FIG 19.26 In the apical three-chamber view, it is possible to see the left atrium (LA), left ventricle (LV) and aorta (AO) FIG 19.27 Apical two-chamber view showing the left atrium (LA) and the left ventricle (LV), cutting the superior and inferior walls of the left ventricle This image is important for the assessment of left ventricular function Views From the Suprasternal Notch When the transducer is positioned in the suprasternal notch, with the notch of the transducer itself at the 3 o'clock position, the standard short-axis section will demonstrate the left brachiocephalic vein, the short-axis cut of the aortic arch, the right pulmonary artery, and the left atrium (Fig 19.28) The four pulmonary veins can be seen entering the left atrium when the transducer is tilted more posteriorly, producing the so-called “crab view.” The right superior caval vein is seen to the right By sweeping cranially, the branching pattern of the cranial vessels can be described When the first branch of the brachiocephalic artery is directed to the right, then the aortic arch will be left sided, whereas when the first branch is directed leftward, the arch will be right sided Should the first branch from the aortic arch not bifurcate, then an aberrant origin of the subclavian artery should be suspected Counterclockwise rotation of the transducer provides a long-axis view of the aortic arch (Fig 19.29) With further counterclockwise rotation and leftward angulation, the crossing of the left pulmonary artery relative to the descending aorta can be demonstrated Better views of the aorta are sometimes obtained with the transducer to the right of the suprasternal notch or when it is positioned in high parasternal position FIG 19.28 Suprasternal short-axis view showing the superior caval vein (SCV) rightward of the aorta (AO), which is cut in its short axis Posterior to the aorta is the right pulmonary artery (RPA), and more posterior still is the left atrium (LA) When tilted a little more posteriorly, the crab view is obtained, showing the four pulmonary veins entering the left atrium