Basics of Ultrasound and Knobology Question Title * 1. ______________ is the number of wavelengths per unit of time and is inversely related to wavelength. Frequency Velocity Amplitude Resolution Question Title * 2. ______________ is the distance traveled between two consecutive peaks or troughs of a wave. Frequency Velocity Amplitude Wavelength Question Title * 3. The lower the frequency of an ultrasound wave the greater the ________________________. resolution velocity amplitude depth of penetration Question Title * 4. All of the following statements regarding frequency and wavelength are true except Resolution is improved with high frequency sound waves Resolution is improved with higher wavelengths Lower frequency sound waves are absorbed less than higher frequency sound waves Higher frequency sound waves create longer near fields Question Title * 5. _______________ transducers are used for superficial structures and provide the best image resolution for functions such as invasive lines. Phased array Curvilinear Linear array Convex array Question Title * 6. _____________ is the mode used for standard 2-D image creation and is the standard for transesophageal echocardiography. B-Mode (brightness mode) M-Mode (Motion Mode) PW Mode (Pulsed Wave Mode) Doppler Mode (Directional Mode) Question Title * 7. A good general rule in regards to determining flow using Color Doppler is Blue Color=blood flow moving towards the transducer Red Color=Blood flow moving towards the transducer Brighter Color=slower velocity Red Color=blood flow perpendicular to the transducer Question Title * 8. Advantages of transesophageal echocardiography over transthoracic echocardiography include easier to manage during ongoing surgery in an intubated patient posterior cardiac structures such as the atrial septum are easier to image Improved imaging due to absence of intervening lung or bones all of the above Question Title * 9. Absolute contraindications to transesophageal echocardiography exam include Perforated esophageal viscous and bleeding Atlantoaxial joint disease Prior radiation to the chest History of dysphagia Question Title * 10. Sites of potential injury during transesophageal echocardiography exam with experienced sonographers/clinicians include Oral (e.g., dental and lip trauma) Oropharyngeal trauma (e.g., laceration, perforation) Gastric trauma (e.g., laceration, perforation) All of the above Question Title * 11. Which of the following is an important consideration for transesophageal echocardiography probe insertion and safety? Verify functioning anteflex/retroflex and lateral tilt knobs prior to insertion Ensure the transducer head is facing downwards during insertion Advance until the stomach is seen before starting/acquiring first view Never freeze the transesophageal echo image especially during cardiopulmonary bypass Question Title * 12. Which of the following is NOT a probe/transducer manipulation or capability utilized during transesophageal echocardiography exam? TEE probe flexion TEE probe advancement Omniplane Gastric suction Question Title * 13. The small knob on the transesophageal echocardiography probe controls Anteflexion/retroflexion Left/right tilt Image rotation Image depth Question Title * 14. During transesophageal echocardiography exam midesophageal windows are typically at a depth of 20-25 cm 30-40 cm 40-45 cm 45-55 cm Question Title * 15. During multiplane imaging (omniplane) the transducr beam may be rotated similar to rotating a surface probe. Using the omniplane buttons at ________ the beam is _________. 0 degrees; transverse 45 degrees; longitudinal 90 degrees; transverse 180 degrees longitudinal Question Title * 16. When a standard orientation is used at 0 degrees omniplane for midesophageal four chamber views, the image seen on the right side of the display is On the patient's left On the patient's right Cephalad Caudad Question Title * 17. Imaging depth on the ultrasound console should be set At the top of the structure of interest (e.g., mitral valve) In the middle of the structure of interest (e.g., mitral valve) Just beyond the structure of interest (e.g., mitral valve) To the tip of the spine for all posterior cardiac structures (e.g., mitral valve) Question Title * 18. If the gain is set too high on the ultrasound controls The image will appear bright and tissues like the mitral valve will appear thickened even when normal The image will only demonstrate thicker structures such as the pericardium The blood will appear nearly black The cardiac tissues will appear gray Question Title * 19. Which of the following is false regarding Time Gain Compensation Controls (TGC)? Time Gain Compensation Controls allow differential adjustment of depth Time Gain Compensation Controls are used to eliminate mirror artifacts Time Gain Compensation Controls are set lower for near field and higher for far field images Higher frequency is used when the structure of interest (e.g., mitral valve) is closer to the transducer Question Title * 20. If you adjust the color gain (Nyquist limit) too high you may Underestimate a regurgitant jet as in mitral regurgitation Overestimate a regurgitant jet as in mitral regurgitation Increase the frame rate, slow down the image processing and create image drop out Reverse the color pattern and Doppler effect Question Title * 21. Which of the following is true regarding use of Doppler for transesophageal echocardiography examination for heart valve disorders? Pulse wave Doppler can be used to measure very high velocities as may occur with aortic stenosis Continuous wave Doppler can measure only a limited range of velocities but allows sampling of blood flow in a specific area/chamber Blue colors denote blood flow towards the transesophageal echocardiography probe when using color flow Doppler Mosaic patterns represent turbulent flow and may be seen when there is valvular stenosis or regurgitation when using Color Flow Doppler Question Title * 22. Acoustic shadowing/dropout will produce a dark area Proximal to the strong reflector Distal to the strong reflector Left of the strong reflector Right of the strong reflector Question Title * 23. Which of the following is typically NOT a hyperechoic structure? Pericardium Pacemaker lead Bioprosthetic mitral valve pericardial effusion Question Title * 24. Which machine control can assist in lowering the probe temperature? Gain Compression Freeze Depth Question Title * 25. A normal aortic valve may appear thickened due to the improper use of which ultrasound machine control? Gain Depth Freeze Reject Done
