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Cardiac Ultrasound Physics Review
Registry Review Flashcards
431
Health Care
Undergraduate 1
12/23/2015

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Cards

Term
(True/False) Valve area is more accurate than valve gradient to determine the severity of valvular stenosis
Definition
True
Term
(True/False)Normal resting cardiac output is approximately5 liters/min
Definition
True
Term
Ventricular ejection time is influenced by which of the following?
A. Left Bundle branch block
B. Heart rate
C. Afterload
D. Pre-ejection period
Definition
C. Afterload
Term
The left and right bundle branches divide and sub divide into the?
Definition
Purkinje fibers
Term
What cardiac structure lies superior to the ventricle and curves around the left side of the pulmonary trunk?
Definition
Left atrial appendage
Term
Turbulence or disturbed flow velocities denote the presence of?
Definition
Random vortices
Term
What are the common radiographic views of the left ventricle that are preformed during cardiac catheterization?
Definition
Right anterior oblique and left anterior oblique
Term
An increase in ventricular muscle mass (hypertophy) leads to changes in the eletrocardiogram, what are these changes?
Definition
A. Increase in R wave amplitude
B. Changes in the ST segment
C. T wave inversion
D. Pronounced Q Wave
Term
What is the term that describes the normal relationship between the position of the heart, lobes of the lungs, and the abdominal organs?
Definition
Situs solitus
Term
What is the major component of the circulating blood volume?
Definition
Plasma
Term
List three things that can influence coronary blood flow.
Definition
A. Diastolic blood pressure
B. Auto regulation
C. Coronary artery obstruction
Term
What happens to the velocity of blood flow in the arterioles due to peripheral resistance?
Definition
Decreases
Term
During strenuous exercise, the metabolic rate (ml of O2/K/Min) can increase approximately?
Definition
Ten fold
Term
In assuming an upright position, venous return, and ventricular filling will?
Definition
Decrease
Term
Which of the following statements is true regarding the normal end-diastolic pressure of the left ventricle?
A. LVED pressure is greater than RVED pressure
B. LVED pressures is lower than RVED pressure
C. There is no difference between the LVED pressure and the RVED pressure
D. LVED pressure is only greater when right heart disease is present
Definition
A. LVED pressure is greater than RVED pressure
Term
The dP/dt is the?
Definition
Rate of change in left ventricular pressure during isovolumetric contraction
Term
What law states that the cardiac output increases in proportion to the degree of diastolic fiber stretch?
A. Poiseuille's law
B. Frank Starling law
C. Edward's law
D. Bernoulli's law
Definition
B. Frank Starling law
Term
Most congenital defects of the hart occur in a complex stage of cardiac development known as?
Definition
Septation
Term
What determines the dominance of either coronary artery?
Definition
The artery supplying the postero-inferior portion of the heart
Term
What portion of the aorta is the isthmus located?
Definition
Descending aorta
Term
What causes the opening and closing of the cardiac valves?
Definition
Pressure differences between contiguous cardiac chambers
Term
In the developed fetal circulation what cardiac communications exist that close soon after birth?
Definition
Patent foramen ovale and patent ductus arteriosus
Term
The atrioventricular valves are formed in utero from the?
Definition
Endocardial tissue
Term
why is the right ventricular wall thickness normally less than left ventricular wall thickness?
Definition
Pulmonary vascular resistance is lower than systemic vascular resistance.
Term
What are the names of the leaflets that make up the tricuspid valve?
Definition
Anterior, posterior, septal leaflets
Term
List four common presenting symptoms of patents with myxomas
Definition
A. Embolism
B. Chest pain
C. Syncope
D. Weakness or fatigue
Term
(True/False) The carotid pulse waveform is similar to the arterial pressure waveform.
Definition
True
Term
What is the purpose of the depth gain compensation or time gain compensation controls?
Definition
These controls help to compensate for attenuation of sound energy as the distance from the transducer to the target increases
Term
The temporal resolution of a real-time scanner is dependent upon what factor?
Definition
Frame rate

Temporal resolution is the ability to determine the position of a moving structure at any particular moment in time. The higher the frame rate, the better the temporal resolution
Term
What type of display mode operation causes a brightening of the spot on the CRT rather than a deflection each time a reflection is received?
Definition
B mode
Term
What does the ratio of the maximum amplitude to the minimum amplitude describe?
Definition
Dynamic range

(Typically 110-120dB, some newer machines claim a higher dynamic range but the literature still uses this range as the average)
Term
What is the purpose of the scan converter?
Definition
The purpose of the scan converter is to accept the output video signal from the receiver (usually in an analog format) and convert it to a digital format and store the image in a computer memory before it is set to the TV monitor for final display
Term
Using the formula frequency x wavelength will provide information regarding:
A. Amplitude
B. Period
C. Propagation speed
D. Duty factor
Definition
C. Propagation speed
Term
When strong echoes are received from structures behind weakly attenuation regions it is referred to as?
A. Enhancement
B. Attenuation
C. Ring down
D. Reverberation
Definition
A. Enhancement
Term
Which one of the following would decrease the imaging frame rate?
A. Decrease the size of the image sector
B. Increase the size of the image sector
C. Decrease the image depth
D. Increase the image gain
Definition
B. Increase the size of the image
Term
List (at least) five parameters of an ultrasound system which require periodic testing
Definition
A. Sensitivity
B. Axial resolution
C. Longitudinal resolution
D. Depth calibration
E. Range resolution
F. Dead zone
Term
If stiffness is increased, propagation speed will?
A. Increase
B. Decrease
C. Remain the same
D. Be cut by 1/2
Definition
A. Increase
Term
Which one of the following artifacts would appear as equally spaced reflections on an image?
A. Mirror image
B. Comet tail
C. Reverberation
D. Side lobe
Definition
C. Reverberation
Term
If the density of a medium is increased what happens to the propagation speed?
A. The propagation speed increases
B. The propagation speed decreases
C. The propagation speed is unaffected
D. The propagation speed doubles
Definition
B. The propagation speed decreases
Term
Routine performance and acceptance tests, routine preventative maintenance, frequent service consultations, and documentation of equipment repair and performance are all integral part of a?
Definition
Quality assurance program
Term
What is the average propagation speed of sound in the soft tissue?
Definition
1540 m/s or 1.54 mm/us
Term
Which of the following is the unitless ratio that describes the distribution of the sound beam in space?
A. Duty factor
B. Beam uniformity coefficient
C. Pulse duration
D. Intensity transmission coefficient
Definition
B. Beam uniformity coefficient

This is also known as the SP/SA factor, and is equal to the spatial peak intensity divided by the spatial average intensity. The beam will become more homogeneous as the SP/SA factor gets closer to one.
Term
what type of ultrasound is used for diagnostic ultrasound imaging?
Definition
Pulsed ultrasound
Term
Total time x duty factor is the formula that determines?
Definition
Sound-on time
Term
What are the three mechanisms of action for ultrasound biological effects?
Definition
A. Heat
B. Cavitation
C. Mechanical (non-thermal, or non-cavitational)
Term
The AIUM has stated that no independently confirmed significant biological effects in mammalian tissue have been reported below what intensity?
Definition
100 mW/cm^2 SPTA
Term
Heating depends on which one of the following intensities?
A. SPTA
B. SATA
C. SPPA
D. SAPA
Definition
A. SATA intensity
Term
The phenomenon produced by sound waves in a liquid, or liquid like media, that involves the expansion and compression of bubbles or cavities containing gas or vapors is referred to as?
A. Capacitation
B. Pitting
C. Cavitation
D. Decimation
Definition
C. Cavitation
Term
What appropriate time should be used when calculating SPTA intensities of pulsed and continuous wave ultrasound?
Definition
Total exposure time
Term
Which one of the following is NOT a factor considered to contribute to the biological effects from diagnostic ultrasound?
A. Extracellular movement
B. Cavitation
C. Shearing action
D. Thermal effects
Definition
A. Extracellular movement
Term
When frequency is decreased, spatial pulse length will?
Definition
The spatial pulse length will increase
Term
Which of the following statements is true regarding video tapes?
A. Video tapes are light sensitive
B. Video tapes are magnetic
C. Information recorded on video tapes does not degrade over time.
D. Information recorded on video tapes can degrade over time.
E. B and D
F. B and C
Definition
B and D
Term
Grating lobes are artifacts typical of which type of transducer technology?
A. Multi-element transducers
B. Single element transducers
C. Occurs in all types of transducers
D. Is not an artifact associat4ed with the type of transducer used
Definition
A. Multi-element transducers
Term
What is the typical SATA output intensity for a doppler instrument?
Definition
10 mw/cm^2 to > 400 mw/cm^2

continuous wave doppler system generally have larger values than imaging and pulsed doppler units
Term
Which one of the following types of transducers is utilized for creating variable focusing in two dimensions, is mechanically driven, but is not capable of beam steering?
A. Phased array
B. Linear array
C. Mechanical sector
D. Annular array
Definition
D. Annular array
Term
What is the purpose of changing the excitation time from one frame to the next (phase) in phased array transducers?
A. It allows for increasing the frequency of the transducer
B. It allows for decreasing the frequency of the transducer
C. It allows for focusing and steering of the ultrasound pulse
D. It increases the frame rate
Definition
C. It allows for focusing and steering of the ultrasound pulse
Term
What is the unit of power or intensity ratio?
A. Watt
B. Hertz
C. Joules
D. Decibel
Definition
D. Decibel
Term
What effect does increasing the frequency of sound have on attenuation?
A. None
B. Attenuation increases
C. Attenuation decreases
D. Attenuation decreases by 1/2 for every megahertz of increase in frequency
Definition
B. Attenuation increases
Term
The length of time that sound persists is the definition for?
A. Duty factor
B. Spatial pulse length
C. Q factor
D. Wavelength
Definition
C. Duty factor
Term
Which of the following statements is NOT true regarding annular array transducers?
A. Annular array transducers are mechanically steered
B. The piezoelectric elements are energized sequentially
Definition
C. Annular array transducers cannot be steered mechanically
Term
The operating frequency of a transducer is determined by?
A. Propagation speed of the transducer material
B. The thickness of the transducer element
C. Gain
D. Power applied to the transducer
E. A and C
F. A and B
G. All of the above
Definition
F. A and B Propagation speed of the transducer and the thickness of the transducer element
Term
If the bandwidth is 1 MHz and the operating frequency is 3 MHz, what is the Q factor?
A. 0.33
B. 3
C. 3.5
D. 0.35
Definition
3

Q factor = operating frequency/bandwidth
Q=3/1=3
Term
Which of the following statements is NOT true regarding specular reflections?
A. The reflector surface is smooth as compared to the wavelength
B. The reflector surface is irregular as compared to the wavelength
C. Increasing frequency does not change specular reflections
D. the wavelength is small as compared to the dimensions of the boundary
Definition
B. The reflector surface is irregular as compared to the wavelength
Term
Axial resolution is directly dependent on?
A. Crystal thickness
B. Number of cycles in the pulse
C. Spatial pulse length
D. Frequency
Definition
C. Spatial pulse length
Term
Which of the following statements is NOT true regarding the Reynolds number?
A. The Reynolds number depends on speed of flow to predict the start of turbulence
B. The Reynolds number depends on the viscosity of the fluid to predict the start of turbulence
C. The Reynolds is unitless
D.Flow becomes turbulent when the Reynolds number is less than 2000
Definition
D. Flow becomes turbulent when the Reynolds number is less than 2000
Term
Sound frequencies below 20 Hz are called?
Definition
Infrasound
Term
What is the frequency range of audible sound?
A. 20 Hz to 20,000 Hz
B. < 20 Hz
C. > 20 kHz
D. > 20 MHz
Definition
A. 20 Hz to 20,000 Hz
Term
What type of energy do ultrasound transducers convert into mechanical energy or ultrasound energy?
A. Kinetic energy
B. Potential energy
C. Electrical energy
D. Physical energy
Definition
C. Electrical energy
Term
What does the term piezoelectric mean?
Definition
Pressure electric
Term
What principle is being demonstrated when the ultrasound transducer converts and electric signal into mechanical motion that results in the production of ultrasound?
Definition
The principle of piezoelectricity
Term
Random variations in a voltage signal that are caused by heat are called?
A. Reflections
B. Turbulence
C. Scatter
D. Noise
Definition
D. Noise
Term
In order to send and receive sound continuously, continuous wave transducers much have?
A. A sample gate
B. A sample volume
C. an angle correct
D. two elements one that sends sounds, and one that receives sound
Definition
D. Two elements one that sends, and one that receives sound
Term
Transducers that are driven by voltage pulses are referred to as?
Definition
Pulsed wave transducers
Term
Which of the following statements is NOT true regarding pulsed doppler transducers.
A. Pulsed doppler transducers require two elements to send receive
B. Pulsed doppler transducers use the FFT technique
C. Pulsed doppler transducers have a sample gate
D. Pulsed doppler transducers require only one element to send and receive
Definition
A. Pulsed doppler transducers require two elements to send and receive
Term
What does the damping material that is placed behind the transducer element help to reduce?
Definition
Damping material helps to reduce the number of cycles in each pulse
Term
If pulse duration and spatial pulse length are reduced, what will happen to the longitudinal resolution?
Definition
It will improve
Term
What is the purpose of the matching layer on the face of the transducer?
Definition
It reduces the reflection of the ultrasound at the element surface
Term
The change in sound direction when it crosses a boundary is referred to as?
A. Impedance
B. Backscatter
C. Refraction
D. Rayleigh scatter
Definition
C. Refraction
Term
(True/False) The narrower the bandwidth, the more exact the frequency emitted by the transducer
Definition
True
Term
When there is a change in reflected frequency caused by reflector motion in relation to the transducer it is referred to as the?
Definition
Doppler effect
Term
The difference between the transmitted frequency and the received frequency or incident frequency minus reflected frequency refers to the?
Definition
Doppler shift
Term
The minimum reflector separation along the sound path required for separation reflections to be produced describes?
A. Lateral resolution
B. Axial resolution
C. Longitudinal resolution
D. Both A and C
E. Both B and C
Definition
E. Both B and C; Axial and Longitudinal resolution
Term
All of the following are terms that are synonymous with longitudinal resolution EXCEPT?
A. Axial resolution
B. Range resolution
C. Depth resolution
D. Transverse resolution
Definition
D. Transverse resolution
Term
If spatial pulse length is reduced, longitudinal resolution will?
A. Improve
B. Decrease
C. Not be affected
Definition
A. Improve
Term
What affect does increasing the frequency have on the wavelength?
A. Wavelength is increased
B. Wavelength is decreased
C. None
Definition
B. Wavelength is decreased
Term
If frequency is increased the depth of penetration will?
Definition
Decrease
Term
When performing a cardiac ultrasound exam on an obese person, which of the following transducer frequencies would be most helpful?
A. 10 MHz
B. 5 MHz
C. 3.5 MHz
D. 2.25 MHz
Definition
D. 2.25 MHz (Lower frequency equals greater depth of penetration)
Term
What is axial resolution equal to?
A. 1/4 of the spatial pulse length
B. 1/2 of the spatial pulse length
C. Two time the spatial pulse length
D. Four times the spatial pulse length
Definition
B. 1/2 the spatial pulse length
Term
What is the product of density and propagation speed?
A. Half value layer thickness
B. intensity transmission coefficient
C. Impedance
D. Refraction
Definition
C. Impedance
Term
What is the primary factor that determines impedance?
Definition
The medium the sound is traveling through
Term
Each complete scan of the sound beam that produces and image on the display is referred to as a?
Definition
Frame
Term
(True/False) Coronary blood flow is from endocardium to epicardium.
Definition
False
Term
The sinus venosus, the cardiac loop, and the aortic and branchial arches are portions of the?
Definition
Primitive heart tube
Term
Most of the myocardial blood flow drains into the great cardiac vein. This vessel then drains flow into the?
A. Inferior vena cava
B. Superior vena cava
C. Coronary artery
D. Coronary sinus
Definition
D. Coronary sinus
Term
The stretch in blood vessels in response to an increase in pressure is termed?
A. Compliance
B. Elasticity
C. Expansion
D. Elongation
Definition
A. Compliance
Term
Which one of the following statements is NOT true regarding the flow of fluid and pressure?
A. The driving force behind fluid flow is pressure
B. Pressure is the force per unit area
C. In order for flow to occur a pressure difference is not necessary
D. Pressure is distributed equally through a static fluid.
Definition
C. In order for flow to occur a pressure difference is not necessary
Term
When a cardiac murmur is heard it is graded on a scale of 1-6. A 4/6 systolic murmur along the lower left sternal border accompanied by a palpable "thrill" would be indicative of?
A. An atrial septal defect
B. A ventricular septal defect
C. a patent ductus arteriosus
D. Aortic regurgitation
Definition
B. Ventricular septal defect
Term
The normal electrocardiogram has a "QRS" configuration. When a transmural infarction occurs, there are changes in the waveform which are manifested as?
Definition
Deep Q waves
Term
What is the purpose of a coupling agent used on a transducer?
Definition
To eliminate the layer of air between the transducer and body surface
Term
What are the units for intensity?
A. W/cm^2
B. Decibels
C. Hertz
D. Amps
Definition
A. W/cm^2
Term
Which one of the following statements is NOT true regarding a continuous wave Doppler transducer?
A. A CW Doppler transducer has only one element
B. A CW Doppler transducer has two elements
C. A CW Doppler transducer does not have a pulse repetition frequency
D. CW Doppler transducers cannot be set to sample at specific sites
Definition
A. A CW Doppler transducer has only one element
Term
The unit of viscosity is?
A. Stroke
B. Joule
C. Poise
D. g/ml
Definition
C. Poise
Term
Should a transducer be autoclaved before preforming a procedure where a sterile environment is necessary?
Definition
No. The piezoelectric element would be damaged
Term
What term best describes the magnitude of a signal?
Definition
Amplitude
Term
Which one of the following is TRUE regarding the volume flow rate when the pressure difference id doubled?
A. The volume flow rate is quartered
B. The volume flow rate is doubled
C. the volume flow rate is quadrupled
D. the volume flow rate is halved
Definition
B. the volume flow rate is doubled
Term
which value indicates the average intensity over one on-off beam cycle?
A. Spatial average (SA)
B. Temporal average (TA)
C. Spatial peak, Temporal average (SPTA)
D. Spatial peak, Temporal peak (SPTP)
Definition
B. Temporal Average (TA)
Term
What type of Doppler system can give motion information as a function of depth?
Definition
Pulsed Doppler
Term
What type of flow is present when the fluid has a constant speed across a vessel?
A. Plug Flow
B. Parabolic flow
C. Steady flow
D. Laminar flow
Definition
D. Laminar Flow
Term
Which one of the following does NOT affect the acoustic impedance of a medium?
A. Compressibility
B. Velocity
C. Temperature
D. Stiffness
E. Density
F. Frequency
Definition
F. Frequency
Term
The area of the sound beam where the beam diameter increases as the distance from the transducer increases is referred to as the?
A. Far zone
B. Near zone
C. Fresnel zone
D. Fraunhofer zone
E. A and B
F. A and D
Definition
F. A and D Near zone and Fraunhofer zone
Term
The temporal resolution of a real time scanner is dependent on the?
Definition
Frame rate
Term
What are the four acoustic variables of a sound wave?
Definition
A. Pressure
B. Density
C. Temperature
D. Particle motion
Term
When a high grade stenosis is encountered in a large vessel that typically has laminar flow, at what point or points is the pressure energy the greatest?
