TCDs

Question 1

Probe frequency used

Answer 1

2 MHz

Question 2

The carotid siphon is located ____

Nomenclature segments are

Answer 2

Proximal to ICA intracranial branches

C1, C2, C3

Question 3

T/F the smaller the number (segment nomenclature) the closer to midline

Answer 3

True

Question 4

Posterior cerebral artery segments

Answer 4

P1 & P2

Question 5

Anterior cerebral segments

Answer 5

A1 & A2

Question 6

Middle cerebral artery segments

Answer 6

M1 & M2

Question 7

What are the US windows for TCD (4)

Answer 7

Transtemporal
Transorbital
Submantibular
Suboccipital

Question 8

Which window visualizes the CAROTID SIPHON and OPTHALMIC artery?

Answer 8

Transorbital Approach

Question 9

Which approach has an anterior and posterior orientation?

Answer 9

Transtemporal

Question 10

ANTERIOR ORIENTATION of the transtemporal approach visualizes (5)

Answer 10

C1 (carotid siphon)
A1 (ACA)
Anterior communicating artery
M1 + M2 (MCAs)

Question 11

POSTERIOR ORIENTATION of TRANSTEMPORAL insinuates (4)

Answer 11

P1 + P2 (PCA)
Posterior communicating A
Basilar A (top)

Question 12

WINDOW for DISTAL VERTEBRAL As & BASILAR A (entire length)

• What is it called
• Where is the probe placed & aimed

Answer 12

Suboccipital transforaminal

- probe between foremen magnum and spinous process of C1 vertebrae

Question 13

T/F the transorbital approach is not used as much as the transtemporal and suboccipital

Answer 13

True

Question 14

SUBMANDIBULAR is good for visualizing (2)

Answer 14

Carotid dissection

Chronic ICA occlusion with collaterals

Question 15

PUT IN ORDER from DEEP to SUPERFICIAL - INSONATION DEPTHS

Answer 15

Basilar (75 mm)
ACA (70 mm)
PCA (65-70 mm)
Carotid siphon (65 mm)
MCA (50 mm)

Question 16

PUT IN ORDER from FASTEST to SLOWEST - INSONATION VELOCITIES

Answer 16

MCA (55 cm/s)
ACA (50 cm/s)
PCA/Basilar (40 cm/s)
Carotid (39 cm/s)

Question 17

VESSEL IDENTIFICATION strategies (6)

Answer 17

Depth
Direction
Velocity (mean, systolic, diastolic)
Probe position
Direction of US beam
Traceability of vessels

Question 18

Transcranial vessels have what PULSATILITY?

Answer 18

Low resistant flow, monophasic, high end diastolic flow - similar to ICA

Question 19

What is the FIRST vessel you identify with TCD? At what depth?
Where do you angle thereafter?

Answer 19

MCA at 50-55 mm

Ipsilateral arterial anteriorly toward ACA then posteriorly toward PCA

Question 20

What indicates insonation of A1 (anterior cerebral) segment when tracking the MCA?

Answer 20

When tracking the MCA medially flow will go from TOWARD the transducer to AWAY from the transducer at around (60-70mm depth)

Question 21

A velocity of 220 cm/s in the MCA could indicate what?

Answer 21

Vasospasm

Question 22

In which arteries is flow AWAY from the transducer? (2)

Answer 22

Basilar A and vertebral A