CCI Review
Which valve separates the area of greatest pressure differences? - ANS -Mitral Valve
Which aortic leaflet is the superior one in the parasternal long axis view? - ANS -RCC
From the left parasternal window which of the following are you most likely to get accurate
velocity measurements?
a.) LVOT
b.) mitral stenosis
c.) pulmonary artery
d.) mitral regurgitation - ANS -c. pulmonary artery
Name the tricuspid leaflets in the RVIT view? - ANS -posterior and anterior
Where is the LAA on TTE? - ANS -Sometimes in the parasternal SAX Ao Valve level
(better seen in the apical 2ch)
The coronary arteries come off the:
a.) descending aorta
b.) coronary sinuses
c.) pulmonary artery
d.) sinuses of Valsalva - ANS -d.) sinuses of Valsalva
During which phase do the coronaries fill?
a.) early systole
b.) late systole
c.) early diastole
d.) late diastole - ANS -c.) early diastole
End Diastole= - ANS -frame after the mitral valve closure, or frame in the cardiac cycle where
the dimension is largest
End Systole= - ANS -frame proceeding mitral valve opening, or the frame in the cardiac cycle
where the dimension is smallest
The best images of the ascending aorta are often obtained from which transducer view?
,a.) apical
b.) subcostal
c.) suprasternal
d.) right parasternal - ANS -c.) suprasternal
Name the vessels coming off the arch and most proximal or distal. - ANS -innominate
(proximal, left common carotid, left subclavian (distal)
What cardiac pathology is associated with bicuspid aortic valves? - ANS -Coarctation of the
aorta
Which window do you use to look for the secondary finding with bicuspid values? - ANS
-Suprasternal
Where do most aortic coarctations occur? - ANS -After the take-off of the left subclavian artery,
or within the aortic isthmus
Where are the pulmonary veins located? Which ones are seen in this view? - ANS -Left atrium,
right & left (inferior) pulmonary veins
From the Apical 4ch view how do you rotate the transducer to obtain the apical LAX?
a.) clockwise 90 degrees
b.) clockwise 120 degrees
c.) counterclockwise 90 degrees
d.) counterclockwise 120 degrees - ANS -d.) counterclockwise 120 degrees
Where is the coronary sinus located? - ANS -Posterior AV groove
To visualize the coronary sinus on the apical 4 chamber view you should tilt the transducer?
a.) medial
b.) anterior
c.) lateral
d.) posterior - ANS -d.) posterior
Which valve sits at the opening of the coronary sinus?
a.) Todaro
b.) Vieussens
c.) Thebesian
d.) Eustachian - ANS -c.) Thebesian
What portion of the pulmonary venous PW Doppler represents atrial systole? - ANS -a wave
,What portion of the pulmonary venous PW Doppler represents systolic inflow? - ANS -s wave
What portion of the pulmonary venous PW Doppler represents diastolic inflow? - ANS -d wave
At what temperature is it unsafe to use a TEE probe?
a.) 20-25 c
b.) 25-30 c
c.) 30-40 c
d.) 40-45 c - ANS -d.) 40-45 c
Know where the LA appendage is by TEE - ANS -2ch
Know where the left upper pulmonary vein is located in the 2 ch during TEE - ANS -
TEE- ME 4ch degrees? - ANS -0
TEE- ME 2CH degrees? - ANS -90
TEE- ME LAX degrees? - ANS -120
TEE- ME AV SAX degrees? - ANS -60
Which has the fastest intrinsic rate?
a.) AV node
b.) Bundle of HIS
c.) SA node
d.) Purkinje fibers - ANS -c.) SA node
What is the absolute refractory period? - ANS -That period when a muscle cell is not excitable-
from phase 1 until into phase 3. The "relative refractory period" is during phase 3 and the
muscle cell might contract if the stimulus is strong.
P wave= - ANS -atrial systole
P-R interval= - ANS -includes P-R segments (from atrial to ventricular depolarization)
QRS complex= - ANS -Ventricular systole (depolarization)
T wave= - ANS -ventricular diastole (depolarization)
What is a normal duration for the QRS complex?
, a.) 0.10 msec
b.) 1.0 msec
c.) 0.10 sec
d.) 1.0 sec - ANS -c. 0.10 sec
electrocardiogram
a.) 1 small box=
b.) 1 big box=
c.) 5 big boxes= - ANS -a.) 0.04 sec
b.) 0.2 sec
c.) 1 sec
What is the Frank-Starling law of the heart? - ANS -the more the heart fills with blood during
diastole, the greater the force of contraction during systole
HINT: Acute AI is hypercontractile because we shift up the Starling curve. Chronic AI is failure
when we drop off the end. - ANS -
Echo findings for preload vs afterload - ANS -Preload = dilatation
Afterload = hypertrophy
Which study does not allow for the calculation of ejection fraction?
a.) 2D echo
b.) cardiac angio
c.) chest xray
d.) cardiac nuclear study - ANS -c.) chest xray
SV x HR= - ANS -cardiac output
Bernoulli's Equation - ANS -
Does venous return increase or decrease with inspiration? - ANS -Increase
Inhalation of amyl nitrite causes?
a.) increased preload
b.) decrease preload
c.) increase afterload
d.) decrease afterload - ANS -d.) decreased afterload
Mitral valve velocity during inspiration?