A. Proximal to the stenosis
B. Distal to the stenosis
C. At the site of the stenosis
D. None of the above
E. Both A and B
Definition
E. Both A and B, both proximal and distal to the stenosis
Term
What effect does increasing the frequency for a given transducer size have on the beam diameter?
Definition
The beam diameter is decreased
Term
How many hertz are in one megahertz?
Definition
1,000,000 hertz
Term
The time it takes one cycle to occur is referred to as?
A. Frequency
B. Period
C. Wavelength
D. Amplitude
Definition
B. Period
Term
What is the reciprocal of the pulse repetition frequency?
Definition
Pulse repetition period
Term
Which one of the following is NOT synonymous with lateral resolution?
A. Azimuthal resolution
B. Transverse resolution
C. Angular resolution
D. Longitudinal resolution
Definition
D. Longitudinal resolution
Term
What is the purpose of the gray scale display?
Definition
It displays a range of reflection amplitudes, from white to black. Grayscale is an important factor in contrast resolution
Term
If the beam diameter is reduced, what will happen to the lateral resolution?
Definition
It will improve
Term
The speed that a wave moves through a medium is referred to as the?
Definition
propagation speed
Term
What can be done to the sound to reduce beam diameter?
Definition
It can be focused
Term
What type of artifact is produced when echoes are put too close to the transducer due to a second pulse emitted before they could be received?
A. Reverberation artifact
B. Range ambiguity artifact
C. Section thickness artifact
D. Side lobe artifact
Definition
B. Range ambiguity artifact
Term
If the beam diameter is decreased, and lateral resolution is increased, what will happen to depth of penetration?
Definition
The depth of penetration will decrease
Term
True/False As frequency increases, the attenuation coefficient increases
Definition
True: In clinical imaging, the attenuation coefficient ranges from 0.5-1.1 dB/cm per MHz of frequency
Term
Curving the element of the transducer if one method of?
Definition
Focusing the sound beam
Term
Which of the following parameters is NOT measured by a hydrophone?
A. Amplitude
B. Period
C. Pulse duration
D. Pulse repetition period
E. Effective penetration of the Doppler beam
Definition
E. Effective penetration of the Doppler beam
Term
A transducer utilizing rectangular rows of elements that are pulsed at small intervals refers to what type of transducer?
Definition
Linear phased array
Term
What parameters are measured by radiation force?
Definition
Power of intensity
Term
What effect will increasing the line density have on the following imaging characteristics?
A. Image quality
B. PRF
C. Maximum imaging depth
D. Frame rate
Definition
Increasing line density will result in:
A. Improved image quality
B. Lower PRF
C. Lower maximum depth of image
D. Lower frame rate
Term
What is a calorimeter?
Definition
A device which measures that temperature rise in an absorbing liquid. From this, total energy absorbed can be measured.
Term
the velocity of a sound wave is equal to?
Definition
Frequency X wavelength
Term
What is a beam profiler?
Definition
a Device designed to give three dimensional reflection amplitude information. It demonstrates beam characteristics.
Term
If the frequency of sound in the body is doubled what will happen to the velocity?
Definition
It remains the same.
The average speed of sound in tissue is 1540 m/s regardless of transducer frequency
Term
The number of pulses occurring in a second describes?
A. Pulse repetition frequency
B. Pulse repetition period
C. Amplitude
D. None of the above
Definition
A. Pulse repetition frequency
Term
What factor is proportional to the square of the amplitude of a sound wave?
Definition
Intensity
Term
The time from the beginning of one pulse to the beginning of the next is called?
A. Pulse repetition frequency
B. Pulse repetition period
C. Amplitude
D. Propagation speed
Definition
B. Pulse repetition period
Term
What is the conversion of sound energy to heat (which is a by-produce) called?
Definition
Absorption
Term
Sound scattering in all directions due to the reflector being much smaller than the pulse wavelength is referred to as?
A. Spectular reflection
B. Backscatter
C. Rayleigh scattering
D. All of the above
Definition
C. Rayleigh scattering
Term
What is the attenuation of sound per unit length of travel called?
Definition
Attenuation coefficient
Term
True/False The damping material will increase the bandwidth of a transducer
Definition
True
Term
What is the angle of incidence of a sound beam equal to?
Definition
Angle of reflection
Term
Is the propagation speed for pulsed wave the same as continuous wave int he same medium?
Definition
yes
Term
What is the change in direction of a sound beam at an interface between two media of different impedance values called?
Definition
Refraction
Term
What are the two terms used when describing the strength of sound?
Definition
Amplitude and Intensity
Term
The resonant frequency of a transducer is determined basically by what?
Definition
The speed of the crystal material
Term
True/False Focusing the sound beam will increase the intensity of the sound beam.
Definition
True
Term
What are two factors which would increase the intensity of the sound beam?
Definition
Intensity is the amount of energy or power per second that travels a specific area. It is affected by.
A. focusing the beam
B. Increasing the power level
Term
A reduction in the reflection amplitude from reflectors that lie behind a strongly reflecting or attenuating structure describes what type of artifact?
Definition
Shadowing
Shadowing artifacts can be due to attenuation or refraction of the sound beam
Term
When sound hits two or more strong reflecting surfaces (usually close to the skin surface), what type of artifact can occur?
Definition
Reverberation artifacts
Term
In clinical imaging, what is the attenuation coefficient range?
Definition
The attenuation per centimeter for each megahertz of frequency ranges from 0.5-1.1 dB
Term
What is a missing reflector artifact?
Definition
When tow reflectors are seen as one (resolution)
Term
Of the following, which will create the higher attenuation of the sound beam?
A. Lung
B. Bone
C. Soft tissue
Definition
A. Lung
Term
If the particle dimensions are less than the wavelength, what type of scattering occurs?
Definition
Rayleigh scattering
Term
What does the critical angle refer to?
Definition
The angle at which total reflection occurs
Term
If the frame rate is increased, how will it affect the following imaging characteristics?
A. Image quality
B. Line density
C. Maximum depth of penetration
D. PRF
Definition
Increasing the frame rate will result in:
A. Improved image quality for evaluating moving structures
B. The line density may limit the increase in frame rate
C. The maximum depth of imaging will reduced
D. The PRF will increase
Term
What percentage of time is pulsed ultrasound system capable of receiving sound?
Definition
99.9%
Term
If amplitude is doubled, what happens to intensity?
Definition
it is quadrupled
Term
What is the wavelength of 1 MHz ultrasound in soft tissue?
Definition
1.54 mm
Term
What method is utilized in most color flow systems to analyze the Doppler flow information?
Definition
Auto-correlation
Term
What factor determines the acoustic power?
Definition
Acoustic power is dependent upon the signal from the pulser. The magnitude of crystal vibration is related to the pulser voltage. Acoustic power is controlled by the sonographer and is also referred to as energy output, output gain, transmit gain, transmitter output, or pulse power.
Term
What is side-lobing, and is it considered to be an artifact?
Definition
Side lobing is extraneous beams of ultrasound generated from the edges of individual transducer elements and not in the direction of the main ultrasound beam. The reflectors may appear in an off-axis location or appear in multiple locations on the image.
Yes, side lobing is considered an artifact
Term
Imaging performance typically is determined by measuring all of the following parameters EXCEPT?
A. Compensation (TGC) operation
B. Detail resolution
C. Contrast resolution
D. Penetration and dynamic range
E. Color resolution
F. Distance and depth measurements (accuracy)
Definition
E. Color resolution
Term
The intensity averaged over the entire duration of the pulse is called the?
A. Temporal average intensity
B. Temporal peak intensity
C. Spatial peak pulse average
D. Pulse average intensity
Definition
D. Pulse average intensity
Term
Demodulation converts the voltages delivered to the receiver from one form to another. this is done by what two processes?
Definition
A. Rectification
B. Smoothing
Term
What is the purpose of the rejection function?
Definition
Eliminates the smaller amplitude voltages produced by weaker reflections to eliminate noise
Term
Which three receiver functions are normally operator adjustable?
Definition
A. Amplification (gain)
B. Compensation
C. Rejection
Term
Which one of the following is NOT a function of the receiver?
A. Amplify
B. Compensation
C. Compress
D. Demodulation
E. Reject
F. Contrast resolution
Definition
F. Contrast resolution
Term
List the three different methods of displays for the received ultrasound information (non-Doppler)
Definition
A. A-mode
B. B-mode
C. M-mode
Term
True/False Amplitude imaging is more sensitive to detecting slow flow as compared to color Doppler.
Definition
True
Term
What is a screen converter?
Definition
A device which stores the gray scale image and allows it to be displayed on a TV monitor.
Term
What relationships do the following equations describe?

