Cerebrovascular

Question 1

What is “tardus parvus”

Answer 1

Low systolic velocity

Question 2

When a tardus parvus Doppler waveform is seen in a unilateral CCA, most likely cause is:

a) low cardiac output
b) CCA origin or brachiocephalic artery stenosis
c) aortic stenosis
d) decreased myocardial function

Answer 2

b) CCA origin or brachiocephalic artery stenosis

(the others would cause a BILATERAL decrease in CCA velocity, NOT unilateral!)

Question 3

The segment of the ICA that passes between the 2nd and 3rd cranial nerves at the Sylvian fissure is the:

a) Cervical portion
b) Cerebral segment
c) Cavernous portion
d) Petrous portion

Answer 3

c) Cavernous portion

Question 4

What is the FIRST MAJOR BRANCH of the ICA?

a) Suborbital
b) Anterior cerebral
c) Ophthalmic
d) Superior thyroid

Answer 4

c) Ophthalmic

Question 5

Cerebral artery branches of the internal and vertebral arteries come together at the base of the brain to form this important collateral pathway.

Answer 5

Circle of Willis

Question 6

TRUE OR FALSE:
It has been estimated that only 50% of people have an intact and functioning Circle of Willis.

Answer 6

TRUE!
Anatomical variation of C.O.W. is common.

Question 7

What is an effect for a patient without a functioning Circle of Willis?

Answer 7

They may suffer more profound neurologic ischemia in the presence of ICA obstruction.

Question 8

What is RIND?

Answer 8

Reversible
Ischemic
Neurological
Deficit

Question 9

TIA has complete resolution of focal cerebral ischemia symptoms within ______ hours.

a) 6
b) 24
c) 48
d) 36

Answer 9

b) 24

(A TIA is usually embolic, and should demonstrate complete resolution of focal cerebral ischemia within a few minutes or a few hours; but never more than 24 hours.)

Question 10

A carotid body tumor is a small mass of ___________ tissue that adjoins the carotid sinus.

a) Non-vascular
b) Highly vascular
c) Venous
d) None of the above

Answer 10

b) Highly vascular

Question 11

Where is a carotid body tumor located?

Answer 11

Between the bifurcation of the ICA and the ECA

Question 12

Is a carotid body tumor benign or malignant?

Answer 12

Benign

Question 13

Which window can be used to locate the proximal intracranial portion of the ICA?

a) Transoccipital window
b) Submandibular window
c) Orbital window

Answer 13

b) Submandibular window

(Depth is 40 - 60 mm with flow usually away from the probe)

Question 14

Flow velocities in the basal cerebral arteries _________with age.

a) Increase
b) Decrease

Answer 14

b) Decrease

Question 15

What is the first branch off the aortic arch?

a) Right CCA
b) Right Subclavian artery
c) Innominate artery
d) Left CCA

Answer 15

c) Innominate artery

Question 16

What is the current time window for administering the only approved therapy for stroke, systemic tissue plasminogen activator?

Answer 16

4 hours after onset of symptoms.

Question 17

What is TPA?

Answer 17

Tissue Plasminogen Activator!

Question 18

What is the first branch off the aortic arch?

a) Right CCA
b) Right subclavian artery
c) Innominate artery
d) Left CCA

Answer 18

c) Innominate artery

Question 19

Bilat arm pressure differential of 20mmHg or more suggests the presence of ____ on the side with the lower pressure?

a) subclavian obstruction
b) vertebral obstruction
c) CCA obstruction
d) Axillary obstruction

Answer 19

a) Subclavian obstruction