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vascular anatomy > Arterial Hemodynamis Class 8 Unit 16 COPY > Flashcards

Arterial Hemodynamis Class 8 Unit 16 COPY Flashcards

1
Q

Systolic velocity is ________ than diastolic velocity

A

Higher

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2
Q

Why is systolic velocity higher than diastolic velocity?

A

Because of the heart pumping in systole and flowing moving on it’s own momentum in diastole .

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3
Q

Does systolic velocity increase or decrease, as the blood flows to the ankles?

A

It decreases.

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4
Q

When viewing in ultrasound of the peripheral arterial flow, what characteristic is usually found within the waveform?

A

Peripheral arterial flow is pulsatile, due to the pumping of the heart.

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5
Q

Doppler velocity waveforms demonstrate what?

A

Demonstrate velocity changes, throughout the cardiac cycle

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6
Q

In the peripheral arteries (le and ue), how is the velocity pattern demonstrated on doppler?

A

Velocity pattern is forward in systole, with a sharp upstroke, and narrow peak, followed by a short reversal of flow.

(Looks more triaphasic )

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7
Q

In the normal le and ue, flow reversal is primarily due to what?

A

The resistance of the distal vascular bed that the artery is feeding.

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8
Q

In normal le and ue arteries, what is the resistance controlled by?

A

Arterioles

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9
Q

During exercise, what happens to the arterioles?

A

Arterioles open, which causes the resistance to decrease, and increases the flow needed for the muscles to work.

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10
Q

What determines the diastolic portion of the velocity waveform?

A

Resistance of distal vascular bed

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11
Q

Is there a high or low resistance, in the vessels feeding the brain, kidney, and liver?

A

Low resistance

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12
Q

Peripheral arteries normally _________ resistance at rest.

A

High

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13
Q

Why do arterioles open?

A

to reduce resistance and increase flow as needed.

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14
Q

When do arterioles open?

A
  • During a proximal obstruction in the artery.
  • inflammation
  • exercise
  • anything that may cause decreased peripheral resistance.
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15
Q

Normal mean velocities in the peripheral arteries

These are not criteria, just average velocities

A

Come back to this and put the chart

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16
Q

When do velocities usually change in the peripheral arteries?

A

Usually around the stenosis and occlusion

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17
Q

What does peri-stenosis mean?

A

Around the stenosis

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18
Q

During peri-stenotic flow changes, as velocity increases, pressure ____________ .

A

decreases

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19
Q

During peri-stenotic flow changes, as velocity decrease distally, pressure _________.

A

increases

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20
Q

In a peri- stenotic, when the velocity decreases , and pressure increases, is the pressure higher than the inflow (initial) pressure?

A

no, its not as high as the inflow pressure.

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21
Q

arterial velocity changes & waveforms

A

come back to put the image

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22
Q

what has to happen to the velocity in a artery, in order to say there is a stenosis in it?

A

velocity increases at least double the pre-stenosis.

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23
Q

Is pre stenosis predictable?

A

no

24
Q

In pre stenosis, if there is a triphasic waveform on Doppler, what may this indicate?

A

minor stenosis, or good collateralss

25
Q

During pre stenosis, does the Doppler signal have diastolic flow?

A

no

26
Q

During pre stenosis, a biphasic or monophasic doppler signal indicates ____________.

A

proximal disease present

27
Q

When you turn on Doppler in the stenosis, how will the waveform look?

A

it will have a spectral broadening

put in image 11

28
Q

During post -stenosis, what happens to the velocities?

A

they decrease along the artery distal to the stenosis

29
Q

During post-stenosis, what is present on the doppler waveform?

A
  • initially turbulence is present
  • may have reversed flow under the peak
  • feathered peak velocities in the peak

(put image 12)

30
Q

how will you know if the stenosis is significant, when viewing the waveform on doppler?

A

when moving distal from the pre stenosis, if it shows biphasic or monophasic waveform, you know its a significant.

31
Q

List characteristics that a PRE -occlusive doppler waveform may have in ultrasound

A
  • may have no diastolic flow
  • may have diastolic flow if good collaterals exist to the sample volume
  • velocity may be low
32
Q

List characteristics that IN - occlusion doppler waveform may have in ultrasound

A
  • no doppler signal

- b- mode usually shows echoes

33
Q

List characteristics that POST occlusion doppler may have in ultrasound

A
  • almost always has a monophasic shape

- low velocity

34
Q

In systole, the systolic portion of the wave indicates what?

A

indicates the inflow patency or obstruction

35
Q

what does a slow upstroke indicates in systole?

A

a significant proximal obstruction

36
Q

In diastole, the diastolic portion of the wave indicates what?

A

the resistance of the distal vascular bed

37
Q

what does a high resistance wave demonstrate?

A

the diastolic flow, which can be at the baseline or below the baseline

38
Q

what does a low resistance wave demonstrate?

A
  • forward flow throughout the cycle, about the baseline

- indicates proximal obstruction or post exercise or meds

39
Q

which arteries are normally high resistance?

A
  • le arteries
  • ue arteries
  • eca
  • sma
40
Q

which arteries are normally low resistance?

A
  • ica
  • vert
  • celiac
  • renal
41
Q

What are some normal situations that change the resistance of the arterioles?

A

-exercise

(changes arteries from high resistance to low resistance, so flow can increase and help muscles work)

  • eating

( changes the superior mesenteric artery from normally high resistance to low resistance to help digestion)

  • post ichemia

(normal high resistance to low resistance )

we see this when you come in from cold and fingers, toes and cheeks, may be low resistance to encourage flow

42
Q

Peripheral arteries distal to a significant obstruction will become low resistance, due to what?

A

arterioles opening to encourage flow

43
Q

The CCA will change from low to high resistance, proximal to an _________ occlusion, due to distal resistance,

A

ICA

44
Q

ICA will change from a low to high resistance proximal to an intracranial ________ occlusion, due to distal resistance.

A

ICA

45
Q

terminology : waveform patterns

A

slide 20 post

46
Q

terminology:waveform patterns

A

slide 21 post

47
Q

The systolic portion of the arterial waveform is affected by what?

A

A proximal obstruction, which may cause it to have a slow upstroke.

48
Q

The diastolic portion of the arterial waveform, demonstrates what?

A

the distal resistance.

49
Q

What is a characteristic of a high resistance waveform?

A

have diastolic flow at or below the baseline

50
Q

What is a characteristic of a low resistance waveform?

A

have forward flow throughout the cardiac cycle

51
Q

Do velocities increase or decrease, from the aorta to the ankles ?

A

They decrease

52
Q

what type of a waveform should you see with a normal le doppler signal ?

A

triphasic signal

53
Q

The normal triaphasic signals can become biphasic or monophasic under what conditions?

A
  • excercise
  • inflammation
  • proximal significant obstruction
  • close proximity occlusion.
54
Q

in stenos the velocity is at least ________ the pre stenosis velocity.

A

2 times

55
Q

what is the flow pattern for post stenotic ?

A

turbulence, and further downstream a change in the waveform shape

56
Q

what are some recognizable flow patterns in the waveforms?

A
  • triphasic
  • biphasic
  • monophasic
  • stenotic
  • turbulent
  • staccato
  • pendulum
  • bruit

vascular anatomy (7 decks)

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