Brainscape's Knowledge GenomeTM

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


See full index

Vascular > Quiz 3 (vessel recognition) > Flashcards

Quiz 3 (vessel recognition) Flashcards

1
Q

what is the intimal wall thickness?

A

less than or equal to 0.9

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

what axis is the intimal wall thickness measured?

A

longitudinal image (SAG)

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

specular reflection

A

Demonstrate a sharp line that emanates from the intimal surface

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

what is the black line on an carrotid on a SAG image indicate?

A

tunica media

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

what does the outermost white line on a SAG carotid artery indicate?

A

tunica adventitia

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

what are the characteristics of low pulsatility?

A
  • broad systolic peak
  • forward flow throughout diastole
  • always completely above or below baseline (depending on direction of flow)
  • low peripheral resistance flow as in the carotid, vertebral, and renal arteries
  • monophasic waveform
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the characteristics of moderate pulsatility?

A
  • tall and sharp systolic peak
  • forward flow through all of diastole
  • diastolic flow is relativity less than seen in low pulsatility waveforms
  • flow is typically seen ECA
  • dicrotic notch is found
  • temporary cessation of forward flow
  • biphasic waveform
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what does the ECA supply?

A
  • face and neck

- SMA during fasting

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

what is the dicrotic notch?

A

transition from systole to diastole. It is a normal finding that represents the closure of the aortic valve

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

what is the dicrotic notch thinking about flow?

A

temporary cessation of forward flow followed by resumption of forward flow driven by the elastic rebound of the arterial wall

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

what are the characteristics of high pulsatility?

A
  • narrow, tall, sharp, systolic peaks
  • brief flow reversal, then brief flow reversal
  • triphasic waveform
  • typically seen in resting state peripheral arteries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

monophasic waveform

A

all flow is above baseline

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

biphasic waveform

A

single antegrade and single retrograde

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

triphasic waveform

A

flow is systole is above baseline then reversed segment in diastole below baseline and third component of diastolic flow above the base line

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

what is the CCA identity?

A
  • moderate pulsatility
  • close to baseline
  • low diastolic flow
  • sharp upstroke
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how do you locate the CCA?

A

place probe TRV on the anterolateral neck at the level of the thyroid. It is seen lateral to the lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are the characteristics of the ICA to differentiate it from the ECA?

A
  • lower pulsatiity
  • rounded peak window
  • high diastolic flow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

wat are the characteristics of the ECA to differentiate it from the ICA?

A
  • higher pulsatility
  • higher upstroke
  • closer to baseline
  • lower diastolic flow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

how do you locate the ICA and ECA?

A

follow the CCA upward in TRV. It will bifurcate into ECA and ICA. The vessel with the bulb is ICA-lateral. The vessel that is narrower is ECA-medial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are the characteristics of the vertebrals?

A
  • low pulsatility
  • similar to ICA with lower velocity
  • forward flow throughout diastole
  • travels cephalad through transverse foramina of C6 to C2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

how do you locate the vertebral artery?

A
  • find the CCA sagitally in anterolateral plane
  • angle probe laterally slowly until vertebrals bodies are seen
  • the artery and vein will be seen within gaps of vertebrae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

where is the subclavian located?

A

posterior to clavicle

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

what are the characteristics of the subclavian artery?

A
  • high pulsatility, high resistant signal
  • sharp systolic upstroke
  • triphasic signal
  • reverse diastolic component
  • forward diastolic component
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

describe the appearance of the monophasic arterial flow?

A
  • spectrum is completely above baseline
  • systolic and diastolic portions
  • flow does not touch baseline (0)
  • good example is the low resistant ICA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

describe the appearance of the biphasic arterial flow?

A
  • all systolic portion is above baseline
  • diastolic flow crosses the baseline and is below it
  • high resistance flow pattern since flow reaches 0 and has negative component
  • good example is abnormal triphasic waveform
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

describe the appearance of the triphasic arterial flow?

A
  • systolic phase is above baseline
  • first diastolic component is below baseline
  • third component of diastolic flow is above baseline
  • high resistant flow patterns
  • good example is subclavian and femoral arteries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what does some abnormal flow pattern signify?

A
  • approaching stenosis
  • stenosis
  • post stenosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what are some abnormal flow patterns?

A
  • internalization of ECA-antegrade ECA
  • —(CCA occlusion/ICA occlusion)
  • externalization of CCA
  • Thud flow
  • Tardus Parvus waveform
  • severe aortic regurgitation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is the difference between 2 waveforms when they are both low resistant and one has a clean window and one does not?

A

clean window is larger superficial artery such as CCA and broadened is deeper vessels such as renal artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what is a stenosis?

A

narrowing of the arterial lumen, causing a hemodynamically significant change in flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what may happen if an stenosis or occlusion occurs?

A

collateralization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

where does plaque commonly form and what does it involve?

A

Common carotid bifurcation and it involves the:

  • distal CCA
  • prox ECA/bulb
  • prox ICA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what is plaque categorized as?

