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ECQ Quizzes
Introductory Cardiac & Vascular
| Question | Answer |
|---|---|
| True or False: The heart receives oxygenated blood during systole | False |
| The layers of the heart from inner to outer | Endocardium, myocardium, epicardium, pericardium |
| What is the origin of the first heart sound ("lubb")? | Ventricular contraction when AV valves are closing |
| Which two coronary arteries are the first to branch off of the aorta? | Right and left coronary arteries |
| The basic protein units responsible for contraction of the cardiac muscle? | Sarcomeres |
| The junction that connects cardiac muscle fibers is? | Intercalated disks |
| True or False: The right heart functions as the systemic pump and under high pressure | False |
| True or False: Cardiac tamponade is considered a life-threatening condition | True |
| The atrioventricular valves differ from the semilunar valves how? | Attached to chordae tendinae, have thinner leaflets, have papillary muscles |
| What determines coronary artery dominance? | Artery giving rise to posterior descending artery |
| What happens to the imaging capability of an ultrasound system if too many focal zones are utilized during cardiovascular examinations? | Decreased frame rate |
| What is one of the major advantages of continuous wave (CW) Doppler? | Resistance to aliasing at higher flow velocities |
| What is a major advantage of using the Resistive Index (RI) or Pulsatility Index (PI) to evaluate arterial blood flow? | The Doppler angle is ignored |
| What may happen to a spectral Doppler waveform if the gain is set to high? | Aliasing |
| Effect of the Cosine function on the Doppler shift frequency | The cosine function is the relationship between the ebeam and the direction of blood flow, the doppler shift is directly proportional to the cosine of the angle |
| What may happen to a spectral Doppler waveform if the gain is set too low? | A waveform may not be displayed |
| What is the first step to take in order to eliminate aliasing in a spectral Doppler waveform? | Increase the PRF (velocity scale) settings |
| The sample volume width in a normal artery should not exceed what fraction of the vessel's diameter? | 2/3 |
| Sound waves whose frequency is below 20 Hz | Infrasound |
| Most correct statement in describing the color flow appearance of variations in blood flow velocity | Faster velocities have a brighter color |
| Where should the sample volume be placed during the spectral Doppler examination of a normal artery? | In the center of the vessel |
| What type of spectral Doppler waveform is usually seen in a normal peripheral artery? | Triphasic |
| What happens to the PRF as the sample volume depth increases with a pulsed Doppler system? | Decreases |
| What causes the notch in the envelope of the spectral doppler waveform of a normal artery? | Aortic valve closure |
| Which wave vibrational frequency is generally used to describe "ultrasound" waves? | >20,000 |
| In a pulsed Doppler system, which term refers to the number of pulses transmitted per second? | PRF |
| What spectral Doppler waveform characterisitcs are present when the sample volume is located within a high grade arterial stenosis? | Very fast flow velocities |
| Why is the sample volume placed in the middle of a normal artery during a spectral doppler examination? | This avoids turbulent blood flow near the vessel walls |
| What is the purpose of angling (steering) the color box during color flow imaging? | Inputs the Doppler angle into the system |
| What is the range for the angle of insonation for vascular scanning? | 45-60 degrees |
| What can a delayed arterial upstroke and an increased time to peak (TTP) signify in a spectral doppler waveform? | a stenosis proximal to the sample volume |
| True or False: Changing the angle of the color box will not have any effect on the appearance of the color flow image | False |
| Why is a vessel angle of 0 degrees most favorable? | It allows more accurate velocity calculations |
| What may happen to a spectral doppler waveform if the sample volume is set too wide during the examination of a normal artery? | Slower blood flow velocities near the vessel walls may be displayed |
| The Sympathetic Nervous system controls? | Fight and Flight response |
| Alpha 1 & 2, Beta 1 & 2, and dopamine receptor sites are receptors in which autonomic nervous system? | Sympathetic nervous system |
| True or False: Myocardial ischemia, if not reversed, can lead to myocardial infarction, which is death of the myocardial tissue affected by ischemia | True |
| Specialized nerve tissue that detect changes in blood pressure are known as? | Baroreceptors |
| What is a possible cause of inadequate oxygen supply to the myocardium? | Anemia |
| What is the definition of angina pectoris? | Symptoms such as chest discomfort of sudden onset |
| Given a situation in which a patient has been determined to have suffered a temporary or permanent blockage of a coronary artery, the diagnosis could include? | Acute coronary syndrome |
| Muscarinic receptors in cardiac muscle act in which manner? | Slows the natural pacing rate of the heart |
| Which of these is the largest vein that drains the heart muscle? | Coronary sinus |
| Chronotropy | Change in heart rate |
| The Parasympathetic Nervous system controls? | Rest and digest response |
| Another name given to the sympathetic response is? | Autonomic response |
| What is the flow profile characteristics of the CCA? | Intermediate resistance flow profile. Has a sharp systolic upstroke and a continuous flow throughout diastole |
