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Ultrasound VASCULAR > Ultrasound vascular 8-13 > Flashcards

Ultrasound vascular 8-13 Flashcards

1
Q

What are we looking for in an arterial scan?

A

Occlusion

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2
Q

What are the symptoms of PAOD?

A

Intermittent claudication

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3
Q

What is claudication?

A

Pain in large muscle groups caused by activity

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4
Q

Where does claudication occur?

A

distal to site of disease

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5
Q

What is true claudication?

A

when symptoms are relieved with quiet standing

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6
Q

what is Ischemic rest pain?

A

Symptoms are more serve and have diminish flow. Pain occurs when legs are at rest.

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7
Q

What is advanced POAD? and symptoms?

A

Most severe state with tissue loss causing thick toenails, scaliness, elevation pallor, gangrene, blue toes.

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8
Q

How should a patient be positioned?

A

Head raised and legs at the same level as the heart

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9
Q

What happens if cuff isn’t right?

A 
narrow= false elevated pressure
wide= false low pressure
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10
Q

What is a normal abi?

A

about 1 *lower=worse POAD

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11
Q

Explain a normal thigh pressure?

A

30 m mHg higher than highest brachial. *higher = prox obstruction

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12
Q

Contraindications for treadmill testing?

A

Chest pain, Arrhythmias, Post myocardial infarction, unsteady, hypertension.

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13
Q

What is recovery time and what does it suggest?

A

ABI returns to normal within 5=single >10=multi

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14
Q

What is Plethysmography?

A

cuff is used to measure volume changes in limb

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15
Q

With plethysmography what does a moderate to severe disease look like?

A

delayed peak, round peak, and diastolic phase becomes convex.

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16
Q

What is Photoplethysmography (PPG)?

A

infrared light is used to detect variations in blood flow.

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17
Q

What is a normal toe brachail index?

A

> .8

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18
Q

Common location for POAD in arms?

A

sublavian to the prox axiallry

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19
Q

What difference in ABI for arms indicates a disease?

A

> 20

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20
Q

How to detect Thoracic outlet syndrome?

A

Any postion should be held for 30 secs. to see if symptoms happen. **TOA example when raising your arm

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21
Q

What is Raynaud?

A

from cold sensitivity or emotional stimuli that can be either primary or secondary.

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22
Q

What id the difference between primary and secondary Reynaud?

A 
Primary= vasopspam only (younger)
secondary= fixed obstruction with associated vasospasm. (older)
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23
Q

What is secondary reynauds associated with?

A

tissue loss, trauma, and scleroderma, cancer, drug induced, autoimne.

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24
Q

What is the Allen test?

A

used to determine digital perfusion prior to certain surgical procedures

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25
Q

Signs and symptoms of acute arterial insufficiency?

A

Pallor, Pulselessness, Paralysis, Parthesia, Pain, Coolness

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26
Q

Risk factors for lower extr. arterial insufficiency?

A

Diabetes, Hypertension, Smoking, Obesity, Age, Heredity, Gender

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27
Q

Normal findings for spectral analysis:

A

PSV does not increase, High resistance=sharp upstroke, rapid deceleration, retrograde in early, Antegrade in late

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28
Q

What is contrast arteriography?

A

“GOLD STANDARD” for arterial stenosis.

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29
Q

What are some limitations to using a arteriography?

A

Delineates patent arterial lumen only. Missed thromobsis in pop. Low flow=poor. Radiation.

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30
Q

What causes a upper extremity arterial disease?

A

Mechanical obstruction. Embolism. Trauma. Raynaud. Occulsion.

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31
Q

Where does most atherosclerotic disease in upper ex occur?

A

lt prox subclavian if extensive it is in aortic arch

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32
Q

What is Takayasu arteritis?

A

it is a auto imune disorder that affects the arteris of the aortic arch and visercal abdominal aorta. Result of long occlusion or stenosis.

33
Q

Who is common for takaysu?

A

women 20-30’s

34
Q

Symptoms of takaysau?

A

acutley: fever, malaise, arthralgias, and myalgias

35
Q

Who is common for giant cell?

A

white women in 40

36
Q

What arteris are affected by giant cell?

A

opthalmic, subclavian, axillary, superfical temporal.

37
Q

Who gets thromboangiitis (buerger)?

A

smokers under 50

38
Q

What vessels get buerger?

A

small vessels of hands and feet

39
Q

How to improve buerger?

A

stop smoking

40
Q

Patients with dialysis grafts or fistulas may have

A

gangrene from end stage renal disease

41
Q

Downfall to a prosthetic bypass graft

A

poor long termed patency rates

42
Q

Why are autogenous vein grafts preffered?

A

better long term patancy

43
Q

What is in situ bypass graft?

A

vein being used for bypass is left in its original anatomic position usually the great saphenous v. Lareg to small.

44
Q

What is the difference in orthograde and retrograde by pass grafts both can be freed from natural postion

A

Orthograde=lyzing valves
retrograde= flipping vein
both= large to small

45
Q

When do you have problems with bypass grafts and what are they?

A

technical occurs within 30 days

problems = retained valve, intimal flap, problems at suture, graft intapment, thrombosis

46
Q

Between 1-24 months what can occur with a bypass graft?

A

myointimal hyperplasi creating stenosis or a stenosis..

47
Q

After 24 months what can occur?

A

progression of atherosclerotic disease in inflow or outflow vessel. OR aneurysmal dialation

48
Q

What images are needed for a bypass graft check up?

A 
infow
prox anastomosis
mid graft
sistal anasomosis
outflow
49
Q

How do PTFE grafts appear?

A

double line

50
Q

What is myometrial hyperplasia?

A

rapid proliferation of cells into intimal layer

51
Q

Normal bypass waveform?

A

multiphasic. high resistance. reversal may be absent in earlt period.

52
Q

What an foward flow in diastol be a sign of?

A

indication of hyperemia or arteriovenous fistula

53
Q

Stenosis categorization

A

Normal below 150 cm/s…… Above 180=abnormal

54
Q

Treatments for PAD:

A

Medical treatment
surgical reconstruction/ graft
endovascular therapy

55
Q

Types of endovascular treatments:

A

PTA,
Subintmal angio
mechanical atherectomy
stent graft angio

56
Q

Nonatherosclerotic disease include

A

inflammatory,,, congenital abnormalities,,,, aquird,,, injuries

57
Q

What is Vascular arteritis?

A

Inflammatory that affects vessels

58
Q

W/ arteritis inflammatory process involves?

A

media cells infiltrated w/ white blood cells
muscular and elastic portions are eroded
fibrosis develops
weak wall and necrosis

59
Q

Symptoms of arterisi

A

claudication
decreased asymmetrical bp
TIA/ STROKE symptoms

60
Q

ANother name for giant cell arteritis

A

temporal arteritis

61
Q

Symptoms of Giant cell arteritis

A 
temporal headaches
tenderness over superfical temp artery
decreased pulse
asymmetrical bps
cord-like structure over temporal artery
aching/stiffness in neck
jaw claudication
visulal disturbances
62
Q

Labs for Giant cell =

A

elevated erythrocyes sedimentation rate and C-reactive protein

63
Q

Symptoms of Takayasu arteritis

A 
absent peripeheral pulse
brachial bp difference
light headednes
amaurosis fugax
diplopia
tias
hemiparesis
upper extemity claudication
64
Q

Does Buerger affect one side or both?

A

both but one is worse

65
Q

Radiation Induced arteritis???

A

rare from radiation therapy for cancer…. results in perivascular fibrosis, inflammation, and acceleraion of atherosclerosis

66
Q

What is embolic disease?

A

occlusion or obstruction of an artery by a transported clot of blood or mass, bacteria, or other foreign substance

67
Q

Where do most arterial emboli come from?

A

80-90% cardic source

68
Q

What causes cardiac emboli?

A 
arterial fib********most common
post myocardial infarction lt ventricle 
mechanical heart valves
intracardiac tumors
vegetation
paradoxical emboli
69
Q

What % of emboli arises from outside of the heart

A

10-20%

70
Q

Other sources for emboli rather than the heart

A

subclavian
atherosclerotic disease in the aorta, iliac, femoral, pop
mural thrombosus from aneurysms in these vessels

71
Q

Where does most pseudoanerysms, injurys occcur?

A

femoral artery as a result of catheter based procedur

72
Q

Pseudoaneurysms symptoms

A

mass
ecchymosis
pain
extrinsi compressing that causes nerve irriation and venous compression swelling

73
Q

AV fistula injury???

A

abnormal connection b/w artery and vein from trauma or catherization

74
Q

signs and symptoms of av fistula injury

A

bruit
papable thrill
hematoma

75
Q

Arterial occlusions trauma ????

A

occurs after various interventions or cannulations

76
Q

With a arterial occlusion injury a pt may present with

A

partial to complete thrombosis

cold, pulseless leg

77
Q

What is popliteal artery entrapment syndrome?

A

occurs when pop artery is compressed by medial head of gastrocnemius muscle or adjacent tendons result of congenital deformity

78
Q

repeated compression of pop artery can produce?

A

aneurysm formation
thromboembolism
thrombosis

79
Q

Symptoms of pop artery entrapment syndrome

A 
claudication in young 
may occur after extensive exercise
may be chronic
may occur with walking not running
parasthesia and numbness have been recorded

Ultrasound VASCULAR (1 decks)

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