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cv > Unit 5: Carotid Procedures (signs, symptoms, indications, risk factors) > Flashcards

Unit 5: Carotid Procedures (signs, symptoms, indications, risk factors) Flashcards

1
Q

What are the patient interactions you should have as a sonographer?

A
  • Intros
  • ID
  • Ask how they are feeling
  • Explain test
  • Take history, sx, risk
  • Answer questions
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2
Q

What are some medical risk factors?

A
  • High BP
  • Smoking/Secondhand smoke
  • High cholestrol
  • Diabetes
  • Obstructive sleep apnea
  • Cardiovascular disease.
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3
Q

Why is high blood pressure a risk factor?

A

The risk of stroke begins to increase at blood pressure readings higher than 120/80 mm HG.

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4
Q

Why is an abnormal heart rhythm a risk factor?

A

It can cause a blood clot to form.

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5
Q

What are some other risk factors?

A
  • Personal or family hx of stroke, heart attack or TIA
  • Age >55
  • Race
  • Overweight/obese
  • Physical inactivity
  • Heavy or binge drinking
  • Use of illicit drugs
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6
Q

What race has a higher risk of stroke than others?

A

African Americans.

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7
Q

An appropriate indication for an exam must be present and documented in the medical record for what to occur?

A

Reimbursement.

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8
Q

Why should you confirm appropriate incidications for an exam?

A
  1. To give adequate attention to answer the questions involved,
  2. To avoid committing fraud.
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9
Q

What is the time frame of a TIA?

A

<24 hours with full recovery

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10
Q

What is the time frame for a CVA?

A

>24 hours with at least some residual symptoms.

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11
Q

where do 80% of ischemic stroke occurs?

A

Carotid territory (anterior brain)

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12
Q

Where is the vertebrobasilar territory?

A

Posterior brain.

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13
Q

What are the 4 types of carotid symptoms?

A
  1. TIA
  2. CVA
  3. Carotid territory
  4. Vertebrobasilar territory
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14
Q

What are 5 indications for a carotid duplex exam?

A
  1. TIA
  2. CVA
  3. Bruit
  4. Pre-op
  5. Post-op
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15
Q

In the carotid territory, what do the carotid arteries feed?

A

They feed the right and left cerebral hemispheres.

ICA, MCA, ACA, ACoA

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16
Q

What are the 4 carotid territory symptoms?

A
  1. Motor/sensory
  2. Visual
  3. Speech
  4. Behavior
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17
Q

What are the carotid territory symptoms dealing with the motor/sensory area?

A
  • Unilateral symptoms:
    • symptoms occur contralateral to the side of the brain/carotid with disease.
    • Weakness (hemiparesis) on one side.
    • Numbness on one side.
    • Tingling (paresthesias) on one side.
    • Facial droop on one side.
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18
Q

What are the carotid territory symptoms that are visual?

A

Amaurosis fugax

19
Q

What is amaurosis fugax?

A
  • It is a shade effect
  • Monocular
  • Ipsilateral to the carotid disease that caused it.
20
Q

Why does amaurosis present symptoms on the same side as disease?

A

Because the emboli gets lodged right in the eye, not in the brain artery, so its on the same side as the disease.

21
Q

What are the carotid territory symptoms that deal with speech?

A
  • Dysphasia→difficulty with speech
  • Aphasia→no speech.
22
Q

What hemisphere controls speech?

A

The dominant hemisphere.

ie. right handed ? dominant left hemisphere
ie. left handed? dominant right OR left hemisphere.

23
Q

Where do the carotid territory symptoms that affect behavior come from?

A
  • May be from ischemia of temporal lobe
  • May be from infarction of MCA branch
24
Q

What feeds the vertrebrobasilar territory?

A

Basilar artery feeds brain stem, cerebellum, occipital lobes of brain.

25
Q

What does the posterior brain circulation consist of?

A

Vertebral, basilar, posterior cerebral, posterior communicating arteries.

26
Q

What are 6 vertebrobasilar symptoms?

A
  1. Vertigo
  2. Dysphagia
  3. Syncope
  4. Ataxia
  5. Bilateral parethesias
  6. Visual
27
Q

What are 5 non-localized vertebrobasilar symptoms?

A
  1. Dizziness (light headedness)
  2. Syncope (transient loss of consciousness)
  3. Difficultly with speech
  4. Headache
  5. Confusion
28
Q

What is vertigo?

A

Difficulty with equilibrium.

It is a sensation of having objects moving around oneself r moving oneself around in space.

29
Q

What is dysphagia?

A

Inability to swallow.

30
Q

What is diplopia?

A

Double vision.

31
Q

What is a symptoms?

A

What the patient feels or experiences.

32
Q

What is a sign?

A

What is obsevred/seen/heard/felt

33
Q

What are risk factors?

A

SOmething that increases the likelihood of developing a disease.

34
Q

What are some risk factors for a stroke?

A
  1. Hypertension
  2. Diabetes
  3. Smoking
  4. Hypercholesteromia
  5. Age
  6. Family history
  7. Obesity
  8. Hypercoaguability state
  9. Cardiac disease
35
Q

What are some signs of a stroke?

A
  • Bruit
  • Hollenhorst plaque
  • TIA
  • Decreased unilateral carotid pulse
36
Q

What is hollenhorst plaque?

A

It is plaque seen in retinal vessels through an eye exam.

37
Q

T/F:

A bruit is nothing signifcant and should be ignored.

A

FALSE!!

The presence of a bruit is signifcant

38
Q

What are some causes for a bruit?

A
  • Moderate to severe ICA stenosis
  • ECA source
  • Aortic valve
  • A bruit heard ONLY in the high neck is most likely from the bifurcation area.
  • A bruit heard low in the neck may be from the heart or the common cardiac/brachiocephalic
39
Q

T/F:

The lack of bruit does NOT rule out significant stenosis.

ie. ICA occlusion will not produce a bruit.

A

True.

40
Q

Why might pulses be different on each side of the neck?

A
  • Tortuous on one side
  • Aneurysm on one side
  • Technical error
  • Obstruction on one side.
41
Q

What is subcalvian steal?

A

It is a proximal SCA obstruction that causes vertebral flow on ipsilateral side to reverse and feed arm.

42
Q

What are the symptoms of subclavian steal?

A
  • may be asymptomatic
  • Dizziness
  • Arm claudication
43
Q

What questions should you ask the patient pior to an exam?

A
  • Why are you having this test?
  • What symptoms did you have?
  • How long did they last?
  • Go through a list of risk factors.
44
Q
A

cv (16 decks)

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