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cv > Unit 1: Cerebrovascular procedures > Flashcards

Unit 1: Cerebrovascular procedures Flashcards

1
Q

While using ultrasound, what are you assessing?

A

Assessing the extracranial and intracranial arteries of the neck and head.

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2
Q

What is the goal of assessing the extracranial and intracranial arteries?

A

To prevent stroke and evaluate vasospasm of the brain after subarachnoid hemorrhage.

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3
Q

What is the purpose of assessing extracranial and intracranial arteries?

A

Define the presence, severity, location, and changes in disease in these arteries.

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4
Q

What are the primary ultrasound procedures?

A
  1. Duplex of the extracranial arteries.
  2. Transcranial Doppler (TCD) of the intracranial arteries.
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5
Q

What is the primary disease of the carotid arteries?

A

Atherosclerosis.

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6
Q

What is the primary cause of a stroke?

A

Atherosclerosis.

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7
Q

When does a stroke occur?

A

A stroke occurs when the blood supply to part of your brain is interuppted or severely reduced, depriving brain tissue of oxygen and nutrients, within minutes, brain cells begin to die.

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8
Q

What are the symptoms of stroke?

A

Symptoms depend on what part of the brain is affected controls.

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9
Q

Why should you note when the signs and symptoms of a stroke began?

A

The length of timme they have been present may guide the treatment decisions.

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10
Q

What are some symptoms of a stroke?

A
  1. Trouble with speaking and understanding.
  2. Paralysis or numbness of the face, arm or leg.
  3. Trouble with seeing in one of both eyes.
  4. Headache.
  5. Trouble with walking.
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11
Q

What does “FAST” stand for?

A

F (FACE): Ask the person to smile. Does the side of the face droop?

A (ARMS): Ask the person to raise both arms. DOes one arm drift downward? or is one arm unable to raise up.

S (SPEECH): Ask the person to repeat a simple phrase, call 911 immediately.

T (TIME): If you obeserve any of these signs, cll 911 immediately.

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12
Q

What are the two causes of stroke symptoms?

A
  1. Ischemia
  2. Hemorrhage
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13
Q

What is an ischemia caused by?

A

A blocked artery.

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14
Q

What can an ischemic stroke be?

A

It can be either thrombotic or embolic.

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15
Q

What are some of the locations that can cause ischemia?

A
  • Could be blocked by a thrombus that forms at the site of a carotid plaque.
  • Could be blocked by an embolus breaking from a carotid plaque.
  • Could be blocked by an embolus from the heart.
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16
Q

About ____ of strokes are ischemic, caused by a _____ artery feeding the ________

A

About 85% of strokes are schemic, caused by a blocked artery feeding the brain.

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17
Q

Thrombotic strokes occur as an artery is……

A

Blocked at the site by thrombosis formed there.

18
Q

An embolic stroke occurs as an artery is…..

A

Blocked from something that originated proximally (Ccarotid or carotid embolus), moved there and then blocked the artery because it was too small to pass through.

19
Q

The most common ischemic strokes include?

A

Thrombotic strokes and Embolic strokes.

20
Q

When does a thrombotic stroke occur?

A

It occurs when a blood clot (thrombus) forms and blocks flow in one of the arteries that supply blood to the brain or in the brain.

21
Q

A thrombus is likely to form on what?

A

Fatty deposits (athersclerotic plaque) that build up in arteries and cause reduced blood flow or other artery conditions.

22
Q

When does an embolic stroke occur?

A

It occurs when a blood cloth or other debris forms away from your brain and is swept through your blood stream to lodge in narrower brain arteries.

23
Q

Where does emboli commonly form?

A

It commonly forms in the heart (a-fib) or possibily from thrombus forming over a carotid plaque.

24
Q

When does a hemorrhagic stroke occur?

A

It occurs when a blood vessel in your brain leaks or ruptures.

25
Q

What is an intracerebral hemorrhage?

A

It is a blood vessel in the brain that burst and spills into the surrounding brain tissue, damaging brain cells.

26
Q

What are some risk factor of a intracerebral hemorrhage?

A
  • High blood pressure
  • Trauma
  • Vascular malformations
  • Overtreatment of blood-thinning medications.
27
Q

What is a subarachnoid hemmorhage?

A

It is an artery on or near the surface that burst and spills into the space between the surface of the brain and your skull.

28
Q

What is subarachnoid hemmorhage usually signaled by?

A

A sudden, severe headache.

29
Q

What is a subarachnoid hemmorhage commonly caused by?

A

The bursting of a small sacl-shaped or berry-shaped aneurysm.

30
Q

What happens after a hemmorhage?

A

The blood vessels in your brain may widen and narrow erratically (vasospasm), causing brain cell damage by further limiting blood flow.

31
Q

What is the leading cause of death in the US and UK?

A

A stroke.

32
Q

How many people suffer from a stroke per year?

A

Approx. 795,000 people suffer from a stroke.

33
Q

What is the lleading cause of serious, long-term disability in the United States?

A

A stroke/

34
Q

What is a transient ischemic attack (TIA)?

A

“ministroke”

It is a brief period of stroke symptoms (<24 hours).

It is a temporary decrease in blood supply to part of your brain causes TIA’s, which often last less than five minutes.

35
Q

Why does a TIA occur?

A

Like an ischemic stroke, a TIA occurs when a clot or debris blocks blood flow to a part of your brain.

36
Q

T/F:

Having a TIA puts the patient at greater risk of having a full blown stroke.

A

True.

37
Q

What does a TIA likely indicate?

A

It indicates there’s likely a partially blocked or narrowed artery leading to the brain or clot source in the heart.

38
Q

T/F:

Up to half of people whose symptoms appear to go away actually have had a stroke causing brain damage.

A

True.

39
Q

What are the treatment options for a stroke?

A
  1. Control risk factors.
  2. Medical→TPA for non-hemmorhagic, acute strokes.
  3. Endovascular→Stents
  4. Surgical→Carotid endarterectomy, rarely bypass.
40
Q

What is TPA?

A

“tissue plasminogen activator”

It dissolves a clot.

It is used for non-hemmorhagic, acute strokes. It MUST be given within 3.5-4 hours since SYMPTOMS started.

41
Q

What is a sonographers role in a carotid duplex exam?

A
  1. To detect, localize, and grade disease in the extracranial carotid arteries.
  2. To detect change
  3. To identify athersclerosis and other pathology in the carotid system.
42
Q
A

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