Ch. 6,7,8 Flashcards

1
Q

A venous Doppler exam of the popliteal vein reveals a sustained flow signal upon release of distal compression. This would indicate which of the following?

A. Proximal Obstruction
B. Venous Reflux
C. Normal venous flow
D. Distal obstruction

A

B. Venous Reflux

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2
Q

Virchow’s triad is best described as the following?

A. Circulatory stasis and hypocoagulability with intimal injury
B. Circulatory stasis, hypercoagulability and intimal injury
C. High cardiac output and intimal injury
D. Intimal injury, hypercoagulability and poor stroke volume

A

B. Circulatory stasis, hypercoagulability and initial injury

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3
Q

Continuous, non-phasic venous flow unilaterally in a common femoral vein suggests which of the following conditions?

A. Normal flow
B. Femoral vein thrombosis
C. IVC obstruction
D. Iliac Vein obstruction

A

D. Iliac Vein obstruction

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4
Q

What is another name for an abnormal popliteal structure containing synovial fluid?

A. Hematoma
B. Ganglion Cyst
C. Baker’s Cyst
D. Lymph node

A

C. Baker’s Cyst

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5
Q

The presence of respiratory variation in the femoral vein rules out DVT in the ipsilateral popliteal vein. True or False?

A. True
B. False

A

B. False

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6
Q

A condition resulting in a grossly swollen and cyanotic leg that is caused by iliofemoral venous thrombosis is known as:

A. Stasis dermatitis
B. Lymph edema
C. Homan’s sign
D. Phlegmasia Cerulea dolens

A

D. Phlegmasia cerulea dolens

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7
Q

What is the name of the perforating veins located in the upper thigh?

A. Cockett’s
B. Boyd’s
C. Hunterian
D. Dodd’s

A

C. Hunterian

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8
Q

Incompetence in this valve often leads to the entire GSV being incompetent. Name this valve?

A. External Iliac valve
B. Terminal Valve
C. Mitral Valve
D. Saphenous-popliteal valve

A

B. Terminal Valve

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9
Q

In addition to incompetent valves, which of the following is a cause of venous insufficiency?

A. Arterial occlusive disease
B. IVC filter
C. Chronic venous outflow obstruction
D. Atresic great saphenous vein

A

C. Chronic venous outflow obstruction

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10
Q

With the patient standing, what time value is the threshold between normal and abnormal reflux in the deep veins?

A. 0.35 second
B. 0.5 second
C. 1 second
D. 2 seconds

A

C. 1 second

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11
Q

Perforating veins exceeded this diameter have a high predictive value for being incompetent.

A. >1.5 mm
B. >2 mm
C. >2.5 mm
D. >3.5 mm

A

D. >3.5 mm

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12
Q

Which of the following describes the anatomical position of the popliteal vein compared to the popliteal artery?

A. It lies posterior to the artery
B. It’s lateral to the artery
C. It’s medial to the artery
D. It lies anterior to the artery

A

A. It lies posterior to the artery

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13
Q

Thrombosis of the left common iliac vein by extrinsic compression of the right iliac artery is known as:

A. Marfan’s syndrome
B. Nutcracker syndrome
C. Arcuate ligament syndrome
D. May-Thurner syndrome

A

D. May-Thurner syndrome

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14
Q

Which of the following best describes primary venous insufficiency?

A. Insufficiency caused by chronic outflow obstruction
B. Insufficiency caused by congenital absence of valves
C. Insufficiency resulting from previous deep vein thrombosis
D. Insufficiency resulting from poor arterial inflow

A

B. Insufficiency caused by congenital absence of valves

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15
Q

Which of the following veins should not be evaluated with the valsalva maneuver for reflux?

A. Popliteal
B. Great saphenous
C. Common femoral
D. Proximal femoral

A

A. Popliteal

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16
Q

Perforating veins should be evaluated with the patient in which of the following positions?

A. Supine
B. Sitting, leg dependent
C. Trendelenburg
D. Semi-Fowler’s

A

B. Sitting, leg dependent

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17
Q

Why is Doppler angle correction not necessary in venous imaging?

