Ch. 2, 3, 37 Flashcards by Destiny S

Which normal cerebrovascular vessel demonstrates the highest flow resistance?

external carotid artery

How well did you know this?

Not at all

Perfectly

which of the following best describes the position of the ICA in the neck?

It lies more posterior to the ECA.

How well did you know this?

Not at all

Perfectly

A high resistance flow pattern in the distal portion of the ICA Suggests which of the following conditions?

severe distal ICA stenosis

How well did you know this?

Not at all

Perfectly

A stroke symptom when a patient cannot speak or express themselves is called?

Aphasis

How well did you know this?

Not at all

Perfectly

in the following sonogrophic image, how would you describe the arterial wall?
(look at image)

Homogeneous plaque with smooth surface characteristics.

How well did you know this?

Not at all

Perfectly

what is the first branch of the ICA

ophthalmic artery

How well did you know this?

Not at all

Perfectly

The NASCET study clearly demonstrated benefits of carotid endarterectomy over medical Management in patients who are symptomatic and have stenosis greater than or equal to %

How well did you know this?

Not at all

Perfectly

What is the first branch of the ECA

Superior thyroid artery

How well did you know this?

Not at all

Perfectly

A patient presents with the classic Cerebrovascular Symptom of left amaurosis fugax. of the choices below what is the most likely cause?

atheroemboli from the left ICA

How well did you know this?

Not at all

Perfectly

which of the following is the most common cause of re-stenosis following carotid enarterectomy

Neointimal hyperplasia

How well did you know this?

Not at all

Perfectly

which of the following is a non-atherosclerotic disease involving the mid segment of the ICA and found predominately in females

fibromuscular dysplasia

How well did you know this?

Not at all

Perfectly

which of the following is angiographic measurement method recommended by the SRU consensus conference of 2003, also known as the NASCET method?

the distal ICA lumen compared to the residual ICA lumen.

How well did you know this?

Not at all

Perfectly

A longitudinal image of carotid plaque can sometimes be misleading as to the diameter reduction due to which of the following?

Slice thickness of the beam.

How well did you know this?

Not at all

Perfectly

A patient with a ICA plaque has a 2mm residual lumen. The distal ICA lumen is 6mm. what is the percent stenosis (via NASCET method)?

67%

How well did you know this?

Not at all

Perfectly

In this example, the ICA velocities may underestimate the category of stenosis. Why?
(look at image)

sample was not obtained at maximum stenosis.

How well did you know this?

Not at all

Perfectly

A warning sing of stroke is:

A. severe neck pain
B. loss of smell
C. temporary blindness in one eye
D. unilateral leg pain

c
(Warning sings include: sudden numbness or weakness of the face, arm, or leg; sudden confusion; trouble speaking; sudden vision troubles; loss of balance or coordination; sudden headache.)

How well did you know this?

Not at all

Perfectly

A difference of greater than 20 mmHg pressure between arms suggests disease of the:

A. common carotid artery
B. Internal carotid artery
C. Vertebral artery
D. Subclavian artery

d
(A difference of greater than 20 mmHg pressure between arms suggests disease of the subclavian or I nominate artery.)

An ultrasound finding of the Doppler signal from an external carotid artery (ECA) Is:

A. Low resistance
B. High resistance
C. Triphasic
D. Tardus parvus

b
(The ECA reflects a high-resistance waveform.)

An ultrasound characteristic of the internal carotid artery (ICA) includes:

A. Originates anterior and medial at the bifurcation
B. Low-resistance Doppler signal
C. Cervical branches
D. Smaller lumen

b
(The ICA reflects a low-resistance waveform.)

Which of the following is not an ultrasound finding of an ICA occlusion:

A. Echogenic material filling the lumen
B. Lack of arterial pulsations
C. Loss of diastolic flow in the common carotid artery (CCA)
D. Reduced diastolic flow pattern

d
(An occluded ICA does not demonstrate any blood flow.)

Which of the following phrases describes a transient ischemic attack (TIA)?

A. A permanent loss of vision bilaterally.
B. Residual neurologic deficit.
C. Duration less than 24 hrs.
D. Loss of consciousness.

c
(A neurologic deficit that lasts less than 24 hrs is termed a TIA.)

Which of the following should be used to classify a greater than 80% diameter reduction of the origin of the ICA?

A. Peak systolic velocity less than 140 cm/sec
B. Peak systolic velocity greater than 140 cm/sec
C. End diastolic velocity less than 155 cm/sec
D. End diastolic velocity greater than 155 cm/sec

d
(A stenosis of greater than 80%diameter reduction demonstrates an end diastolic velocity of greater than 155 cm/sec.)

Normal vertebral arteries:

A. Are asymmetrical
B. Are branches of the axillary artery
C. Demonstrate a high-resistance Doppler signal
D. Demonstrate an alternating blood flow pattern.

a
(Asymmetry of the vertebral arteries is common. Only 25% of cases demonstrate equal vertebral arteries.)

Placement of Doppler sample volume should be parallel to the:

A. Color jet
B. Plaque surface
C. Vessel walls
D. Skin surface

c
(Doppler interrogation of the carotid system is performed using a Doppler angle of 60° or less, with placement of the sample volume parallel to the vessel wall.)

The degree of stenosis at the origin of the ICA is determined by: A. Echo characteristics of the plaque B. The presence of acoustical shadowing C. Peak systolic and end diastolic velocities. D. ICA:ECA Peak systolic velocity ratio

c (The degree of stenosis of the ICA is determined by the peak systolic and end diastolic velocities and ICA: CCA ratio.)

Approximately __________ strokes occur each year in the United States. A. 10,000 B. 100,000 C. 700, 000 D. 1,000,000

c (Approximately 750,000 strokes occur each year; approximately 160,000 result in death.

The I nominate artery divides into the ______ and _______ arteries. A. Right common carotid; right subclavian B. Left common corotid; left subclavian C. Right subclavian; right vertebral D. Left subclavian; left vertebral

a (The innominate artery divides into the right common corotid and the right subclavian artery.)

The Doppler sample volume should be kept _______ during a carotid duplex imaging examination. A. Near the deep wall B. Near the superficial wall C. Large D. Small

d (The sample volume size should be small and placed in the center of the artery (or center stream).)

An abnormal spectral Doppler waveform shape from the ICA suggests: A. Contralateral disease B. Arterial branches C. Proximal or distal disease/occlusion D. Venous thromnosis

c (An abnormal waveform shape may indicate a more proximal (subclavian) or distal (intracranial) disease.)

A contralateral ICA occlusion may cause the ipsilateral ICA velocities to be: A. the same B. reversed C. increased D. decreased

c (In the pressence of an ICA occlusion, the velocity in the contralateral ICA may be elevated.)

Which of the following ICA:CCA ratios determines a greater than 70% diameter reduction of the ICA? A. 1.0 B. 4.0 C. 7.0 D. 10.0

b (An ICA:CCA ratio of greater than 4.0 is demonstrated in an ICA stenosis of 70% to 95%)

When determining the ICA:CCA ratio, the CCA velocity should be obtained from the: A. proximal segment B. mid-segment C. distal straight segment D. bulb

c (When determining the ICA:CCA ratio, the CCA velocity should be obtained from the distal segment.)

A characteristic of a subclavian steal is: A. reversal of blood flow in the vertebral artery B. equal blood pressure bilaterally C. loss of diastolic flow D. increased pulsatility

a (A subclavian steal is present if there is a reversal of the vertebral flow direction secondary to obstruction of the ipsilateral subclavian or innominate artery.)

A systolic velocity recorded from the origin of the ICA that is less than 125 cm/sec suggests: A. no plaque present B. a stenosis less than 50% diameter reduction C. a stenosis greater than 50% diameter reduction D. a stenosis greater than 80% diameter reduction

b (A systolic velocity from the origin of the ICA less than 140 cm/sec suggests a stenosis less than 50% diameter reduction.)

Intraoperative carotid duplex imaging identifies: A. contralateral ICA disease B. abnormal blood flow C. increased blood pressure D. the need for a carotid shunt

b (Intraoperative carotid duplex imaging identifies abnormal flow, disturbed blood flow, and anatomic abnormalities.)

Transient partial or complete loss of vision. A. aphasia B. ataxia C. vertigo D. amaurosis fugax

d (Amaurosis fugax is a transient partial or complete loss of vision.)

The carotid body assists in regulating all except: A. balance B. heart rate C. blood pressure D. respiration

a (The carotid body assists in regulating heart rate, blood pressure, and respiration.)

The most commonly visualized branch of the ECA is: A. facial B. superior thyroid C. lingual D. superficial temporal

b (The superior thyroid artery is the most commonly visualized branch of the ECA.)

Noise caused by tissue vibration produced by turbulent flow is: A. boundary layer separation B. aliasing C. bruit D. reverberation

c (Noise caused by tissue vibration produced by turbulent flow is termed a bruit.)

A normal flow disturbance along the posterior wall of the bulb is: A. a bruit B. aliasing C. a boundary layer separation D. a jet

c (A boundary layer separation is a normal flow disturbance demonstrating transient reversal of blood flow along the posterior wall of the bulb.)

FMD (fibromuscular dysplasia) typically affects which portion of the carotid artery

Mid portion of ICA

Which portion of the ICA is evaluated during carotid duplex imaging scanning?

cervical