A
  • homogenous
  • soft
  • heterogenous
  • ulcerated
  • calcified
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Plaque should be carefully evaluated to determine the:

A
  • extent
  • location
  • surface contour
  • texture
  • assess degree of luminal stenosis
  • evaluate in SAG and TRV
  • use gray scale ultrasound
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

CIMT

A

intima-media thickness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what is plaque a combination of?

A

increased thickness of intima-media layers and by echogenic material that encroaches on the lumen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

plaque characterization-homogenous

A

-uniform and smooth surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

plaque characterization-calcified

A

produces posterior acoustic shadowing (asymptomatic patients)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

plaque characterization-heterogenous

A

complex echo pattern-contains one or more sonolucent areas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

plaque characterization-ulcerated

A
  • focal depression or break in plaque surface

- irregular border contour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

fibromuscular Dysplasia

A

growth of cells in walls causing narrowing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

carotid pseudoaneurysm

A

collection of blood between media and adventisa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

carotid/vertebral artery dissection-intimal flap

A

flap in lumen, separation of wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

takayasus, temporal and giant cell arteritis

A

inflammation of vessel walls, lumen gets narrow (chemo)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Raynaud’s phenomenon

A

blood flow is reduced to fingers and toes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Carotid body tumor

A

at bifurcation tumor causes widening and highly vascular and usually benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

thoracic outlet syndrome

A

compression of nerves, arteries, or veins from extra cervical rib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

endarterectomy

A

surgical treatment for stenosis (peel plaque off)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

carotid setting

A

go through artery and place stent in narrowing and widen back up

50
Q

what is the gray scale characteristics of vessel?

A
  • normal carotid has smooth vessel walls
  • no appreciable plaque in lumen
  • intimal-media layer is clearly visable
  • uniform throughout vessel
  • lumen is anechoic
  • occasional reverberation artifacts in lumen because of IJV
51
Q

what are the grayscale images in TRV gray scale?

A
  • prox
  • mid
  • distal
  • bifurcation
  • prox ICA/bulb
52
Q

what are the grayscale images of SAG gray scale?

A
  • prox
  • mid
  • distal
  • bifurcation with ICA and ECA (or separate)
53
Q

what is the sonographers role of scanning carotids?

A
  • assessing lumen for presence of wall thickening and plaque
  • measuring the AP wall thickness
  • follow protocol for carotid
  • images are taken on the left and right side
54
Q

when using color doppler, which axis do we access first?

A

TRV

55
Q

how many axis do we take pictures with colour doppler?

A

2 (SAG and TRV)

56
Q

using duplex flow where do we assess flow?

A 
SCA 
-prox 
-mid
CCA
-distal
ECA (w temporal tap)
Bulb
ICA
-prox
-mid
-distal
57
Q

what do you do if you noticed a area of plaque?

A

run the doppler sample carefully through the potential stenosis

58
Q

where do you document increased doppler flow signal at levels of stenosis?

A
  1. proximal to stenosis (asses flow change)
  2. within stenosis (highest velocity)
  3. distal to stenosis (detect post stenotic turbulence)
  4. further downstream for tardus parvus waveform
59
Q

when measuring velocity within stenosis, how many samples do you take?

A

3

60
Q

what do you measure on all vessels?

A

-PSV (peak systolic velocity)
-EDV in ICA stenosis
for grading purposes

61
Q

how do you document vertebral artery?

A

flow and direction with triplex doppler

62
Q

what must be assessed if there is a reversal of flow in the vertebral artery?

A

ipsilateral (same side) SCA must be assessed for stenosis/occlusion
-also the ECA flow PSV

63
Q

where can the SCA be accessed?

A

level of superior clavicle in the mid portion

64
Q

what should the signal be in the SCA, INN A?

A

high resistant and triphasic

65
Q

what does the water hammer associate with?

A

aortic regurgitation

66
Q

what is subclavian steal syndrome?

A

blood in vertebrals retrogrades (reverses) flow

67
Q

if SCA stenosis or occlusion is suspected then what do we access?

A

vertebral artery for subclavian steal syndrome

68
Q

what is the average normal velocity in SCA?

A

140 cm/s

69
Q

what is the average normal velocity in CCA?

A

80-100cm/s

70
Q

what is the average normal velocity in ICA?

A

less than 125 cm/s

71
Q

what is the average normal velocity in ECA?

A

120 cm/s

72
Q

what is the average normal velocity in vertebrals?

A

20-60 cm/s

73
Q

signal nomenclature of SCA?

A

high resistant

high pulsatiity

74
Q

signal nomenclature of CCA?

A

mix of ECA and ICA

medium pulsatiity

75
Q

signal nomenclature of ICA?

A

low resistant

low pulsatiity

76
Q

signal nomenclature of ECA?

A

high resistant signal

high pulsatility

77
Q

signal nomenclature of vertebral?

A

low resistant

low pulsatility

78
Q

grading ICA stenosis-normal

A

less than 125 cm/s

minimal or no spectral broadening

79
Q

grading ICA stenosis-1-15%

A

less than 125 cm/s

spectral broadening during deceleration phase of systole

80
Q

grading ICA stenosis-16-49%

A

less than 125 cm/s

spectral broadening throughout systole

81
Q

grading ICA stenosis-50-79%

A

greater or equal to 125 cm/s with end diastolic less than 140 cm/s
-marked spectral broadening

82
Q

grading ICA stenosis-80-99%

A

greater than 125 cm/s with end diastolic greater than 140 cm/s
-marked spectral broadening

83
Q

grading ICA stenosis-occlusion

A

no signal

84
Q

does ECA have little or lots of diastolic flow?

A

little diastolic flow

85
Q

does ICA have little or lots of diastolic flow?

A

high diastolic flow

86
Q

where is low resistant flow in the body?

A

cephalad (towards head or superficial) throughout cardiac cycle

87
Q

what does high resistant waveform look like?

A

flow-forward flow in systole-low or reversed in diastole and third component forward flow above the baseline

88
Q

does areas having high metabolic flow need low or high resistant flow?

A

low resistant flow

89
Q

what factors affect ICA waveform?

A
  • atheroma/plaque
  • tortuosity
  • aortic valve disease
  • aortic arch/innominate disease
  • distal carotid siphon disease
  • intracranial vessel disease
  • contralateral carotid occlusion
  • high cardiac output states
90
Q

what are some problems and pitfalls of waveform?

A
  • Incorrect doppler sample volume(gate) position or size
  • Doppler angle too large > 60 degrees
  • Doppler settings too high for low velocity, low volume flow
  • Tortuous vessels
  • High grade stenosis
  • Calcified plaque
91
Q

how do you make sure you have the correct sample volume setting?

A
  • Sample volume with angle correct at 60 degree
  • Located centrally within vessel and parallel to walls
  • Color flow box angled correctly
  • Spectral waveform set correctly with baseline and velocity scale
92
Q

where is a lumen with plaque measured?

A

in TRV

93
Q

what are causes of pulsatile neck masses?

A
  • Normal but prominent carotid artery bulb
  • Ectatic carotid,brachiocephalic or subclavian artery
  • Aneurysm of carotid artery
  • Carotid body tumor
  • Enlarged lymph node adjacent to carotid sheath
94
Q

atherosclerosis

A

a chronic progressive disease

95
Q

what does plaque of atherosclerosis consist of?

A

deposits of cholesterol and other lipids, calcium and large inflammatory cells called macrophages

96
Q

plaque

A

sticky yellowish deposits

97
Q

what problems can plaque cause?

A
  • protrude into the artery causing a partial or complete obstruction to flow
  • rupture causing a thrombus to form
  • weaken the wall and cause aneurysm
98
Q

atherosclerosis coronary arteries

A

angina, heart attack

99
Q

atherosclerosis cerebrovascular circulation

A

stroke

100
Q

atherosclerosis renal arteries

A

kidney disease

101
Q

atherosclerosis aorta

A

aortic aneurysm

102
Q

atherosclerosis peripheral arteries

A

leg claudication (pain when walking)

103
Q

what are risk factors for atherosclerosis?

A
  • smoking
  • Hyperlipidemia
  • Hypertension
  • Diabetes
  • Obesity
  • Fam history
  • Psychosocial factors
  • unhealthy diet
  • gender
  • age
104
Q

what high blood pressure can lead to the heart working harder and harm the arteries?

A

over 140/90mm

105
Q

what is normal blood pressure?

A

120/80mm

106
Q

how does smoking effect your arteries?

A

nicotine and carbon monoxide in cigarette smoke damages the epithelium

107
Q

hyperlipidemia

A

elevated levels of cholesterol and triglycerides in the blood damages the epithelium

108
Q

what do most diabetics die from?

A

heart attacks caused by atherosclerosis

109
Q

what is the good cholesterol?

A

High Density Lipoprotein-HDL

110
Q

what is the purpose of HDL?

A

maintains the inner walls-endothelium of blood vessels

111
Q

what is good levels of HDL?

A

over 60mg/dl

112
Q

what is the bad cholesterol?

A

Low Density Lipoprotein-LDL

113
Q

why is LDL bad?

A

deposits in the walls of arteries and over time grows into plaque

114
Q

what is plaque made up of?

A

cholesterol, cells, and debris

115
Q

why is obesity a risk factor for atherosclerosis?

A

excess weight strains the heart and increases the risk

-associated with high triglycerides and cholesterol

116
Q

what are the signs of a heart attack?

A
  1. chest discomfort
    -pressure, squeezing, fullness, or pain, burning or heaviness
  2. discomfort in the upper body
    -neck, jaws, arms, and back
  3. shortness of breath
    4.sweating
    5.nausea
    6.light headedness
    CALL 911
117
Q

what is the leading cause of death in the US?

A

heart disease

118
Q

what is the second leading cause of death in the US?

A

cancer

119
Q

what is the third leading cause of death in the US?

A

stroke (secondary to atherosclerosis)

120
Q

what is another name for stroke?

A

cerebrovascular accident (CVA)

121
Q

what are the levels of LDL?

A

greater than 160 mg/dl is too high

Vascular (10 decks)

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