Hard Study Questions Flashcards
1
Q
Celiac artery compression/stenosis happens when? How is it relieved?
A
Happens with expiration, goes away with inspiration
2
Q
The Arc of Rolan can serve as a collateral for what to vessels?
A
IMA and SMA
3
Q
What acceleration time in a RAS study is consistent with high-grade stenosis?
A
> 100
4
Q
Which one of these 3 are not related to mesenteric angina?
SMA/IMA
Celiac
Lt Gastric
A
Lt Gastric
5
Q
If a patient has an ABI of 0.6 , what disease range does that indicate?
A
claudication
6
Q
What PBI (penile) cutoff defines abnormality?
A
less than 0.65
7
Q
The Hunter’s canal represents the termination of what artery?
A
SFA
8
Q
The inguinal ligament represents the termination of what artery
A
hypogastric artery (internal iliac)
9
Q
If a 35 year old man came in smelling like cigarettes, and had scabs on his fingers and said that they hurt, what would we think he had?
A
Buergers syndrome
10
Q
Celiac artery compression syndrome is the exstrinic compression of the celiac artery due to
A
median arcuate ligament
11
Q
In the presence of a celiac artery stenosis, what vessel may have retrograde flow?
A
hepatic artery
12
Q
What are normal velocities in a normal functioning dialysis access graft?
A
PSV- 250 EDV-100
13
Q
What is a normal acceleration time in a normal functioning kidney?
A
70 msec
14
Q
The right gastric is a branch off the celiac artery,
True or False
A
False
15
Q
Resistance is inversely related to the radius of a vessel. True OR False
A
True
16
Q
What is the ideal vessel diameter for a radial artery mapping for coronary grafts?
A
2 mm or greater
17
Q
If we hear a bruit over the subclavian artery when we are doing an arterial mapping for TRAM flap procedure, why is that worrisome?
A
The intramammary artery is a branch off the subclavian.
The intramammary artery is what is harvested to do a TRAM procedure so it may be compromised if there is an occlusion of the subclavian.
18
Q
The RAR provides useful info if there is plaque or thrombus in the artery
True or False
A
True
19
Q
What does the Allen’s test for?
A
to test patency of the palmar arch
20
Q
If a patient goes through an in-situ bypass, what is a common complication?
A
fistula formation
21
Q
Which layer of the artery contains the vasa vasorum?
A
the external layer
22
Q
What is the FIRST branches of the aorta?
A
coronary arteries
23
Q
The innominate then branches off into what two arteries?
A
CCA and Right Subclavian
24
Q
Name the arteries of the aortic arch in order of right to le
A
Right innominate, left CCA, left subclavian
25
The celiac artery branches off into what three vessels?
Left gastric, Hepatic, and Splenic artery
26
What is the first branch of the Pop Artery?
the anterior tibs
27
What is the landmark for finding the external iliac artery?
Major Psoas
28
What artery supplies the base of the foot?
posterior tibs
29
What is the average speed of Ultrasound through soft tissue?
1540 cm/s
30
The Doppler shif is the difference between the wave frequency directed into tissues and what returns.
True or False
True
31
ABI's are an example of ____ continuous wave ultrasound
analog
32
Which is the better of the two Continuous wave ultrasound? Analog or Digitial?
DIGITAL - like FFT
33
Does PW Doppler have depth resolution?
Yes
34
What is the nyquist limit? What does it cause if we go above it?
1/2 greater than the PRF, aliasing
35
The smaller the sample volume the ____ spectral broadening will occur.
LESS.
36
What is the appropriate sample volume size?
1.5-2.5 mm
37
How come CW will more likely have spectral broadening compared to a Pulse Wave?
because the CW doesn't have depth resolution andhas a larger sample volume
38
The deeper the vessel of interest, the longer the pulse sent out, the frame rate will _____
Increase or Decrease?
decrease,
39
Why would we see the "mirroring" artifact ?
results in apparent flow in opposite direction
40
When do we consider arterial occlusions a medical emergency?
if no collaterilization
41
In arterial dissections, do we often see active flow in both the false lumen and true lumen>?
