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Vascular I & Physics I > Ch. 8 Vascular > Flashcards

Ch. 8 Vascular Flashcards

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1
Q

Winding and bending of the carotid artery

A

Tortuosity/kinking

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2
Q

With tortuosity, up to _____ of adults will have some degree of _____

A

1/4 (25%), angulation

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3
Q

Is tortuosity bilateral?

A

usually yes

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4
Q

Signs and symptoms of tortuosity

A

usually asymptomatic, may cause stroke or TIA,

head turning can cause symptoms, pulsatile mass

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5
Q

Color is a useful tool to appreciate the tortuous coarse of the _______ ICA

A

distal

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6
Q

With tortuosity, evaluation can be challenging because aliasing is likely present along

A

outer edges of curve or as vessel becomes more vertical (creating 0 degree doppler angles)

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7
Q

T/F: It is difficult to image entire tortuous vessel in one image

A

True

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8
Q

With tortuosity, doppler waveforms should be taken from

A

straighter portions of vessel when possible

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9
Q

Do you sample the area of the tightest curve in a tortuous vessel

A

No

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10
Q

What do you do if the doppler waveform must be taken from curved portion

A

angle is set so that middle of angle correct cursor is parallel to vessel walls / sample volume is to remain small / keep sample volume center stream

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11
Q

When doing doppler sample volume through the tortuous segment

A

pre and postcurve or kink velocities should be noted / flow changes may be documented with head rotation

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12
Q

Strict velocity criteria _____ be applied to tortuous vessels

A

cannot

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13
Q

_____ velocities _____ to curves and kinks are to be expected

A

increased, distal

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14
Q

Significant stenosis in tortuosity will be followed by

A

post stenotic turbulence

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15
Q

Separation of the layers of an artery due to intimal tear

A

dissections/intimal flaps

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16
Q

Dissections may be associated with

A

pseudoaneurysm, thrombus and/or second intimal tear

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17
Q

False lumen flow pattern variations include

A

antegrade flow with secondary tear /
antegrade flow into true lumen and out of the false lumen in a to-and-fro pattern / antegrade flow in the true lumen and retrograde flow in the false lumen

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18
Q

Dissections and intimal flaps usually originate from

A

aorta and extend into CCA

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19
Q

Dissections may be associated with other diseases such as

A

Marfan syndrome or ehler-danlos syndrome

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20
Q

Dissections can be

A

spontaneous or traumatic

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21
Q

Dissections associated with history of hypertension are

A

spontaneous

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22
Q

Dissections that are subtle from head rotation or obvious like blunt trauma

A

traumatic

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23
Q

______ may occur after endarterectomy

A

intimal flap

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24
Q

Dissections/intimal flaps signs and symptoms

A

asymptomatic /
head, face or neck pain /
hemispheric stroke or TIA symptoms /
young patients with stroke symptoms

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25
Q

Duplex findings associated with dissection include

A

unusual color flow pattern in an artery that shows no artherosclerosis /
presence of thin white line in vessel lumen / may flutter with each pulse

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26
Q

(dissection) blind ended tear appearance

A

low resistance doppler signal in true lumen / if false lumen is thrombosed then stentotic flow in true lumen / false lumen will demonstrate high-resistance flow patterns unless thrombosed / reversed/retrograde flow may be present in false lumen

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27
Q

(dissection) secondary tear appearance

A

blood allowed back into lumen / true and false lumen may demonstrate antegrade flow with different waveform contours / reversal of flow in either lumen

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28
Q

Fibromuscular dysplasia (FMD) apearance

A

abnormal growth of smooth muscle cells and fibrous issue in artery walls / narrowing of arterial lumen in multiple sections / slight aneurysm dilation may be noted in between stenotic sections

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29
Q

FMD causes a __________ appearance of artery on arteriography

A

“string of beads”

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30
Q

FMD signs and symptoms

A

young caucasin females / most common in renal arteries causing hypertension / ICA second most common

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31
Q

FMD in ICA signs and symptoms

A

often does not cause symptoms / cervical bruit (most common / emboli may occur and cause TIA

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32
Q

FMD bilateral disease is typical. T/F

A

T

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33
Q

In FMD, doppler analysis is likely to show ______ and _______ past the ______ ICA segment

A

turbulence, high velocities, proximal

34
Q

_____ frequency transducers and _______ are useful to identify _____ ICA flow

A

lower, power doppler, distal

35
Q

Carefully examine ____ ICA with ____, _____ and _____

A

distal

color, doppler and b mode

36
Q

What frequency probe may be needed to visualize most distal segments

A

lower

37
Q

What additional images should be included for FMD

A

distal ICA w color / spectral of highest velocities mid to distal / any post stenotic turbulence / power doppler for string of beads / b mode of affected area for diameter changes