Which valve separates the area of greatest pressure differences? - ANS -Mitral Valve
Which aortic leaflet is the superior one in the parasternal long axis view? - ANS -RCC
From the left parasternal window which of the following are you most likely to get accurate
velocity measurements?
a.) LVOT
b.) mitral stenosis
c.) pulmonary artery
d.) mitral regurgitation - ANS -c. pulmonary artery
Name the tricuspid leaflets in the RVIT view? - ANS -posterior and anterior
Where is the LAA on TTE? - ANS -Sometimes in the parasternal SAX Ao Valve level
(better seen in the apical 2ch)
The coronary arteries come off the:
a.) descending aorta
b.) coronary sinuses
c.) pulmonary artery
d.) sinuses of Valsalva - ANS -d.) sinuses of Valsalva
During which phase do the coronaries fill?
a.) early systole
b.) late systole
c.) early diastole
d.) late diastole - ANS -c.) early diastole
End Diastole= - ANS -frame after the mitral valve closure, or frame in the cardiac cycle where
the dimension is largest
End Systole= - ANS -frame proceeding mitral valve opening, or the frame in the cardiac cycle
where the dimension is smallest
The best images of the ascending aorta are often obtained from which transducer view?
,a.) apical
b.) subcostal
c.) suprasternal
d.) right parasternal - ANS -c.) suprasternal
Name the vessels coming off the arch and most proximal or distal. - ANS -innominate
(proximal, left common carotid, left subclavian (distal)
What cardiac pathology is associated with bicuspid aortic valves? - ANS -Coarctation of the
aorta
Which window do you use to look for the secondary finding with bicuspid values? - ANS
-Suprasternal
Where do most aortic coarctations occur? - ANS -After the take-off of the left subclavian artery,
or within the aortic isthmus
Where are the pulmonary veins located? Which ones are seen in this view? - ANS -Left atrium,
right & left (inferior) pulmonary veins
From the Apical 4ch view how do you rotate the transducer to obtain the apical LAX?
a.) clockwise 90 degrees
b.) clockwise 120 degrees
c.) counterclockwise 90 degrees
d.) counterclockwise 120 degrees - ANS -d.) counterclockwise 120 degrees
Where is the coronary sinus located? - ANS -Posterior AV groove
To visualize the coronary sinus on the apical 4 chamber view you should tilt the transducer?
a.) medial
b.) anterior
c.) lateral
d.) posterior - ANS -d.) posterior
Which valve sits at the opening of the coronary sinus?
a.) Todaro
b.) Vieussens
c.) Thebesian
d.) Eustachian - ANS -c.) Thebesian
What portion of the pulmonary venous PW Doppler represents atrial systole? - ANS -a wave
,What portion of the pulmonary venous PW Doppler represents systolic inflow? - ANS -s wave
What portion of the pulmonary venous PW Doppler represents diastolic inflow? - ANS -d wave
At what temperature is it unsafe to use a TEE probe?
a.) 20-25 c
b.) 25-30 c
c.) 30-40 c
d.) 40-45 c - ANS -d.) 40-45 c
Know where the LA appendage is by TEE - ANS -2ch
Know where the left upper pulmonary vein is located in the 2 ch during TEE - ANS -
TEE- ME 4ch degrees? - ANS -0
TEE- ME 2CH degrees? - ANS -90
TEE- ME LAX degrees? - ANS -120
TEE- ME AV SAX degrees? - ANS -60
Which has the fastest intrinsic rate?
a.) AV node
b.) Bundle of HIS
c.) SA node
d.) Purkinje fibers - ANS -c.) SA node
What is the absolute refractory period? - ANS -That period when a muscle cell is not excitable-
from phase 1 until into phase 3. The "relative refractory period" is during phase 3 and the
muscle cell might contract if the stimulus is strong.
P wave= - ANS -atrial systole
P-R interval= - ANS -includes P-R segments (from atrial to ventricular depolarization)
QRS complex= - ANS -Ventricular systole (depolarization)
T wave= - ANS -ventricular diastole (depolarization)
What is a normal duration for the QRS complex?
, a.) 0.10 msec
b.) 1.0 msec
c.) 0.10 sec
d.) 1.0 sec - ANS -c. 0.10 sec
electrocardiogram
a.) 1 small box=
b.) 1 big box=
c.) 5 big boxes= - ANS -a.) 0.04 sec
b.) 0.2 sec
c.) 1 sec
What is the Frank-Starling law of the heart? - ANS -the more the heart fills with blood during
diastole, the greater the force of contraction during systole
HINT: Acute AI is hypercontractile because we shift up the Starling curve. Chronic AI is failure
when we drop off the end. - ANS -
Echo findings for preload vs afterload - ANS -Preload = dilatation
Afterload = hypertrophy
Which study does not allow for the calculation of ejection fraction?
a.) 2D echo
b.) cardiac angio
c.) chest xray
d.) cardiac nuclear study - ANS -c.) chest xray
SV x HR= - ANS -cardiac output
Bernoulli's Equation - ANS -
Does venous return increase or decrease with inspiration? - ANS -Increase
Inhalation of amyl nitrite causes?
a.) increased preload
b.) decrease preload
c.) increase afterload
d.) decrease afterload - ANS -d.) decreased afterload
Mitral valve velocity during inspiration?
