Cardio.5- Echocardiography

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  1. What is the different between trans-thoracic echo (TTE) and trans-esophageal echo (TEE)?
    • TTE is performed through the chest wall, does not require general anesthesia (may require sedation on a case-by-case basis).
    • TEE requires general anesthesia, the probe is placed above the heart base within the esophagus, and are useful to image heart-base tumors and congenital heart lesions.
  2. What US frequency range is commonly used for ECG in small animals?
    2-16 MHz
  3. What does imaging "frame rate" mean?
    number of updated images per second
  4. How does ECG work?
    ultra-high frequency sound waves are produced by piezo-electrical crystals in the probe transducer--> waves bounce off tissues and are received back in the probe to generate an image
  5. What kind of transducers do ECG probes have? In contrast, what kind of probes are used in abdominal ultrasonography?
    sector transducers; vector/linear probes
  6. Describe the resolution and penetration of a high-frequency probe.
    excellent resolution, low penetration (not useful on a horse)
  7. Describe the resolution and penetration of a low-frequency probe.
    low resolution, greater penetration (used in large animals)
  8. Describe the 2-D mode for ECG.
    Real-time echo/ B-mode; heart tissue is white, blood is black and movement of structures is shown in real time
  9. Describe M-mode echo. What is it used to assess?
    one-dimensional image shown as a time-motion graph, displaying motion of certain parts of the heart with extremely high resolution; used to assess systolic function (emptying)
  10. What parts of the heart can be assessed with right parasternal imaging views? (5)
    left atrial size, left ventricular systolic function, pericardial space, left ventricular outflow tract, interventricular septum
  11. What parts of the heart can be assessed with left parasternal imaging views? (5)
    left ventricular diastolic function, left auricular function, left ventricular outflow tract, right-sided chambers and tricuspid valve, and right ventricular outflow tract
  12. What is assessed from the subcostal imaging view? (1)
    measurements of peak LV outflow velocity
  13. The higher the frame rate, the...
    more clear/crisp the image.
  14. What are the echo windows? (3)
    right and left parasternal, subcostal
  15. What are the standard views/imaging planes with 2-D/real-time echo? (4)
    right parasternal long axis, right parasternal short axis, right parasternal subcostal, left parasternal apical
  16. Name the 2-D view and label the structures being evaluated.
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  17. Name the 2-D views shown here and label the structures being evaluated.
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  18. Name the 2-D view and label the structures being evaluated.
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    • Right parasternal short axis view 2
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  19. Name the 2-D view and label the structures being evaluated.
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    • Right parasternal short axis view 3
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  20. Name the 2-D view and label the structures being evaluated.
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  21. Name the 2-D view and label the structures being evaluated.
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  22. Name the 2-D view and label the structures being evaluated.
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  23. Name the 2-D view and label the structures being evaluated.
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  24. Name the 2-D views and label the structures being evaluated in each.
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    • Right parasternal short axis view- aortic valve
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  25. What cardiac structure is specifically shown in the "fish mouth" view?
    Mitral valve- right parasternal short axis view
  26. What cardiac structure is specifically shown in the view displaying the "Mercedes Benz" sign?
    Aortic valve- right parasternal short axis view
  27. What chambers and valves are seen on the left parasternal apical 4-chamber view?
    RV, LV, RA, LA, mitral valve, tricuspid valve
  28. Draw the M-mode image that would accompany this 2-D left ventricular short axis view.
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  29. What is shortening fraction?
    M-mode measurement of the left ventricular systolic function;

    the systolic properties of the LV as described by segmental shortening of the LV along one cursor line; indicator of systolic function/contractility/pump function
  30. How is shortening fraction calculated?
    SF%= (LVed -LVes) ÷ LVed x 100

    • On M-mode graph
    • LVed= LV end diastolic dimension
    • LVes= LE end systolic dimension
  31. What are normal shortening fraction values for dogs, cats, and horses?
    • dogs- 25-45%
    • cats- 35-55%
    • horses- >29%
  32. What shortening fraction would a dog with hypokinesia have?
    <25%
  33. Describe the Doppler principal of echo.
    when US waves hit moving blood cells, they change their reflected frequency, which is proportional to the velocity of the blood cells
  34. Stationary object: F0 ___ F1.
    F0= emitted frequency
    F1- reflective frequency
    =
  35. Object moving toward probe: F0 ______ F1.
    F0= emitted frequency
    F1= reflective frequency
    <
  36. Object moving away from probe: F0 _______ F1.
    F0= emitted frequency
    F1= reflective frequency
    >
  37. What is the equation for Doppler frequency shift (Fd)?
    Fd= F1 - F0

