Quiz 1 - Carotid Protocol, Pt Care, Sono Care, Cerebriovascular Symptoms Flashcards
With a suspected carotid artery stenosis, what should you do if the lumen is very narrow?
Open up sample gate
ICA waveform (5)
Low resistant, low pulsitility Rounded peak on systole Systolic window High diastolic flow Away from the baseline
CCA wall thickening of ____ is normal
<0.9 mm
Document in your report (5)
Wall thickening in CCA with measurement <0.9 mm is normal Location of plaque Thickness of plaque Degree of luminal reduction Plaque morphology (grey scale is better)
ECA recognition vs ICA (5)
Smaller than ICA Always branches Anterior towards face High resistance waveform Responds to temporal tap
ECA waveform (4)
High resistance, mod pulsatility
Sharp upstroke
Closer to baseline
Low diastolic flow
Transducer position that best visualizes carotid bifurcation and ICA
Posterolateral approach
The temporal tap identifies which vessel?
ECA
What is a normal waveform for the SCA? What is a pathological sign?
Normal - triphasic, high resistant
Path - low resistant/damped monophonic
ICA recognition vs ECA (5)
Larger No branches Deep and posterior Low resistance waveform Does not respond to temporal tap
Vertebral artery evaluation
3
Longitudinal image between transverse processes of vertebral bodies
PSV measurement
Direction of flow to R/O SSS
Important history questions (9)
Previous stroke/TIA Smoker High BP Cholesterolemia Sudden headaches Diabetes Dizziness Amaurosis faugax Weakness
Carotid artery scan indications (6)
Stroke Bruit Headaches Weakness F/U carotid exam Surveillance post endarterectomy/stent
T/F a carotid protocol is always bilateral
True
If the patient has subclavian steal (4)
Bilateral brachial systolic measurements
The side with the inn/subclavian stenosis will have lower pressure
Damped/monophonic flow
40 mmHg difference between arms (reverse flow) - 20 mmHg it’s bidirectional
T/F
TIA affects opposite of the brain except amaurosis fugax
True
RIND stands for
What does it mean
Reversible Ischemic Neurological deficit - Sx lasting >24 hr, resolves thereafter
SYMPTOMS of potential stroke (6)
Dizziness Syncope Numbness affecting tongue, face, with hemiparesis Slurred speech/aphasia Headaches
The most cause of stroke is infarction of ______
MCA - middle cerebral artery
Endarterectomy
Surgically removes art hero atoms plaque, reduces risk of stroke
Artery narrowed >70% + pt symptomatic CEA recommended
Compare vertebrovascular (posterior circulation) TIA symptoms VS carotid (anterior circulation) TIA symptoms
Posterior: BILATERAL motor/sensory deficits
Anterior: UNILATERAL motor/sensory deficits
Non-surgical methods for treating carotid atherosclerosis includes (2)
What are the risks
Balloon angioplasty and atherectomy
Acute embolization secondary to these procedures