A. Velocity is already known
B. Velocity calculation is not necessary
C. Doppler angle can be at 90 degrees
D. Flow direction is not important

A

B. Velocity calculation is not necessary

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18
Q

During inspiration, what condition listed below occurs in the upper extremity veins?
A. Intra-thoracic pressure is decreased causing an increase in flow.
B. Intra-thoracic pressure is increased causing an increase in flow.
C. Intra-thoracic pressure is increased causing a decrease in flow.
D. Inspiration only affects flow in the leg veins

A

Intra-thoracic pressure is decreased causing an increase in flow.

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19
Q

The cephalic and the basilic veins are connected distally by which of the following vein?
A. Median cubital.
B. Brachial.
C. Subclavian.
D. Radial.

A

Median cubital

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20
Q

The innominate vein is formed by the confluence of what two veins?
A. Axillary, subclavian.
B. Internal jugular, subclavian.
C. External jugular, internal jugular.
D. Brachiocephalic, subclavian.

A

Internal Jugular, Subclavian

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21
Q

Which of the following is a sign of normalcy in a subclavian vein that is usually not present in the lower extremity veins?
A. Respiratory variation.
B. Augmentation.
C. Prominent cardiac pulsatility.
D. Steady, continuous, non-phasic flow.

A

Prominent cardiac pulsatility

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22
Q

What is the best ultrasound method for assessing the central veins?
A. Compressibility-coaptation.
B. Spectral Doppler flow pattern assessment.
C. Color Doppler.
D. Augmentation from the arm.

A

Spectral doppler flow pattern assessment

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23
Q

The majority of lower extremity blood volume is carried by the:
a. Perforator system
b. Superficial system
c. Deep venous system
d. Other

A

Deep venous system

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24
Q

The longest vein in the lower extremities is:
a. Greater saphenous vein
b. Popliteal vein
c. Femoral vein
d. Gastrocnemius vein

A

Greater saphenous vein

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25
Q

The venous flow direction in the lower extremities is:
a. Superficial to deep
b. Deep to superficial
c. Alternates depending on physiological reasons

A

Superficial to Deep

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26
Q

The calf Veno-Motor Pump performs the following functions, EXCEPT:
a. Facilitates venous return to heart
b. Reduces the effect of hydrostatic pressure
c. Improves capillary fragility
d. Reduces venous pooling

A

Improves capillary fragility

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27
Q

Which one of the following is NOT one of the three factors of the Virchow triad?
A. Hypercoagulability
B. Stasis
C. Lysis
D. Vein injury

A

Lysis

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28
Q

. Perforating veins connect the superficial and deep venous systems. Blood flow in the perforating veins is normally from the ___________________ to the _______________.
a. superficial system; deep system b. deep system; superficial system
c. distal veins; central veins
d. central veins; distal veins

A

Superficial System, Deep System

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29
Q

The characteristics of a normal venous Doppler signal from the lower extremity include all of the following except:
a. phasicity.
b. spontaneity.
c. pulsatility.
d. augmentation with distal limb compression.

A

Pulsatility

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30
Q

The presence of an incompetent venous segment is determined by which one of the following?
a. Venous reflux less than 1 second
b. Venous reflux on augmentation c. Color Doppler filling of the lumen
d. Gray-scale image of valve motion

A

Venous reflux on augmentation

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31
Q

The superficial femoral vein is a ______________ vein.
a. perforating
b. superficial
c. deep
d. complex

A

Deep

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32
Q

Risk factors for deep-vein thrombosis (DVT) include all of the following except:
a. pregnancy.
b. orthopedic surgery.
c. Baker cyst.
d. oral contraceptive use.

A

Baker’s Cyst

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33
Q

Which of the following characterizes blood flow to a low-resistance vascular bed?
a) minimal spectral broadening
b) reversed diastolic flow
c) forward diastolic flow
d) high amplitude

A

forward diastolic flow

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34
Q

All of the following are points to remember when scanning the carotid arteries EXCEPT?
a) you may need to use a variety of scan planes
b) increased transducer pressure may be required to see deeper arterial segments.
c) multiple transducer frequencies may be required
d) you may need to make slight rocking motions with the transducer to see vessel segments.

A

increased transducer pressure may be required to see deeper arterial segments.

35
Q

What is suggested by diastolic flow of 0 in a common carotid artery?

A

distal carotid stenosis or occulsion

36
Q

Atherosclerotic disease in the extracranial carotid arteries is most common at points of _______________ and within the __________ ________.

