107 Flashcards
Aphasia
inability to speak/ express oneself
Dysphasia
impaired of uncoordinated speech
Dysarthria
poor articulation
lateralized paresthesia
tingling and numbness of limb (contralateral hemisphere)
hemiparesis
lateralized weakness (contralateral)
hemiplegia
lateralized paralysis (contralateral)
amaurosis fugax
transit blindness in one eye (ipsilateral)
ataxia
uncoordinated muscle movements (contralateral)
Diplopia
double vision (vert-basilar)
vertigo
sensation room is moving around you (vert-basilar)
syncope
fainting (vert-basilar)
dizziness
you are moving (vert-basilar)
drop attacks
spontaneous fall and fast recovery (vert-basilar)
binocular blindess
both eyes affected (vert-basilar)
CVA
cerebrovascular accident: complete brain stroke, does not fully resolve
TIA
Transient ischemic attack: symptoms resolve within 24hrs “mini stroke”
RIND
symptoms resolve fully after 24 hrs
FMD
Fibromuscular dysplasia; usually bilateral, in women, known to occur in renal arteries, look like pearls in angio, scan ICA D as far as you can
Carotid body tumor
chemodactoma; usually benign, lies in “crotch” of carotid BIF
Eddy flow
flow moving in opposite direction to mainstream flow
plug flow
all blood cells are moving at same speed, systole (narrow spectrum)
parabolic flow
blood cells in center stream move faster than those closer to the wall, diastole (wider spectrum)
laminar flow
normal flow
Turbulence
depends on: 1. density of fluid 2. viscosity 3. diameter of vessel Reynolds # describes when turbulence is likely to occur (approx >2000
Reynolds #
RE=(avg flow X density X tube diameter)/ viscosity
vertebrobasilar symptoms
Vertigo, syncope, drop attacks, diplopia
indications for subclavian artery exam
supraclavicular bruit, reduced arm bp, arm weakness, or abnormal vert spectral/ flow direction
Criteria for hemodynamically significant stenosis
- presence of plaque
- increase in velocities
- post stenotic turbulence (in spectral, does not have clean windows)
When you suspect occlusion, take spectral tracing where:
- prox /pre-stenosis
- Point of max stenosis
- post stenosis
- distal to suspected occlusion to check if laminar flow returns
NASCET
North American Symptomatic Carotid Endarterectomy Trial, determine the benefit of carotid endarterectomy in symptomatic pt’s, found 17% reduction in ipsilateral stroke at 2 yrs post op for pt’s w/ 70% stenosis
Plaque characterization includes
- echogenicity: hyper echoic (brighter than comparing vessel), isoechoic(same echogenicity as surroundings), hypo echoic (darker than comparing vessel)
- Homogeneity: homo(same shade of grays), heterogeneous (diff types of grays)
- Contour: smooth, regular, irregular, ulcerated (risky plaque)
Cystic spaces
are anechoic
Intraplaque hemorrhage (IPH)
plaque characterization, sonolucent/ hypoechoic region with thin fibrous cap “eggshell” pattern
ulceration
heterogeneous, sharper irregular borders, >2mm defect and could be IPH