38
Q

FMD should be suspected with the following

A

young patients / no evidence of artheroscleroic disease / marked turb in distal ICA with increases vel

39
Q

Demonstration of “string of beads” appearance on

A

b mode, color, power doppler

40
Q

Diagnosis of FMD is often confirmed with

A

angiography

41
Q

Carotid body is a _______ structure in the _____ of the carotid bifurcation

A

1-1.5mm / adventitia

42
Q

Carotid body tumors are classified as

A

paragangliomas

43
Q

Carotid body tumor signs and symptoms

A

asymptomatic / small lump anterior to neck / discomfort / rarely cause headaches or change in voice

44
Q

Carotid body tumors usually present as a well-defined mass located between the __________ at the bifurcation

A

ICA and ECA

45
Q

Carotid body tumors cause ____ of the two vessels

A

splaying

46
Q

CBT is a _______ tumor, demonstrating a ____ resistance waveform on spectral doppler

A

highly vascular, low

47
Q

CBT diagnosis includes

A

identification of highly vascularized mass / splaying of ICA and ECA / low resistance wave forms in mass

48
Q

Carotid aneurysm is

A

dilation of carotid involving all three walls / most commonly occur in CCA / atherosclerosis main cause / may be result of infection

49
Q

Carotid aneurysm that is a result of an infection is called

A

mycotic aneurysm

50
Q

CA signs and symptoms

A

pulsatile mass in neck / asymptomatic / TIA/stroke symptoms

51
Q

In CA, rupture is ____ but can cause

A

rare, cranial nerve dysfunction

52
Q

CA rupture and cranial nerve dysfunction may result in

A

patient hoarseness

53
Q

CA diagnosis is

A

rare / difficult to differentiate from large bulb

54
Q

Pseudoaneurysm is

A

perforation in arterial wall allowing blood to extravasate into surrounding tissue / false aneurysm

55
Q

Pseudoaneurysm is uncommon is carotid arteries. T/F

A

true

56
Q

PA is usually the result of

A

penetrating trauma or iatrogenic injury

57
Q

PA may form at

A

endarterectomy site or at anastomotic site of carotid bypass graft

58
Q

PA signs and symptoms

A

palpable/pulsatile neck mass / carotid bypass graft with mass

59
Q

In PA, blood flow outside arterial wall creates _________ that is connected to artery by _____

A

mass in surrounding tissue, “neck”

60
Q

Pseudoaneurysm mass appearance

A

thrombus / low velocity “yin yang pattern”

61
Q

PA diagnosis

A

pulsatile mass with yin yang color filling is classic presentation for pseudoaneurysm

62
Q

Radiation-induced arterial injury is

A

injury to vessel walls from therapeutic irradiation of various tumors

63
Q

What vessels may be affected by RIAI and why

A

capillaries, arterioles and venules / radiation damages endothelial cells of walls

64
Q

RIAI causes ______ due to injury to the _______ in the _____ layer of the vessel

A

fibrosis, vaso vasorum, medial

65
Q

RIAI stenoses are ____ than most typical atherosclerosis lesions

A

longer

66
Q

RIAI lesions ____ contain calcifications and may have ____ effect

A

do not, hypoechoic

67
Q

Arteritis is

A

inflammation of the artery wall that breaks down parts of wall structure

68
Q

Arteritis has to forms often encountered:

A

takayasu disease, temporal arteries

69
Q

Takayasu disease affects

A

aortic arch and great vessels

70
Q

Giant cell arteritis (temporal arteries) affects

A

medium and larger sized arteries

71
Q

Arteritis signs and symptoms

A

autoimmune disease suspected / women affected more

72
Q

Takayasu typically affects what age group

A

younger

73
Q

Giant cell arteries typically affects what age group

A

elderly

74
Q

Takayasu signs and symptoms

A

claudication of arms / no radial pulses / TIA/stroke symptoms / bruits

75
Q

Temporal arteritis signs and symptoms

A

headaches / low grade fever / jaw claudication / tender temporal region / BLINDNESS

76
Q

Takayasu disease lesions tend to appear as

A

long, smooth, homogenous narrowing (general wall thickening)

77
Q

Giant cell arteries usually affects the

A

superficial temporal artery off the ECA

78
Q

In GCA, the STA may have a ______ appearance surrounding the artery

A

halo

79
Q

Takayasu technical considerations

A

doppler wf as far proximal as possible / bilateral brachial bp / subclavian wf

80
Q

In TD, B Mode images in long and trans should be obtained to examine for areas of

A

arterial thickening

81
Q

GCA technical considerations

A

entire STA examined in transverse / identify halos

82
Q

In arteritis diagnosis, look for characteristic

A

long segments of thickened arterial walls in takayasu disease

Vascular I & Physics I (19 decks)

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