Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MIDS 237 > Ch 12 Uncommon Carotid Pathology > Flashcards

Ch 12 Uncommon Carotid Pathology Flashcards

1
Q

What is an aneurysm?

A

Localized dilatation of the wall of an artery that involves ALL layers of the arterial wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a carotid body tumor?

A

-Benign mass (aka paraganglioma or chemodectoma) of the carotid body that is a small round mass at the carotid bif
-Forms from chemoreceptor cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a dissection?

A

-Tear along in intima layer, resulting in splitting/separation of the walls of the vessel
-Due to trauma or rupture of vasa vasorum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is fibromuscular dysplasia?

A

-Abnormal growth + development of the muscular layer of an artery wall with fibrosis + collagen deposition causing a localized series of stenoses

-A non atherosclerotic inflammatory disease in artery wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is an intimal flap?

A

-Small tear in vessel wall resulting in part of the intima + media protruding into the lumen of the vessel
-May move with pulsations of flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is a pseudoaneurysm?

A

-Disruption of an arterial wall or anastomosis that results in a pulsating/expanding hematoma outside the artery
-Dilatation NOT covered by all layers of wall
-Aka a false aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which vessel is m/c affected by tortuosity?

A

ICA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What angle makes a kink sharp?

A

<30 degrees

(m/c kinks are less acute from 30-90 degrees)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Symptoms of tortuosity?

A

-M/c asymptomatic
-If kinked there can be symptoms of stroke or TIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the benefit of using power doppler over CD when evaluating tortuous vessels?

A

It can demonstrate the course of the vessel w/o distracting angle changes seen with CD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Where should we place our SVB when using PW in a normal vessel?

A

Place in middle of vessel b/c it avoids accelerated velocity along the edges

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Where should we place our SVB when using PW in a tortuous vessel?

A

-Place it through the tortuous segment/kink
-Do PW before, in + after the curves/kinks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How to know if a tortuous vessel may be turning into a stenosis?

A

-Turbulence
-Drop in distal velocity
-Distal tardus parvus waveform
-Doubling velocity in kink

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Dissections are seen in what 3 clinical situations?

A

-Extension into CCA from Ao dissection
-Trauma/microtrauma of ICA
-From underlying diseases in vessel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

If a rupture re-enters the lumen, what will the 2 flow channels be?

A

-True lumen above intima
-False lumen below intima

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Most Ao dissections will propagate into the ___?

A

CCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the hallmark of an ICA dissection?

A

An intramural hematoma with luminal narrowing or occlusion of the true lumen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When there is a true + false lumen, what are the 3 ways blood can exit out the false lumen?

A

-Through the same tear in false lumen
-Through secondary tear distal to original tear (antegrade flow)
-Through secondary tear prox to original tear (retrograde flow)

(blood in false lumen can also thrombose + cause true lumen to narrow)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

___ is the m/c cause of a stroke in young/middle aged people?

A

Dissections - due to blood clots that embolize

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

___ is suspected when a young pt has major trauma or symptoms of stroke, with no risk for atherosclerosis?

A

ICA dissection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Symptoms of ICA + CCA dissection?

A

ICA:
-unilateral pain in head/face/neck
-partial horner syndrome
-cerebral or retinal ischemia

CCA:
-headaches
-neck pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How to identify an Ao dissection in the CCA?

A

Must identify true + false lumen, with dissection flap

2D:
-intraluminal line that flutters in 2 planes

CD:
-may show different directions of flow in 2 lumens

Spectral:
-true lumen has normal waveform, mild spectral broadening + elevated PSV
-false lumen has irregular waveform, very pulsatile + high resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How to identify an ICA dissection?

A

-M/c can not identify on carotid scan

-If it is seen, there will be a hematoma in false lumen with the true lumen appearing narrowed
-Waveform will appear high resistance (opposite of normal) with no/small plaque

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How would FMD appear?

A

-Multiple areas of narrowing + dilatations
-String of beads pattern (fibromuscular ridges with arterial dilations)
-M/c in mid to distal ICA + renal arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Who m/c gets FMD?

A

Young female pt’s, MUST scan distal ICA

26
Q

M/c symptoms of renal FMD?

A

Hypertension

27
Q

M/c symptoms of cerebrovascular FMD?

A

Headache

28
Q

Significant complications of cerebrovascular FMD’s?

A

-Stroke
-TIAs
-Dissection
-Subarachnoid hemorrhage
-Aneurysms

29
Q

3 criteria to diagnose FMD?

A

-Young pt
-No atherosclerotic disease in bif, but turbulence + increased velocity in distal ICA
-String of beads pattern or focal stenosis, with no plaque in mid to distal ICA

30
Q

What is the carotid body?

