CCI ECHO COMPREHENSIVE EXAM UPDATED QUESTIONS
AND ANSWERS SURE A+
✔✔Describe the anatomy of the tricuspid valve, including the name and location if each
leaflet. - ✔✔Location is between the Right atria and right ventricle.
It has three leaflets: anterior, posterior, and medial or (septal) leaflets.
The names reflect the anatomical relationship to the right ventricle. The medial leaflet is
connected to the septal wall. It's insertion is located closer to the cardiac apex than that
of the anterior mitral valve leaflet.
✔✔Name and describe two main layers of the pericardium? - ✔✔Often referred to as 2
main layers as visceral and parietal. This visceral layer lies directly upon external
surface of the heart and is commonly referred as the epicardium. The parietal or fibrous
pericardium is the thick outer sac. Pericardial cavity lies between the two layers.
Anatomically 3 layers are: serous visceral, serous parietal, fibrous pericardium.
✔✔Name the three major coronary arteries. - ✔✔The three major coronary arteries are
the right, left ant descending (LAD), and the circumflex arteries
✔✔The heart tube loops _______ at day ____ - ✔✔The heart tube loops ANTERIORLY
and RIGHTWARD at day 22
✔✔The AV canal is a large communication between the __________ and ________ -
✔✔Primitive atria and primitive ventricle
✔✔The ________ divides the AV canal into right and left AV orifices - ✔✔Endocardial
cushions
✔✔The ductus arteriosus closes after birth due to increased systemic pressure and
becomes the _______ - ✔✔Ligamentum arteriosum
✔✔What are the two Right to Left shunts in the normal fetal circulation? - ✔✔Foreman
ovale
Ductus arteriosus
✔✔Following electrical depolarization of the myocardial cell membrane, which ion
rushes in first and which ion rushes in later? - ✔✔Sodium is a rest
* Calcium is 2nd and responsible for contraction
✔✔Where is a subaortic membrane (DSS) located? - ✔✔just below the Aortic Valve
✔✔Tricuspid Valve leaflets seen in the PSAX-Aortic valve - ✔✔Medial (septal)
,Anterior
✔✔Name the cardiac walls supplied by each of the coronary arteries. - ✔✔Normally, the
major coronary arteries supply the cardiac walls as follows (based on the ASE 17
segment model):
right coronary artery
a) inferior wall
b) inferoseptal
c) right ventricular apex
d) right ventricular free wall.
**RIGHT= inferior, septals, right
✔✔Left anterior descending artery - LAD - ✔✔a) anterior wall
b) anteroseptal
c) left ventricular apex
**LEFT = anterior, apical, left
✔✔Circumflex artery - ✔✔a) anterior lateral wall
b) inferolateral wall
CIRC = laterals
✔✔What walls do the LAD supply? - ✔✔Anterior IVS, Anterior Left Ventricle and Apex
✔✔What walls do the CX supply? - ✔✔Anterolateral and inferolateral
✔✔What walls do the Posterior descending artery supply? - ✔✔Inferior Left Ventricle,
Inferior Right Ventricle and Inferior IVS
✔✔The LAD lies in the _______ interventricular sulcus? - ✔✔anterior
✔✔walls and coronary artery circulation on PLAX?. - ✔✔1. anterior RVOT - RCA
2. anterior IVS - LAD
3. inferolateral - CX/RCA
✔✔walls and coronary artery circulation on PSAX? - ✔✔1. anterior IVS - LAD
2. anterior - LAD
3. anterolateral - CX/LAD
4. inferolateral - CX/RCA
5. inferior - Posterior descending
6. inferior IVS - Posterior descending /LAD
✔✔walls and coronary artery circulation A4? - ✔✔1. anterolateral - CX/LAD
2. apex - LAD
3. inferior IVS - LAD/RCA
4. lateral Right Ventricle - RCA
,✔✔walls and coronary artery circulation Apical 2 Ch? - ✔✔1. anterior - LAD
2. apex - LAD
3. inferior - Posterior descending artery (of the RCA)
✔✔The circumflex artery supplies? - ✔✔anterolateral and inferolateral walls
✔✔The Posterior descending artery ( of the right coronary artery) supplies? - ✔✔inferior
Left Ventricle, inferior Right Ventricle and inferior IVS
✔✔The anterior septum and anterior wall of the Left Ventricle is supplied by the? -
✔✔LAD
✔✔The anterolateral, lateral and inferolateral walls of the Left Ventricle are supplied by
the? - ✔✔Circumflex
✔✔The inferior wall of the Left Ventricle and inferior septum are supplied by the? -
✔✔Posterior descending artery
✔✔The cardiac apex is supplied by the? - ✔✔LAD
✔✔Which coronary artery provides blood to the Right Ventricle? - ✔✔RCA
✔✔Which coronary artery provides blood to the inferior septal walls in right dominant? -
✔✔Posterior descending artery
✔✔Which walls of the left ventricle are seen in the parasternal and apical long axis
views - ✔✔Which two aortic valve leaflets are seen in these views?
The anterior septal and the inferolateral walls of the LV are seen in the parasternal
apical long axis Views.
The right & non coronary leaflets are seen in these views. The right leaflet is on top
(superior) and the non-coronary is on the bottom (inferior)
✔✔Where are the coronary arteries located on the surface of the heart? - ✔✔The
coronary arteries are located on the outer, epicardial surface of the heart as follows:
the right coronary artery (RCA) arises from the right aortic root sinus, follows the right
atrioventricular junction, and to descends along the posterior interventricular groove.
The left anterior descending coronary artery (LAD) follows the Anterior interventricular
groove.
The circumflex coronary artery's or courses along the left AV junction.
✔✔Complications with MI? - ✔✔1. pericarditis/PE
2. Dressler's syndrome (PE post MI)
3. Left Ventricle true aneurysm
, 4. Left Ventricle false or pseudo aneurysm
5. Left Ventricle thrombus
6. Ventricular septal defect
7. papillary muscle dysfunction
8. Right Ventricle infarct
✔✔While scanning a 43 old man with history of an old myocardial infarction, you notice
at the anterior cardiac wall is akinetic. Which coronary artery is most likely to have been
involved in the infarction? - ✔✔The left anterior descending (LAD) coronary artery,
which supplies blood to the inferior cardiac wall, is most likely to have been involved.
This artery also supplies the inferior portion of ventricular septum and the left ventricular
apex.
**LEFT = anterior, apical, left
✔✔In the apical 4 ch view of another patient, the distal ventricular septum and left
ventricular apex are hypo-contractile. Which coronary artery is most likely to be
diseased? - ✔✔Again, the left Anterior descending (LAD) coronary artery is the most
likely choice. Some patients with distal septal hypocontractility, the proximal portion of
the septum moves normally because it is supplied by the RCA.
NOTE: LEFT= left, ant, apicals
✔✔To visualize the inferior lateral wall the left ventricle, which 2D view would you use? -
✔✔The anteriolateral wall of the left ventricle is best visualized in the apical four
chamber view.( The lateral wall can also be seen in the short axis views, but the four
chamber view is the best.)
NOTE: 2 CH is anterior & inferior
✔✔The normal intracardiac pressure for the Right Atrium is? - ✔✔5mmHG
NOTE: RIGHT SIDED PULMONARY PRESSURES ARE LOWER THAN THE LEFT
Right Atrium=5, Right Ventricle=25, PA=25 5-25-25
Left Atrium=10, Left Ventricle=120, Aorta =120. 10-130-120
✔✔The normal intracardiac pressure for the Right Ventricle is? - ✔✔25/5mmHg
✔✔The normal intracardiac pressure for the PA is? - ✔✔25/10mmHg
✔✔The normal intracardiac pressure for the Left Atrium is? - ✔✔10mmHg
✔✔The normal intracardiac pressure for the Left Ventricle is? - ✔✔120/10mmHg
✔✔The normal intracardiac pressure for the Aorta is? - ✔✔120/80mmHg
AND ANSWERS SURE A+
✔✔Describe the anatomy of the tricuspid valve, including the name and location if each
leaflet. - ✔✔Location is between the Right atria and right ventricle.
