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Transoesophageal Echocardiography study guide and practice mcqs phần 6

Chèn vào IVC gần đến cơ hoành (~ 30 ◦) / diam 5-11mm Doppler dòng chảy bao gồm S, SR, D và A sóng (Hình 3,22 (b)) S sóng: ↓ RAP do: thư giãn tâm nhĩ TAPSE SR sóng : nhẹ đảo chiều của dòng chảy ở cuối của sóng RV tâm thu D: ↓ RAP như TV sẽ mở ra một làn sóng: RA co → đảo ngược của dòng chảy nhỏ | 68 Transoesophageal Echocardiography Vena cavae hepatic veins IVC From common iliac veins at L5 to RA Passes through diaphragm at T8 11-25 mm diameter Doppler flow composed of S D and A waves Fig. 3.22 a SVC From R and L innominate veins to RA at third CC HVs Insert into IVC proximal to diaphragm at 30 5-11mm diam Doppler flow composed of S SR D and A waves Fig. 3.22 b S wave ị RAP due to atrial relaxation TAPSE SR wave slight reversal of flow at end of RV systole D wave ị RAP as TV opens A wave RA contraction small reversal of flow Normal anatomy and physiology 69 Coronary arteries From sinuses of Valsalva LCA 10 mm long 3-10 mm diam bifurcates into LAD and LCx LAD supplies ant LV ant 2 3IVS PWD of LAD during diastole 40-70 cm s LCx supplies lat LV SAN 40 AVN 15 post 1 s IVS RCA supplies RA RV SAN 60 AVN 85 post 1 3 IVS Post 1 3IVS from post. desc. artery RCA 50 LCx 20 RCA LCx 30 Septa Interatrial septum Thin muscular membrane separating RA and LA Depression in mid portion fossa ovalis foramen ovale in fetus Development Fig. 3.23 Downward growth of septum primum Septum primum separates from superior atrium and continues downward growth Downward growth of septum secundum to right of septum primum creates flap foramen ovale FO Fetus RAP LAP FO open Birth LAP RAP FO closes 25 of population have patent FO PFO IAS motion Reflects RAP vs. LAP Predominantly reflects LAP because LA less compliant than RA therefore increase in volume increases LAP RAP Normal anatomy and physiology 71 Concave to LV Normal IVS 7-12 mm thick LV free wall thickness measured in mid-diastole Thin septum post-MI scar tissue 7 mm high echogenicity 30 thinner than surrounding myocardium IVS motion Contracts with LV inwards towards centre of LV SAX view Multiple choice questions 1. The normal left atrial area is A 4 mm2 B 1.4 cm2 C 4 cm2 D 10 cm2 E 14 cm2 2. Normal right atrial oxygen saturation is A 55 B 65 C 75 D 85 E 95 3. From the transgastric short axis view of the left ventricle normal .