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107 Unit 3


Echocardiogram -sonogram of the heart -real time images of the cardiovascular system in action -used for diagnosis, management, and follow-ups
Information Provided by an Echo -location & Extent of any tissue damage -Ejection Fraction -Pumping Capacity -Calculation of Cardiac Output -Size and Shape of the Heart -Diastolic Function -Detection of abnormalities
Interface Surface formed when two media of different densities come together
Reflection -Sound that bounces back from the interface
Reflection Depends Upon -Degree of Difference between the two media -Closer to 90 Degrees the angle of the transducer is to the interface, the greater the sound that will be reflected
Refraction -The bending of sound from a straight path as it goes from one media to another
Disadvantage of Echo -poorly transmitted through a gaseous medium and attenuation occurs rapidly especially at higher frequencies
What does the amount of reflection and refraction depend on? -acoustic properties of the media through which the ultrasound beam passes
Which Tissues reflects most of the energy and result in poor penetration? -solid material interfaced with gas -lung
Which tissues allow more energy to be disseminated and increases penetration? -soft tissues and blood
Which kind of mediu does ultrasound travel faster through? -stiff medium -bone
Transducer -consists of Piezoelectric elements (Crystals) -Sends and Receives the ultrasound
Piezoeletectric Elements -many small, carefully arranged piezoelectric elements that are interconnected electronically -each element is coupled to electrodes that transmit current to the signals and record the voltage generated by the returning signals
Transuducer Placement for Apical Imaging -The Point of Maximal Impulse (PMI)
Parasternal Long -Axis (PLAX) -transducer in Left parasternal region 3rd or 4th Intercostal space -notch will be to the patient's right shoulder -patient is in left lateral decubitus position -views heart from base to apex (vertical split)
PLAX views -LA -LV- -MV -RV (RVOT) -AO -VS
Parasternal Short Axis -left parasternal region 3rd or 4th intercostal space -notch in patient's left shoulder -views heart from side to side (horizontal split) -short axis planes
Parasternal Short Axis Planes -Apical Level -Papillary Muscle Level -Mitral Valve level "fish-mouth" -Basal (Aortic) View
Apical Level -apex of the left ventricle
Papillay Muscle Level -Tilting the Transducer superiorly
Papillary Muscle Level Views -RV -VS -LV -Posteromedial Papillary Muscles (PMVL) -Anterolateral Papillary Muscles (AMVL)
Mitral Valve Level "Fish Mouth" -superior and rightwign tilting of the transducer
Mitral Valve Level Views -RV -VS -LV -Anterior Mitral Valve Leaflet -Posterior Mitral Valve Leaflet
Basal (Aortic) View -tilting the transducer further superiorly
BAsal (AorticI View Views -LA -Atrial Septum -RA -RVOT -Right Coronary Cusp -Left Coronary Cusp -Non coronary Cusp -Pulmonary Valve -Pulmonary artery
Apical Views -4 chamber -2 chamber -Long axis -"five" chamber -3 chamber
4 Chamber view -patient is rotated to the left and the transducer placed at the cardiac apex -notch is toward the spine
5 chamber view -transducer is tilted to a shallower angle from the 4 chamber view -includes the LVOT and Proximal Aorta
4 chamber view can view -LA -LV -RA -RV
2 Chamber -4 chamber is the reference -transducer is rotated counterclockwide 60 degrees -records different walls of the LV -combination of the two views often provide an accurate representation of LV size, shape and function
2 chamber views -LA -LV -MV
3 Chamber -4 chamber is the reference -transducer is rotated clockwise 60 degrees -similar to PLAX view but from a lower interspace
3 Chamber Views -LA -LV -MV -AO
Subcostal Examination -transducer in the midline or slightly to patient's right -notch pointed down toward the patient's spine -only view that visualizes the superior portion of the atrial septum -records the inferior vena cava and hepativ veins -COPD and emphysema
What can the Subcostal Examination also view? short axis plane
Suprasternal Approach -examine the great vessels -short axis view of the aortic arch by rotating the transducer clockwise to the notch faces posteriorly toward the patient's trachea
Suprasternal Views -Ascending aorta -Aortic Arch -Brachiocephalic Vessels -Descending Thoracic Aorta
M-Mode Echocardiography -meausrement of dimensions -essential for display of subtle motion abnormalities of specific cardiac structures -detailed motions -volume shots
Detailed motions of M-Mode Echocardiography -Distance or depth (vertical) -time (horizontal)
M-Mode Basal-Aortic Level -dimension of the LA and end systole/diastole -Aorta -Aortic Valve -Posterior Wall -RV -RVOT -VS
Dopplar Imaging -measures blood flow velocities in the heart and great vessels -provies a colorized image representing the velocity and direction of blood -pulsed valve doplar -continout wave doplar -color dopplar M-Mode Imaging
Pulsed Valve Doplar -measures velocity at any specific point within the cardiac anatomy -single ultrasound crystal sends and receives sound beams -reflected from moving red blood cells
Continour Wave Doplar -two crystals one to send and one to receive -records all velocities along the path of the ultrasound beam -used to detect and record the highest flow velocity available -image-guided display
Color Dopplar M Mode Imaging -displays blood flow in 3 color -red, blue, green -used to assess abnormal flow patterns
Red Blood flows toward the positive frequency shift in the transducer
Blue Blood flows away from the positive frequency shift in the transducer
Multiple colors -abnormal blood flow according to direction and velocity
Created by: Mdarrielle09



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