It has three leaflets: anterior, posterior, and medial or (septal) leaflets.
The names reflect the anatomical relationship to the right ventricle. The medial leaflet is
connected to the septal wall. It's insertion is located closer to the cardiac apex than that
of the anterior mitral valve leaflet.
✔✔Name and describe two main layers of the pericardium? - ✔✔Often referred to as 2
main layers as visceral and parietal. This visceral layer lies directly upon external
surface of the heart and is commonly referred as the epicardium. The parietal or fibrous
pericardium is the thick outer sac. Pericardial cavity lies between the two layers.
Anatomically 3 layers are: serous visceral, serous parietal, fibrous pericardium.
✔✔Name the three major coronary arteries. - ✔✔The three major coronary arteries are
the right, left ant descending (LAD), and the circumflex arteries
✔✔The heart tube loops _______ at day ____ - ✔✔The heart tube loops ANTERIORLY
and RIGHTWARD at day 22
✔✔The AV canal is a large communication between the __________ and ________ -
✔✔Primitive atria and primitive ventricle
✔✔The ________ divides the AV canal into right and left AV orifices - ✔✔Endocardial
cushions
✔✔The ductus arteriosus closes after birth due to increased systemic pressure and
becomes the _______ - ✔✔Ligamentum arteriosum
✔✔What are the two Right to Left shunts in the normal fetal circulation? - ✔✔Foreman
ovale
Ductus arteriosus
✔✔Following electrical depolarization of the myocardial cell membrane, which ion
rushes in first and which ion rushes in later? - ✔✔Sodium is a rest
* Calcium is 2nd and responsible for contraction
✔✔Where is a subaortic membrane (DSS) located? - ✔✔just below the Aortic Valve
✔✔Tricuspid Valve leaflets seen in the PSAX-Aortic valve - ✔✔Medial (septal)
,Anterior
✔✔Name the cardiac walls supplied by each of the coronary arteries. - ✔✔Normally, the
major coronary arteries supply the cardiac walls as follows (based on the ASE 17
segment model):
right coronary artery
a) inferior wall
b) inferoseptal
c) right ventricular apex
d) right ventricular free wall.
**RIGHT= inferior, septals, right
✔✔Left anterior descending artery - LAD - ✔✔a) anterior wall
b) anteroseptal
c) left ventricular apex
**LEFT = anterior, apical, left
✔✔Circumflex artery - ✔✔a) anterior lateral wall
b) inferolateral wall
CIRC = laterals
✔✔What walls do the LAD supply? - ✔✔Anterior IVS, Anterior Left Ventricle and Apex
✔✔What walls do the CX supply? - ✔✔Anterolateral and inferolateral
✔✔What walls do the Posterior descending artery supply? - ✔✔Inferior Left Ventricle,
Inferior Right Ventricle and Inferior IVS
✔✔The LAD lies in the _______ interventricular sulcus? - ✔✔anterior
✔✔walls and coronary artery circulation on PLAX?. - ✔✔1. anterior RVOT - RCA
2. anterior IVS - LAD
3. inferolateral - CX/RCA
✔✔walls and coronary artery circulation on PSAX? - ✔✔1. anterior IVS - LAD
2. anterior - LAD
3. anterolateral - CX/LAD
4. inferolateral - CX/RCA
5. inferior - Posterior descending
6. inferior IVS - Posterior descending /LAD
✔✔walls and coronary artery circulation A4? - ✔✔1. anterolateral - CX/LAD
2. apex - LAD
3. inferior IVS - LAD/RCA
4. lateral Right Ventricle - RCA
,✔✔walls and coronary artery circulation Apical 2 Ch? - ✔✔1. anterior - LAD
2. apex - LAD
3. inferior - Posterior descending artery (of the RCA)
✔✔The circumflex artery supplies? - ✔✔anterolateral and inferolateral walls
✔✔The Posterior descending artery ( of the right coronary artery) supplies? - ✔✔inferior
Left Ventricle, inferior Right Ventricle and inferior IVS
✔✔The anterior septum and anterior wall of the Left Ventricle is supplied by the? -
✔✔LAD
✔✔The anterolateral, lateral and inferolateral walls of the Left Ventricle are supplied by
the? - ✔✔Circumflex
✔✔The inferior wall of the Left Ventricle and inferior septum are supplied by the? -
✔✔Posterior descending artery
✔✔The cardiac apex is supplied by the? - ✔✔LAD
✔✔Which coronary artery provides blood to the Right Ventricle? - ✔✔RCA
✔✔Which coronary artery provides blood to the inferior septal walls in right dominant? -
✔✔Posterior descending artery
✔✔Which walls of the left ventricle are seen in the parasternal and apical long axis
views - ✔✔Which two aortic valve leaflets are seen in these views?
