Ch. 10 Vascular

Question 1

What important vessel participates in anterior circulation

Answer 1

cavernous ICA (carotid siphon)

Question 2

What is another name for the cavernous ICA

Answer 2

carotid siphon

Question 3

What instrument is used for non-imaging

Answer 3

TCD (1-2 MHz)

Question 4

What does TAP-V stand for

Answer 4

mean velocities

Question 5

All vessels in the intracranial system have ____ resistance and ____ diastolic flow, except which vessel

Answer 5

low, high, Ophthalmic artery

Question 6

The Ophthalmic artery has what resistance and flow

Answer 6

high resistance, low diastolic flow

Question 7

What anatomical approaches (acoustical windows) are used to access cerebral vasculature

Answer 7

transtemporal, transorbital, transoccipital, submadibular

Question 8

What is the 5th acoustical window/anatomical approach that can be used to image intracranial vessels

Answer 8

atlas loop

Question 9

In transorbital approach, where is ultrasound transmitted

Answer 9

through the thin orbital plane of frontal bone

Question 10

In transorbital approach, ______ must be reduced to limit direct exposure to the eye

Answer 10

power intensity

Question 11

In atlas loop approach, what is it used to evaluate

Answer 11

extracranial vertebral artery

Question 12

In atlas loop approach, where is the transducer placed

Answer 12

below the mastoid process, behind the sternocleidomastoid muscle

Question 13

The examination technique has five primary criteria used to identify a vessel, what is the equation for flow velocity

Answer 13

MCA>ACA>PCA=BA=VA

Question 14

Where does the VA confluence occur

Answer 14

approximately 70 mm depth

Question 15

The VAs join together to form

Answer 15

basilar artery

Question 16

BA is traced throughout its ______ because it is a

Answer 16

length, long vessel

Question 17

What are the 3 segments of the cavernous ICA/carotid siphon

Answer 17

parasellar, genu, supraclinoid

Question 18

ICA branches

Answer 18

ophthalmic artery, posterior communicating artery (PCOA)

Question 19

In doppler imaging for the OA, where do you aim the transducer

Answer 19

medially

Question 20

When imaging the OA, what depth is the color box placed and what do you do with the scale

Answer 20

40 to 60 mm, lower

Question 21

Normal flow in the OA is directed _____ the transducer

Answer 21

toward

Question 22

Normal flow in the OA is

Answer 22

from the brain toward the orbit of the eye

Question 23

If collateral from the ECA, the flow in the OA is

Answer 23

from the eye to the brain

Question 24

OA waveform will have

Answer 24

low velocity with high resistance

Question 25

in duplex imaging, carotid siphon transducer placement will be

Answer 25

same orientation as OA

Question 26

In duplex imaging, the color box for the carotid siphon is placed at what depth? What happens to the color scale

Answer 26

60 to 75 mm, increase color scale slightly

Question 27

In duplex imaging, the flow in the carotid siphon may be

Answer 27

toward, away or both

Question 28

In duplex imaging for the posterior cerebral artery (PCA) place the color box

Answer 28

around butterfly-shaped midbrain (PCAs encircle it)

Question 29

In duplex imaging for the PCA, P1 segment flows

Answer 29

towards the transducer

Question 30

In duplex imaging for the PCA, P2 segment typically flows

Answer 30

away from the transducer

Question 31

In duplex imaging of the submandibular approach, the retromandibular ICA is obtained in patients that require calculations of

Answer 31

the lindegaard ratio

Question 32

The lindegaard ration is useful in differentiating _____ volume from _______ vessel diameter with ______ velocities

Answer 32

increased, decreased, high

Question 33

Technical considerations of anatomical variations in the circle of willis (50%) include

Answer 33

differences in origin, size (caliber) and course of vessel

Question 34

When diagnosing, the spectral waveform parameters include

Answer 34

velocity (TAP and PSV), pulsatility

Question 35

Velocity in spectral waveform parameters is also referred to as

Answer 35

mean velocity or TAP and PSV

Question 36

Pulsatility in spectral waveform parameters is also expressed as

Answer 36

gosling pulsatility index

Question 37

In collateral flow, the ECA to ICA through reversed OA have

Answer 37

retrograde flow in OA, decreased pulsatility, increased velocity in OA, reversal of flow in the OA with compression of the branches of the ECA

Question 38

TCD is useful for detection of >50%

Answer 38

intracranial stenoses and occlusions

Question 39

Conditions that produce stenosis include

Answer 39

atherosclerosis, dissection, FMD, moyamoya disease

Question 40

Vasospasm interpretation is complicated by

Answer 40

hematocrit, arterial CO2

Question 41

What 3 things can all affect intracranial velocities

Answer 41

hematocrit, CO2 levels and age

Question 42

TCD an be used to monitor for emboli during procedures such as

Answer 42

CEA, CAS, cardiopulmonary bypass surgery, neurological procedures

Question 43

________ signals have a unique _______ signature

Answer 43

microembolic, doppler

Question 44

What is the microembolic signal that has a unique doppler signature also called

Answer 44

HITS

Question 45

What is the percentage for anatomical variations in circle of willis

Answer 45

50%

Question 46

What are the two things in mean velocity

Answer 46

TAP and PSV

Question 47

Application for intracranial exam, collateral flow, ECA to ICA through

Answer 47

reversed ophthalmic artery