| Sonographic characteristics of hard plaque | Echogenic bc of calcification, there will be shadowing because of the sound beam not being able to penetrate, and it can either be smooth or have irregular shape |
| Collateral Blood Circulation | Where blood finds new pathways through other vessels to go around disease or stenosis. The purpose is to maintain enough flow to the organs and tissues to keep them alive and prevent tissue death |
| What changes in the distal spectral doppler waveform may occur due to a significant proximal ICA stenosis? | Increased acceleration times |
| Why does the normal internal ICA have a high level of diastolic flow? | The low vascular resistance in the brain |
| What changes in the distal spectral Doppler waveform may occur due to a significant proximal ICA stenosis? | Increased acceleration times |
| What is one of the major disadvantages of CW Doppler? | Lack of depth discrimination |
| The atrioventricular valves differ from the semilunar valves in? | Attached to chordae tendinae, have thinner leaflets, have papillary muscles |
| Why does the normal internal Carotid Artery (ICA) have a high level of diastolic flow? | The low vascular resistance in the brain |
| A significant plaque formation in an intracranial artery can usually be diagnosed with TransCranial Doppler (TCD) by noting intrastenotic flow acceleration. What other pathological condition can also increase flow within the intracranial arteries? | Anemia |
| A normal vertebral artery exhibits what kind of flow pattern when examined with Spectral Doppler? | Monophasic |
| How is the brain supplied with blood flow if both ICAs are severely stenosed? | From the vertebral arteries and the Circle of Willis |
| How may blood get to the ICA if the ipsilateral CCA is occluded proximal to the carotid bifurcation? | Flow reversal in the ICA |
| Where do most carotid artery stenoses occur? | CCA bifurcation |
| What type of gland is the thyroid? | Endocrine |
| What is the function of afferent lymphatic vessels? | Carry unfiltered lymph into the lymph node |
| What is a goiter? | Enlarged thyroid |
| What is the echogenicity of a lymph node with malignant lymphoma? | Markedly low |
| When interrogated with Spectral Doppler, what is the maximum velocity of blood flow in a normal thyroid artery? | 20 |
| As it is used in the textbook to describe the diffuse hypervascularity of Grave’s Disease, what does pathognomonic mean? | Distinct characteristic of a disease |
| About how many lymph nodes are in the cervical region of the neck? | 300 |
| True or False: Sonography alone is not very sensitive in differentiating a malignant thyroid nodule from a benign mass | True |
| Blood pressure is defined as? | Force exerted by circulating blood on walls of arteries |
| True or False: The stroke volume and ejection fraction are expressed the same way and mean the same thing | False |
| What is the normal range of right atrial pressure? | 2-6 mm Hg |
| During which part of the cardiac cycle does blood return to the heart? | Atrial diastole |
| What factors determine cardiac output? | Stroke volume, heart rate |
| Epinephrine and norepinephrine are two hormones that are secreted by the adrenal medulla and may cause what to happen? | Increase the force of the heart’s contractions |
| What is the “atrial kick”? | Contraction of atrial from SA node impulse |
| A patient’s stroke volume decreases, what must occur with the heart rate to maintain a constant cardiac output? | Increase |
| What term refers to the force exerted on the walls of the ventricles at the end of diastole? | Preload |
| True or False: The cardiac output of the right ventricle is normally equal to that of the left ventricle on a minute to minute basis | True |
| What term refers to the pressure or resistance against which the ventricles must pump to eject blood? | Afterload |
| Which of the following is true of the portal venous flow as measured by Doppler sonography? | The peak velocity increases postprandial |
| What vessel normally crosses posterior to the IVC? | Right renal artery |
| Which of the following leads to pathological flow reversal in the IVC during systole? | Tricuspid valve insufficiency |
| How should splanchnic arteries appear on post prandial examinations? | low resistant |
| Portal hypertension may NOT result from which of the following? | Anemia |
| ”TIPSS” is an acronym for which of the following medical procedures? | A shunt between the IVC and the portal system |
| What is the normal range of diameters for the abdominal aorta? | 15-20 mm |
| Hepatic vein thrombosis is known as which of the following? | Budd-Chiari Syndrome |
| Flow velocities in the aorta are approximately ? Cm/second slower than in peripheral arteries because of the large aortic caliber | 30 cm/second |
| True or false: There can never be more than three hepatic veins | False |
| Which of the following refers to an occlusion of the distal abdominal aorta that involves the iliac bifurcation? | Leriche Syndrome |
| What alternate name do myocardial cells have? | Mechnical cells |
| What state of a cell exists when at rest and the inside of the cell is more negative than the outside? | Polarized |
| What occurs in cells during depolarization? | Inside of cell becomes positive |
| What makes pacemaker cells unique compared to other cells? | Capable of generating an electrical impulse without nerve stimulation |
| What term is defined as the ability of cardiac muscle to respond to external stimulus? | Excitability |
