Class 3 (test 2)

Question 1

Carotid color flow exam

Answer 1

Best use of color
Never depend on color alone
Frozen image is temporal color velocities

Question 2

Best use of color for carotid exam

Answer 2

Identify course of vessels

Identify areas of interest for Doppler

Question 3

Velocity color shows

Answer 3

Mean velocities
Direction of flow
Course of vessels
Areas to Doppler

Question 4

Color scale

Answer 4

Start around .3
Avoid aliasing in entire vessel
Set scale to show areas of disturbance
Full vessel wall to wall

Question 5

Color box

Answer 5

Large size unless fillings an issue
Steer to lowest point, straight for angled vessel
Trans-point towards head to create angle
Appropriate gain-wall to wall. No bleeding

Question 6

Vertebral color

Answer 6

Ap approach: CCA in long then tilt probe slightly lateral
Decrease scale, increase gain
Vein is superficial to artery
One vert A typically larger with high velocity than other side

Question 7

When does color mosaic occur

Answer 7

High velocities at stenosis
PRF too low for velocities
Flow disturbance

Question 8

Power color

Answer 8

Useful to see vessels going different directions

Can’t determine vein from artery (all same color)

Question 9

Flow separation

Answer 9

Normal at sudden widenings

Laminar flow separates by outer wall and reverses flow

Question 10

Reasons for color aliasing

Answer 10

Scale too low
Low angle
High velocities 
Post stenotic turbulence 
High velocity around curve

Question 11

Correcting aliasing in full vessel by

Answer 11

Increasing scale

Question 12

When there’s no color seen try

Answer 12

Increasing gain

Question 13

Doppler controls

Answer 13

Long view
Steering angle
Sample volume size
Center stream 
Gain
Doppler angle
Scrolling through arteries 
Samples at correct locations

Question 14

Measuring carotid velocities

Answer 14

PSV
EDV
ICA/CCA ratio (highest ICA/mid CCA)

Question 15

Doppler angle

Answer 15

Avoid measuring on curve
Set parallel to walls
Split difference if walls aren’t parallel

Question 16

Measuring calcified areas

Answer 16

Steer at angle under calcium on both ends
Compare velocities before and after shadow area
Same velocities show normal. Different poss stenosis

Question 17

ICA Doppler

Answer 17

Low resistance
Diastolic flow above zero except in bulb
EDV higher than ECA

Question 18

ECA Doppler

Answer 18

High resistance
Diastolic flow near or below zero
EDV lower than ICA
Branches

Question 19

CCA Doppler

Answer 19

Combo of ICA and ECA

EDV between ICA and ECA

Question 20

Carotid waveforms

Answer 20

Compare EDV waves
ICA highest
CCA middle
ECA lowest

Use ICA distal to bulb*

Question 21

ICA waveform

Answer 21

Constant forward flow above baseline

Question 22

ECA waveform

Answer 22

Often shows notch in downslope

Question 23

ECA temporal rap

Answer 23

ECA is medial vessel
Find STA pulse by ear, tap STA to check for taps in waveforms
Compare effects of tapping on both sides
Rare

Question 24

Vertebral techniques

Answer 24

Patient look straight
AP approach 
Find CCA in long
Move transducer lateral
Vertebral processes (spinal bones)

Question 25

Vertebral arteries

Answer 25

Decrease color scale and increase gain
Vertebral shadows-picket fence appearance
Deep to vein
Low resistance

Question 26

Subclavian artery

Answer 26

Best to use distal SCA past clavicle
Use color above clavicle for prox SCA
Doppler waveform
Normally triphasic with higher PSV than CCA

Question 27

IAC documentation

Answer 27

If you can’t prove it, it doesn’t matter
Document normal vs abnormal 
Color 
Doppler
Protocol 
Bilateral

Question 28

Gray scale images minimal

Answer 28

Long of
CCA
bifurcation
ICA

Question 29

Eileen’s thought of gray scale minimal

Answer 29

Long of
M CCA
D CCA into ICA
D CCA into ECA
M&D ICA

Question 30

IAC minimum Doppler/velocities

Answer 30

P CCA
M CCA
D CCA
P ICA
D ICA
ECA
VERT
Abnormal areas