    • F1= reflective frequency
    • F0= emitted frequency
  38. What information is obtained from a Doppler echocardiogram with regard to blood flow? (3)
    direction, velocity, quality
  39. What are the 2 types of spectral Doppler echocardiography?
    pulsed wave (PW) and continuous wave (CW)
  40. What is the difference b/w PW (pulsed wave) and CW (continuous wave) Doppler echocardiography?
    PW uses the same piezo-electrical crystals to emit and receive, which occurs in cycles; CW uses continuously emitting and continuously receiving crystals that are working independently of one another
  41. What is the difference b/w what you can measure with PW (pulsed wave) and CW (continuous wave) Doppler echocardiography?
    • PW- depth selective blood flow velocity measurements (only up to 2m/s, which is normal)
    • CW- cannot select the depth at which to measure (range ambiguity) but can measure velocities up to 10m/s
  42. What pattern of spectral Doppler flow is this? What is it an indication of?
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    Laminar flow- normal; blood is flowing steadily, and all cells have approximately the same velocity
  43. What pattern of spectral Doppler flow is this? What is it an indication of?
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    Turbulent flow- swirling; cells are moving different velocities; can be due to valve stenosis, valve insufficiency, shunted flow
  44. What can cause a swirling pattern on Doppler flow echocardiography? (3)
    valve stenosis, valve insufficiency, shunted flow
  45. What is blood flow direction with regard to the stationary transducer when the color coded Doppler blood signal is blue?
    blood moving toward transducer
  46. What is blood flow direction with regard to the stationary transducer when the color coded Doppler blood signal is red?
    blood is moving away from transducer
  47. What does turbulent blood flow look like on color flow Doppler echo?
    variance in colors: blue and red mixed with green (some cells coming towards, some going away- valve regurgitation)
  48. What echo technique gives you a time-motion graph?
    M-mode
  49. What echo technique gives you a time-velocity graph?
    spectral Doppler
  50. What is a normal left ventricular outflow velocity in a young-to-middle aged dog?
    <2 m/s
  51. Normal flow of blood leaving the heart in systole via the right or left ventricular outflow tracts is a __________ process.
    monophasic
  52. Diastolic flow via the mitral or tricuspid valves is a _________ process.
    biphasic
  53. What are the 2 phases of diastolic ventricular filling?
    • E- early passive filling
    • A- late active filling by atrial contraction
  54. Which bi-leaflet valve can be considered normal with a small amount of regurgitation of blood?
    in healthy animals, the left-sided valves (mitral and aortic) should NOT leak in systole (emptying); mild right-sided valve (tricuspid and pulmonic) regurgitation is considered normal
  55. Normal flow across the semilunar valves is ___________; normal flow across the AV valves is ___________.
    monophasic; biphasic
  56. Peak flow velocity can be transformed into a pressure gradient between the __________ and __________ using _________ equation; this is clinically significant because...
    expelling chamber; receiving chamber; Bernoulli's; it is used to estimate the severity of valve stenosis.
  57. With normal biphasic flow through the AV valves, the ______ should be higher than the ______; at peak velocities, the peak E: peak A ratio should be ________.
    E wave; A wave; 1-2 (ie. E should be the same to double the value of A)
  58. Echogenic swirling pattern of blood flow caused by an increased ultrasonic back scatter from an aggregation of cellular blood components due to blood stasis or low-velocity blood flow; can occur normally during sinus rhythm.
    spontaneous echocardiographic contrast
  59. During the diastole, the aortic valve is __________; this coincides with the ________ on a single lead EKG.
    closed; QRS complex
  60. During the systole, the aortic valve is __________; this coincides with the ________ on a single lead EKG.
    open; end of the T wave
  61. The QRS complex on EKG corresponds to the...
    depolarization of the right and left ventricles of the heart; diastole (aortic valve closed).
  62. The T wave on EKG corresponds to the...
    repolarization (or recovery) of the ventricles; end of T wave is systole (aortic valve open).

Card Set Information

Author:
Mawad
ID:
314073
Filename:
Cardio.5- Echocardiography
Updated:
2016-01-25 14:52:05
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vetmed cardio
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vetmed cardio.5
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