| What do electrical charges of opposite polarity possess when they are separated? | Potential energy |
| Where does the 5 phrases of the “fast response action potential” occur? | Atrial and ventricular myocardial cells, Pukinje Fibers |
| True or False: Depolarization is the same thing as contraction | False |
| What are electrolytes, such as sodium, potassium, and calcium which carry a positive charge, known as? | Ions |
| Flow velocities in the aorta are approximately ? Cm/second slower than in peripheral arteries because of the large aortic caliber | 20 cm/second |
| Which of the following refers to an occlusion of the distal abdominal aorta that involves the iliac bifurcation? | Leriche Syndrome |
| What is the major "compression syndrome" of the upper extremity? | Thoracic outlet |
| What type of spectral doppler flow pattern is present in normal, unexercised peripheral arteries? | Triphasic |
| Which arterial bifurcation in the lower extremity is a common site for atherosclerotic disease? | Common femoral artery |
| Leriche syndrome refers to chronic thrombosis of which arterial bifurcation? | Aortic |
| What is considered to be a normal Ankle/Brachial Index (ABI) calculation for the peripheral arteries? | >0.97 |
| What techniques may result in understimation of arterial pressure when performing a peripheral arterial evaluation? | Deflating the pressure cuff too rapidly |
| What are some limitations of Color Duplex Sonography (CDS) in lower extremity arterial examinations? | Small caliber vessels and multiple plaques are present |
| What are the major complizations of flase aneurysm? | Rupture and nearby nerve compression |
| How is the ABI calculated? | Dividing the highest ankle pressure by the highest brachial pressure |
| What is one of the earliest sonographic signs of incipient atherosclerotic arterial disease? | Thickening of the tunica intima and tunica media |
| Where should an examination of the lower extremity arteries begin? | Starts at the pelvic level |
| Which lower extremity artery is frequently a site of true aneurysms? | Popliteal |
| What causes the biphasic spectral Doppler waveform seen in arteries during exercise of the extremities? | Decrease in peripheral vascular resistance |
| What cardiovascular risk is associated with an arteriovenous malformation (AVM) | Volume overload on the heart |
| Leads I, II, and III axes form what with the heart at the center? | Einthoven's triangle |
| Horizontal plane leads view the front of the body as though it were flat | No |
| What non-standard leads can be utilized to visualize infarctionof the right ventricle? | V1R-V6RR |
| Right or wrong: Each electrode placed in a "V" position is a positive electrode | Wrong |
| The difference in placement of non standard chest leads V7-V9 as opposed to V1-V6 is? | Placed further left and towardsthe back |
| A reference point that is the average of the limb lead electrical potentials is known as? | Central terminal |
| Which leads view the heart in the front plane? | Standard limb leads, augmented limb leads |
| Which of the following is associated with significatn fetal cardiac insufficiency? | Double pulsations in the umbilical vein |
| What RI, measured in in the uterine or myometrial arteries, is used as the lower end of normal for assessing suspicious malignancies or hormonal influences of perfusion during the fertile period of the menstrual cycle? | RI <0.4 |
| What is the ductus venosus Doppler finding that is associated with IUGR? | Reversal of diastolic flow in the ductus venosus |
| If IUGR is due to placental insufficiency and fetal hypoxia, which of the following would be expected? | Reduced flow in the umbilical arteries and increased flow in the middle cerebral arteries |
| Which of the following is associated with a physiologic notch in early diastole in either the uterine or gonadal arteries? | Placental abruption, preeclampsia, IUGR |
| After which LMP week should normal umbilical artery diastolic flow always be detected? | LMP week 15 |
| Uterine myomas (fibroids) usually exhibit which of the following? | Increased peripheral flow with color Doppler |
| Which of the following Doppler findings has a pathologic significance in pregnancy? | Unusually low or reversed umbilical artery diastolic flow |
| After what week in normal pregnancies should the "physiologic notch in early diastole" cease to be observed? | LMP week 20 |
| True or False: Fractional shortening is an important parameter when evaluating the function of the left ventricle | True |
| True or False: M-mode utilizes a single beam to transmit and receive information regarding the movement of cardiac structures | True |
| Which of the following structures is not visualized in the parasternal short axis view? | IVC |
| Of the following, which one is described as "the most important tool of the cardiologist for diagnosing significant structural or functional abnormalities of the heart?" | Echocardiography |
| The aortic valve is open during? | Systole |
| True or False: Echocardiography is an excellent modality in the evaluation of Left Ventricular Function as well as evaluating will motion abnormalities | True |
| Which of the following is not considered an echocardiography method? | A-mode |
| In the apical five chamber view which direction in blood normally flowing? | Away from the transducer |
| Which position in the patient scanned in while obtaining the apical four chamber view? | Left lateral decubitius |
| Which imaging window provides the best evaluation of mitral inflow? | Apical 4 chamber |
Created by:
marissagirl