Yes.
42
What is a dissecting aneurysm
when the vessel dilates
43
What are S/S of Coarctation of the aorta?
high blood pressure and absent LE pulses and pain
44
A man comes in in his 40's with a pack of cigs in his hand. What disease does he likely have and what are his signs and symptoms?
Buegers,
occlusion of fingers and rest pain/ ulcerations/ gangrene
45
What can result from a patient having a pop artery entrapment?
stenosis, aneurysm or occlusion.
46
What are the symptoms of thoracic outlet syndrome?
numbness, tingling of arm, pain aching of arm and shoulder in certain arm positions.
47
If a man comes in with absent femoral pulses, pain in ips, thighs, calves, what should we suspect?
Leriche syndrome
48
With claudication, where is the actual disease probably located ?
prox to area of claudication
49
Ischemic pain is pain at _____
Pain at rest
50
Ischemic pain INDICATES SEVERE disease
True or False
true
51
What does pallor mean?
white / pale
52
What is the capillary refill techique and when is it useful?
Its when you squeeze on the patients toe, and when you release, the toe should go back to its normal color.
should happen in less than 3 seconds
53
What are the 6 P's of arterial occlusion acute?
pain, pulselessness, paralysis, pallor, paresethesia, and cold (Polar)
54
What Is the difference between inflow collaterals and out flow collaterals when it comes arterial occlusion
The inflow collaterals are located at the point of vessel reconstitution or were the vessel opens distally
the outflow collaterals are where the point of occlusion is
55
When we see a common iliac artery occlusion, explain why there would be retrograde flow in the internal Iliacs?
The flow reversed in order to supply the external iliacs.
56
When we are doing a stenosis interpretation profile, what are we comparing?
Pre stenotic velocity to the intranstenotic velocity
57
If we see a patient who has an apparent aortic occlusion, what would the CFA waveform look like? And what we diagnose he or she with?
He’d have Leriche syndrome which is an aortic iliac occlusion,
He’d have bilateral hip butt pain with claudications
58
What are three common sites you’d feel the pulses?
Brachial radial ulnar
59
What is the most common aneurysm in the upper extremity?
Subclavian artery aneurysm
60
What would be the cause of an ulnar artery aneurysm?
hypothenar hammer syndrome !
Basically repetitive blunt trauma to the superficial palmar arch of the ulnar artery.
61
What symptoms would a patient with hammer hand syndrome have clinically?
Embolization to digits
62
If we saw an arterial occlusion in the arm,what wave forms would we see proximal and distal to this?
Would go from high resistive proximally to a low resistance monophasic distally
63
When we see increased diastolic flow wheee it’s not normally found, what does that indicate?
That’s not normal. That means that distally there is a decreased distal peripheral resistance
Page 67
64
If the room is cold during a Doppler waveform analysis, what can that do to the vessel?
Vasoconstriction- make the vessel smaller
65
If we see a waveform that would normally be triphasic, be monophasic with a rounded appearance, what would we think?
Occlusion with POOR collaterals
66
A patient with a Pulsatility Index of 5.0 is considered normal or abnormal?
Normal
Should be 4.0 or more
67
A patient with a PI of 4.2 is considered normal or abnormal?
Normal
68
If we see a patient with a PI of 3.6, that is normal or abnormal?
Abnormal. Should be 4.0 or greater
69
If we see a patient with a PI of 3.0 , what percentage of stenosis is noted?
60%
70
The slower the acceleration time, the more the disease.
True
71
A patient with an acceleration time of 155 milliseconds is considered normal
No that’s abnormal
72
What is the limits of normal and abnormal acceleration time?
Normal is less than 133 milliseconds
Abnormal is more than 133 milliseconds
73
If we see an acceleration time of 170 milliseconds and dampened flow in the SFA, Where would the disease be?
Iliac obstruction proximal to the SFA
74
Aorto-iliac disease is considered in-flow or out-flow disease?
