Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Summer 2014 - Intro to Vascular ✔️ > Extracranial Cerebrovascular Pathology > Flashcards

Extracranial Cerebrovascular Pathology Flashcards

0
Q

Describe plaque of atherosclerotic disease

A

Location

Surface characteristics - smooth vs irregular

Echogenicity - homogeneous, heterogeneous, calcification
(low, moderate, strong)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

describe atherosclerosis

A

thickening
hardening
loss of elasticity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

name the 6 types/forms of plaque

A 
plaque
accumulations
lipid complex carbohydrates
fibrous tissue
calcium
fibrin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

describe fatty streak plaque

A

thin layer of lipid material
homogeneous
low level echoes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

describe fibrous plaque

A

homogeneous
low to medium echoes
accumulation of lipid and other

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

describe complicated lesion plaque

A

fibrous with collagen and debris
heterogeneous
bright echoes with shadow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

describe ulcerative lesion plaque

A

deterioration of the surface

may result in embolization - breaking off

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what plays a role in plaque

A

inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

plaque has a ______ matrix because lipids are ingested by ______

A

fibrous

macrophages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

define plaque

A

echogenic material that encroaches on the arterial lumen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

uncomplicated or stable plaque is ______

A

uniform

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

complicated plaque is _____ _____ and has _______

A

not uniform

ulcerations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is embolism

A

piece of thrombus that moves until it lodges in a blood vessel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is an aneurysm

A

abnormal localized dilatation - rare in the cervical carotid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are 2 types of nonatherosclerotic disease

A

arteritis

Takayasu’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is Takayasu’s

A

chronic inflammation that results in narrowing of arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

describe degree of stenosis

A 
elevated velocity through the narrowed segment
color changes
post stenotic disturbances
turbulent blood flow
spectrul broadening
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Important to differentiate a stenosis from an ______

A

occlusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how do you rule out any trickle of flow

A 
doppler
color doppler
power doppler
decrease color PRF
adjust sample volume
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

describe an ICA occlusion - secondary characteristics

A 
echogenic material filling the lumen
lack of arterial pulsations
reversed blood flow
loss of diastolic flow in CCA
increase velocity in ECA
increased velcity in contra ICA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

describe a stenosis

A

increased velocity - peak systolic velocity, end diastolic velocity, systolic velocity ratio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the criteria for a stenosis

important

A

Stenosis chance PSV EDV
< 50% < 125 cm/sec n/a
50-79% >/= 125 cm/sec n/a
80-99% >/= 125 cm/sec >/= 140 cm/sec

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

describe a critical stenosis

A

pressure and flow volume descrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what does a degree of abnormality depend on when dealing with a critical stenosis

A 
length of narrowing
diameter of narrowing
pressure
resistance
collateral
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

describe the 3 things in a stenosis profile

A

prox to stenosis, flow is dampened and pulsatility increases

at the stenosis, increase velocities and spectral broadening

post stenotic, flow reversals, disturbed flow

25
Q

stenosis:

_____ pitched sound
_____ velocities
_____ broadening
_____ to a stenosis - turbulent (dampeded/more round)

A

higher
higher
spectral
distal

26
Q

the highest velocity obtained from and ICA stenosis is used to classify what

A

degree of narrowing

27
Q

doppler signals obtained distal to the area of poststenotic flow disturbance may be _____ or _____, and the upstroke of the distal doppler spectral waveform may be _____

A

normal or diminished

slowed

28
Q

stenosis usually happen where

A

distally

29
Q

stenosis are _____ and systolic peak is _____

A

dampened

rounded

30
Q

stenosis have a ______ ______ - delay arrival of systolic peak with low velocity

A

Tardus parvus

31
Q

An ICA occlusion is not amenable to _______ intervention

A

surgical

32
Q

To characterize an ICA as occluded, the artery should be evaluated with what

A

doppler, color doppler, and power doppler to rule out the presence of trickle flow

33
Q

when determining if the ICA is occluded, the color PRF should be ______ to document the presence of any slow moving blood flow and the color gain should be ______ to enchance any blood flow that may be present

A

decreased

increased

34
Q

how is a residual lumen/trickle flow seen sonographically

A

the “string sign” using power doppler

35
Q

what surgery is done for plaque removal

A

thrombo endarterectomy

36
Q

Flow compensation:

internalized ECA - indicates _______

high grade stenosis of ECA - _____ flow elevated

high grade stenosis of ICA - _____ demonstrates higher resistance flow

A

disease - CCA occlusion

ICA

CCA

37
Q

turbulent flow is caused by what

A

stenosis
kinking
tortuosity
increase in vessel diameter

38
Q

describe vertebral artery

A

branches of the subclavian arteries

asymmetrical

unite to form basilar artery

long CCA - angle posterolaterally toward the back of neck

wide variation in velocities

direction of flow

reversal of flow = subclavian steal –> obstruction in subclavian artery on same side

39
Q

describe subclavian steal

A

reversed flow in vertebral artery

monophasic flow dampened

more often on left side

deceleration with late systolic velocities

40
Q

describe subclavain artery

A

multiphasic high resistance doppler

blood pressure difference of greater than 20 mmHG is associated with disease in the side of the lower pressure

41
Q

what needs to be interpreted with a carotid exam

A 
location of stenosis
extent of plaque
patency of distal ICA
presence of tortuosity
characteristics of plaque
42
Q

2 types of error interpretations

A

technique - positioning

equipment settings

43
Q

Placement of sample volume must be _______ to the vessel wall

A

parallel

44
Q

sample volume should be kept ______

A

small

45
Q

sample volume in the ______ of the vessel

A

center

46
Q

angle of _____ degrees or less must be used for doppler

A

60

47
Q

describe 5 things about aneurysms

A 
uncommon
pulsatile neck masss
bruit
weakness of the media
blood swirling
48
Q

describe CCA aneurysms

A

tortuous
significant increase in vessel diameter
abn blood flow pattern

49
Q

describe a dissection

A 
blunt and penetrating trauma
cervial injuries
neck flexion
associated with Marfan's syndrome
between intima & medial layers creating a false lumen
50
Q

dissections can be caused by ______

A

trauma

51
Q

desribe dissection appearance

A

blood tears through the intima into the media
different flow in lumen
luminal narrowing

52
Q

describe fibromuscular dysplasia (FMD)

A 
non atherosclerotic
unknown etiology
affects the media of the arterial wall
mid segment of the ICA
bilateral in 65%
usually in females
53
Q

FMD gold standard is

A

angiography - “string of pearls”

turbulent flow and absence of plaque

54
Q

what is the carotid body

A

small mass of vascular tissue that adjoins the carotid sinuses
ovoid - 1 mm in size
located in adventitia - posterior aspect of CCA bifurcation
component of autonomic nervous system

55
Q

carotid body assists in regulating ______, ______, and ______

A

heart rate
blood pressure
respiration

56
Q

describe carotid body tumors

A

rare
hypervascular structure that usually lies between the ICA and ECA
ECA branch supplies blood to the tumor
slow growing neoplasms

57
Q

clinical symptoms of a carotid body tumor

A

palpable neck mass

headache

58
Q

after a endarterectomy the ______ layer is missing because of removal

A

intima

59
Q

_____ _____ _____ is a technique that has been introduced as an alternative to carotid endarterectomy in selected patients

A

carotid artery stenting

60
Q

the gray scale image of a stent produces ______ echos

A

bright

61
Q

review protocol…

A

slide 224

Summer 2014 - Intro to Vascular ✔️ (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions