Sei sulla pagina 1di 9

Echocardiography

Study online at quizlet.com/_305y7n

1. ... 3. ...

parasternal long axis view

blood across the aortic valve, occurs during diastole.


should blood go from aorta to ventricle? no. this is aortic
suprasternal notch view regurgitation/insufficiency

line = aortic dissection 4. ...

2. ...

where the mouse is = aortic valve


apical long axis or apical 3 chamber (LA, LV, aorta) -tricuspid valve to the left
-RV at the top
the structure opening and closing is the mitral valve -pulmonic valve to the right

LV looks kinda big and hypokinetic - it's not moving very if this was a hemodynamically significant pericardial
well. is it completely hypo kinetic or is there one part effusion, it would cause collapse of the chambers
worse than the other? you can use M mode to see the (particularly RV). RV collapse would look like a double
motion. in B mode, look at short axis parasternal (donut) bounce as it's coming up through diastole from systole

in short axis parasternal - you can see different walls and


what they're perfused by. to see an ischemic
cardiomyopathy as opposed to a non-ischemic
cardiomyopathy, short axis parasternal can help

on 4 chamber view - you can see septal and lateral walls


on 2 chamber view - you can see anterior and inferior
walls
5. ... 8. ...

to get to the apical 2 chamber from the apical 4 chamber


liver at the top
view turn turn 24 deg

first black space = effusion


you see mostly LA and LV

RA = black hole, to the right is the RV 9. ...

6. ...

4 chamber apical view

apical 4 chamber
septal wall shared b/t LV and RV

on right hand side you have LV, LA


septal wall doesn't have great endocardial definition -
7. ... we're looking at the endocardium moving in and out as
opposed to the myocardium. that tells us with more
certainty what the heart is truly doing.

what we can see is that the septum is not moving great -


septal wall is hypokinetic (not akinetic)

The 2 bumps of the anterior leaflet are normal, this is LA


contraction. Early diastolic filling wave where ventricle
actively sucks blood in the E [early wave].

if you line up the P wave with the A wave that's atrial


contraction

in which diseases would the A wave disappear? Afib (no


organized atrial contraction) or potentially Aflutter
10. ... 11. ...

2 chamber apical view parasternal short axis view -

RV disappears, septal wall disspears donut

we have the inferior wall on the left that's anterior wall on mitral valve - anterior leaflet (2/3), posterior leaflet (1/3)
the right. they seem to be moving slowly
if you see papillary muscles you know you're in the middle
in the LA you can see the left atrial appendage (near the of the ventricle
house
you have your anterior wall (top), septal wall (left - shared
mitral valve is working ok, LV is not doing a whole lot - it's wall with RV), inferior wall (bottom), and lateral wall
globally hypokinetic but more so in the anterior wall. (right). if cutting from an apical view (from top to bottom)
might have a combination of an ischemic and non you're cutting across the anterior and inferior. if cutting
ischemic cardiomyopathy. from left to right, you're cutting across lateral and septal
RV is a little dilated but looks good wall

septal and lateral wall moving ok

might have mild issue hypokinesis but moderate-severe


anterior wall hypokinesis. this person prob had an LAD
occlusion causing an infarct. maybe slightly anterior septal
wall
12. ... 14. ...

subcostal view - to look at IVC mouse = descending aorta

expect IVC to look enlarged descending aorta has a white line going
through it - that's the dissection
liver on top
15. 2 chamber
apical view
RA, RV, tricuspid, IVC should be to the left (mouse) but we
couldn't see it
13. ...

turn 45 deg to shoot upward to the base of


the heart

here we are seeing inferior wall and anterior


wall (as it pertains to LV)
parasternal long axis view
16. 4 chamber
apical view
is the aortic root dissecting or not? we would see an extra
line in the ascending aorta (where the mouse is)

if it dissects down into the coronary sinus, the dissection


can be complicated by a heart attack (occluding the flow)

looking at septal wall and lateral wall (as it


pertains to LV)
17. 4 views of 21. Echo MOA
the heart

1. Parasternal

2. Apical
transducer has piezoelectric crystals lined up in
a precise fashion
3. Subcostal

as the crystals get stimulated electronically,


4. Suprasternal
they send out US waves. they go down and
bounce back up. the crystals pick them up
*all of these spots avoid bone and they try to
avoid the lungs 22. ideal no hair, fat is ok, you need a good intercostal
person for space (hate bone), air makes them scatter (need
18. apical view
ECHO to put gel on head of probe, there's also air in
the lungs. if there's a lot of air trapped in the
lungs [COPD] that makes it difficult)

fat is not bad - the problem with fat is that if


they're really big people there's a limit to how
far the US waves can penetrate. the higher the
frequency, the less tissue they're able to
penetrate. can penetrate 10-15 cm
apical view from the apex - depending how
you cut it you're either looking at a 4 pediatric pics are better bc the probes are
chamber view or a 2 chamber view higher frequency bc don't need to travel as
19. Color By convention, Doppler color flow systems much distance. if frequency higher, the capacity
Doppler assign a given color to the direction of flow to distinguish one spot from the other is better
-red is flow toward the transducer. 23. imaging aortic dissection - get a CT or occasionally
-blue is flow away from the transducer for aortic transesophageal US (gets you closer to the
20. Color dissection? heart - probe is higher frequency and can get
Doppler - you good pics of stuff near the esophagus like
apical 4 the aorta, LA)
chamber

left side = RV, RA

right side = LV, LA

we can see the mitral valve

red is heading away from LV into LA - this


should not happen. this is mitral regurgitation.
24. IVC 25. M-Mode
on Echocardiography
echo

M = motion

dark tube heading toward the heart and right behind The ultrasound beam is aimed manually
the liver --> IVC at selected cardiac structures to give a
graphic recording of their positions and
IVC is helpful in case you want to know how much movements.
fluid is in a person's body. magic # is 2
Very high pulse frequency= high
if someone is congested or in tamponade and heart sampling rate (1800 vs. 60)
can't pump the fluid away, IVC is going to be very big
and congested/distended M mode is an offshoot of B mode

if you take a breath, IVC should collapse. but if pic at the top = parasternal long axis
congested, you have a dilated IVC that doesn't view (you're seeing RV at the top, if you
collapse with respiration. that tells you there's an inc in go left you're seeing LV, if you go right
filling P because blood heading toward the heart is you're seeing the aorta, as you move
not being processed quickly enough down you see LA). as you cut straight
across that's M mode
in hypovolemic shock and heart is pumping fine but
there's not a lot of fluid, the IVC will be collapsed you can see the motion of the different
cardiac structures as they go through the
cardiac cycle

when it's happening - M mode


what is happening - B mode
where the blood is going - Doppler
26. Parasternal 29. Parasternal
Long Axis Short Axis
- Papillary
Muscle
Level echo
pic

if a person gets stabbed in the chest


precordial right where parasternal notch is,
the 1st chamber of the heart to get cutting across RV
damaged is the RV
will see a donut - for cases where people have
in the parasternal long axis, you'll see the an MI and there's an occlusion of the coronary
RV first. RV is thin walled structure, hugs artery, the LAD artery supplies anterior and
around the LV which takes up the majority anterior septal walls. if you have an infarction
of the view that occludes the LAD, the anterior and septal
walls will stop moving
dividing LV and LA is the mitral valve
(anterior and posterior leaflets) --> mitral same thing with the right coronary artery and
valve opens during diastole that supplies the inferior and inferior septal
wall (sometimes lateral wall)
dividing LV and AO is the aortic valve (will 30. pericardial
see right and non coronary cusp) --> aortic effusion on
valve opens in systole echo -
27. Parasternal parasternal
Long Axis - long axis
echo pic view

parasternal long axis view = top thing you're


going to see is RV
28. Parasternal -underneath RV you should have aortic valve
Short Axis - -underneath aortic valve down and to the left
Papillary you have mitral valve
Muscle Level -behind aortic gavel and mitral valve you have
LV
-tissue = white
-liquid / air = black --> this is a pericardial
effusion

cross section = short axis (also abbreviated


SAX)
31. pericardial 33. short axis
effusion on - echo pic
echo - 2
parasternal
short axis
view

same view
rotate 90 deg from parasternal long axis view
and incline it a little bit to see the donut remember in the parasternal long axis, you have
-can also see effusion on this view --> can the mitral valve and aortic valve. aortic valve
see RV, donut, effusion was slightly up and closer to the base than
32. short axis - mitral valve
echo pic
parasternal short axis at the base is a good view
of this
34. stuff to
see on
apical
we are in the middle of the ventricle in the view
parasternal short axis

if you cut it in the middle and you include the


probe upward, you're going to head toward
the base of the heart

at the base of the heart, you're going to have 35. Stuff to


all of your valves see on
long axis
once you are right in the middle, you're going (PLAX)
to get the aortic valve to pop right in there.
aortic valve will be surrounded by the
pulmonary valve on the right and the
tricuspid valve on the left

the RV is hugging up and around


aortic root is important in aortic dissection -
if you include it further downward, you'll see particularly the types that affect the ascending
the mitral valve (mitral and aortic valve are in aorta
the same plane)
regional wall motion - usually talking about LV
36. Stuff to see on 40. susprasternal
short axis notch

37. stuff to see on


subcostal
should see ascending aorta, right pulmonary
artery underneath, great vessels heading
toward the arm and head

difficult view to get, can help with aortic


dissection
38. subcostal view
41. Tomographic
Images of
selected
cardiac
sections

if you have a patient with bad COPD you


can use this view

sub-xiphid view, you'll see the liver too when you have the probe placed in the spot,
you can turn in a clockwise or
39. subcostal view counterclockwise direction
echo pic
apical view is right where the PMI is (4-5th
intercostal space). at that spot, the tip is at the
bottom and base is at the top. if you're
cutting it across one way, you'll only see LV.
the other way you'll see LV and RV coming in

parasternal view - at the base of the heart. LV


is in the middle. if you cut it down the middle,
it will look like a circle. if it's an ellipsoid and
you get it tangentially, it will like like a V
(pacman?)

Potrebbero piacerti anche