Inflow, that’s where the blood is coming from (prox is closer to the heart)
75
Normally, which pressure is often higher than the other?
Ankle systolic pressure or brachial
Ankle is usually greater than or equal to the brachial
76
How can a patient segmental pressure be limited when they have medial calcinosis (calcified vessels)
Calcified vessels can result in falsely elevated pressure
77
What’s the main difference between the four cuff and three cuff segmental method?
Using the 4 cuff can determine whether disease is prox or distal.
78
Often when using the 4 cuff method, the 20% rule is violated and the thigh pressures are often ___ mmhg higher
30 mmhg
79
List the follow on whether they are normal or abnormal ABIs,
```
Greater than 1.0
0.9-1.0
O.8
0.5
0.3
```
Greater than 1.0 is Normal
0. 9-1.0 probably abnormal
0. 6-0.8 -Claudication single level
0. 5 -multilevel disease
0. 3 -ischemic rest pain
80
If we see 20-30 mmhg or greater pressure drop from one level to another, we should suspect?
A normal ABI, proximal disease
81
If a Patient has a wound and we do the wound healing oximetry, what levels would indicate good chances healing and which would indicate bad chances of healing.
Toe pressure—
Greater than 30 mmhg- good healing
Less than 30 mmhg- bad healing
82
If there is a 15-20 prsssure difference in the upper extremity, this is abnormal
True
83
What is an example of pseudo-claudication?
arthritic pain
84
If we see a >20mm/hg drop in the ankle pressures after exercise, we are safe to assume what?
claudication
85
If the ankle pressure returns back to the resting state in 2-6 minutes this indicates a __ level disease.
Single or multilevel?
single
86
Air-plethysmography is used to measure the ____ change.
Volume
87
Why is photo plethysmography used?
to eval flow in digits where a Doppler would be hard to see bc of the small size of vessels.
88
When interpreting digit arterial plethymography waveforms, which ones are considered obstructive?
Organic / fixed
89
Photo-plethysmography is when we put the sensor on the toe during an ABI
True
90
If we see a "peaked"waveform on PPG, what should we think?
Raynauds
91
What is the cold stress test?
Used on patients (raynauds), submersed hand for 3 minutes, and you take their measurements, then do it again in 5 minutes and repeat.
92
A person has cold sensitivity if after ___ minutes after the cold stress test, the waveforms don't go back to normal.
5 minutes
93
What are the three vessels we look at during a penile study
dorsal arteries, cavernosal arteries, and dorsal vein (superficial and deep)
94
Penile arteries can have limited flow if there is an obstruction in what arteries?
Iliac disease
95
If there is a Penile Brachial index of 0.65 or less, that is consistent with?
abnormal, there is vasculogenic impotence
96
Out of all of the veins imaged, the___ vein is only obtained post- medication injection.
Dorsal vein flow
97
What is a disease in which a "extra-anatomic" bypass graft would be used?
iliac disease
98
In which autogenous vein bypass graft is the valves NOT removed?
reversed saph vein graft
99
What would be an indication to look at a bypass graft?
loss of pulse and decreased ABIs
100
In the "in-situ" bypass grafts, what part of the vessel may become a AVF?
the retained tributaries
101
If we see high velocities within the stents, what should we think?
nothing, its normal to see higher velocity within a stent
102
Is the ulnar or the radial the bigger supplier to the hand?
the ulnar due to the palmar arch
103
When performing the Allen's test, the blood flow should return in how many seconds?
10 seconds
104
Why would there be reversed retrograde flow in the common hepatic artery in the instance that there is a celiac artery occlusion
to supply the spleen
105
What is a Normal RAR
Less than 3.5
106
How do we calculate the RAR
divide the highest renal artery PSV by the aorta psv
107
What is the normal peak systolic velocity for a RAs
Less than 180 mmhg
108
What is a normal RI
Less than 0.8
109
The AT time in a RAS study is a little different. This is obtained at the distal renal artery. The normal limits are
Less than 100 milliseconds
110
What should the cortex of the kidney measure?
Greater than 1 cm.. less would be cortical thinning
111
In a renal transplant patient, the renal artery is anastomoses to the ____ or ____ _____ veins
Internal or external
112
What does the vertebral artery supply?
The back of the brain
113
What is the first branch off the external carotid artery
The superior thyroid artery
114
The right and left ICA, And the right and left vetebrals joint into the ____ ____ ______\
Circle of Willis
115
Fibromusculsr dysphasia is most commonly found in what vessel?
The distal ica
116
If a patient had an endarectomomy 9 months ago, and they come in with intimal ticketing and a higher velocity , what should we suspect?
Neointimal thickening
117
What’s another word for a paraanglioma?
Carotid body tumor
118
there is usually (high/low) resistance flow in the false lumen of a dissection
High
119
What’s the time difference between a RINd and a TIA
TIA lasts up to 24 hours
RIND lasts longer than 24 but will resolve
120
If a patient comes in and has left sided weakness and they suspect a stroke, what hemisphere would be effected
The right side because hemispheric symptoms are contralateral
121
If an ICA embolizes to the ANTERIOR CEREBRAL ARTERY, the (leg /arm) is more affect
Leg
122
If an ICA lesion embolizes to the MIDDLE Cerebral ARTERY; the (arm/leg) would be more affect
Arm
123
What are the 5 Ds for vertebrobasilar lesions (think of the circle of Willis that’s at the posterior portion of the brain)
```
Dizziness
Ataxia (lack of muscular coordination)
Drop attack
Dyslexia
Diplopia double vision.
```
124
If a patient comes in complaining of “fleeting vision” what is that called and what’s it mean
Amaurosis FUgax
Transient loss of vision in one eye
If we see a right ICA embolus to the RIGHT opthalamic artery would result in RIGHT amaurosis fugax
125
If a patient loses the right field of view in BOTH eyes, that’s called?
Homonymous hemianipia
126
If we hear bruits in multiple areas (carotid , subclavian) what should we suspect?
Cardiac source disease
127
What is the temporal tap?
It helps differentiate the ica with the eca.
Tapping on the temporal artery can create oscillation of the ECA
128
In carotid scanning ,
An END diastolic velocity of 140 or greater indicates what?
80% or more
129
Is subclavian steal more common the left or the right?
Left
130
If a patient has an ICA/ECA ratio higher than 4.0 and is symptomatic, he need an endarectomy
True
131
The opthalmaic artery branches off the terminal____
Ica
132
Tamv is used not the PSV in TCDs.
True
133
Brain death is apparent when we see that the ICA MCA AND ACA All have high resistive To no flow.
True
134
If there’s a collateral pathway between the external carotid and the internal carotid, there would be retrograde flow in the ____ artery
Opthalmaic
135
normally, ankle systolic pressure is _____ (greater or lesser) than the brachial pressure?
GREATER THAN OR EQUAL TO
136
When a patient has medial calcinosis, how can this affect segmental pressures?
it will create falsely elevated pressures. This is often seen in diabetics
137
Where should we put the cuff bladder when doing segmental pressures?
over the artery so inflation quickly transmits the pressure into the tissue to compress the artery.
138
Does the three cuff method follow the 20% rule when it comes to segmental pressures?
YES
139
Does the four cuff method follow the 20% rule when it comes to segmental pressures?
NO. It artificially has higher elevated pressures (around 30 mm/hg higher.
140
In what order should we do segmental pressures?
Arm, ankle, calf above knee and then thigh. If we do this out of order it may affect and give us incorrect segmental pressures.
141
A pressure gradient of 20-30 mmhg or greater in a leg segmental pressure indicates what?
(when doing segmentals)
ABNORMAL ABI, proximal obstruction
142
When doing an upper exremity segmental pressure, what is the abnormal pressure gradient?
