RAB: Brant Ch 54 Vascular Ultrasound Flashcards
This happens with high-velocity blood flow and improper velocity scale and baseline settings.
On spectral display, they are seen as a “wraparound” of peak velocities to the opposite end of the scale
Aliasing
right CCA arises from the bifurcation of the _____ artery
Inominate artery
[aka brachicephalic artery or trunk]
True of Common Carotid artery [CCA]
1. Ascend antero______ up the neck, medial to the jugular vein, and lateral to the thyroid.
2. Each CCA measures ___ mm in diameter
3. Three layers of normal vessel on UTZ:
A. ____intima
B. ____ media
C. _____adventitia
4. The distance between the two echogenic lines (intima-media thickness) is normally less than ___ mm.
5. The CCA dilates normally at the common carotid bulb and bifurcates into the ICA and ECA near the angle of the jaw
- Anterolaterally
- 6 to 8 mm in diameter
- Echogenic, hypoechoic, echogenic
- <1 mm
True of ECA (external carotid A)
- usually (70%) assumes an antero____ course off the carotid bulb.
- It overlaps the ICA in 20% of patients and is ___ to the ICA in 10%. 3. The ECA has branch vessels that supply the head and face.
- It measures ___ to ___ mm in diameter
- Anteromedial course (70%)
- Lateral to the ICA
- True
- 3 to 4 mm
True of ICA:
1. Assumes a ___ course off the carotid bulb
2. measures ___ to ___ mm in diameter.
3. The arterial wall between the ICA and ECA at their origin is the flow divider
- Posterolateral course
- 5 to 6 mm
- True
True of Vertebral Artery:
The vertebral artery (VA) arises as the _____ branch of the subclavian artery, ascends in the transverse foramen of vertebrae C6 to C2, and crosses the posterior arch of C1 to enter the foramen magnum and form the ____ artery
First branch;
Basilar
Carotid plaques are most comonly found within ___ cm of the carotid bifurcation.
Within 2 cm of the carotid bifurcation
An index of the presence of atheroscleros and a determinant of risk for stroke.
Initima-media thickness
[normal thickness <1mm]
This plaque has a lipid rich necrotic core covered by thin inflammed fibrous cap.
Plaque shows intimal neovascularity, fibrous cap fissures and high macrophage count.
Vulnerable plaque
True or False
Intraplaque HEMORRHAGE does not significantly change the echolucent appearance of the vulnerable plaque.
True. But it increases the risk of plaque rupture and stroke.
A severe complication of vulnerable carotid plaque.
increases the risk of thrombosis, carotid occlusion, embolism, and stroke
show an irregular plaque surface with focal depression
Plaque ulceration
A well established marker of significant cardiovascular disease
Calcification
Match the waveforms:
ICA, ECA, CCA, VA
A. Low resistance, high flow velocities maintained throughout diastole, provide constant BF to brain
B. HIgh resistance, sharp upstroke at onset of systole, little to no BF during diastole
C. systolic upstroke (straight arrow) is sharp, similar to the ECA. Forward flow is maintained at relatively high velocity throughout diastole (curved arrow) similar to the ICA. An early diastolic notch (arrowhead) is present similar to the ECA
D. low resistance similar to that of the ICA, with forward flow maintained throughout diastole (curved arrow
A - ICA
B - ECA
C - CCA
D - VA
Results from inominate or subclavian artery occlusion or severe stenosis proximal to the origin of the VA. In this circumstance, the ipsilateral upper extremity receives blood from the ___ through the circle of Willis and down the VA, partially or completely reversing its flow
Subclavian steal syndrome;
- UE receives blood from CCA
True of Abdominal Aorta
1. Enters the abdomen via ___ and descends to the left of midline anterior to spine
2. Bifurcates into B common iliac A at level of ___
3. Has ___ main branches
4. Proximal aorta measures ___ cm in men and ___ cm in women.
5. Spectral analysis: ___ waveform
- Aortic hiatus
- L4
- 5 main branches (3 ant, 2 lat; CA, SMA, IMA & RAs)
- 2.3 cm men, 1.9 women
- Triphasic
True of IVC:
1. As it reaches liver, it is cotained in deep groove on its _____ surface.
2. The hepatic veins enter the IVC from the _____ surface of liver
3. Spectral analysis of the IVC demonstrates the classic “______” pattern from cardiac and respiratory pulsations similar to the hepatic veins
4. Spectral pattern near common iliac veins is ___
- Posterior
- Posterior
- Sawtooth pattern
- Distally, more phasic pattern near common iliac
The left renal vein is ____ times longer than the right
Left renal V is 3x longer than right.
The renal veins are ____ to their corresponding arteries and enter the IVC at right angles.
Anterior
True of AAA:
1. More than 95% involve the ____ aorta.
2. AAA tht involve the ____ arteries are more difficult to repair.
3. Most are _____ and enlarge at a rate of 2 to 4 mm per year.
4. Surgery is recommended for size ___ cm
5. AAA is defined as focal enlargemetn of aorta greater than ___ cm in AP diameter.
6. The AP dimension can be overestimated in ___ plane and ___ underestimated in ___ plane.
7. Normal aorta tapers from ____ to ___.
- Infrarenal aorta
- Renal arteries
- Fusiform
- > 5 cm
- greater than 3 cm in AP diameter
- Transverse, longitudinal
- Tapers from proximal to distal
In the upper extremity, the right subclavian artery arises from the ____ artery and the left subclavian artery originates directly from the ____.
The SCA lie ____ to the SCV.
Innominate artery
Aortic arch
SCA is superficial to SCV
The subclavian artery continues as the axillary artery. The axillary artery becomes the ____ artery, which courses along the ______ aspect of the arm. At the elbow, the brachial artery branches into the ulnar and radial arteries, which continue into the hand forming the palmar arches
Brachial artery
medial;
The common femoral artery arises at the inguinal ligament and quickly bifurcates into the profunda femoris (deep femoral artery [DFA]) and superficial femoral artery (SFA). The SFA travels along the anteromedial thigh through the ____ (_____’s) canal and becomes the popliteal artery
adductor’s (Hunter’s) canal
The ____ tibial artery descends anteriorly and terminates in the dorsalis pedis artery. The peroneal artery terminates above the ankle, while the ____ tibial artery continues behind the medial malleolus to supply the plantar surface of the foot
Anterior tibial;
Posterior tibial
a contained rupture of an artery wall with a persistent connection (neck) to the artery resulting in a pulsatile mass containing swirling blood flow. Most arise from the common femoral artery as a complication of arterial puncture, surgery, or trauma. The use of large-bore catheters, long indwelling catheter time, and routine postprocedure anticoagulation have increased the incidence of pseudoaneurysm from arterial puncture to as high as 6%
Pseudoaneurysm
Comprise the superficial venous system
GSV and LSV
Originate on the medial side of the ankle, ascends anteromedially along the thigh and empties into the CFV at the inguinal ligament
GSV
It originates laterally at the ankle and ascends posteriorly along the calf. It usually empties into the popliteal vein or rarely into the profunda femoris or GSV
LSV
connect the superficial to the deep system in the calf and lower thigh. Flow is directed from the superficial to deep system.
Small perforating veins
