Carotid Exam Flashcards
What are the warning signs of a stroke?
Aphasia Dysphasia Dysphagia Dysarthria Tingling and numbness Vertigo Transient blindness
p33
If there is a difference in blood pressures from arm to arm, what area is diseased from that indication?
There is stenosis
Subclavian and/or vertebral disease
Subclavian steal
What type of flow does ECA have?
High resistive
p47
What type of flow does ICA have?
Low Resistive
p47
What are the spectral analysis ultrasound findings of an ICA occlusion?
No Doppler flow
ECA and CCA will have similar waveforms
p60
Lack arterial pulsations bc there is no arterial flow
Loss of diastolic flow
What is the difference between CVA and TIA?
CVA- is a complete brain stroke; permanent or semi-permanent
TIA- has the same symptoms but they only last for 24 hours
p33
Where do you place the gate/angle in the vessel?
parallel in middle of vessel
- What are the measurements for the degree of stenosis in the ICA?
- What are the two measurements that are most important to us?
1. Normal (no stenosis) < 50% (stenosis) 50-69% (stenosis) =or > 70% (stenosis to near occlusion) total occlusion pg 72 4th edt.
- Peak systolic velocity and end diastolic velocity
How many strokes occur each year?
795,000. (google)
over 700,000
per beth
What does the innominate artery divide into?
RT CCA
RT Subclavian A
pg. 35 4th ed.
What should the sample volume (gate) be?
2 mm
per Beth
What blood vessels are symmetrical?
vertebral arteries
per Beth
If there is an abnormal Doppler waveform in the ICA, where would that suggest disease at?
A high resistance ICA waveform may also occur with stenosis in the distal ICA. However, condition usually coexists with extensive disease in the proximal ICA.
p65
What might happen to the velocities to the ipsilateral side of the contralateral ICA is occluded?
If one side is occluded, the other side ( the contralateral) will have an increased velocity
p80
When determining the ICA/CCA ratios, what section of the CCA is used for the ratio?
Mid/dist
per Beth
What characteristics would be demonstrated with a subclavian steal?
Retrograde flow in the vertebral
Per Beth
What would a less than 125 cm/s PSV suggest?
Normal
less than 50% stenosis
p73
What is transient partial or complete loss of vision called?
Amaurosis fugax
p33
The carotid body assists in regulating ____.
It assists in heart rate, blood pressure, and respiration
What is the most common visualized branch of the ECA?
Superior thyroid artery
p36
What is the noise created by tissue vibration?
Bruit
Per Beth
With color duplex imaging there may be an area where the color doesn’t fill in the vessel, what might this be from?
Boundary layer separation
Per Beth
The vertebral arteries join to form the _____.
Basilar artery
p35
What is the inability to speak or express oneself?
Aphasia
p33
What does NASCET mean?
North American Symptomatic Carotid Endarterectomy Trial
Guidelines for symptomatic patients to undergo surgery or not based on % stenosis
p70
What can cause a stroke?
Emboli
Thrombosis
Hemorrhage
PPT slide 5
What does RIND mean?
Reversible Ischemic Neurologic Deficit
Symptoms resolve within 48 hours
p33
What are the vertebral-basilar symptoms?
Drop attacks Syncope Vertigo Dizziness Diplopia Binocular blindness
p33
What is IPH?
Intraplaque hemorrhage
Appears anechoic compared to the echogenic surrounding plaque
p84
Anatomy of the carotid system (image on test)
p35
What are the images on pg 47 (4th ed.) showing?
tortuous ICA’s
top three images on p47
Identify the CCA and its waveform.
Low resistance
p52
Identify the ECA and its waveform.
High resistance
p53
Describe the disease, what are the different types of plaque?
Smooth Irregular Heterogenous, echolucent Heterogenous Intraplaque hemorrhage Calcified Ulceration
p83-85
Identify the ICA and its waveform.
Low resistance
p53
Identify the vertebral artery.
Low resistance
p53
Identify ECA vs ICA
p 46
