled)
  46. The minimal pressure in the arterial system during a cardiac cycle is termed:

    A.) Pulse pressure.
    B.) Mean pulse pressure.
    C.) Diastolic pressure.
    D.) Systolic pressure.
    E.) Mean pressure.
    C.) Diastolic pressure.
    (this multiple choice question has been scrambled)
  47. In measuring human blood pressure, the first sound was heard at 130 mmHg, the second at 105, the third at 100, and the last at 95. What is the estimated mean blood pressure?

    A.) 118 mmHg.
    B.) 115 mmHg.
    C.) 104 mmHg.
    D.) 107 mmHg.
    E.) 122 mmHg.
    D.) 107 mmHg.
    (this multiple choice question has been scrambled)
  48. Which ONE of the following is a correct statement describing transmission of the arterial pressure wave?

    A.) It slows with increasing age.
    B.) It is caused in part by the inertia of blood in the aorta.
    C.) It slows with increasing calcification of the vessels.
    D.) It originates at the level of the arterioles.
    B.) It is caused in part by the inertia of blood in the aorta.
    (this multiple choice question has been scrambled)
  49. In laminar flow, the velocity of the blood is:
    A.) Directly proportional to the cross-sectional area of the vessel.
    B.) Zero at the vessel wall.
    C.) Highest at the vessel wall.
    D.) Lowest at the center of the vessel.
    E.) Lowest when kinetic energy is highest.
    B.) Zero at the vessel wall. The fact that normal blood flow is zero at the vessl wall and highest at center stream is one reason why continuous- wave Dopplers show wider frequency shifts (decreased windowing) when spectrally analyzed.
    (this multiple choice question has been scrambled)
  50. The principal site of peripheral resistance in the vascular bed is determined to be in the arterioles because:

    A.) The blood flow is slowest in the arterioles.
    B.) The blood pressure is highest here.
    C.) The pressure drop across these vessels is greatest.
    D.) These vessels have thick muscular coats.
    E.) The blood pressure does not change across these vessels.
    C.) The pressure drop across these vessels is greatest.
    (this multiple choice question has been scrambled)
  51. As the arterial pressure wave moves toward the periphery, all of the following occur except:
    a.) The pulse amplitude is increased by the presence of reflected waves.
    b.) Speed of propagation diminishes.
    c.) Pulsatile changes in arterioles and capillaries are "dampened" owing to vascular distensibility and resistance.
    d.) Speed of propagation increases.
    b.) Speed of propagation diminishes.
  52. The incisura on the aortic pressure wave:
    A.) Is inscribed just after the aortic valve closes.
    B.) Indicates closure of the AV valves.
    C.) Results from aortic valve malfunction.
    D.) Occurs during rapid ventricular filling.
    E.) Occurs when the aortic valve opens.
    A.) Is inscribed just after the aortic valve closes.
    (this multiple choice question has been scrambled)
  53. Starling's law of the heart can best be expressed by which one of the following?
    A.) As heart rate increases, ventricular contractility also increases.
    B.) The product of heart rate and stroke volume equals the cardiac output.
    C.) Within limits, an increase in venous return results in an increase in stroke volume.
    D.) Increasing the arterial pressure decreases the stroke volume.
    C.) Within limits, an increase in venous return results in an increase in stroke volume.
    (this multiple choice question has been scrambled)
  54. Which ONE of the following best describes the role of the heart as a pump?
    A.) suctioning blood from the venous circulation.
    B.) Regulating cardiac output.
    C.) Forcing blood from the venous to the arterial circulation, restoring energy necessary for the blood flow.
    C.) Forcing blood from the venous to the arterial circulation, restoring energy necessary for the blood flow.
    (this multiple choice question has been scrambled)

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