CCI RCS Study Guide (revised)
Cavitation is - correct answer The creation or vibration of small gas filled bodies by the
ultrasound beam.. This tends to occur only with higher-intensity exposures, and may result in
implosion of the bubbles within the body.
The 6 intensities from highest to lowest are - correct answer 1.) SPTP 4.) SATP
2.)SPPA 5.) SAPA
3.)SPTA 6.) SATA
What tricuspid valve leaflets are noted in PLAX/PSLA inflow? - correct answer Anterior and
septal leaflets, most commonly.
Formula for calculating EF? - correct answer EF% = (SV/EDV) x 100%
Stroke Volume (SV) formula - correct answer SV= EDV - ESV
What is stroke volume (SV)? - correct answer Amount of blood pumped out of each ventricle
during a single heart beat/cardiac cycle.
What is the chiari network? - correct answer Network of fibers originating from eustachian
valve. Remnant of embryonic sinus venous around the inlet of the IVC.
Where can the chiari network be found - correct answer Right atrium, originating from the inlet
of IVC
What is the most anterior chamber of the heart? - correct answer Right ventricle
Which pair of intensities has the lowest value? - correct answer SATA (spatial average, temporal
average)
Where is the Eustachian valve located ? - correct answer In between the IVC and the right
atrium.
What's another name for the Right Ventricular Outflow Tract (RVOT) ? - correct answer
Infundibulum
Where is the coronary sinus located in relation to the descending aorta? - correct answer
Anterior/"above" in PLAX/PSLA
The three cusps of the tricuspid valve are? - correct answer Anterior (free wall side)
Medial/septal (smallest)
Posterior
What are the two main layers of the pericardium? - correct answer 1.) Visceral = lies directly
upon external surface of the heart and is commonly referred to as the epicardium.
,2,) Parietal = or fibrous pericardium is the thick outer sac.
*The pericardial cavity lies between these two layers. These layers are continous with each
other
What is the normal pressure for the right ventricle ? - correct answer 25/5 mmHg (a/mean)
What is the normal pressure for the pulmonary artery? - correct answer 25/10/15 mmHg
(sys/diast/mean)
What is the normal pressure for the left atrium (PCWP/PAWP)? - correct answer 10mmHg
What is the normal pressure for the aorta ? - correct answer 120/80/95 mmHg
(sys/diast/mean)
What are the two cusps of the mitral valve ? - correct answer Anterior (long) and the posterior
(short)
When is the left ventricular pressure the lowest? - correct answer Early diastole
What is Becks Triad and what does it indicate? - correct answer JVD, hypotension and a "quiet
heart". indicative of cardiac tamponade.
What are the effects of pulmonary HTN ? - correct answer Dilated pulmonary artery, Increased
TR , RV dilation/hypertrophy, septal flattening (mainly systole, pressue)
What happens to the size of an aneurysm during systole? - correct answer It increases
In patients with A-Fib which heart sound would be missing ? - correct answer S4, atrial gallop
What is the normal O2 saturation of the left heart ? - correct answer 98%, (95-100%)
What is cardiac output? - correct answer It is the total amount of blood (liters) ejected per
minute.
*CO =SV x HR
*normal cardiac output = 5-6 liters/minute
Effects of left side heart failure (HFrEF, forward failure) - correct answer Blood backs up into the
to lungs, causing paroxysmal nocturnal dyspnea, orthopnea, elevated PCWP, pulmonary
congestion/edema, hemoptysis, tachycardia, DOE, fatigue, cyanosis
What part of the heart is affected when there is pulmonary edema ? - correct answer Left side
of heart
What is the primary cause of Congestive Heart Failure? - correct answer Systolic dysfunction.
What part of the heart is affected when there is peripheral edema? - correct answer Right side
of the heart
, When the foremen ovale closes after birth due to increased left atrial pressure the spot it was
located is now called? - correct answer Fossa ovalis
Mitral regurge hemodynamic evaluation is done in ? - correct answer Systole
Aortic stenosis evaluation is done in? - correct answer Systole
Tricuspid stenosis evaluation is done in ? - correct answer Diastole
Is left atrial thrombus common in patients with mitral stenosis? - correct answer relatively yes,
mainly in the appendage
What are 3 factors affecting stroke volume? - correct answer Preload, after-load, contractility
What is fractional shortening? - correct answer Percentage of change in the LV cavity diameter
that is lost in systole.
*normal range = 27-45%, FS= [(LVEDD-LVESD) + LVEDD] x 100
If a patient has a stroke volume of 70ml and a heart rate of 90bpm what would be their cardiac
output? - correct answer CO (L/min)= SV x HR
70ml= .07 L x 90bpm = 6.3 L/min
What is QP and QS? - correct answer QP= pulmonary circulatory flow
QS= systemic circulatory flow
Atrial septal defect surgery is mainly considered when the QP/QS ratio exceed? - correct
answer 1.5
*normal = 1:1, division equalling 1
What are the 2 most common encountered congenital heart lesions diagnosed in adults ? -
correct answer Atrial septal defect/PFO
Bicuspid aortic valve
What chamber of the heart would be greater affected in patients with ventricular septal defects
and left to right shunting? - correct answer Right atrium
A patient with a higher blood pressure in the right arm than the left arm may have? - correct
answer Coarctation of aorta above the left subclavian artery branch
How is the 2D image of a phased array transducer created? - correct answer Sequentially
activating a series of adjacent crystals to angle the ultrasound beam. pattern will look like an
edge sloping up or down,
What is a heterograph/ xenograph? - correct answer A bioprosthetic valve transferred from
animals to humans.
