Ch.5 Common Studies Flashcards
What is the best indicator for DVT
Acute lateral edema
2 reasons to perform a venous
- Deep vein thrombus (DVT)
2. Pulmonary embolism (PE)
What are risk factor of Virchow’s triad?
- Stasis
- Hypercoagulabilty
- Vessel wall injury
Define stasis
Blood not moving which promotes thrombus
Define hypercoagulability
Blood that clots more regularly
Define the effects of vessel wall injury
- Start the clotting process
2. Promotes aggregation of platelets
What are Soleal Sinuses?
Are pouch like areas that receives blood from the Soleus muscle.
What do the Soleal sinuses drain into?
Posterior Tibial and peroneal veins which is the source of most DVT
Stasis risk factors (OVC/PBP)
Pregnancy Age Obesity Varicose veins CHF Previous DVT Bed rest/ prolonged sitting
Hypercoagulability risk factors?
ICD TS
Pregnancy and age Infection Cancer Dehydration Trauma Surgery
Define pulmonary embolism
Is thrombus that propagates proximally into
Popliteal»_space; Femoral»_space;Iliac system» IVC
Name some PE Sx?
SOB Chest pain Sweating Cough Fever Shock
Acute thrombus characteristics
- Homogeneous appearance
- Soft/dark echoes
- Partly compressible
- Attached to the wall
- Distended vein
Chronic thrombis characteristics
- Heterogeneous
- Incompressible
- Bright Echoes
- Irregular walls
- Rechannel flow (recanalization)
- Presence of large collaterals
What affects venous flow in Doppler
- Intra abdominal pressure
2. Compression maneuvers
What do bright echoes suggest?
Older clot
6 Reasons to perform LE studies
- Chronic atherosclerosis
- Acute occlusion
- Follow up bypass grafts
- Ateriovenous fistula
- Aneurysm
- Pseudoaneurysm
Define claudication
Pain with exercise that subsides with rest
What is Chronic atherosclerotic obstructive disease patients main Sx
Patients with pain in the legs with exercise (claudication)
Patients who undergo cardiac cath suffer from what?
- Hematoma
2. Pseudoaneurysm
Define hematoma
A clot or mass in the tissue
Describe a Pseudoaneurysm?
Flow in/out of a area of tissue through arterial wall
How is a pseudoaneurysm treated?
By ultrasound guided thrombin injection or probe compression
What is a Arteriovenous Fistula?
- Abnormal communication between artery and vein
2. Steals flow from distal circulation causing ischemic Sx
Fistula steals flow from distal circulation which results in?
- Reduce distal resistance
2. Cause some heart failure
In scanning LE normal flow is described as?
Multiphasic
Arterial stenosis flow is described as?
Biphasic/ Monophasic
What is the normal aortic diameter?
Range from 1.5-2.5 cm
What is the diameter for a aneurysmal ao? And what size is needed for repair?
Aneurysmal 3 cm
Repair 5cm
Name the most common assessment in abdominal scanning?
Obstruction of the renal artery
Obstructing of flow in the renal arteries do what?
Disrupt the kidneys role in balancing blood pressure
Chronic obstruction of the messengering artery is from?
Patient who is malnourished
Name 2 of the 3 arteries that categorize chronic obstruction of the mesenteric artery
Superior Mesenteric
Inferior Mesenteric
Celiac trunk
Portal hypertension is due to what 2 factors?
- Cirrhosis of the liver due to alcohol abuse
2. Liver damage due to hepatitis
What is the Doppler character distal to renal arteries
Multiphasic similar to lower extremities
What is the velocity criteria for abdominal Doppler in Renal and SMA:
- Renal PSV > 180 cm/sec suggest > 60% stenosis
2. SMA PSV > 275 cm/sec suggest > 60% stenosis
What is patient protocol for patient prep for abdominal studies?
- Patient to fast for 6-12 hours
Drinking clear uncarbonated liquids - No dietary fat the day before
What is another name for a stroke?
CVA Cerebrovascular accident.
Stroke is the _____ leading cause of death.
4th
What are the 2 clinical conditions of stroke?
- Resolving ischemic neurological deficit (RIND)
2. Transient ischemic attack (TIA)
Describe RIND
- Sx of stroke for kore than 24 hours but fewer than 72 hours.
- No permanent damage
Describe TIA
- Stroke Sx lasting fewer than 24 hours
2. No permanent damage
What are the 2 categories of stroke?
- Ischemic
2. Hemorrhage
Define ischemic
- Too little blood to the brain
2. 80% of strokes
Define Hemorrhage
Bleeding from a ruptured vessel
Most ischemic strokes (TIA/RINDS) are caused by….
Plaque at the bifurcation where atherosclerosis is promoted.
What are the 2 Sx of cerebrovascular insufficiency?
- Carotid territory
2. Vertebrobasilar
Name the 7 carotid territory Sx…..
- Dysphasia
- Aphasia
- Amaurosis fugax
- Hemiparesis
- Hemiparesthesia
- Hemiplegia
- Homonymous hemainopia
Carotid territory are considered _______ symptoms.
Lateralizing
Name the 6 vertebra basilar symptoms…..
Vertigo Syncope Nausea Ataxia Binocular Dysphasia
Vertebra basilar are generally ________ Sx….
Nonlateralizing
Define dysphagia
Speech disturbance
Define aphasia
Absence of speech
Define hemi–paresis
Weakness one side (arm,leg, side of face)
Define Hemi–plegia
One sided loss of function
Define paresthesia
One sided tingling sensation
Define Hemanopia
Loss of half the visual field in both eyes
Define ataxia
Loss of coordination
Define Dysphasia
Difficult swallowing
Define atherosclerosis
Growth of the lumen restricting lesions in arterial walls
In diameter-reduction to area-reduction measurement
Diameter of 50%= _________area
80% = _______area
50% = 75%
80% = 96%
What is the Doppler criteria for stenosis
> 50% diameter = ________ cm/sec PSV
> 50% =125 PSV
What is the Doppler criteria for stenosis
70%= __________ cm/sec PSV
__________ Cm/sec EDV
PSV = >230 cm/sec
EDV = > 100 cm/sec
What is the Doppler criteria for stenosis
80% = ________ CM/sec EDV
EDV= > 140 cm/sec
Carotid stenosis is usually categorized
Mild
Moderately
Moderately severe
Severe
Mild =15%
Moderately =15-50%
MS = 50-80%
Severe = >80%