The anterior septal and the inferolateral walls of the LV are seen in the parasternal
apical long axis Views.
The right & non coronary leaflets are seen in these views. The right leaflet is on top
(superior) and the non-coronary is on the bottom (inferior)
✔✔Where are the coronary arteries located on the surface of the heart? - ✔✔The
coronary arteries are located on the outer, epicardial surface of the heart as follows:
the right coronary artery (RCA) arises from the right aortic root sinus, follows the right
atrioventricular junction, and to descends along the posterior interventricular groove.
The left anterior descending coronary artery (LAD) follows the Anterior interventricular
groove.
The circumflex coronary artery's or courses along the left AV junction.
✔✔Complications with MI? - ✔✔1. pericarditis/PE
2. Dressler's syndrome (PE post MI)
3. Left Ventricle true aneurysm
, 4. Left Ventricle false or pseudo aneurysm
5. Left Ventricle thrombus
6. Ventricular septal defect
7. papillary muscle dysfunction
8. Right Ventricle infarct
✔✔While scanning a 43 old man with history of an old myocardial infarction, you notice
at the anterior cardiac wall is akinetic. Which coronary artery is most likely to have been
involved in the infarction? - ✔✔The left anterior descending (LAD) coronary artery,
which supplies blood to the inferior cardiac wall, is most likely to have been involved.
This artery also supplies the inferior portion of ventricular septum and the left ventricular
apex.
**LEFT = anterior, apical, left
✔✔In the apical 4 ch view of another patient, the distal ventricular septum and left
ventricular apex are hypo-contractile. Which coronary artery is most likely to be
diseased? - ✔✔Again, the left Anterior descending (LAD) coronary artery is the most
likely choice. Some patients with distal septal hypocontractility, the proximal portion of
the septum moves normally because it is supplied by the RCA.
NOTE: LEFT= left, ant, apicals
✔✔To visualize the inferior lateral wall the left ventricle, which 2D view would you use? -
✔✔The anteriolateral wall of the left ventricle is best visualized in the apical four
chamber view.( The lateral wall can also be seen in the short axis views, but the four
chamber view is the best.)
NOTE: 2 CH is anterior & inferior
✔✔The normal intracardiac pressure for the Right Atrium is? - ✔✔5mmHG
NOTE: RIGHT SIDED PULMONARY PRESSURES ARE LOWER THAN THE LEFT
Right Atrium=5, Right Ventricle=25, PA=25 5-25-25
Left Atrium=10, Left Ventricle=120, Aorta =120. 10-130-120
✔✔The normal intracardiac pressure for the Right Ventricle is? - ✔✔25/5mmHg
✔✔The normal intracardiac pressure for the PA is? - ✔✔25/10mmHg
✔✔The normal intracardiac pressure for the Left Atrium is? - ✔✔10mmHg
✔✔The normal intracardiac pressure for the Left Ventricle is? - ✔✔120/10mmHg
✔✔The normal intracardiac pressure for the Aorta is? - ✔✔120/80mmHg