A

-A 1-1.5mm structure in adventitia of carotid bif
-Controls BP + pH

31
Q

Are CBT’s normally symptomatic?

A

No

32
Q

SF of a CBT?

A

-Hypoehoic mass b/w ICA + ECA at the bif
-Highly vascular (fed by ECA branches)
-Spectral doppler shows low resistance waveform in CBT

33
Q

How to diagnose CBT?

A

-Highly vascular mass at carotid bif, splaying the ICA + ECA
-Take CD image to show vascularity + any mass effect on ICA/ECA

34
Q

Are carotid aneurysms common?

A

No

35
Q

M/c location for carotid aneurysm?

A

CCA + ICA bif, m/c fusiform

36
Q

Main cause of carotid aneurysms?

A

Atherosclerosis

36
Q

Clinical presentation of a carotid aneurysm?

A

Nontender, pulsatile mass in neck

37
Q

Which plane would we measure a carotid aneurysm?

A

TRV

38
Q

How to diagnose an ICA + CCA aneurysm?

A

ICA: diameter >2x normal ICA

CCA: diameter >1.5x normal CCA

39
Q

M/c cause of a pseudoaneurysm (PA)?

A

Trauma or from a deep dissection

(iatrogenic causes include disruption of graft or endarterectomy site)

40
Q

Clinical presentation of a PA?

A

Palpable pulsatile mass in neck, with history of trauma or carotid intervention

41
Q

SF of a PA?

A

-Mass with partial or complete pulsatile color beside artery
-Mural thrombus may be seen
-“Ying Yang” appearance (CD flow within PA)
-“To and fro” waveform (rapid flow into PA during systole, slow reversed flow through diastole)

42
Q

How to document a PA?

A

Document PA, neck of PA + feeding artery

43
Q

How to diagnose a PA?

A

-Pulsatile CD flow in mas with yin-yang sign

-Most important characteristic is the to-and-fro doppler pattern in the neck of the PA

44
Q

What causes radiation induced arterial injury (RIAI)?

A

The use of therapeutic irradiation during treatment for various tumors of the head + neck

45
Q

What can RIAI cause?

A

Atherosclerosis, sometimes stenosis too

46
Q

Which carotid artery has a higher incidence for RIAI?

A

CCA (rather than ICA or the bif)

47
Q

How to diagnose RIAI?

A

-Atypical carotid lesion with history of radiation treatment
-Radiation stenotic lesions are longer than non-radiation lesions
-M/c located at distal end of stenotic area
-Stenotic lesions are m/c hypoechoic w/o calcifications

48
Q

2 forms of arteritis?

A

-Takayasu’s disease
-Temporal arteritis (form of giant cell arteritis)

49
Q

Takayasu’s arteritis affects which vessels?

A

Ao arch + great vessels, in the following order:

-Subclavian
-CCA
-Ao
-Renal arteries

50
Q

Takayasu’s arteritis m/c affects what pt’s?

A

Young women

51
Q

Giant cell arteritis affects which vessels?

A

Medium + larger sized arteries:

-Ao arch
-Carotid
-Axillary arteries

52
Q

Giant cell arteritis m/c affects what pt’s?

A

Elderly

53
Q

S/S of takayasu’s arteritis?

A

-Limb (m/c arm) claudication/muscle pain + decreased BP in the arm due to narrowing of vessels
-TIA, visual changes, stroke + multiple bruits can occur

54
Q

S/S of giant cell arteritis?

A

-Assess superficial temporal artery + its branches in the head
-Headaches, jaw claudication/pain, tenderness in temporal region + visual issues (blindness)
-Elevated blood sedimentation rate

55
Q

SF of takayasu’s arteritis?

A

-Pay attention to prox CCA
-Lesions appear as long, smooth, homogeneous + thickening of arterial wall

56
Q

Sonographic techniques for imaging giant cell arteritis?

A

-Affects branches of ECA, most accessible branch for u/s is superficial temporal artery
-Scan STA, parietal + frontal branch
-Measure IMT (<1mm normal)
-Thick wall may be dark (halo appearance)

57
Q

How to diagnose takayasu’s arteritis?

A

-Thick artery walls (sometimes stenosis in prox CCA + subclavian)
-Homogeneous
-Macaroni sign
-Possible abnormal waveforms (indicating prox disease in Ao, etc)

58
Q

How to diagnose giant cell arteritis?

A

-Thickened STA + branches
-Echolucent halo around STA

59
Q

List the normal thickness cutoffs for the STA, frontal branch, parietal branch + axillary artery?

A

STA: 0.42mm
Frontal: 0.34mm
Parietal: 0.29mm (smallest)
Axillary: 1.0mm (largest)

MIDS 237 (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions