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DMS 500 Vascular > Lecture 6: Carotid Pathology > Flashcards

Lecture 6: Carotid Pathology Flashcards

1
Q

stroke is the leading cause of permanent disability. T/F?

A

true

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2
Q

what is another name for transient ischemic attack?

A

mini stroke

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3
Q

what is a ministroke?

A

it is a neurological ischemic deficit that reverses within 24 hours (usually minutes)

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4
Q

which part of the brain does a TIA affect?

A

anterior circulation

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5
Q

what causes a mini stroke?

A

a temporary clot in the artery but will dissolve within 24 hours

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6
Q

what is the risk of getting a stroke after a TIA in 3 months?

A

10% increased risk

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7
Q

what is the risk of getting a stroke after a TIA within 5 years?

A

increased 17x

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8
Q

4 S&S of TIA?

A
  1. amaurosis fugax
  2. dysphasia/aphasia
  3. contralateral hemiparesis/monoparesis
  4. behavioral disturbances
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9
Q

what does RIND stand for?

A

reversible ischemic neurological deficit

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10
Q

what is RIND?

A

a neuro deficit that lasts more than 24 hours but less than 72 hours

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11
Q

patients get a sudden onset of symptoms with RIND. T/F?

A

true

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12
Q

what is amaurosis fugax?

A

transient blindness in one eye

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13
Q

what is the normal duration for amaurosis fugax?

A

transient – seconds to minutes

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14
Q

what causes amaurosis fugax?

A

a temporary blockage of small blood vessels in the eye

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15
Q

where is disease located when a patient has amaurosis fugax?

A

disease will be on the ipsilateral side as the affected eye

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16
Q

what is bruit?

A

an abnormal low rumbling sound heard on the stethoscope over the carotid artery

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17
Q

what causes a bruit?

A

blood rushing over an obstruction

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18
Q

2 normal reasons for a bruit

A
  1. bifurcation of CCA
  2. tortuous
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19
Q

what is aphasia?

A

unable to speak

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20
Q

what is dysphasia?

A

difficulty speaking

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21
Q

what is dysarthria?

A

slurring & speech distortion due to lack of muscle control

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22
Q

what is lateralized paresthesia?

A

numbness or tingling usually in the extremities

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23
Q

what is hemiparesis?

A

weakness on one side of the body

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24
Q

which hemisphere is affected when a patient has aphasia or dysphasia?

A

left hemisphere

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25
Q

which hemisphere is affected when a patient has dysarthria?

A

either left or right

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26
Q

which hemisphere is affected when a patient has lateralized paresthesia or weakness?

A

either left or right

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27
Q

which hemisphere is affected when a patient has hemiparesis?

A

the contralateral hemisphere of the side being affected

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28
Q

what does VBI stand for?

A

vertebro-basilar insufficiency

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29
Q

what is VBI?

A

when there is a disturbance in the flow of blood in the vertebral or basilar arteries

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30
Q

which part of the brain does VBI affect?

A

posterior circulation

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31
Q

what is the most common symptom of vertebro-basilar insufficiency?

A

vertigo

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32
Q

what is ataxia?

A

loss of muscle coordination

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33
Q

the following are S&S of what neurological disorder?
1. vertigo
2. ataxia
3. weakness in limbs
4. drop attacks
5. paresthesia
6. visual disturbances
7. numbness around lips & mouth

A

VBI

34
Q

what is syncope?

A

fainting due to ischemia of brain

35
Q

what is the duration of a stroke in evolution?

A

72 hours - 2 weeks

36
Q

what is another name for a complete stroke?

A

cerebrovascular attack (CVA)

37
Q

how is smoking a predisposing factor for strokes?

A

smoking irritates the endothelium lining, which can slough it off and lead to stroke

38
Q

how is hypertension a predisposing factor for strokes?

A

hypertension irritates the endothelium lining, which can slough it off and lead to stroke

39
Q

how does diabetes increase the risk for stroke? (2)

A
  1. diabetes increases the risk for hypertension, a predisposing factor for stroke.
  2. diabetes also increases the chance for atherosclerosis
40
Q

females are more likely to have strokes than men. T/F?

A

false – men are 1.5x more likely to have a stroke

41
Q

what age group is more at risk for strokes?

A

60+ years old

42
Q

why is obesity a predisposing risk factor for strokes?

A

increased chance of atherosclerosis

43
Q

how does birth control increase the chance for a risk of stroke?

A

increased estrogen use may lead to blood clots

44
Q

what is polycythemia vera?

A

increased RBCs

45
Q

how can polycythemia vera increase the chance for stroke?

A

increased RBC –> increased blood viscosity –> increased chance for arteries getting blocked

46
Q

what is hyperlipidemia and how does it increase the risk for stroke?

A

it is an increase cholesterol & triglycerides in your blood – increases the risk of plaque being deposited in your arteries

47
Q

what are the 3 types of CVA?

A
  1. cerebral thrombosis
  2. cerebral embolism
  3. hemorrhage
48
Q

what is a cerebral thrombosis?

A

a blood clot within the brain’s arteries

49
Q

what is cerebral embolism?

A

when an embolus blocks the brain’s arteries

50
Q

what can an embolism be?

A

solid, liquid, or a gas

51
Q

what is a hemorrhagic stroke?

A

when a blood vessel ruptures, leading to bleeding within or over the brain surface

52
Q

what is the most common type of stroke? how often does it occur?

A

cerebral thrombosis causes 40-50% of strokes

53
Q

what is the 2nd most common type of stroke? how often does it occur?

A

cerebral embolism causes 30-35% of strokes

54
Q

how often do hemorrhages cause strokes?

A

20-25%

55
Q

what are 2 complications of strokes?

A
  1. pneumonia
  2. DVT
56
Q

how can pneumonia be a complication of stroke?

A

patient age & immobility can cause pneumonia

57
Q

how can DVT be a complication of stroke?

A

patient is immobile –> thrombus formation in veins of legs

58
Q

where do atypical carotid disease conditions occur in relation to the circle of willis?

A

they occur before the circle of willis, but there is still stenosis/ischemia somewhere

59
Q

what is carotid artery aneurysm?

A

rupture of a dilated carotid artery

60
Q

carotid artery aneurysms are common. T/F?

A

false – they are rare

61
Q

the following are causes of which atypical disease?
1. congenital weakness
2. trauma
3. infection
4. atherosclerosis

A

carotid artery aneurysm

62
Q

what is fibromuscular dysplasia?

A

an atypical carotid patho – dysplasia of media leads to overgrowth of collagen within the media

63
Q

are women or men more at risk for FMD? why?

A

women due to more collagen production

64
Q

how does FMD look like on angiography?

A

bead-like

65
Q

what is a carotid body tumor?

A

a very vascular tumor between the ECA & ICA

66
Q

how can a carotid body tumor become vascularized?

A

ECA & sometimes ICA develop branches to feed it blood supply

67
Q

what is the treatment for a carotid body tumor?

A

surgical

68
Q

a carotid body tumor functions as a ____

A

chemoreceptor

69
Q

what is a carotid dissection?

A

a type of aneurysm where the intima and media are separated due to a tear in the lumen –> separate flow channel in the wall of the artery

70
Q

where does a carotid dissection typically occur?

A

proximal & distal ICA

71
Q

the following are causes to which type of atypical carotid pathology?
1. FMD
2. congenital weakness of media
3. trauma to neck
4. chiropractic treatment
5. idiopathic

A

carotid dissection

72
Q

how do anti-hypertension drugs help treat carotid patho?

A

by decreasing the force of blood on the endothelium

73
Q

what are two anticoagulants you can take to help treat carotid patho?

A

aspirin
persatine

74
Q

what is an endarterectomy?

A

a surgical procedure where the artery is opened to remove atherosclerosis

75
Q

why is endarterectomy not performed on patients with 100% occlusion of CCA or ICA?

A

if the patient is still alive not symptomatic, it means collaterals have successfully formed

76
Q

how is the artery kept open after closing an endarterectomy?

A

surgeon places stent in artery

77
Q

what is a bypass graft?

A

a surgical intervention where an alternative pathway around a stenosis is created using part of body’s vein or a synthetic material

78
Q

which artery is a bypass graft more commonly used for?

A

prox CCA

79
Q

why might surgical intervention be done for coiling, kinking, or tortuosity of a vessel?

A

shortening the vessel decreases the risk for ischemia

80
Q
A

DMS 500 Vascular (20 decks)

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