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Final Flashcards

1
Q

A patient who experiences a visual disturbance and describes it as a “shade being drawn over one eye” may be?

A

amaurosis fugax

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2
Q

The doppler equation, the symbol “c” stand for ?

A

speed of sound in soft tissue

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3
Q

which normal cerbrovascular vessel demonstrates the highest flow resistance?

A

external carotid artery

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4
Q

typically, dizziness is classified as?

A

posterior symptom

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5
Q

What is the first branch of the ECA?

A

Superior Thyroid Artery

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6
Q

The NASCET study clearly demonstrated benefits of carotid endarterectomy over medical management in patients who are symptomatic and have stenosis greater than or equal to______%

A

70%

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7
Q

angiographic measurement method recommended by the SRU Consensus Conference of 2003, also know as the NASCET method

A

distal ICA lumen compared to the residual ICA lumen

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8
Q

a longitudinal image of carotid plaque can sometimes be misleading as to the diameter reduction due to?

A

slice thickness of the beam

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9
Q

The appearance of earlys systolic deceleration in the left vertebral artery waveform is usually due to ?

A

proximal left subclavian stenosis

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10
Q

What is the first branch of the ICA?

A

ophthalmic artery

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11
Q

If flow is progressing right to left across the screen, and the color box is steered to the left, what color would the carotid artery show up as given that the color bar orientation is red over blue?

A

Blue

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12
Q

what is the correct order of orgination of the great vessels from the aortic arch?

A
  1. inominate artery
  2. left common carotid
  3. left subclavian
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13
Q

what is the first branch off the subclavian artery?

A

vertebral artery

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14
Q

A ____ mmHg gradient between left and right brachial pressures suggests subclavian stenosis?

A

20

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15
Q

Measurement of an ICA stenosis in the _____ view can be misleading

A

sagittal

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16
Q

A transient ischemic attack differs from a stroke because?

A

a TIA lasts for less then 24 hours and completely resolves

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17
Q

An ICA peak systolic velocity of 150 cm/s correlates to a stenosis of ______ based on the 2003 RU consensus criteria

A

50-69%

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18
Q

An ICA peak systolic velocity of 250 cm/s correlates to a stenosis of ______ based on the 2003 SRU consensus criteria

A

>70% to near occlusion

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19
Q

AN ICA peak systolic velocity of 120cm/s correlates to a stenosis of _____ based on the 2003 SRU consensus criteria

A

<50%

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20
Q

An ICA End diastolic velocity of 105cm/s correlates to a stenosis of _____ based on the 2003 SRU consensus criteria

A

>70% to near occlusion

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21
Q

An ICA End diastolic velocity of 55cm/s correlates to a stenosis of ____ based on the 2003 SRU consenesus criteria

A

50-69%

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22
Q

Standard Carotid protocol

A
  1. patient history2. trasverse imaging 3. long imaging 4.color doppler
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23
Q

Generally the best approach for ICA measurement of sstenosis is?

A

posterolateral

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24
Q

describe the correct bifurcation maneuver.

A

From the distal CCA, pivot the transducer medially to view the ECA

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25
Q

If the orientation marker is correctly pointed toward the patient’s head, then when scanning in transverse at the level of the bifurcation, the right ECA should appear on the _____ side of the screen.

A

right

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26
Q

What is the typicall color scale used to scan the carotid artery?

A

30

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27
Q

If utilizing color doppler, the technologist needs to use an angle in order to detect a frequency shift and therefore display flow. one way to acquire and angle when imaging a carotid artery is?

A

Rock the probe

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28
Q

According to the doppler equation, maximum frequency shift is displayed at an angle of ?

A

0 degree

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29
Q

NASCET stand for?

A

north american symptomatic carotid endarterectomy trials

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30
Q

If a patients right arm measured 100/60mmHg and their left arm measured 122/60mmHg, what is the appropriate conclusion based on these blood findings?

A

right subclavian stenosis

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31
Q

In order to image the vertebral arteries, you would place your transducer in the longitudinal orientation and view the CCA. From there, you would angle the probe more ______ in order to visualize the vertebral artery.

A

posteriorly

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32
Q

what is the primary indication for imaging the subclavian arteries?

A

to detect stenosis

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33
Q

When mapping a stenosis, the technologist samples distal to the stenosis to detect turbulence, and then sample distal to the turbulence to detect ?

A

low flow

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34
Q

Name the causes of stroke that may result in emboli to the brain?