PRF (KHz)= 77/max depth (cm)

Max depth (cm)= 77/PRF (kHz)
Definition
The relationship between PRF and the maximum imaging depth in soft tissue
Term
What is the maximum permissible PRF that will unambiguously image to a maximum depth of 20 cm?
Definition
3.85 KHz
this is determined by the formula:
PRF (KHz)= 77/max depth (xm) = 77/20cm = 3.85 KHz
Term
What is the most common affect resulting from high intensity ultrasound?
Definition
Heat
Term
Which of the following statements most correctly describes the focal zone?
A. The region from the fact of the transducer to the narrowest part of the beam.
B. The region where the sound beam is the narrowest
C. The region of the beam that is beyond the narrowest portion of the beam
D. None of the above
Definition
B. The focal zone is the narrowest segment of the beam, and is the region where the best quality images would be obtained
Term
What is temporal average intensity?
Definition
Temporal average intensity is the average throughout both transmitting and receiving
Term
Which one of the following Doppler angles will result in the greatest Doppler shift?
A. 60 degrees
B. 45 degrees
C. 70 degrees
D. 0 degrees
Definition
D. 0 degrees
Term
What is the primary factor which determines the velocity or propagation speed of the sound wave?
Definition
The medium through which the sound is traveling
Term
What is refraction?
Definition
The change in direction of an ultrasound beam when it passes from one medium to another, in which elasticity and density differ from those of the first medium
Term
What is Huygens' principle?
Definition
It states that all points on a wavefront can be considered as point sources for the production of spherical secondary wavelets. When all of the wavelets combine according to the Huygens' Principle, a sound beam is produced with the majority of the energy transmitted along a main central beam
Term
What type of scan converters are more commonly utilized today? Why?
Definition
Digital scan converters

Digital scan converters were developed to overcome the inherent instability problems experienced with analog scan converters
Term
What ultrasound factor does the fraction of time that pulsed ultrasound is actually on describe?
Definition
Duty factor
Term
What is sensitivity?
Definition
The ability of an imaging system to detect weak reflections.
Term
What are the units for attenuation?
Definition
dB (decibels)
Term
The cardiac index would be calculated as?
Definition
Cardiac output/Body surface area
Term
What happens to the velocity of flow through a constriction as compared to the flow velocity proximal to it?
Definition
The flow velocity is greater
Term
What nerve supplies the SA node and controls heart rate?
Definition
Right vagus nerve
Term
How many vessels drain into the right atrium?
Definition
Two: Inferior Vena Cava (IVC)
Superior Vena Cava (SVC)
Term
The principle of the conservation of mass forms the basis for what equation?
Definition
Continuity equation
Term
201-Thallium scintigraphy is used for evaluation of?
Definition
Myocardial perfusion defects
Term
An atrial gallop sound can be distinguished by auscultation at the apex. This usually described as an?
A. S4 or fourth heart sound
B. S1 or first heart sound
C. Pause
D. S2 or second heart sound
Definition
A. S4 or fourth heart sound
Term
True/False Closure of the semilunar valves is responsible for S1 (first heart sound)
Definition
False
Term
As fluid moves through a tube, fluid layers in the center have higher velocities than along the walls. This is called a?
Definition
Parabolic flow profile
Term
What is the time interval between semilunar valve closure and atrioventricular valve opening termed?
Definition
Isovolumetric relaxation
Term
How many pulmonary veins join the left atrium?
A. Two
B. Four
C. Six
D. Three
Definition
B. Four
Term
In the Modified Bernoulli equation, what two factors are assumed to be negligible in the pressure drop?
Definition
A. Acceleration
B. Viscous effects
Term
The standard chest x-ray can be used to determine which of the following?
A. Cardiomegaly
B. Intracardiac shunting
C. Enlarged right ventricle
D. Cardiomyopathy
Definition
A. Cardiomegaly
Term
Exercise electrocardiograph stress testing can be employe4d for detection of myocardial ischemia with stress. This is recognized by what finding on the ECG?
Definition
Depression of the ST segment
Term
The difference between the highest and lowest frequency emitted by the transducer is the definition for?
A. Range solution
B. Spatial pulse length
C. Bandwidth
D. Axial resolution
Definition
C. Bandwidth
Term
The area in which the sound beam diameter decreases as the distance from the transducer increases is referred to as the?
Definition
Near zone
Term
True/False When the color box (window) is steered to the right the frame rate changes?
Definition
False
Term
What factors must be known in order to calculate distance to a reflector?
Definition
A. Travel time
B. Speed
Term
True/False A large V wave on the pulmonary capillary wedge pressure is a classic finding in aortic regurgitation.
Definition
False, it is a finding for mitral regurgitation
Term
True/False When noise occurs in the Doppler signal while performing a cardiac exam it may be due to clutter?
Definition
True, clutter occurs mostly from the heart or vessels walls and is caused by high-amplitude, Doppler shifted echoes.
Term
Which of the following do NOT describe sound wave characteristics?
A. Wavelength
B. Amplitude
C. Joule
D. Frequency
E. Velocity
Definition
C. Joule
Term
To eliminate the aliasing artifact in spectral Doppler, all of the following could be adjusted except?
A. Baseline
B. PRF (scale, velocity, range)
C. Doppler transmit frequency
D. Wall filter
E. Switch to CW Doppler
Definition
D. Wall filter
Term
What two factors should allow for the transfer of sound from the transducer to the patient (and vice-versa) more efficiently?
Definition
A. Grinding the matching layer to 1/4 wavelength of the velocity of sound through the matching material
B. Use of coupling gel
Term
The minimum reflector separation perpendicular to the sound path needed for separate reflections to be produced describes?
A. Axial resolution
B. Lateral resolution
C. Far zone
D. Fraunhaufer zone
Definition
B. Lateral resolution
Term
Which one of the following is NOT reflector information that can be from an M-mode display?
A. Distance
B. Motion
C. Multiple dimensions
D. All of the above
Definition
C. Multiple dimensions
Term
What are the two preferred methods of determining cardiac output angiographically?
Definition
Fick Oxygen Technique
Indicator Dilution Method
Term
Cardiac output/systolic ejection period X Heart rate/44.30 (0.85) X the square root of the mean pressure gradient, represents the?
A. Modified Simpson's equation
B. Modified Bernoulli's equation
C. Gorlin Formula
D. Frank Starling law
Definition
C. Gorlin Formula
Term
Normal physiologic splitting of S2 heart sound occurs with?
A. Expiration
B. Inspiration
C. Mitral Stenosis
D. Aortic stenosis
Definition
B. Inspiration
Term
The difference between systolic and diastolic pressure is referred to as?
Definition
Pulse pressure
Term
Late diastolic equalization of aortic and left ventricular pressures is referred to as?
Definition
Diastasis
Term
Clinically, cardiac tamponade is suspected in the presence of Becks Triad. What are the three features constituting Becks Triad?
Definition
A. Venous hypertension
B. Arterial hypotension
C. Distant heart sounds
Term
By Doppler Echocardiography, peak instantaneous gradient is used to assess aortic stenosis. What is used by heart catheterization?
Definition
Peak to peak
Term
During depolarization what happens to the insides of the cardiac cells with respect to the area outside of the cell membranes?
A. They become positively charged
B. they become negatively charged
C. They remain neutral
D. None of the above
Definition
A. They become positively charged
Term
What technique is used for graphically recording heart sounds using a microphone placed on particular areas of the heart and recording these sounds on photosensitive paper.
A. Hydrophonocardiography
B. Microphonocardiography
C. Phonecardiography
D. Echoencehpalocardiography
Definition
C. Phonocardiography
Term
Which of the following is NOT a method that can be used on a patient to accentuate and determine the location of cardiac murmurs?
A. Administering amyl nitrite
B. valsalva manuever
C. Patient positional changes (bending over)
D. Inspiration
Definition
D. Inspiration
Term
Which of the following is NOT a situation in which the S3 heart sound can be auscultated?
A. Non-compliant left ventricle
B. Mitral insufficiency
C. Tricuspid insufficiency
D. Aortic insufficiency
Definition
D. Aortic insufficiency
Term
In the normal heart, where is the puulmonic valve in relation to the aorta (from PSAX)
A. Anterior and to the right
B. Anterior and to the left
C. Posterior and to the right
D. Posterior and to the left
Definition
B. Anterior and to the left
Term
during embryonic development, the semilunar valves are derived from the?
Definition
Truncal and valve cushions and Truncus arteriosus
Term
On the electrocardiogram, atrial repolarization occurs during ventricular systole and is obscured by the?
Definition
QRS complex
Term
When sympathetic stimulation causes the heart to beat with improved contractility and a faster rate, not only is systolic function more forceful and faster, but relaxation and elastic recoil are also more rapid. This mechanism is known as the?
A. Force-velocity relationship
B. Frank Starling law
C. Interval strength relationship
D. Interval timing relationship
Definition
A. Force velocity relationship
Term
The period of time between semilunar valve closure and atrioventricular valve opening is referred to as?
Definition
Isovolumic relaxation
Term
What phase of the cardiac cycle occurs with the opening of the semilunar valves following the isovolumic contraction phase of the cardiac cycle?
Definition
Ventricular ejection phase
Term
The area of the heart where the artial septum joins the ventricular septum is referred to as the?
Definition
Crux of the heart
Term
The orifice of the inferior vena cava is guarded by a rudimentary and incomplete valve called the?
Definition
Eustachian valve
Term
the heart's pacemaker cells are able to depolarize without external stimulation, this electrical property is known as?
A. Synchronicity
B. Elasticity
C. Excitability
D. Automaticity
Definition
D. Automaticity
Term
Which of the following is NOT true regarding power Doppler imaging?
A. Color is assigned according to the strength of the Doppler shifted echoes
B. Power Doppler does not alias
C. Power Doppler can show peak velocity information
D. Power Doppler is angle dependent
E. All of the above
F. A and C
G. C and D
Definition
G. C and D
Term
Which of the following would suggest a large left to right shunt through a ventricular septal defect?
A. Enlarged right atrium and right ventricle
B. Enlarged left atrium and left ventricle
C. Increased pulmonary blood flow
D. Exaggerated right ventricular wall motion
E. B and C
Definition
E. B and C
Term
What is the most common lesion associated with a ventricular septal defect?
Definition
A ventricular septal aneurysm arising from the tissue comprising the margins of the defect
Term
D-loop transposition is also referred to as?
A. Truncus arteriosus
B. Tetralogy of Fallot
C. Marfan's syndrome
D. Transposition of the great arteries
Definition
D. Transposition of the Great Arteries
Term
In the fetal aortic arch system, which of the arches persist in the adult heart?
A. III,IV,and VI
B. I,II and III
C. I,II and VI
D. I, V and VI
Definition
A. III, IV and VI
Term
What are the three channels of communication in the fetal circulation that disappear shortly after birth?
Definition
A. Ductus venosus
B. Ductus arteriosus
C. Patent foramen ovale
Term
The highest O2 saturation in the fetal circulation is found in the?
A. Umbilical artery
B. Ductus venosus
C. Umbilical vein
D. Ductus arteriosus
Definition
C. Umbilical vein
Term
The interatrial septum, interventricular septum, and the artioventriclar valves in the adult heart are developed from the?
Definition
Endocardial cushions
Term
The Sunus Venosus in the fetal heart tube is absorbed into the right atrum and in the adult heart forms the?
Definition
Coronary sinus
Term
What occurs around day 22 in the development of the fetal heart and determines the placement of the ventricles and great vessels?
Definition
Cardiac looping
Term
What are the two roles of the Ca2+ ion in myocardial excitation-coupling?
Definition
Initiation of contraction and regulation of contraction
Term
True/False The force of velocity relationship refers to the inverse relationship that exists between the initial speed of muscle fiber contraction and the load placed on the muscle fiber?
Definition
True
Term
The first phase of ventricular systole, coinciding with the initial mitral component of the first heart sound, as well as the first detectable rise in left ventricular pressure is termed?
Definition
Isovolumetric contraction
Term
What occurs when the semi-lunar valves open, there is a rise in aortic and pulmonary artery pressures, and a decrease in ventricular pressure?
Definition
Ventricular systole
Term
The p wave, which coincides with the a wave on the left atrial pressure tracing, refers to?
A. Ventricular systole
B. Ventricular diastole
C. Atrial systole
D. Atrial diastole
Definition
C. Atrial systole
Term
The effects of soft tissue on ultrasound are called?
A. Acoustic proliferation
B. Dynamic effects
C. Acoustic propagation
D. Biologic effects
Definition
C. Acoustic propagation properties
Term
If the frequency is decreased, what will happen to the wavelength?
Definition
Wavelength will increase
Term
When is temporal peak intensity measured?
Definition
At the time the pulse is present
Term
Of the following, which has the lowest intensity?
A. Spatial Average, Temporal Average
B. Spatial Peak, Temporal Average
C. Spatial Peak, Temporal Peak
D. Spatial Average, Temporal Peak
Definition
A. Spatial Average, Temporal Average (SATA)
Term
In the average pulsed ultrasound system, the duty factor is always less than what?
Definition
One
Term
A low transducer Q-Factor will result in what kind of bandwidth?
Definition
Wide bandwidth
Term
What effect will increasing the transducer frequency have on axial lateral resolution?
Definition
Increasing frequency will improve axial & lateral resolution
Term
How does dynamic range affect contrast resolution?
Definition
Low dynamic range = high contrast
High dynamic range = low contrast

High dynamic range allows better contrast resolution through more shades of gray to demonstrate subtle changes in tissue compliance or stiffness
Term
True/False Increased diffraction results with increased attenuation
Definition
True
Term
What do the intensities of transmitted or reflected sound depend on?
Definition
A. Incident intensity
B. Impedance of the medium
Term
Sound waves striking a target with an irregular surface that is the same dimension as the wavelength are called?
A. Scatter
B. Specular reflections
C. Rayleigh scatter
D. None of the above
Definition
A. Scatter
Term
What principle does Snell's Law apply to?
A. Reflection
B. Refraction
C. Rarefaction
D. Deflection
Definition
B. Refraction
Term
This is the formula for?
Sine of Transmission = Sine of Incidence Angle (0) X Medium two propagation speed (mm/micro sec)/Medium one propagation speed (mm/micro sec)
A. Poiseuille's Law
B. Snell's Law
C. Gorlin's Law
D. Frank Starling's Law
Definition
B. Snell's Law
Term
How many shades of gray can the human eye perceive?
Definition
Approximately 100 shades of gray
Term
True/False Refraction occurs with normal incidence
Definition
False
Term
How many horizontal lines does a typical TV monitor have?
Definition
525
Term
Which of the following transducers is a hybrid of the linear and phased array transducer technologies having multiple elements, a curved transducer face, a sector image made possible through beam steering, and focusing capabilities?
A. Annular array transducer
B. Linear array transducer
C. Mechanical transducer
D. Convex or curvilinear array transducer
Definition
D. Convex or curvilinear array trandsucer
Term
Mass per unit volume is the definition for?
A. Viscosity
B. Density
C. Stiffness
D. Mass
Definition
B. Density
Term
All of the following are factors affect the amount of ultrasound absorption in a sound beam EXCEPT?
A. Frequency
B. Decibels
C. Viscosity
D. Relaxation time
Definition
B. Decibles
Term
What are the confirmed biological effects of the use of real time ultrasound on pregnant patients?
Definition
No confirmed biological effects in the diagnostic output power ranges below 100 mw/cm^2
Term
What is the range of pulse repetition frequencies utilized in 2-D imaging?
Definition
1- 10 KHz (1000-10,000 Hz)
Term
what is the percentage of the normal right heart pressure as compared tot he left heart pressure?
A. 50%
B. 70%
C. 10%
D. 20%
Definition
D. 20%
Term
What type of Doppler instrument is able to distinguish between a positive and negative shift?
Definition
Bi-directional Doppler
Term
All of the following factors can affect axial resolution EXCEPT?
A. Spatial pulse length
B. The medium being insonated
C. Bean width
D. Sound source
Definition
C. Beam width
Term
What is the duty factor of a continuous wave Doppler?
Definition
1 (100% of the time) A continuous wave Doppler transmit crystal is active 100% of the time
Term
What is the "main bang"?
Definition
The first vertical deflection of the A-mode which corresponds to the transducer face
Term
An artifact that is produced from the interaction of the incident beam with a curved surface and results in an acoustic shadow is an
A. Side lobe artifact
B. Edge artifact
C. Grating artifact
D. Ring down artifact
Definition
B. Edge artifact
Term
What type of artifact results from refraction of the sound beam at a muscle/fat interface, and displays a double image?
A. Mirror image artifact
B. Side lobe artifact
C. Split image artifact
D. Edge artifact
Definition
C. Split image artifact
Term
True/False An annular array is a mechanical transducer
Definition
True
Term
When the travel direction of the ultrasound beam to a medium is not perpendicular, it is referred to as?
A. Perpendicular incidence
B. Horizontal incidence
C. Oblique incidence
D. Angular incidence
Definition
C. Oblique incidence
Term
What term is used to describe a sound beam which has perpendicular interaction with a medium?
Definition
Normal incidence
Term
When the cardiac output is adjusted to consider the body surface area it is referred to as the?
A. Body surface area
B. Cardiac index
C. Cardiac ratio
D. None of the above
Definition
B. Cardiac index
Term
What causes a granular appearance to the image or spectral display and is a result of the interference of echoes from the distribution of scatterers in the tissue?
A. Side lobes
B. Speed error
C. Refraction
D. Speckle
Definition
D. Speckle
Term
Chronic volume overload to the left ventricle are in the case of severe aortic insufficiency results in what cardiac chamber adaptation?
Definition
Left ventricular dilation
Term
Which event occurs between the end of the T wave and the onset of the QRS complex?
A. Flow out of the left ventricle
B. Right ventricular systole
C. Pulmonary artery filling
D. Tricuspid valve opening
Definition
D. Tricuspid valve opening
Term
What is the most common cardiac lesion associated with Down's Syndrome patients?
Definition
Endocardial Coushion Defect
Term
Which of the following is a component of blood?
A. Leukocytes
B. Erythrocytes
C. Platelets
D. Gases (oxygen, carbon dioxide, nitrogen)
E. Proteins
F. All of the above
G. All except E
Definition
F. All of the above
Term
What are three observable changes seen with right ventricular volume overload on 2D echo?
Definition
A. Enlarged right heart
B. Praadoxical interventricular septal motion
C. An atrial septum that bulges to the left
Term
The Coronary arteries fill during which cardiac phase?
A. Atrial diastole
B. Ventricular systole
C. Ventricular diastole
D. Isovolumic contraction
Definition
C. Ventricular diastole
Term
The circumflex coronary artery supplies the?
A. Anterior left ventricle, and anterior interventricular septum
B. Posterior left ventricle, and posterior interventricular septum, if left dominant
C. Right atrium and right ventricle
D. Inferior and diaphragmatic surface of the right ventricle
Definition
B. Posterior left ventricle, and posterior interventricular septum, if left is dominant
Term
If flow is laminar, what is the mean velocity of flow as compared to the peak velocity of flow?
A. Approximately 1/2
B. Approximately 1/4
C. Approximately 2 times
D. Approximately 4 times
Definition
A. Approximately 1/2
Term
Blood flow that is organized and that causes similar Doppler shifts due to similar velocities of individual red blood cells is termed?
A. Laminar
B. Parabolic
C. Plug
D. Turbulent
Definition
A. Laminar flow
Term
Pressure gradients determination utilizing Bernouli's equation yields?
A. Peak to peak pressure gradients
B. Peak instantaneous pressure gradients
C. Mean pressure gradients
D. Integrated pressure gradients
Definition
B. Peak instantaneous pressure gradeints
Term
What type of murmur is associated with aortic insufficiency when the regurgitant jet hits the anterior leaflet of the mitral valve?
Definition
Austin Flint murmur
Term
When the spectral display of the Doppler shift is partially located on the wrong side of the baseline due to aliasing, it is referred to as?
A. Doppler shit
B. Wrap around
C. Reverberation
D. Speckle
Definition
B. Wrap around
Term
All of the following determine beam area EXCEPT?
A. Wavelength (frequency0
B. Transducer diameter
C. Distance from transducer
D. Medium
Definition
D. Medium
Term
What type of wave is sound?
Definition
A mechanical longitudinal wave
Term
The depth at which the intensity is reduced to one half its original value is the?
A. spatial pulse length
B. Half value layer thickness
C. Attenuation coefficient
D. None of the above
Definition
B. Half value layer thickness
Term
True/False The half value layer thickness is dependent upon the frequency and the medium through which the sound travels?
Definition
True
Term
A traveling wave of acoustic variables is the definition for?
A. Frequency
B. Sound
C. Wavelength
D. Energy
Definition
B. Sound
Term
The spreading of the sound beam as it moves farther from the sound source describes?
A. Scattering
B. Interference
C. Divergence
D. Reflection
Definition
C. Divergence
Term
All of the following will improve sound transmission from the transducer into the tissue EXCEPT?
A. Matching layer
B. Coupling material
C. Damping material
D. Refraction
E. C & D
Definition
E. C & D damping material and refraction
Term
What does increasing frequency for a given transducer size do to the near zone length?
Definition
The near zone length is increased
Term
The number of cycles that an acoustic variable goes through in 1 second of time describes?
A. Frequency
B. Period
C. Wavelength
D. Amplitude
Definition
A. Frequency
Term
How is the propagation of sound in a medium related to the medium's stiffness and density?
Definition
Propagation of sound is directly proportional to the medium's elasticity, and inversely proportional to the medium's density. As the density of the medium increases, the speed decreases. As the stiffness increases, the speed decreases
Term
In order to eliminate image flicker, what frame rate is necessary in a real time imaging system?
Definition
> 15-20 frames per second
Term
How is lateral resolution related to beam diameter?
Definition
Lateral resolution is equal to beam diameter
Term
The length of space which one cycle occurs is called?
A. Frequency
B. Period
C. Wavelength
D. Amplitude
Definition
C. Wavelength
Term
True/False The nodules of Aranti are bead like interruptions at the center of each semilunar valve cusp. Their purpose is to lend support to the valve leaflets.
Definition
True
Term
True/False The innermost layer of the heart is called the myocardium
Definition
False
The innermost layer of the heart is called the endocardium
Term
Externally, the two ventricles of the heart are separated by?
Definition
Interventricular Sulci

