Carotid

Question 1

6 vessels that make up the circle of willis

Answer 1

MCA, ACA, PCA, ICA, vertebrals, basilar

Question 2

Four indications for a carotid ultrasound:

Answer 2

stroke/TIA, bruit, trauma, pulsatile neck mass

Question 3

First branch of the ICA is:

Answer 3

opthalmic artery

Question 4

ICA has a more ____ location

Answer 4

posterior

Question 5

ICA originates from the _____

Answer 5

bulb

Question 6

ICA waveform:

Answer 6

low resistant

Question 7

1st branch off the ECA

Answer 7

superior thyroid artery

Question 8

ICA supplies blood to the:

Answer 8

anterior brain, eyes forehead, nose

Question 9

ECA supplies blood to the:

Answer 9

neck, face, scalp

Question 10

ECA has a more _____ location

Answer 10

anterior, medial

Question 11

Ways to differentiate ECA from ICA

Answer 11

ECA has multiple branches, more prominent dicrotic notch, is smaller than the ICA, and has a high resistant waveform.

Question 12

Located in the wall of the sinus; causes slowing of the heart, vasodilation, and fall in blood pressure

Answer 12

pressoreceptors

Question 13

Protocol for area of stenosis:

Answer 13

more than one velocity, distal to the site to document disturbed flow, scan through vessel, transverse image for diameter ms., use power doppler

Question 14

Mild disease classified as:

Answer 14

less than 50% diameter reduction; benefit from therapy

Question 15

moderate to high end disease classified as

Answer 15

50 - 70 % diameter stenosis; treated medically and follow-up

Question 16

severe disease classified as

Answer 16

over 70 % diameter reduction; benefit from surgery

Question 17

ICA/CCA velocity ratio 2 - 4 =

Answer 17

50 - 69% stenosis

Question 18

ICA/CCA velocity ratio of 4 or greater =

Answer 18

70% and over stenosis

Question 19

Where should you measure velocity for ICA/CCA ratio

Answer 19

mid - dist CCA; Prox ICA

Question 20

ICA end diastolic of 40 - 100 cm/s and PSV 125 - 230 cm/s =

Answer 20

50 - 69% stenosis

Question 21

ICA end diastolic of >100 and PSV >230 cm/s =

Answer 21

80 - 99% stenosis

Question 22

Risk factors for carotid disease

Answer 22

HTN, diabetes, smoking, family hx, obesity

Question 23

Criteria for TIA

Answer 23

Symptoms last

Question 24

Criteria for RIND

Answer 24

symptoms >24 hrs,

Question 25

Criteria for complete stroke/ CVA

Answer 25

Symptoms >72 hrs, residual effects, usually ischemic

Question 26

most stroke fatalities from ______

Answer 26

hemorrhagic stroke (blood vessel in head bursts)

Question 27

Post endarterectomy early occlusion due to thrombus happens:

Answer 27

within 24 - 48 hrs and is extremely urgent.

Question 28

Post enarterectomy stenosis:

Answer 28

results from neointimal hyperplasia, develops within 12 - 18 months

Question 29

Differentials for a pulsatile neck mass?

Answer 29

prominent carotid artery, dilated carotid, aneurysm of carotid

Question 30

may develop from trauma to the neck or secondary to iatrogenic

Answer 30

carotid dissection

Question 31

fibroplasia of the intima, media, or adventitia of an artery describes

Answer 31

fibromuscular dysplasia (growth of fibrous tissue in wall of artery - causes narrowing)

Question 32

Fibromuscular dysplasia affects

Answer 32

medium and large arteries, young to middle aged women

Question 33

Symptoms of fibromuscular dysplasia related to ___

Answer 33

ischemic events

Question 34

Fibromuscular dysplasia most often affects; second most frequent location?

Answer 34

renal arteries (middle and distal thirds); ICA

Question 35

Most common cause of renovascular HTN in young adults

Answer 35

fibromuscular dysplasia

Question 36

May present as cerebral ischemia/TIA and is associated with _______

Answer 36

Fibromuscular dysplasia; cerebral aneurysms

Question 37

most common type of fibromuscular dysplasia of the ICA

Answer 37

medial fibroplasia (renal). string of beads appearance.

Question 38

Fibromuscular dysplasia may be associated with

Answer 38

carotid artery dissection

Question 39

Most FMD lesions occur at

Answer 39

level of 1st/2nd vertebra

Question 40

flow reducing lesion in the innominate or subclavian artery prox. to the vertebral

Answer 40

subclavian steal

Question 41

arm with the lowest brachail pressure is the

Answer 41

postive side (w/ subclavian disease)

Question 42

High blood pressure can cause

Answer 42

plaque to break off and emoblize

Question 43

Stenosis is described as

Answer 43

narrowing to vessel lumen; usually d/t atherosclerosis

Question 44

Thin layer of lipid material on intimal layer

Answer 44

fatty streak

Question 45

accumulation of lipids covered by lips, collagen, elastic fiber deposits

Answer 45

fibroud plaque

Question 46

contains fibrous tissue, collagen, and calcium

Answer 46

complicated lesion

Question 47

deterioration of smooth surface of the fibrous cap

Answer 47

ulcerative lesion

Question 48

Possible causes of cerebrovascular symptoms

Answer 48

carotid artery disease, cardiac arrhythmias, hypotensive episodes

Question 49

Lower body symptoms for ICA occur on the ____

Answer 49

contralateral side

Question 50

Rt side hemiparesis means

Answer 50

Lt ICA is suspect

Question 51

Visual symptoms for ICA occur on the ____

Answer 51

ipsilateral side

Question 52

Symptoms for ICA lesion

Answer 52

paresis, aphasia, amaurosis fugax

Question 53

transient loss of vision in one eye

Answer 53

amaurosis fugax

Question 54

speaking disorder due to brain dysfunction

Answer 54

aphasia

Question 55

lack of muscular coordination

Answer 55

ataxia

Question 56

inability to produce clear speech

Answer 56

dysarthria

Question 57

weakness

Answer 57

paresis

Question 58

abnormal tingling sensations

Answer 58

paresthesia

Question 59

Symptomatic patients that benefit most from intervention have

Answer 59

disease of 70 - 99%

Question 60

Symptomatic patietns with modest benefit from intervention have

Answer 60

50 - 70% disease

Question 61

With less than 50%, treatment includes

Answer 61

blood thinners and behavior modification

Question 62

____ is less invasive than carotid endarterectomy

Answer 62

carotid stenting