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Vascular-Arterial > Chapter 21- Transcranial Dopplers > Flashcards

Chapter 21- Transcranial Dopplers Flashcards

1
Q

The opthalmic artery branches off of what vessel?

A

terminal ICA

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2
Q

The frontal artery arises from what artery?

A

The opthalmic artery

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3
Q

The frontal artery supplies what part of the head?

A

forehead

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4
Q

The supraorbital artery arises from what artery?

A

the opthalmic artery

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5
Q

What is TCD’s good for detecting?

A

Brain death, emboli, subarachnoid hemorrhage, stenosis, occlusion

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6
Q

What is the main limitation with transcranial dopplerS?

A

The penetration of the temporal bone is not good.

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7
Q

What are the three acoustic windows we use for TCDs?

A

transtemporal, transorbital, and suboccipital

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8
Q

What are we measuring during a TCD?

Very important.

A

the Time Averaged Max Velocity(TAMV) OR MEAN VELOCITY

we are NOT NOT NOT doing peak systolic. only the mean velocity.

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9
Q

In what order of technique should we go in when doing TCD

remember the techniques are : Transorbital, transforamenal, and transtemporal.

A

1) Transtemporal to get the ICA, MCA, ACA, and PCA
2) Ipsilateral Transorbital to find opthalmic and carotid siphon
2) Transforamenal to get distal vertebral and basilar artery.

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10
Q

The following vessels should be seen in the Transtemporal view

(There is 4 of them)

A

Middle cerebral artery, terminal ica, Anterior communicating artery, and posterior cerebral artery

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11
Q

The following vessels should be seen in the transopthalmic view

There is 2

A

Opthalmic and ICA

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12
Q

Which vessels should be seen in the subforamenal view?

A

Vertebral and Basilar

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13
Q

The verebral and basilar arteries should have flow coming towards or away transducer?

A

Away

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14
Q

The middle cerebral artery should have flow going towards or away from transducer?

A

towards

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15
Q

Which vessel of the COW has the highest velocity?

A

middle cerebral

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16
Q

What are some factors that can affect the intracranial blood flow?

A

age, sex, hematocrit, oxygen levels.

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17
Q

The highest mean in all of these vessels shouldn’t get any higher than 55 TAMV cm/sec

True or False

A

True

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18
Q

In an intracranial stenosis, the velocities are going to be higher or lower?

A

Higher

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19
Q

Vasospasms most often are seen in which vessel?

A

Middle cerebral artery (mean velocity >120 cm/sec

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20
Q

When a patient is brain dead, the blood flow goes from low resistant to high resistant, so we will see NO diastolic flow in ICA, MCA, or ACA.

True or False

A

True. The brain is dying so it doesnt need the constant flow that low resistant provides, there fore becomes low-resistant

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21
Q

IMPORTANT!!!!

We can detect micro-emboli. Typically it will sound like a moan or chip. What will we see on the waveform?

A

a random line will be seen with the chirp noise.

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22
Q

Where does this micro-emboli come from?

A

Carotid stenosis or a cardiac source

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23
Q

What is an example of the cardiac source micro-emboli can come from?

A

The patent Foramen Ovale-

this alows blood and emboli to travel from the venous side to the arterial side in the left atrium.

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24
Q

MCA stands for ?

A

Middle cerebral artery

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25
Q

The middle cerebral artery can be seen best through which window?

Transtemporal, transorbital or transforamenal

A

temporal (side of head)

26
Q

When imaging the middle cerebral artery, what depth should we have our transducer at?

A

30-60

27
Q

When imaging the middle cerebral artery, what direction will the flow be coming in? and how should we angle our probe?

A

The flow will be coming towards (highest velocity of all) and we should have it anterior and superior

28
Q

The terminal ICA can be seen best through which window?

Transtemporal, transorbital or transforamenal

A

transtemporal

29
Q

When imaging the terminal ICA, what depth should we have our transducer?