These structures are obscured by epicardial fat and contain the left anterior descending coronary artery and the posterior descending coronary artery.
Term
The right coronary artery is located within the?
Definition
Coronary sulcus

the coronary sulcus seperates the atria from the ventricles
Term
True/False Arterial circulation is also referred to as systemic circulation, and is measured by a blood pressure cuff?
Definition
True
Term
True/False Arteriovenous oxygen difference per ml of blood usually in the 30-48% range.
Definition
True
Term
Electrical alternans on a patient's EKG is most likely an indication of presence of?
A. Aortic stenosis
B.Mitral valve prolapse
C. Large pericardial effusion
D. Ventricular septal defect
Definition
C. large pericardial effusion
Term
What are the three vessels that typically arise off the aortic arch?
A. Inominate artery
B. Left common carotid artery
C. Left subclavian artery
D. Left vertebral artery
E. A, B, D
F. A, B, C
Definition
F. A,B,C Inominate, left common carotid and left subclavian artery
Term
The anterior interventricualr septum, and the cardiac apex are usually supplied by what coronary artery?
Definition
Left anterior descending coronary artery
Term
True/False ST segment elevation in leads II,III, and VF suggest an inferior mycardial infraction usually involving the right coronary artery.
Definition
True
Term
From a safety standpoint, which of the following methods is best?
A. High transmitter output and low receiver gain
B. Low transmitter output and high receiver gain
C. High near gain and low far gain
D. Low near gain and high far gain
E. High reject and high transmitter output
Definition
B. Low transmitter output and high receiver gain
Term
The basic concept of hemodynamic monitoring of the cardiac chambers is the conversion of a(n)?
A. Electrical signal to a mechanical signal
B. fluid pressure to an electrical signal
C. Transducer to an electrical signal
D. Transducer to a fluid pressure
Definition
B. Fluid pressure to an electrical signal
Term
True/False Generally, stenotic coronary artery lesions are not clinically significant unless they are 70% occluded or greater.
Definition
True
Term
Name the atrial septal defect most commonly associated with anomalous pulmonary venous return.
Definition
Sinus Venosus Atrial Septal Defect
Term
What pressure gradient obtained through Doppler echocardiographic interrogation of aortic stenosis, best correlates with cath lab data of the same lesion?
Definition
Mean pressure gradient
Term
A large "V" wave on the pulmonary capillary wedge pressure tracing is consistent with what finding in color flow Doppler echocardiography?
Definition
Significant mitral regurgitation
Term
Right ventricular systolic pressure is estimated by Doppler interrogation of the tricuspid regurgitant jet. This obtained by inserting the velocity obtained from the jet into the modified Bernouli equation and adding?
Definition
10mmHg to the pressure gradient obtained.
If there are signs of higher elevated right atrial pressure then 20mmHg may be added
Term
A cardiac defect characterized by reversal of the ventricles is?
A. D-loop transposition
B. L-loop transposition
C. Complete transposition
D. Truncus arteriosus
Definition
B. L-loop transposition
Term
The two portions of the interventricular septum are the?
Definition
Membranous and muscular interventricualr septum
Term
When disturbed or turbulent flow is present the Doppler shift spectrum demonstrates?
A. Reversed flow
B. Spectral broadening
C. Aliasing
D. Mirroring
Definition
B. Spectral broadening
Term
What congenital valve defect is associated with atrial ventricular canal defect?
A. Tricuspid atresia
B. Pulmonic stenosis
C. Mitral valve prolapse
D. Cleft mitral valve
E. Bicuspid aortic valve
Definition
D. Cleft mitral valve
Term
True/False Turbulence is characterized by disordered directions of flow in combination with many different blood cell velocities.
Definition
True
Term
All of the following are potential echocardiographic findings associated with an enlarged cardiac silhouette by chest x-ray EXCEPT?
A. Dilated left ventricle as with a dilated cardiomyopathy
B. Pericardial effusion
C. Ascending aortic aneurysm
D. Aortic stenosis
Definition
D. Aortic stenosis
Term
The two portions of the interventricular septum are the?
Definition
Membranous and muscular interventricualr septum
Term
When disturbed or turbulent flow is present the Doppler shift spectrum demonstrates?
A. Reversed flow
B. Spectral broadening
C. Aliasing
D. Mirroring
Definition
B. Spectral broadening
Term
What congenital valve defect is associated with atrial ventricular canal defect?
A. Tricuspid atresia
B. Pulmonic stenosis
C. Mitral valve prolapse
D. Cleft mitral valve
E. Bicuspid aortic valve
Definition
D. Cleft mitral valve
Term
True/False Turbulence is characterized by disordered directions of flow in combination with many different blood cell velocities.
Definition
True
Term
All of the following are potential echocardiographic findings associated with an enlarged cardiac silhouette by chest x-ray EXCEPT?
A. Dilated left ventricle as with a dilated cardiomyopathy
B. Pericardial effusion
C. Ascending aortic aneurysm
D. Aortic stenosis
Definition
D. Aortic stenosis
Term
Select the observations that better corresponds to the hemodynamic consequences of severe aortic insufficiency.
A. left ventricular pressures exceed pulmonary capillary wedge pressures early in diastole
B. Decreased E-F slope on M-mode echocardiography
C. Decreased pressure half-time by continuous wave echocardiogaphic evaluation of mitral inflow
D. Equalization of aortic and left ventricular pressures in late diastole
E. All of the above
Definition
E. All of the above
Term
Shunt quantitation by the oximetry method involves comparing?
Definition
Qp/Qs (volume per minute of pulmonary flow to volume per minute of systemic flow)
Term
An arrhythmia caused by rapid discharge from the numerous irritable automaticity foci in the atrias is called________?
Definition
Atrial fibrillation
Term
What arrhythmia is characterized by a wide QRS, a regular rhythm, and a heart rate greater than 150 beats per minute?
Definition
Ventricular tachycardia
Term
Autocorrelation is the technique by which by which returning echoes are displayed in color Doppler echocardiography. Fast Fourier Transform technique is not used because?
A. the method is too inaccurate
B. the expense consideration
C. The method is not fast enough
D. There is a problem with brightness
E. None of the above
Definition
C. The method is not fast enough
Term
True/False The more bits per pixel, the more shades of gray can be assigned
Definition
True
Term
Frequency of a sound wave is measured in?
Definition
Hertz
One cycle per second = 1 Hertz
one thousand cycles per second = 1 Kilohertz
One million cycles per second = 1 Megahertz
Term
The reduction in intensity and amplitude of sound as it travels through a medium is called?

A. Reflection
B. Impedance
C. Scatter
D. Attenuation
Definition
D. Attenuation
Term
Does attenuation for soft tissue increase or decrease with increased tissue thickness?
Definition
Increase
Term
What is refraction?
Definition
An artifact occurring when the sound waves chang3es direction when traveling from one media to another. This results with the reflector being improperly positioned on the display
Term
In the modified Bernoulli equation, pressure and velocity have a?

A. Direct relationship
B. Inverse relationship
C. Reverse relationship
D. None of the above
Definition
A. Direct relationship
Term
In the fetal circulation, what percentage of blood flow goes to the lungs?
Definition
8-10%
Term
Which of the following is NOT a typical presenting symptom of a type I dissecting aortic aneurysm?

A. Arterial hypotension
B. Tearing chest pain radiating to back
C. Aortic insufficiency murmur
D. Jugular distension
Definition
D. Jugular distension
Term
True/False Patients that are unable to preform adequate exercise due to peripheral vascular disease, musculoskeletal, or neurological disorders cannot have a stress test?
Definition
False

Pharmacological stress agents can be used to adequately increase the heart rate
Term
Which of the following blood flow characteristics can be evaluated with color flow imaging?

A. Flow direction
B. Presence of flow
C. Quality of flow
D. All of the above
Definition
D. All of the above
Term
What is the typical assignment for blood flow towards and away from the transducer?
Definition
Blood flow towards = Red
Blood flow away = Blue

BART = Blue away/Red towards
Term
What do the varying hues from dull to bright colors represent in color flow imaging?
Definition
Varying frequency shifts

Duller the hue = lower frequency shift
Brighter the hue = higher frequency shift
Term
What type of Doppler instrumentation is the color flow information derived from?
Definition
Multi-gate pulsed wave Doppler
Term
True/False The density of blood, velocity, and vessel size all affect flow of blood in the body
Definition
True
Term
The method in which data from a gate on one line is averaged with data on an adjacent line is referred to as?

A. Line averaging
B. Interline interpolation
C. Fast Fourier transform
D. spectral analysis
E. None of the above
F. Both A and B
Definition
F. Both A and B
Term
What type of display preserves some of the reflection dynamic range?
Definition
Grayscale
Term
What is the purpose of the amplification function of the receiver?
Definition
Increases small voltages received from the transducer to larger ones suitable for processing.
Term
What does a mosaic appearance in color flow represent?
Definition
Turbulent flow
Term
True/False The greatest color sensitivity is achieved when the color Doppler beam is directed at an angle 0-20 degrees to flow
Definition
True
Term
If the PRF is increased, what will happen to the duty factor?
Definition
The duty factor will increase. Duty factor is the amount of time the sound is being transmitted. Any factor which increases the time an ultrasound machine is transmitting sound will cause the duty factor to increase.
Term
True/False The loss of image contrast due to side lobe interference can be improved by apodization?
Definition
True

Apodization is a term used to describe the scattering of collimated light beam by diffraction of the side portion. Engineering techniques have been designed for linear array transducers, so that the sensitivity of the peripheral piezoelectric element is reduced.
Term
What factor determines the ultrasound pulse amplitude and intensity?
Definition
Sound source

Both amplitude and intensity are determined by the sound source. Amplitude is the strength of the sound wave and is equal to the maximum variation in an acoustic variable. Intensity is the concentration of energy in a sound wave. The intensity can vary as the sound travels through the body. Intensity is proportional to power. Both amplitude and intensity can be charged by the operator.
Term
The ratio of output to input is defined as?
Definition
Gain
Term
One-line of color-flow information is produced by approximately?

A. 50 pulses
B. 100 pulses
C. 10 pulses
D. 1000 pulses
Definition
C. 10 pulses
Term
What is the pulse repetition frequency (PRF)?
Definition
PRF is the number of electrical pulses produced per second. It is determined by the sound source. In diagnostic imaging, the PRF ranges from 1-10 KHz. The PRF will change with changes in imaging depth. the PRF will decrease with increased imaging depth.
Term
The pulser of an ultrasound system produces and electrical voltage that?

A. Drives the transducer
B. Tells the display where the ultrasound pulses are produced
C. Both A and B
D. A only
Definition
C. Both A and B
Term
What are the five functions of the receiver?
Definition
A. Amplification
B. Compensation
C. Compression
D. Demodulation
E. Rejection
Term
What type of ultrasound transducer has multiple concentric piezoelectric elements that are energized sequentially from the inside out allowing for circular symmetry of the beam?

A. Linear sequenced array
B. Curvilinear array
C. Phased array
D. Annular Array
Definition
D. Annular array
Term
Lateral resolution will vary depending on?

A. Depth
B. Beam diameter
C. transducer frequency
D. Focusing
E. A,B,C
F. All of the above
Definition
F. All of the above
Term
What type of artifact occurs when the path lengths that the pulse travels to and from a structure or reflector are different?

A. Range artifact
B. Multipath artifact
C. Mirror image artifact
D. Side lobe artifact
Definition
B. Multipath artifact
Term
True/False Amplitude imaging of blood flow is angle dependent
Definition
False

Amplitude imaging is also known as color angio and power Doppler. Colors are assigned based on the strength or amplitude of the Doppler shifted echoes making it less dependent on angle of incidence.
Term
True/False The terms suppression and threshold are synonymous with amplification?
Definition
False

These terms are synonymous with rejection
Term
If the soft tissue-air interface is curved sufficiently, the incident beam is reflected in a manner that none of it returns to the transducer, this is displayed as a?

A. Attenuation shadow
B. Comet tail
C. Edge shadow
D. Enhancement
Definition
C. Edge shadow
Term
What term is used to describe the ratio of the largest power to the smallest power that the system can handle?
Definition
Dynamic range
Term
Which of the following affect attenuation?

A. Depth
B. Scattering
C. Absorption
D. All of the above
E. None of the above
Definition
D. All of the above
Term
What purpose does the compensation function have?
Definition
The compensation function equalizes differences in received reflection amplitudes due to reflector depth
Term
Which of the following terms describe compensation?

A. Gain compensation
B. Swept gain
C. Time gain compensation (TGC)
D. Depth gain compensation (DGC)
E. All of the above
Definition
E. All of the above
Term
What are the two types of cavitation?
Definition
Stable and transient cavitation

Stable and transient cavitation occurs when there is steady oscillation of a bubble with the passing of a sound wave. The bubbles absorb most of the acoustic energy. Transient cavitation is initiated by negative pressure of sound waves. There is violent expansion and collapsing of the bubbles.
Term
The distance from the beginning of a pulse to the end of the pulse is the?

A. Wavelength
B. Frequency
C. Spatial pulse length
D. spatial pulse time
Definition
C. Spatial pulse length
Term
Isovolumic indices are derived from the?

A. Afterload phase
B. Ejection phase
C. Pre ejection phase
D. Post ejection phase
Definition
C. Pre ejection phase
Term
The rate of pressure rise within the ventricle during isovolumic systole is?

A. Afterload
B. Pre ejection phase
C. Contraction
D. Relaxation
Definition
C.Contraction
Term
Ventricular function is determined by?

A. Afterload
B. Pre load
C. Contractility
D. All of the above
Definition
D. All of the above
Term
The amount of blood ejected by the ventricle per unit time is the?

A. Cardiac output
B. Strove volume
C. Ejection fraction
D. Cardiac index
Definition
A. Cardiac output
Term
Which of the following occurs during isovolumetric contraction?

A. Pressure in the left ventricle decreases, no valve open
B. Pressure in the left ventricle increases, no valves open
C. Mitral valve opens
D. Aortic valve opens
Definition
B. Pressure in the left ventricle increases, no valves open
Term
True/False As imaging depth increases, pulse repetition period increases?
Definition
True
Term
The atria and ventricles are at rest during?
Definition
Diastole
Term
Ejection fraction can determine which of the following?

A. Cardiac output
B. Overall heart function
C. Wall motion
D. All of the above
Definition
D. All of the above
Term
The ratio of stroke volume to end diastolic volume is?

A. Cardiac output
B. Ejection fraction
C. Cardiac index
D. Afterload
Definition
B. Ejection fraction
Term
Normal adult cardiac output is?