A

bifurcations, carotid bulb

37
Q

Turbulent flow indicates?

A

stenosis exceeding 60%

38
Q

All of the following are associated with a normal vertebral artery EXCEPT
a) low diastolic flow
b) antegrade flow
c) side to side diameter difference
d)rapid systolic upstroke

A

low diastolic flow

39
Q

The common carotid artery lies?

A

lateral to the thyroid gland

40
Q

The most accurate way to confirm the identity of the internal carotid artery is to find?

A

low resistance Doppler spectral waveforms

41
Q

To obtain Doppler spectral waveforms the angle of insonation should be <60. The Doppler cursor should be?

A

aligned parallel to the vessel wall

42
Q

What is the best angle of insonation to use when examining the arterial wall.

A

90 degrees

43
Q

The popliteal artery divides into the ?

A

anterior tibial artery, tibioperoneal trunk

44
Q

The primary diagnostic criterion for venous duplex evaluations is?

A

compressibility

45
Q

The acoustic properties of chronic thrombus are?

A

heterogeneous and homogeneous
*maybe contracted and homogenous (check)

46
Q

In the adductor canal, the femoral vein lies posterior to the?

A

superficial femoral artery

47
Q

Which of the following would facilitate confirmation of collateralization and/or recanalization of a thrombosed vein?
a) increase the wall filter
b) decrease the color Doppler velocity scale.
c) increase the spectral Doppler velocity scale
d) decrease the echo-write priority.

A

decrease the color Doppler velocity scale

48
Q

The majority of valves are found in the?

A

calf vein

49
Q

A continuous, nonphasic venous flow signal indicates?

A

obstruction to venous outflow

50
Q

The common femoral artery lies lateral to the?

A

common femoral vein

51
Q

In a resting patient, the normal lower extremity artery will exhibit a?

A

reversed flow component

52
Q

Deep venous thrombosis of the calf veins commonly originates in the?

A

soleal sinuses

53
Q

When obtaining ankle blood pressures, what is the primary reason for having the patient in a flat, supine position?
A. Patient comfort
B. Venous pressure reduction
C. Easier Doppler placement
D. Reduce/ eliminate hydrostatic pressure

A

D. Reduce/ eliminate hydrostatic pressure

54
Q

Which of the following statements best describes the flow profiles at “X” and “Y” in this spectral Doppler waveform?
A. X is a plug flow, Y is turbulent flow
B. X is a parabolic flow, Y is turbulent flow
C. X is plug flow, Y is parabolic flow
D. X is laminar flow, Y is non-laminar flow

A

C. X is plug flow, Y is parabolic flow

55
Q

Which of the following ankle/brachial indices (ABI) is most consistent with the symptom of ischemic rest pain?
A. 0.3
B. 0.5
C. 0.8
D. 1.0

A

A 0.3

56
Q

Which of the following condition would cause an abnormal pulse volume recording(PVR) at high-thigh location?
A. Superficial femoral artery occlusion
B. Internal iliac artery stenosis
C. Popliteal artery occlusion
D. Significant aortoiliac disease

A

D. Significant aortoiliac disease

57
Q

The reported advantage of a four-cuff segmental pressure test over a three-cuff method is differentiating which of these diseased segments?
A. Aorta disease from iliac disease
B. Femoral artery from popliteal artery disease
C. Aortoiliac from femoral artery disease
D. Common femoral artery from profunda femoris disease

A

C. Aortoiliac from femoral artery disease

58
Q

Photoplethysmography uses which of the following modalities for blood flow evaluation ?
A. Pulse volume recording
B. Ultrasound
C. Ultraviolet
D. Infrared

A

D. Infrared

59
Q

Which of the following lower arterial test modalities provides diagnostic quantitative information?
A. Segmental pressures
B. Continuous-wave Doppler waveforms
C. Photoplethysmography
D. Pulse volume recording (PVR)

A

A. Segmental pressures

60
Q

For accurate blood pressure determination, the cuff bladder should be________ of the limb circumference.
A. 10%
B. 20%
C. 30%
D. 40%

A

D 40%

61
Q

Pulse volume recording is a form of which of the following methods/techniques?
A. Impedance plethysmography
B. Pneumo-plethysmography
C. Photoplethysmography
D. Segmental pressure

A

B. Pneumo-plethysmography

62
Q

Review the PVR & segmental pressure study and select and appropriate comment below.
A. The study is normal
B. The study is abnormal
C. The left ankle pressures are probably erroneous
D. The study is abnormal on the right

A

C. The left ankle pressures are probably erroneous

63
Q

In the image about, how is the ankle to brachial index (ABI) calculated?
A. Left Ankle pressure divided by left brachial pressures and right ankle pressure divided by the right brachial pressure
B. Both right and left ankle pressures divided by the highest brachial pressure
C. The right brachial pressure divided by both ankle pressures
D. Both right and left ankle pressures divided by the left brachial pressure

A

B. Both right and left ankle pressures divided by the highest brachial pressure

64
Q

While preforming segmental pressures on lower extremity, you note a pressure gradient between to cuffs to equal 15 mmHg. What does this finding indicate?
A. Normal result, no big deal
B. Stenosis in the arterial segment proximal to the lowest cuff
C. Total occlusion of the arterial segment
D. Stenosis in the arterial segment distal to the lowest cuff

A

A. Normal result, no big deal

65
Q

Leg pain with exercise that is not due to arterial occlusive disease is often referred to as:
A. Buerger’s disease
B. Psuedo-claudication
C. Rest pain
D. Ateritis

A

B pseudo-claudication

66
Q

Which of the following is a disadvantage of photoplethysmography compared to CW- Doppler in segmental pressure acquisition?
A. PPG cannot be heard
B. PPG uses analog processing
C. PPG has no waveform
D. PPG can only be used for digit pressures

A

A PPG cannot be heard

67
Q

The dorsalis pedis artery is a continuation of which vessel?
A. Peroneal artery
B. Gastrocnemius artery
C. Posterior tibial artery
D. Anterior tibial artery

A

D Anterior tibial artery

68
Q

A 3-cuff PVR and pressure study was performed on this diabetic patient. Normal pulses were palpated to the popliteal levels, no pulses were detected on the right PTA or DPA. What is the disease level on the right?
A. Aortoiliac disease, right.
B. SFA disease
C. Moderate popliteal disease
D. Severe tibial disease

A

D Severe tibial disease

69
Q

The calf muscle veins that drain into the posterior tibial veins?

A

Soleal veins

70
Q

The giacomini vein courses between what two vein segments?

A

Small Saphenous to greater

71
Q

When valves no longer maintain unidirectional movement of the blood and the calf muscle pump no longer forces blood cephalad toward ro from the superficial system into the deep is known as

A

Vascular incompetence

72
Q

Virchow’s triad is best described as the following?

A

Circulatory stasis, hypercoagulability and intimal injury

73
Q

What is another name for an abnormal popliteal structure containing synovial fluid?

A

Baker’s cyst

74
Q

What superficial vessel carries approximately 15% of the venous blood volume in the leg?

A

Great saphenous vein

75
Q

A vein that appears large and circular in shape is most likely having the following?

A

Higher intraluminal pressure

76
Q

Image of lower leg (starts with GSV) SIX BLANK SPACES

A
77
Q

All of the following is true regarding the popliteal vein except

A

Continuation of the femoral artery

78
Q

When a patient exhales venous blood flow in the legs will?

A

Increase

79
Q

IMAGE ON PAGE 105 IN DAIGLE BOOK

A

respiratory variation
(Looking at the flow displayed in picture 3, is the doppler flow recorded here considered to be)

80
Q

Symptoms of superficial thrombophlebitis include all of the following except

A

Persistent calf or leg swelling

81
Q

Phlegmasia cerulea dolens include all of the following symptoms except

A

Ankle ulcers

82
Q

A patient presents in the emergency room with swelling and pain in his calk. Upon physical examination the patient of localized tenderness and swelling behind his knee, the above image 5 was discovered in the popliteal area. This image is most likely represents.

A

Baker’s cyst

83
Q

A patient presents in the emergency room with swelling and pain in his calf. The patient’s history mentions he was playing in a soccer game the day before and received a blunt trauma to bhis calf area. Upon physical examination the patient complains of localized tenderness in the calf area where this image 6 was obtained. The image most likely represents.

A

Intramuscular hematoma

84
Q

Virchow’s triad for the development of venous thrombosis is based on which of the following?

A

Hypercoagulability, Stasis ,
endothelial damage