Duplex Scanning and Color Flow Imaging of the Upper Extremities

Question 1

purpose of duplex scanning and color flow (3)

Answer 1

localizes arterial stenosis or occlusion
evaluates degree of stenosis, treatment, and graft
determines the presence or absence of an aneurysm

Question 2

main use for duplex and color flow imaging in the upper extremities is to ___

Answer 2

evaluate hemodialysis access grafts

Question 3

7 things to do when evaluate access grafts

Answer 3

identify and evaluate inflow artery
identify and evaluate arterial anastomosis
identify and evaluate body of the graft
observe for abnormalities
observe color flow
identify and evaluate venous anastomoses
identify and evaluate outflow vein

Question 4

3 types of dialysis access

Answer 4

Brescia-Cimino fistulas (radial artery & cephalic vein)
Straight synthetic grafts
Looped synthetic grafts

Question 5

___ and ___ are the most common sites for stenosis when there is a dialysis access

Answer 5

Venous anastomosis
Outflow vein

Question 6

what is “steal syndrome”?

Answer 6

distal arterial (high pressure) blood flow is reversed into the venous side (low pressure) of the dialysis access

Question 7

using PPG to assess steal syndrome

apply pressure against the dialysis access, if blood flow improves that means ___

Answer 7

positive steal

the dialysis access is stealing blood from the digits because of the altered pressure gradient

Question 8

brachial artery reactivity testing

assesses the ability of the ___ to regulate ___ by measuring the degree to which the brachial artery dilates in response to reactive hyperemia

Answer 8

assesses the ability of the endothelium to regulate vasodilation by measuring the degree to which the brachial artery dilates in response to reactive hyperemia

Question 9

brachial artery reactivity testing

positive test =

Answer 9

positive test = endothelial dysfunction

higher than normal incidence of long-term coronary events

Question 10

brachial artery reactivity testing

patient position?
fasting or no fasting?

Answer 10

supine and fasting

Question 11

brachial artery reactivity testing

inflate cuff to ___mmHg for ___ minutes

Answer 11

inflate cuff to 250mmHg for 5 minutes

Question 12

brachial artery reactivity testing

normal upper arm - artery diameter increases ___%
normal forearm - artery diameter increases ___%

Answer 12

normal upper arm - artery diameter increases ≥10%
normal forearm - artery diameter increases ≥6%