A. 3-5 liters/min
B. 1-2 liters/min
C. 10-12 liters/min
D. 30-50 liters/min
Definition
A. 3-5 liters/min
Term
Stroke volume is measured in?

A. Velocity
B. Milliliters
C. Centimeters
D. Cardiac output
Definition
B. Milliliters
Term
True/False Intracardiac pressues are constant throughout the cardiac cycle
Definition
False
Term
Hemodynamic pressure readings are measured in?

A. mmHg
B. Centimeters
C. Milliliters
D. Cardiac output
Definition
A. mmHg (millimeters of mercury)
Term
Pulmonary hypertension is suggested when pulmonary artery pressures are?

A. < 10mmHg
B. <20mmHg
C. <30mmHg
D. 35 mmHg or greater
Definition
D. 35mmHg or greater
Term
The normal left ventricle end diastolic pressure is?

A. 5-12mmHg
B. 20-30mmHg
C. 40-50mmHg
D. >100mmHg
Definition
A. 5-12mmHg
Term
The stretching force to which the myocardial muscle is subjected in its relaxed state is?

A. Ventricular contracility
B. Ventricular afterload
C. Ventricular preload
D. Compliance
Definition
C. Ventricular preload
Term
Dark, red blood that is low in oxygen and high in carbon dioxide can be found in which cardiac chamber?

A. Left ventricle
B. Right atrium
C. Left atrium
D. Aorta
Definition
B. Right atrium
Term
True/False When the left ventricle is filling, the aortic valve is open
Definition
False
Term
True/False The coronary arteries fill during diastole
Definition
True
Term
The Valsalva maneuver transiently increases pressure in the?

A. Aorta
B. Pulmonary artery
C. Right atrium
D. Left ventricle
Definition
C. Right atrium
Term
The first mechanical event in the cardiac cycle is?
Definition
Ventricular systole
Term
True/False Heart sounds occur when the cardiac valves close
Definition
True
Term
The first heart sound is also called a?

A. Snap
B. S1
C. S2
D. Click
Definition
B. S1
Term
The healthy human heart sound should be heard as S1/S2 pause S2/S1. The interval between S1 and S2 represents?

A. Ventricular diastole
B. Ventricular systole
C. End diastole
D. End systole
Definition
B. Ventricular systole
Term
Ventricular diastole is represented by the?

A. S2
B. S1
C. Pause
Definition
C. Pause
Term
Murmurs are produced by?

A. Thickened and or narrowed valves
B. Acute angina pectoris
C. Regurgitant lesions
D. All of the above
Definition
D. All of the above
Term
Mechanical events of the heart can be evaluated by?

A. Auscultation
B. Chest x-ray
C. Oximetry
D. Blood Pressure
Definition
A. Ausculation
Term
The abnormal supply of fatty cells below the intima is the initial stage of?

A. Aortic stenosis
B. Congenital heart disease
C. Atherosclerosis
D. Mitral Stenosis
Definition
C. Atherosclerosis
Term
Angina or chest pain may be caused by?

A Embolus
B. Tissue hypoxia
C. Plaque
D. All of the above
Definition
D. All of the above
Term
True/False A stenotic cardiac valve predominately affects the chambers immediately downstream.
Definition
False

A stenotic valve can severely impede flow and cause dilatation of the sending chamber as well
Term
The purpose of the normal cardiac valves is to provide?

A. Bi-directional flow
B. Unidirectional flow
C. No flow
D. Reverse flow
Definition
B. Unidirectional flow
Term
What is the most frequent cause of atherosclerosis?

A. Obesity
B. Smoking
C. Hypertension
D. Genetic predisposition
Definition
D. Genetic predisposition
Term
A murmur occurring in the absence of any pathological change in structure is called a?

A. Austin-Flint murmur
B. Crescendo-decrescendo murmur
C. Functional murmur
D. Gibson murmur
Definition
C. Functional murmur
Term
A patient with aortic stenosis may have an ausculatory finding of a?

A. Crescendo-decrescendo murmur
B. Loud, rough ejection systolic murmur
C. Ejection sound at the left sternal border
D. Diminished our absent second aortic sound
E. All of the above
Definition
E. All of the above
Term
The vibration produced by the movement of blood within the heart is an?

A. Bruit
B. Infarct
C. Murmur
D. Gradient
Definition
C.Murmur
Term
Blowing and hissing following the second heart sound is heard in?

A. Mitral stenosis
B. Pulmonic stenosis
C. Aortic Insufficiency
D. Mitral regurgitation
Definition
C. Aortic Insufficiency
Term
Systolic murmurs are best classified according to?

A. Time of onset and termination
B. Time of termination
C. Time of onset
D. Interval time
Definition
A. Time onset and termination
Term
Mid to late systolic clicks originate in the?

A. Aortic apparatus
B. Mitral apparatus
C. Septum
D. SA node
Definition
B. Mitral apparatus
Term
A graphic representation of electrical activity is a?

A. Electroencephalogram
B. Electrocardiogram
C. Tococardiogram
D. Phonocardiogram
Definition
B. Electrocardiogram (ECG)
Term
Atrial fibrillation is best identified by an?

A. Wide QRS
B. ST depression
C. Absence of P wave
D. Bradycardia
Definition
C. Absence of P wave
Term
Bundle branch block patterns are recognized by a?

A. Wide QRS
B.Q wave
C. ST depression
D. P wave
Definition
A. Wide QRS
Term
Which of the following statements correctly describes events occurring during stimulation of the atria and ventricles?

A. The atria depolarize in a downward fashion.
B. the period of ventricular relaxation is called systole
C. The ventricle depolarization in the direction of the epicardium
D. None of the above
Definition
A. the atria depolarize in a downward fashion
Term
What is the most common life-threatening complication of myocardial infarction?

A. Pulmonary emboli
B. Arrhythmias
C. Mitral regurgitation
D. Ventricular aneurysm
Definition
B. Arrhythmias
Term
A screening tool for identifying patients with significant coronary artery disease and assessing cardiovascular function is a?

A. Holter monitor
B. Echocardiogram
C. Stress EKG
D. EKG
Definition
C. Stress EKG
Term
When preforming a stress EKG, the most likely finding on an individual that can sustain maximal oxygen demand without demonstrating symptoms or ekg changes is?

A. An acute myocardial infarction
B. Suffering from myocardial hypoxia
C. Suggestive of a normal exam
D. Inconclusive
Definition
C. Suggestive of a normal exam
Term
The most common method of determining cardiac output during cardiac catheterization is?

A. Blood pressure
B. Fick oxygen method
C. indocine green dye
D. Ventriculogram
Definition
B. Fick oxygen method
Term
Clubbing may e a physical finding seen in patients with?

A. Endocarditis
B. Aortic stenosis
C. Myocardial infarction
D. Atrial fibrillation
Definition
A. Endocarditis
Term
Typically what is the first symptom of mitral stenosis?

A. Chest pain
B. Exertional dyspnea
C. Clubbing
D. Jugular venous distension
Definition
B. Exertional dyspnea
Term
A patient presenting with possible Marfan's syndrome commonly presents with physical findings of?

A. Long extremities
B. Tall, lean body
C. Disproportionately long and thin digits
D. Pectus carinatum or pectus excavatum
E. All of the above
Definition
E. All of the above
Term
The most common cause of mitral stenosis is?

A. Congenital defect
B. Rheumatic heart disease
C. Ruptured chordae
D. Aging
Definition
B. Rheumatic heart disease
Term
Which of the following are advantages of preforming nuclear stress testing verses stress EKG?

A. Nuclear stress testing can assess cardiac blood perfusion
B. Nuclear stress testing is more sensitive and specific
C. Nuclear stress testing can differentiate between scarring and ischemia
D. Helps to determine the method of possible medical intervention
E. All of the above
Definition
E. All of the above
Term
When an asymptomatic patient has a positive stress EKG, the next possible non-invasive cardiac test ordered may be?

A. Nuclear stress test
B. Stress echocardiography
C. Holter Monitor
D. A and B
E. B and C
F. All of the above
Definition
D. A and B
Term
When preforming stress echocardiography, all four views should be acquired within?

A. The first 5 mins after exercise
B. The first 3 mins after exercise
C. the first minute after exercise
D. Time is not a factor
Definition
C. The first minute after exercise
Term
Which of the following is NOT a reason to preform stress echocardiography?

A. Detection of regional wall motion abnormalities
B. Helps to determine the effectiveness of recent inerventional procedures
C. Detects and evaluates arrhythmias
D. Provides a baseline for comparison with future testing
Definition
C. Detects and evaluates arrhythmias
Term
According to the new guidelines provided by the American Heart Association, what is the first thing you should do if an adult collapses and is unresponsive?

A. Open an airway on the victim
B. Activate the local emergency medical service number
C. Begin chest compression
D. Begin rescue breathing
Definition
B. Activate the local emergency medical services number
Term
When there are two rescuers performing CPR, the rate of chest compression to rescue breathing should be?

A. 5 to 1
B. 15 to 1
C. 5 to 2
D. 15 to 2
Definition
D. 15 to 2 compression to breath
Term
An ausculatory finding in tricuspid stenosis of an increase in intensity of the diastolic murmur with inspiration is referred to as?

A. DeRosier's sign
B. Carvallo's sign
C. Murphy's sign
D. Ebstein's sign
Definition
B. Carvallo's sign
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