15-20 or greater is abnormal
143
What is pseudo-claudication?
things such as neurospinal compression or arthritic pain on exertion...basically its not due to arterial disease, but something else therefore PSEUDO.
144
Exercise testing allows differentiation of vasculogenic claudication from PSEUDO claudication... true or false?
TRUE
145
What are a few reasons why we WOULDNT do exercise testing when doing segmental pressures?
an ABI of < 0.3 (severe disease is evident no need for exercise)
shortness of breath, hypertension
ISCHEMIC ULCERATION
POOR AMBULATORS
If rest of study is normal and symptoms are only "resting" symptoms
146
When doing exercise testing for segmental pressures, we like to evaluate how long it takes the segmental pressures to get back to normal...
if it takes 2-6 minutes for patients pressures to go back, this indicates...?
single level disease
147
When doing exercise testing for segmental pressures, we like to evaluate how long it takes the segmental pressures to get back to normal...
if it takes 6-12 minutes for patients pressures to go back, this indicates...
multi-level disease
148
What is post-occlusive reactive hyperemia? (PORH)
this is alternative method instead of doing the "exercise portion" of an ABI/ segmental pressures.
149
What is considered an abnormal Penile Brachial Index?
less than 0.6
150
If a patient with Leriche syndrome ( aortoiliac obstruction) what could this do to the inflow to the penis?
limit the amount of flow going to the penis. Iliac artery disease.
151
If a patient has an abnormal Penile brachial index, what can this indicate?
obviously limited flow to the penis, but this usually indicates aorto-iliac disease.
152
WHat vessel is the main supplier of an erection ( THIS WAS ON THE REGISTRy but not in edelman book)
Internal pudendal artery
153
Explain the process of doing a penile brachial index scan. Which arteries are imaged?
The cavernosal artery AP diameter is measured, as well as PSV/EDV,
The penis is enjected with a vasodilator, and an erection is induced.
Measrment of cavernosal artery is again looked at as well as the DORSAL vein flow
154
The dorsal vein is only measured before the penile brachial index scan, not after.
T/F
FALSE. we scan the cavernosal artery first, then the dorsal vein after the erection is induced by the physician.
155
When doing a penile brachial index scan, should the cavernosal arteries increase or decrease after post injection ?
INCREASE by greater than 30 cm/sec
156
If the dorsal vein velocities increase in a penile brachial index, that is suggestive of a venous leak
True
157
What is thoracic outlet syndrome a result of?
an extra cervical rib or an old fracture of the collarbone that reduces the space for the vessels and nerves.
158
What are the common symptoms of thoracic outlet syndrome?
numbness, tingling, pain/aching of the shoulder and arm which is worse when they raise their arm
159
What is popliteal artery entrapment syndrome (PAES)?
a SYMPTOMATIC compression or occlusion of the popliteal artery due to an abnormal relationship with the medial head of the gastrocnemius.
160
If a 28 year old male basketball player comes in complaining of intermittent claudication, what should we suspect?
POPLITEAL artery entrapment syndrome
161
If left untreated, popliteal artery entrapment syndrome can lead to??
stenosis, aneurysm or thrombus formation
162
What kind of patients typically have buergers disease?
40 year old male who heavily smokes
163
What are the symptoms of buergers disease?
affects the small vessels in the upper and lower extremities.
foot ischemia, rest pain or ulceration
164
Does takayasu arteritis affect larger vessels or smaller vessels?
larger such as aorta and its branches
165
What would a patient with takayasu arteritis complain of?
pulseless disease
no pulse in the upper extremities as well as renal hypertension if renal is affected.
166
if gone untreated, temporal arteritis can leave a patient blind.
True or False
True
167
What is the most common site for a pseudoaneurysm?
CFA because it often used for arterial access
168
Describe a pseudo aneurysm
A defect of hole in the arterial wall typically from trauma. Not an actaul real aneursym bc it doesn't involve all three layers
169
What is the typical treatment for a pseudo aneursym?
Ultrasound Guided Thrombin- Puts thrombin into the PSA sac and slowly injects until the thrombosis occurs.