A

cardiac, carotid etiology, aneurysm rupture

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35
Q

Risk factor of a stroke

A

diabetes, advance age, tobacco use, high cholesterol

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36
Q

The right and left vertebral confluence in the posterior portion of the circle of willis to become the?

A

basliar artery

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37
Q

What percentage of patient have an intact functioning circle of willis?

A

50%

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38
Q

What transducer orientaio is most accurate for visualizing plaque in the carotid arteries?

A

transverse

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39
Q

When evaluating the right ICA in transverse, which side of the screen should it appear(assuming the index marker is corrctly positioned)?

A

left

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40
Q

T or F; The external carotid artery has cervical branches

A

true

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41
Q

Name some vertebrobasilar symtoms

A

syncope, vertigo, memory loss

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42
Q

you perform percussion maneuvers on the superficial temporal artery and see oscillations on the spectral display. The artery being insonated is most likely?

A

ECA

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43
Q

What is the first branch of the ECA?

A

superior thyroid artery

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44
Q

amaaurosis fugax related to an internal carotid lesion will cause?

A

temporary blindness or shading of the ipsilateral eye

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45
Q

When attempting to obtain good color filling of a low velocity vessel like the vertebral artery, what color controls may be adjusted in order to impove the color?

A

decrease the scale; increase the gain

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46
Q

In the case of vascular doppler, we use an agle of ____ in order to correspond to the diagnostic criteria.

A

60 degree

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47
Q

Whic is the best width for a sample volume in obtaining doppler signals within the carotid arteries? A.1.5mm B.2.0mm C.2.5mm D. 3.0mm

A

A. 1.5mm

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48
Q

If the doppler gain setting is too high, what might that waveform appear to display?

A

spectral broadening

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49
Q

What are the typical doppler sample locations in the carotid ultrasound?

A

proximal CCA, proximal ICA, distal ICA

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50
Q

List four steps involed when mapping a stenosis in the carotid arteries?

A
  1. visualize the plaque 2.work the sample volume through the stenosis 3. record and measure the highest velocity 4. sample and record distal to a stenosis to detect turbulence
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51
Q

What two steps are needed to improve color flow throug a nearly occluded vessel?

A

decrease PRF & increase gain

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52
Q

In order to image the vertebral arteries, you would place your transducer inthe long. orientation and view the CCA. From there you would angle the probe more ______ in order to visualize the vertebral artery.

A

posteriorly

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53
Q

In the case of the left subclavian steal, the technologist may observe retrograde flow in the?

A

ipsilateral vertebral artery

54
Q

What is the longest vein in the body?

A

greater sephenous vein

55
Q

In the suspine individual, hydrostatic pressure at the level of the ankles is approximately?

56
Q

The optimal patient position for imaging of the lower extremeity veins is?

A

suspine, reerse trendelenburg’s postition

57
Q

The veins of which area of the lower extemityhave been found to be difficult to compress, and the reverse technique must be used to visualize vein coaption?

A

distal thigh

58
Q

Which type of lower extemity veins usually carry about 85% of the limb blood volume back to the heart?

59
Q

Which vein is also know as the femoral vein?

A

superficial femoral vein

60
Q

T or F; Bifed/ duplicated femoral vein is NOT uncommon

61
Q

T or F; deep veins have adjacent artery. Superficial veins do not?

62
Q

Which veins pass through the fascial plane and have several valves to prevent retrograde venous flow?

A

perforator veins

63
Q

What vein is formed from the confluence of the right and left common iliac veins?

64
Q

Virchow’s triad includes which three conditions?

A

stasis, vein wall injury, hypercoagulability

65
Q

A condition resulting in a grossly swollen and cyanotic leg that is caused by iliofemoral venous thrombodsis is know as?

A

phlegmasia cerulea dolens

66
Q

Traditionally, venous doppler waveforms have been displayed _______. This is what will be expected on your scan assessment?

A

below baseline

67
Q

Which of the following is usually a symptomof superficial thrombolphlebitis instead of DVT?

A

palpable cord

68
Q

anually the incidence of DVT/’s in the us are estimated to be?

A

1-10 million cases

69
Q

which isw an example of venous stasis? A. cancer B.thrombophilia C. very long airplane ride D.high dose estrogen RX

A

C. very long plane ride

70
Q

Accorging to Daigle, if a patient hass all these symptoms for a DVT; persistent leg pain, persistent leg swelling, calf tenderness; then their chance of having a DVT is ?