A

55-65 (thnk its deeper than the middle cerebral artery so we need to go further than that)

30
Q

What direction will the terminal ICA be going in a transtemporal view?

A

bidrectional. angle superior and anterior. just deeper than MCA

31
Q

The Anterior cerebral artery can be seen best through which window?

Transtemporal, transorbital or transforamenal

A

Transtemporal view

32
Q

When imaging the anterior cerebral artery, what depth should we be at?

A

60-80 (think it is deeper than the middle cerebral and terminal ICA in the brain so we need to go deeper)

33
Q

When imaging the anterior cerebral artery from a transtemporal approach, what direction will the flow be going?

A

away from transducer.

34
Q

The posterior cerebral artery can be seen best through which window?

Transtemporal, transorbital or transforamenal

A

Transtemporal

35
Q

When imaging the posterior cerebral artery, what depth should we use?

A

60-70

36
Q

When imaging the posterior cerebral artery from the temporal approach, should we angle anteriorly or posteriorly?

A

POSTERIORLY (HINT POSTERIOR cerebral artery)

37
Q

When imaging the posterior cerebral artery from a transtemporal approach, which direction will the flow be going?

A

towards

38
Q

The opthalmic artery can be seen best through which window?

Transtemporal, transorbital or transforamenal

A

Transorbital ( think opthalmic has to due with the EYE- hint orbital/eye)

39
Q

When imaging the opthalmic artery, what depth should we be using?

A

40-60

40
Q

When imaging the opthalmic artery from an transorbital approach, what direction will the flow be going?

A

TOWARDS.

41
Q

When imaging the opthalmic artery from a transorbital approach, should we angle medially or laterally?

A

medially

42
Q

The vertebral artery can be seen best through which window?

Transtemporal, transorbital or transforamenal

A

transforamenal

43
Q

When imaging the vertebral artery, what depth should be at ?

A

60-90

44
Q

When imaging the vertebral artery from transformenal approach, what direction will the flow be coming from?

A

away?

45
Q

When imaging the vertebral artery from a transforamenal approach, how should we angle the probe?

A

right and left of midline

46
Q

The basilar artery can be seen best through which window?

Transtemporal, transorbital or transforamenal

A

foramenal

47
Q

When imaging the basilar artery from a transforamenal approach, what direction will the flow be coming from?

A

AWAY.

48
Q

When imaging the basilar artery from a transforamenal approach, how should we angle our probe?

A

Midline

49
Q

When we see velocities much higher than normal for each vessel, what should we suspect?

A

STENOSIS

50
Q

What is the normal velocity for the middle cerebral artery?

A

55 +/- 12

51
Q

What is the normal velocity for the terminal ICA?

A

55 +/- 12

52
Q

What is the normal velocity for the anterior cerebral artery?

A

50 +/- 11

53
Q

What is the normal velocity for the posterior cerebral artery?

A

39 +/- 10

54
Q

What is the normal velocity for the ophthalmic artery?

A

21 +/- 10

55
Q

What is the normal velocity for the vertebral artery?

A

38 +/- 10

56
Q

What is the normal velocity for the basilar artery?

A

41 +/- 10

57
Q

TRUE OR FALSE

We use the MEAN VELOCITY not the peak systolic velocity when doing these TSDs?

A

true true!!!!

Important to remember

58
Q

In what two arteries do we often see occlusions in Transcranial dopplers/

A

ICA or Middle Cerebral artery

59
Q

the anterior cerebral artery and its branches feed which lobes of the brain?

frontal, occiptal, parietal (can be more than one)

A

parietal and frontal lobes

60
Q

What two branches in the brain feed the brain stem and cerebellum?

A

basilar and vertebral

61
Q

Which branch of the circle of willis supplies the CSP and corpus collosum with blood supply?

A

anterior cerebral artery (midline anterior brain location)

Vascular-Arterial (22 decks)

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