170
What is an arteriovenous fistula?
abnormal connection between the high pressure arterial system and the low pressure venous system
171
Why is an arteriovenous fistula near the heart most dangerous?
increased risk for cardiac failure
172
What are some symptoms of compartment syndrome?q
tenderness pain, paresethesia and foot drop.
173
Why does compartment syndrome occur and what can be done as treatment?
occurs when excessive pressure builds up inside the compartments of muscles--can lead to death
Fasciotomy is when the fascia is cut to relieve tension or pressure .
174
What is the point of the allen's test?
to determine patency of palmar arch
175
explain how the allen's test works
manually compress the radial and ulnar, patient makes fist then releases so hand appears blanched.
176
Normal color should return in around 10 seconds when doing the allen's test
True or False
True
177
Radial artery mapping studies are often done to determine suitability for us as a graft for what type of bypass?
coronary artery bypass
178
What should the radial artery measure when doing a radial artery mapping study?
greater than 2 mm
179
Epigastric artery mapping is used to identify adequate arterial supplied muscle section for what type of procedure?
autogenous breast reconstriction.
180
The internal mammary artery arises off the arch of what artery?
subclavian
181
For what instance would we do an internal mammary artery mapping ?
often used to do the TRAM flap for autogenous breast reconstriction AND coronary bypass grafting.
182
In the upper arm, when we are doing a mapping of the basilic and cephalic arteries, what should they measure to fit criteria for surgery?
2-3 mm
183
If we get a patient that comes in with crampy abdominal pain 15-30 minutes after eating is suspected for what disease?
mesenteric ischemia due to stenosis or occlusion limiting the blood flow necessary needed to aid in digestion.
184
If we see a large inferior mesenteric artery, what should w esuspect?
collateralization!
185
What are the two possible connections between the sma and ima?
1) marginal artery of colon
| 2) Arc of Riolan
186
The IMA often severes as a collateral to the iliac arteries via branches of the ____ artery
internal iliac artery
187
What is arcuate liagment compression surgery what is it often called?
often called celiac axis compression syndrome
compression of celiac artery origin by median arcuate ligament of the diaphragm.
188
Whats the main reason we would do the renal artery stenosis studies
hypertension
189
What is arcuate ligament compression syndrome?
compression of the celiac artery by the median arcuate ligament of the diaphrag
190
Explain the process of arcuate ligament compression. How is it resolved, what symptoms
Clinically we wil feel an abdominal bruit that goes away with deep breaths
When we expire, thats when the stenosis occurs, and the diaphragm compresses the celiac and makes it have an S shape. Spikes the PSV high abot 200 cm/sec
When we take a deep breath in, it releases the comperssion and the celiac goes back to normal.
191
Why does renal artery stenosis cause renovascular hypertension?
The RAS causes the release of renin causing vasoconstriction and high blood pressure. This results in RENAL FAILURE.
192
If a patient has renal artery stenosis, where is most of the disease originate from?
@ origin of vessel
193
When it comes to acceleration time in a RAS stidy, what is considered normal and abnormal?
Normal - LESS THAN 100 milliseconds
| Abnormal GREATER than 100 milliseconds
194
Where do we take the acceleration time in regards to a RAS study
At the distal renal artery
195
Transplant kidneys are usually anastomosed to what vessel?
External or internal iliac
196
What name describes a radial artery to cephalic vein fistula?
Breccia-cemino fistula
197
How does native autogenous fistula work?
They Create a connection between a artery and vein. The vein will dilate in response to the arterial pressure
198
If we feel a bruit or thrill on a dialysis grafts what should we think?
Trick question! This is normal and a dialysis access graft
199
Where do most stenosis happen in a hemodialysis graft?
The outflow vein or anastomoses point
200
The first beach off the ECA is the
Superior thyroid artery
201
Fatty streak atherosceloric plaque is also called
INtimal thickening
202
Rare condition resulting in abnormal growth in the walls of medium and large arteries
Fibromuscular dysphasia
203
Which vessel is fibromuscular dysphasia often seen in?