Cavitation is - correct answer The creation or vibration of small gas filled bodies by the
ultrasound beam.. This tends to occur only with higher-intensity exposures, and may result in
implosion of the bubbles within the body.
The 6 intensities from highest to lowest are - correct answer 1.) SPTP 4.) SATP
2.)SPPA 5.) SAPA
3.)SPTA 6.) SATA
What tricuspid valve leaflets are noted in PLAX/PSLA inflow? - correct answer Anterior and
septal leaflets, most commonly.
Formula for calculating EF? - correct answer EF% = (SV/EDV) x 100%
Stroke Volume (SV) formula - correct answer SV= EDV - ESV
What is stroke volume (SV)? - correct answer Amount of blood pumped out of each ventricle
during a single heart beat/cardiac cycle.
What is the chiari network? - correct answer Network of fibers originating from eustachian
valve. Remnant of embryonic sinus venous around the inlet of the IVC.
Where can the chiari network be found - correct answer Right atrium, originating from the inlet
of IVC
What is the most anterior chamber of the heart? - correct answer Right ventricle
Which pair of intensities has the lowest value? - correct answer SATA (spatial average, temporal
average)
Where is the Eustachian valve located ? - correct answer In between the IVC and the right
atrium.
What's another name for the Right Ventricular Outflow Tract (RVOT) ? - correct answer
Infundibulum
Where is the coronary sinus located in relation to the descending aorta? - correct answer
Anterior/"above" in PLAX/PSLA
The three cusps of the tricuspid valve are? - correct answer Anterior (free wall side)
Medial/septal (smallest)
Posterior
What are the two main layers of the pericardium? - correct answer 1.) Visceral = lies directly
upon external surface of the heart and is commonly referred to as the epicardium.
,2,) Parietal = or fibrous pericardium is the thick outer sac.
*The pericardial cavity lies between these two layers. These layers are continous with each
other
What is the normal pressure for the right ventricle ? - correct answer 25/5 mmHg (a/mean)
What is the normal pressure for the pulmonary artery? - correct answer 25/10/15 mmHg
(sys/diast/mean)
What is the normal pressure for the left atrium (PCWP/PAWP)? - correct answer 10mmHg
What is the normal pressure for the aorta ? - correct answer 120/80/95 mmHg
(sys/diast/mean)
What are the two cusps of the mitral valve ? - correct answer Anterior (long) and the posterior
(short)
When is the left ventricular pressure the lowest? - correct answer Early diastole
What is Becks Triad and what does it indicate? - correct answer JVD, hypotension and a "quiet
heart". indicative of cardiac tamponade.
What are the effects of pulmonary HTN ? - correct answer Dilated pulmonary artery, Increased
TR , RV dilation/hypertrophy, septal flattening (mainly systole, pressue)
What happens to the size of an aneurysm during systole? - correct answer It increases
In patients with A-Fib which heart sound would be missing ? - correct answer S4, atrial gallop
What is the normal O2 saturation of the left heart ? - correct answer 98%, (95-100%)
What is cardiac output? - correct answer It is the total amount of blood (liters) ejected per
minute.
*CO =SV x HR
*normal cardiac output = 5-6 liters/minute
Effects of left side heart failure (HFrEF, forward failure) - correct answer Blood backs up into the
to lungs, causing paroxysmal nocturnal dyspnea, orthopnea, elevated PCWP, pulmonary
congestion/edema, hemoptysis, tachycardia, DOE, fatigue, cyanosis
What part of the heart is affected when there is pulmonary edema ? - correct answer Left side
of heart
What is the primary cause of Congestive Heart Failure? - correct answer Systolic dysfunction.
What part of the heart is affected when there is peripheral edema? - correct answer Right side
of the heart
, When the foremen ovale closes after birth due to increased left atrial pressure the spot it was
located is now called? - correct answer Fossa ovalis
Mitral regurge hemodynamic evaluation is done in ? - correct answer Systole
Aortic stenosis evaluation is done in? - correct answer Systole
Tricuspid stenosis evaluation is done in ? - correct answer Diastole
Is left atrial thrombus common in patients with mitral stenosis? - correct answer relatively yes,
mainly in the appendage
What are 3 factors affecting stroke volume? - correct answer Preload, after-load, contractility
What is fractional shortening? - correct answer Percentage of change in the LV cavity diameter
that is lost in systole.
*normal range = 27-45%, FS= [(LVEDD-LVESD) + LVEDD] x 100
If a patient has a stroke volume of 70ml and a heart rate of 90bpm what would be their cardiac
output? - correct answer CO (L/min)= SV x HR
70ml= .07 L x 90bpm = 6.3 L/min
What is QP and QS? - correct answer QP= pulmonary circulatory flow
QS= systemic circulatory flow
Atrial septal defect surgery is mainly considered when the QP/QS ratio exceed? - correct
answer 1.5
*normal = 1:1, division equalling 1
What are the 2 most common encountered congenital heart lesions diagnosed in adults ? -
correct answer Atrial septal defect/PFO
Bicuspid aortic valve
What chamber of the heart would be greater affected in patients with ventricular septal defects
and left to right shunting? - correct answer Right atrium
A patient with a higher blood pressure in the right arm than the left arm may have? - correct
answer Coarctation of aorta above the left subclavian artery branch
How is the 2D image of a phased array transducer created? - correct answer Sequentially
activating a series of adjacent crystals to angle the ultrasound beam. pattern will look like an
edge sloping up or down,
What is a heterograph/ xenograph? - correct answer A bioprosthetic valve transferred from
animals to humans.