71
Q

When performing compressions on the veins at the groin, the best image and best compression is obtained when the transducer is angled?

A

perpendicular to the skin

72
Q

what vessels are present at the suphenofemoral junction?

A

superficial femoral artery, deep femoral artery, common femoral vein, great saphenous vein

73
Q

If a thrombus is present in the GSV, what area is carefully evaluated to make sure there is no extension into the deep system.

A

saphenofemoral junction

74
Q

A condition that presents as a severely swollen, blue, cool lower extremity is called:

A

phlegmasia cerulea dolens

75
Q

Which of the following is not a symptom of acute deep vein thrombosis (DVT)?

A. pain

B. limb swelling

C. increased temperature

D. hyperpigmentation

E. erythema

A

D. hyperpigmentation

76
Q

Virchow’s Triad includes trauma or endothelial change, venous stasis, and _______________.

A. hypertension

B. hyperactivity

C. thrombophilia

D. hypothryroidism

E. hypercoagulability

A

E. hypercoagulability

77
Q

A patient presents with a swollen right lower extremity. Duplex imaging demonstrates patency of the femoral, popliteal, and calf veins. However, Doppler at the common femoral level on the right is continuous, not changing with respiration, while Doppler of the left common femoral vein is phasic. These findings might suggest:

A. Thrombosis of the profunda femoris vein

B. Right iliac thrombosis

C. Left iliac thrombosis

D. Vena cava thrombosis

E. This is not a diagnostically useful finding

A

B. Right iliac thrombosis

78
Q

In the supine individual’s lower extremity during inspiration, venous blood flow is ______________ as a result of the increased intraabdominal pressure

A. increased

B. decreased

C. unchanged

A

B. decreased

79
Q

The examiner listens with CW Doppler to the superficial femoral vein at mid thigh and performs a calf compression. The compression maneuver augments the signal. This finding suggests:

A. Deep vein thrombosis at the iliac level

B. Deep vein thrombosis at the femoral level

C. Deep vein thrombosis in the calf veins

D. Valvular incompetence

E. This is a normal finding.

A

E. This is a normal finding

80
Q

Primary venous insufficiency is due to which of the following?

A. post-phlebitic syndrome

B. chronic venous obstruction

C. reduced arterial inflow

D. congenital absence or defects of valves

E. absence of perforating veins

A

D. congenital absence or defects of valves

81
Q

As you ask your patient to do a Valsalva maneuver, which flow characteristic do you normally expect to see?

A. cessation of flow during the maneuver

B. augmented flow when the patient relaxes and breathes normally

C. increased flow as the patient bears down

D. A and B

E. B and C

83
Q

The absence of respiratory phasicity in the proximal leg veins is suggestive of:

A. obstruction inferior to the transducer

B. extrinsic compression distally

C. obstruction superior to the transducer

D. normal findings

A

obstruction superior to the transducer

84
Q

The primary concern involving patients with acute deep vein thrombosis is:

A. possible venous valve damage

B. lack of blood flow to the limb

C. venous ulceration may form

D. pulmonary embolism may occur

E. rupture of the soleal sinuses

A

D. pulmonary embolism may occur

85
Q

s you perform venous imaging on your next patient, you document this finding in the patient’s popliteal fossa. The structure on the left of the image is LEAST likely to represent which of the following?
13, 14.docx 285 KB

A. hematoma

B. cyst

C. sarcoma

D. acute deep venous thrombosis

E. ruptured Baker’s cyst

86
Q

Secondary varicose veins are due to:

A. previous DVT

B. congenital abnormalities

C. protein c deficiency

D. avalvular veins

A

A. previous DVT

87
Q

On duplex imaging, which of the following would characterize the finding of a chronic DVT?

A. thrombus is easily compressible

B. thrombus is highly echogenic

C. no evidence of venous insufficiency

D. vessel may have increased diameter

E. thrombus is isoechoic compared to the vessel being examined

A

B. thrombus is highly echogenic

88
Q

The Valsalva maneuver:

A. Increases pressure in the thoracic cavity, decreases pressure in the abdominal cavity

B. Decreases pressure in the thoracic cavity, increases pressure in the abdominal cavity

C. Slows down or stops venous flow everywhere in the body

D. Increases venous flow everywhere in the body

E. Affects arterial, not venous, flow

A

C. slows down or stops venous flow wverywhere in the body

89
Q

A complication described as erythema, mild scaling, and brown discoloration of the skin is known as:

A. lymphedema

B. cellulitis

C. stasis ulceration

D. varicose veins

E. stasis dermatitis

A

E. stasis dermatitis

90
Q

The right and left common iliac veins confluence to form the:

A. right and left external iliac veins

B. right and left superficial femoral veins

C. inferior vena cava

D. aorta

91
Q

The posterior tibial veins empty into the:

A. anterior tibial veins

B. peroneal veins

C. popliteal vein

D. tibioperoneal trunk

A

D. tibioperoneal trunk

92
Q

The superficial femoral vein is the result of the:

A. continuation of the popliteal vein

B. continuation of the common femoral vein

C. bifurcation of the common femoral artery

D. bifurcation of the profunda femoral vein

A

A. continuation of the popliteal vein

93
Q

The peroneal veins lie just above the ______ when viewed on the ultrasound image with the transducer on the medial aspect of the calf.

A. interosseous septum

B. intermuscular membrane

C. tibia

D. fibula

94
Q

The vein that is difficult to compress at the adductor hiatus is the:

A. common femoral vein

B. great saphenous vein

C. popliteal vein

D. femoral vein

A

D. femoral vein

95
Q

Which of the following carries approximately 15% of the blood volume of the leg?

A. great saphenous vein

B. small saphenous vein

C. femoral vein

D. common iliac vein

A

A. great saphenous vein

96
Q

The hydrostatic pressure present in the ankle of a person who is walking is approximately:

A. 0 mmHg

B. 10 mmHg

C. 25 mmHg

D. 80 mmHg

97
Q

Calculate the hydrostatic pressure at the ankle of an individual who is standing and measures 5 and a half feet from their heart to their ankle.

A. 15 mmHg

B. 121 mmHg

C. 115 mmHg

D. 210 mmHg

A

B. 121 mmHg

98
Q

About how many cases of deaths from pulmonary emboli are present in the U.S. annually?

A. 1-10 million

B. 600,000

C. 200,000

D. less than 100,000

A

C. 200,000

99
Q

If a patient has cancer, they are at risk of developing a DVT because of the associated __________.

A. venous stasis

B. hypercoagulability

C. vein wall injury

D. congestive heart failure

A

B. hypercoagulability

100
Q

A thrombus in the great saphenous vein that does not extend into the common femoral vein is classified as a:

A. deep venous thrombosis

B. superficial thrombophlebitis

C. superficial venous incompetence

D. deep venous incompetence

A

B. superficial thrombophlebitis

101
Q

Which of the following is NOT a typical Doppler sample site in a lower extremity venous evaluation?

A. common femoral vein

B. popliteal vein

C. distal femoral vein

D. proximal profunda femoral vein

A

D. proximal profunda femoral vein

102
Q

A calf vein DVT would not cause a pulmonary embolism, and that is why not every lab will image the calf veins.

A. true

B. false

103
Q

Which of the following is not a symptom of an acute DVT?

A. local tenderness

B. chronic leg heaviness

C. limb warmth

D. acute limb swelling

A

B . chronic leg heaviness

104
Q

Which of the following is typical of chronic venous insufficiency?

A. foot and ankle swelling

B. ulceration

C. leg heaviness

D. chronic limb swelling

E. all of the above are typical findings

A

E. all of above

105
Q

On a patient, spontaneous and phasic flow is evident in the proximal femoral vein. Spontaneous, nonphasic flow is evident in the ipsilateral common femoral vein. This indicates obstruction in the:

A. ipsilateral iliac veins

B. ipsilateral mid femoral veins

C. contralateral iliac veins

D. ipsilateral proximal femoral vein

A

A. ipsilateral iliac veins

106
Q

May-Thurner Syndrome refers to the condition where the _________________ compresses the left common iliac vein.

A. left common iliac artery

B. right common iliac vein

C. left external iliac artery

D. right common iliac artery

A

D. right common iliac artery

107
Q

Which of the following is a characteristic of a chronic DVT?

A. hypoechoic lumen

B. dilated vein size

C. dilated collaterals present

D. vein larger than the artery

A

C. dilated collaterals present

108
Q

The common femoral vein crosses the inguinal ligament to become the:

A. femoral vein

B. profunda femoral vein

C. external iliac vein

D. common iliac vein

A

C. external iliac vein

109
Q

A duplicated femoral vein has demonstrated to be present in _____% of studies.

A. 10

B. 20

C. 25

D. 30

E. 50

110
Q

The great saphenous vein drains into the ____________ at the level of the saphenofemoral junction.

A. common iliac vein

B. external iliac vein

C. common femoral vein

D. superficial femoral vein

A

C. common femoral vein

111
Q

Increased hydrostatic pressure leads to a/an ___________________ in venous distention and venous pooling.

A. increase

B. decrease

C. no change

112
Q

If a vein with chronic DVT were to undergo recannalization, which of the following might result?

A. resumption of flow through flow channels within the thrombus

B. chronic venous insufficiency

C. valve damage

D. all of the above

A

D. all of the above

113
Q

Which of the following is the MOST correct term for referring to an actual clot within a vessel?

A. blood clot

B. thrombophlebitis

C. phlebitis

D. thrombus

E. thromboembolism

F. thrombosis

A

D. Thrombus

114
Q

Primary venous insufficiency is due to which of the following?

A. post-phlebitic syndrome

B. chronic venous obstruction

C. reduced arterial inflow

D. congenital absence or defects of valves

E. absence of perforating veins

A

D. congenital absence or defects of valves

115
Q

Are you having fun studing all this bullshit?

A

No….Hell NO!!!!!

116
Q

What is the effect of the calf motor pump on hydrostatic pressure?

A. increases

B. decreases

C. no change

A

B. decreases

117
Q

Secondary varicose veins are due to:

A. previous DVT

B. congenital abnormalities

C. protein c deficiency

D. avalvular veins

A

A. previous DVT

118
Q

The superficial femoral vein is the result of the:

A. continuation of the popliteal vein

B. continuation of the common femoral vein

C. bifurcation of the common femoral artery

D. bifurcation of the profunda femoral vein

A

A. continuation of the popliteal vein

119
Q

The vein that is difficult to compress at the adductor hiatus is the:

A. common femoral vein

B. great saphenous vein

C. popliteal vein

D. femoral vein

A

D. femoral vein

120
Q

The great saphenous vein drains into the ____________ at the level of the saphenofemoral junction.

A. common iliac vein

B. external iliac vein

C. common femoral vein

D. superficial femoral vein

A

C. common femoral vein

121
Q

Increased hydrostatic pressure leads to a/an ___________________ in venous distention and venous pooling.

A. increase

B. decrease

C. no change

A

A. increase

122
Q

If a vein with chronic DVT were to undergo recannalization, which of the following might result?

A. resumption of flow through flow channels within the thrombus

B. chronic venous insufficiency

C. valve damage

D. all of the above

A

D. all of the above

123
Q

All of the following are vertebrobasilar symptoms except:

A. syncope

B. vertigo

C. memory loss

D. hemiplegia

A

D. hemiplegia

124
Q

When attempting to obtain good color filling of a low-velocity vessel like the vertebral artery, what color controls may be adjusted in order to improve the color?

A. decrease the scale; decrease the gain

B. increase the scale; decrease the gain

C. increase the scale; increase the gain

D. decrease the scale; increase the gain

A

D. decrease the scale; increase the gain

125
Q

According to the Consensus Panel- 2003, what is the ICA PSV for a stenosis of <50%?

A. <125 cm/s

B. >125 cm/s

C. 125-230 cm/s

D. >230 cm/s

A

A. <125cm/s

126
Q

In the case of a left subclavian steal, the technologist may observe retrograde flow in the:

A. contralateral vertebral artery

B. ipsilateral vertebral artery

C. contralateral common carotid artery

D. ipsilateral subclavian artery

A

B. ipsilateral vertebral artery

127
Q

According to the Consensus Panel- 2003, an ICA PSV of 275 cm/s correlates with which percentage of stenosis?

A. <50% stenosis

B. 50-69% stenosis

C. ≥70% stenosis

D. Occlusion

128
Q

According to the Consensus Panel- 2003, an ICA EDV of 60 cm/s correlates to which degree of stenosis?

A. <50% stenosis

B. 50-69% stenosis

C. >70% stenosis

D. occlusion

129
Q

According to the Consensus Panel- 2003, an ICA PSV of 115 cm/s correlates to which percentage of stenosis?

A. <50% stenosis

B. 50-69% stenosis

C. ≥70% stenosis

D. occlusion

A

A. less than 50%

130
Q

If a thrombus is present in the GSV, what area is carefully evaluated to make sure there is no extension into the deep system?

A. saphenofemoral junction

B. saphenopopliteal junction

C. SFV-PFV confluence

D. CFV-EIV confluence

A

A. saphenofemoral junction

131
Q

Goodluck on the Test!!!!

Vascular (3 decks)

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