Distal ICA. In women 40-60
204
If a Patient had an. Endarectomy and comes in for a carotid ultrasound 6-24 months later, what is a complication we may see?
Neointimal hyperplasia
205
When a Patient has a carotid body tumor where would this be located and what vessel may have decreased resistance due to the vascularity of the tumor?
Located At the bifurcation splaying the ICA and EcA. The ECA have decreased resistance due to feeding the tumor
206
A TIA stroke lasts how long?
Less than 24 hours
207
A RIND stroke lasts longer than ___ hours
24 hours
208
If the anterior circulation of the circle of willis is affected (ICA, MCA, ACA, AComm) what type of symptoms will a patient preent with?
weakness, inability to speak, difficulty with speech, tingling, pins and needles
209
Hemispheric symptoms pertaining to strokes are often contralateral. The right side of brain controls the left and the left side of brain controls the right.
T?F
True
210
If there is a lesion affecting the posterior circulation (for strokes), what type of symptoms may occur?
dizziness, lack of coordination, double vision, fall, dyslesxia
211
Sayyou have a stroke patient with left sided loss of vision. Where would you suspect an embolus to be?
RIght side of brain? or Left
right. vision symptoms are usually ipsilateral.
212
When imaging a carotid stenosis, what PSV / EDV is considered 50-70% stenotic?
greater than 125 systolic
| lessthan 140 diastolic
213
When imaging a carotid stenosis, what PSV/EDV is considered 80%
Greater than 125 systolic and greater than 140 diastolic
214
What is the first branch off the subclavian?
vertebral
215
What is an endarterectomy used for?
surgical procedure in which artery is isolated and open, plaque from carotid is removed and suttered closed.
216
What is the process of an arteriography?
contrast is inserted through a catheter that was placed in the vessel of interest. This can determine if there is a filling defect.
217
Where is a vasospasm often seen in the circle of willis?
MCA with a mean velocity of greater than 120.
218
What is a "cross over" collateral pathway in the circle of willis?
antegrade flow in the ACA ( supposed to be retrograde bc its going away from transducer), this happens because flow from the contralateral ACA collateralized from the Acom artery
219
What is an external carotid to internal carotid collateral pathway?
Retrograde is seen in the opthalmic artery..
this is because the opthalmic artery is the first artery in the terminal ICA.
220
What is a "posterior to anterior " collateral pathway?
increased flow in the PCA with reversed flow in the posterior communicating artery.
221
IF we see a cross over collateral pathway, where should we suspect theres an occlusion?
ICA occlusion on the contralateral side.
222
Usually blood flows from anterior hemisphere to posterior hemisphere- so if we see reversed flow in the PCA or PComm , that is abnormal. True or False
True
223
Mean velocity over 120 in the MCA indicates what?
vasospasm
224
micro-emboli in the brain is often called HITS, which stands for?
high intension transient signals
225
Where do micro-emboli in the brain often come from?
either carotid or cardiac sources.
226
What is the foramen ovale?
is a hole between the right and left atrium, often closes at birth.
227
What is a patent foramen ovale?
source of emboli from an open hole from the right and left atrium that was supposed to close at birth.
228
syndrome in which there is acompression of the iliac vein
MAY - THURNER syndrome.
229
The innominate vein is formed by what two vessels?
subclavian and IJVs
230
What is klippel trenaunay?
multiple surficial varicosities and incomplete deep system
231
What is the differencde between primary and secondary chronic venous insufficiency?
primary has a normal deep system but irregular superficial vein
secondary has an abnormal superficial and deep syste
232
what is phlegmasia cerula dolens? Does this pertain to arteries or veins?
MILK LEG. means there is compromised arterial flow
233
What is phlegmasia cerula dolens?
bluish discoloration due to severely limited venous outflow.
234
Brawny skin changes can be related to arterial and venous disease.
True or False
NOPE brawny skin is related to venous disease.
