The American Society of Echocardiography adopted the "leading edge" method of measurement because
It produces the most consistent and reproducible measurements.
The term basilar area of the ventricle refers to the :
C. ) Ventricular myocardium at the atrioventricular valves.
The infundibulum is related to the area of the right ventricle called the :
C. ) Outflow tract.
The tree primary branches of the aortic arch include what:
Innominate artery.
Left common carotid artery.
Left subclavian artery.
The term tunica adventitia refers to:
The outer lining of the arterial wall.
The term tunica intima refers to what:
The inner lining of the arterial wall.
Dextracardia indicates:
Heart located in the right side of the chest.
You are asked to pay particular attention to the semilunar valves. These valves are the:
A. ) Aortic and Pulmonic valves.
The great vessels of the heart are the:
B. ) Aorta and pulmonary artery.
In M mode, the structure used to pinpoint end systole for measurement is:
D. ) The R wave denotes the electrical stimulation that initiates systole. The Q wave is not always present and is not an indicator of end systole. Although the septum is at its maximum posterior motion under normal conditions, it is susceptible to electrical aberrations and volume and pressure changes and therefore not consistent for measurement. Only the maximum anterior motion of the left ventricular posterior wall is consistent for end-systolic measurement.
The motion of the septum should be evaluated by M mode at the:
B. ) Midventricular level.
The coronary sinus returns blood to the left atrium.
True of False
False: the coronary sinus is the terminal portion of the great cardiac vein, and it returns blood to the right artium.
The ostium of the coronary arteries may sometimes be visualized in a short-axis two-dimensional echo view at the level of the aortic valves.
True or False
True: a narrow opening on the left coronaryh cusp of the av valve at approximately 4 to 5 o'clock may define the ostium (opening) of the left coronary artery.
Since phases of the cardiac cycles are discussed in terms of systole and diastole of the ventricle, what phase would be occurring during atrial filling?
C. ) systole
In the ECG cycle, late ventricular filling occurs after the:
D. ) P wave. The P wave on an ECG is the electrical stimulus that creates the mitral A wave, which coincides with the atrial kick and late diastolic filling.
If a patient presents with an early diastolic murmur you would concentrate interest on the: (True or False)
a.) Aortic valve.
b.) Mitral valve.
c.) Tricuspid valve.
d.) Pulmonic valve.
a.) Aortic valve. True
b.) Mitral valve. False
c.) Tricuspid valve. False
d.) Pulmonic valve. True
Which valve would you suspect to be abnormal if auscultation revealed and Austin-Flint murmur?
B. ) Aortic valve. An Austin-Flint murmur is associated with aortic insufficiency.
Most authors consider the major components of the first heart sound to be:
D. ) Closure of the atrioventricular valves.
The heart sound most often associated with mitral valve prolapse is:
D. ) Systolic click. Systolic clicks are among the most important physical findings in patients with mitral valve prolapse. The clicks may be single or multiple and may be brought out by changes in position or by using the Valsalva maneuver.
The heart sound associated with mitral and/ or tricuspid stenosis is:
D. ) Opening snap. The sounds are sharp and high- pitched. In isolated mitral stenosis, increasing severity of the lesion causes higher atrial pressures and early opening of the valve. A relatively short interval between the aortic component of the second heart sounds and the opening snap (A2-OS interval) implies severe mitral stenosis. A pericardial knock, which occurs with constrictive pericarditis, is an early diastolic sound that can be confused with an opening snap.
Early diastolic murmurs are due to aortic or pulmonic insufficiency.
True or False.
True: The severity of regurgitation is often inversely related to the duration of the murmur. With severe regurge, aortic diastolic pressure falls rapidly and may equalize with ventricular pressure relatively early, causing marked reduction of intensity or cessation of the murmur. Aortic insufficiency may also cause a diastolic rumble at the apex- an Austin-Flint murmur. Pulmonary insufficiency due to pulmonary hypertension, there is a large diastolic gradient. The murmur is high- pitched, follows the second heart sound immediately, and continues throughout diastole. In pulmonary insufficiency caused by valvular disease, there is usually a silent period b/w the pulmonic second heart sound and the initiation of the murmur, which is relatively low in frequency.
Myxomas are tumors that can be located either inside or outside the heart.
True or False.
False. These tumors are located only intracardially.
Approximately 40% of patients with left atrial myxomas have systemic emboli to the brain or extremities.
True or False.
True.
Myxomas occur only in the left atrium.
True or False.
False. Myxomas can occur in either atrium, on the mitral valve, or in the ventricles.
Females are affected slightly more often than males.
True or False.
True.
Symptoms associated with pericarditis include:
a.) A severe, sharp pain located precordially that may radiate into the shoulders and neck.
b.) Ankle swelling.
c.) Changing positions and taking deep breaths increases the pain.
d.) The pain is dull and radiates into the jaw.
a and c
Symptoms noted with mitral valve prolapse syndrome include:
a.) Palpitations and sharp pain inrelated to exercise.
b.) Lower back pain and headache.
c.) Fatigue and dyspnea.
d.) Palpitations and dizzy spells.
a, c, and d.
A pseudonym for mitral valve prolapse syndrome is:
B. ) Barlow's syndrome.
The term trepopnea is the sensation of dyspnea or palpitations, or an uncomfortable feeling that may occur when patients with cardiac diseases lie on their left side.
True or False.
True.
The term dyspnea refers to the condition of:
Difficulty in breathing.
If a patient awakens in the night with shortness of breath, 1 to 2 hours after falling asleep, what disease might be suspected?
D. ) Congestive heart failure.
Anemia or cyanosis may be a manifestation of serious underlying heart disease.
True or False
True.
Heart failure, obstruction of flow by valvular stenosis, and constrictive pericarditis can cause a diminished stroke volume.
True or False.
True.
Normal peripheral pulses arrive later than the carotid pulse.
True or False
True.
Pulses alternans implies impaired ventricular function and is often present in massive periardial effusion, particularly pericardial tamponade.
True or False.
True.
Aortic regurge and carotid atherosclerosis cause a large stroke volume, wide pulse pressure, and lowered peripheral resistance with resultant bounding hyperkinetic pulses.
True or False.
True.
Which of the following signs are indicative but not diagnostic of heart disease?
E. ) all of the above. They may all be indicators of cardiac disease but are not specifically diagnostic.
Which of the following is most likely to cause a decease in cardiac output?
E. ) Decrease in left ventricular stroke volume. Left ventricular stroke volume is directly related to cardiac output. Therefore and decrease in left ventricular stroke volume will reduce cardiac output. Conversely, and increase in left ventricular stroke volume will raise cardiac output.
A decrease in left ventricular contractility secondary to acute myocardial infarction will:
A. ) Left ventricular contractility will decrease delta P and in doing so will reduce cardiac output.
If all other factors remain constant, you would expect a reduction in vessel diameter to:
B. ) Increase velocity. A reduction in vessel diameter increases velocity within the constricted segment. A reduction in vessel diameter also increases the likelihood of turbulence, and if the diameter is sufficiently reduced, flow will be reduced (critical stenosis).
Which one of the following is most likely to cause turbulent flow of blood in the aorta?
D. ) An increse in cardiac output from 5 L/min to 20 L/min.
Which of the following are characteristics of turbulent flow?
a.) It can be predicted by Reynold's number.
b.) It is responsible for murmurs, bruits and thrills.
c.) It increases pressure downstream.
d.) It occurs where there are abrupt variations in vessel diameter.
e.) It is affected by velocity.
All of the above except for c.
During and experiment, a laboratory animal suddenly develops 2:1 heart block, effectively reducing heart rate by one-half. Which ONE of the following responses would account for pressure being maintained at the same level as before the heart block?
C. ) See the analogy to Ohm's law. Cardiac output and pressure are governed not by how much blood the heart can put out in a given period but rather by how much blood the peripheral vessels are capable of accepting. With cardiac output halved and peripheral resistance doubled, pressure remains the same.
A subject has a cardiac output of 5 L/min at a heart rate of 75 beats/ min. If stroke volume remains constant, what will be the effect of an increase in heart rate to 150 beats per minute?
E. ) Cardiac output would increase to 10 L/min.
Which ONE of the following statements is True regarding the term blood pressure?
E. ) It represents the force exerted by the blood against any unit area of the vessel wall.
The minimal pressure in the arterial system during a cardiac cycle is termed:
B. ) Diastolic pressure.
In measuring human blood pressure, the first sound was heard at 130 mmHg, the second at 105, the third at 100, and the last at 95. What is the estimated mean blood pressure?
A. ) 107 mmHg.
Which ONE of the following is a correct statement describing transmission of the arterial pressure wave?
C. ) It is caused in part by the inertia of blood in the aorta.
In laminar flow, the velocity of the blood is:
C. ) Zero at the vessel wall. The fact that normal blood flow is zero at the vessl wall and highest at center stream is one reason why continuous- wave Dopplers show wider frequency shifts (decreased windowing) when spectrally analyzed.
The principal site of peripheral resistance in the vascular bed is determined to be in the arterioles because:
A. ) The pressure drop across these vessels is greatest.
As the arterial pressure wave moves toward the periphery, all of the following occur except: a.) The pulse amplitude is increased by the presence of reflected waves.
b.) Speed of propagation diminishes.
c.) Pulsatile changes in arterioles and capillaries are "dampened" owing to vascular distensibility and resistance.
d.) Speed of propagation increases.
b.) Speed of propagation diminishes.
The incisura on the aortic pressure wave:
D. ) Is inscribed just after the aortic valve closes.
Starling's law of the heart can best be expressed by which one of the following?
C. ) Within limits, an increase in venous return results in an increase in stroke volume.
Which ONE of the following best describes the role of the heart as a pump?
C. ) Forcing blood from the venous to the arterial circulation, restoring energy necessary for the blood flow.
