Vasc Review Flashcards
Does the CCA contain or not contain any branches?
The CCA does not contain any branches
According to Poiseuille’s Law, volume flow increases with a decrease in what factor?
Hematocrit
If flow resistance is halved, what happens to volume flow?
It is doubled
What is the equation fo volume flow?
Q = DP/R
What is related to high PRF mode?
Range ambiguity
Under normal circumstances, what normally demonstrates boundary layer separation?
Carotid bulb
What is the most common vessel variant found in the lower extremity?
Hypoplasia/aplasia of the ATA
If you explain the maintenance of energy in the movement of fluid, what are you describing?
Bernoulli’s Principle
A patient is experiencing thigh claudication, where is the most likely location of disease?
Iliac artery
If a collateral is present, what can they help identify?
Extent of an occlusion
What is a normal PSV of the CFA?
114 +/- 25 cm/s
What kind of resistance would reactive hyperemia have?
Low resistance
What is the most common site of atherosclerosis of the lower extremity?
Distal FA
Thoracic outlet syndrome can result from compression of what? (3)
- Subclavian vein
- Subclavian artery
- Brachial nerve plexus
What are two common causes of peripheral emboli?
Proximal aneurysm and the heart
How would a significant stenosis affect the distal blood pressure post-exercise?
Decrease
Compared to the proximal normal segment, what effect would a >70% stenosis have on the velocity?
Tripled
What is the most common cause of early graft failure (<30 days post-op)?
Errors in graft construction
What conclusions can be made when you observe a monophasic waveform?
Significant inflow disease
What would an ABI of 0.7 most likely indicate?
Moderate, single-level disease
Why is the normal Vr at the distal anastomosis of a graft <3.0?
Due to vessel size change
Is the L4-5 vertebrae the external landmark for the aorta bifurcation?
No
Umbilicus - the L4-5 is the internal landmark
Which of the following variables has the greatest impact on volume flow?
- Vessel radius
- Vessel Length
- Vessel Compliance
- Pressure difference
Vessel radius
Which of the following reflects the Bernoulli effect?
- Pressure increases within a stenosis
- Velocity increases within a stenosis
- Blood flow is related to the vessel radius
- Pressure changes with the tube length changesVelocity increases within a stenosis
Velocity increases within a stenosis
Venules are the vessels that provide the resistance to help control blood flow? T/F
False
Which of the following is a branch of the external carotid artery? A - Ophthalmic artery B - Maxillary artery C - Thyrocervical trunk D - Peroneal arteryB
B
A palpated pulse of 0 indicates a weak pulse (t/f)
False - it indicates no pulse
A patient presents with a right brachial pressure of 80mmHg and a left brachial pressure of 115mmHg. What is likely happening?
A - Left subclavian artery stenosis
B - Right subclavian artery stenosis
C - Single-level disease and claudication
D -Multi-level disease and ischemic rest pain
B
Rest pain is usually the first symptom a patient experiences with PAD?
False - claudication is.
Which of the following describes an embolism?
A: Originates from a distal aneurysm
B - Formation of plaque within an artery
C - Dissection of an artery due to trauma
D - Sudden obstruction of an artery from a clot
D
Which of the following would be a cause of spectral broadening? A Plug Flow B Laminar Flow C Turbulent flow D High resistance flow
C
Which of the following could help distinguish an occluded vessel from near occlusion? A Decrease the SV B Increase the gain C Increase the wall filter D Increase the pulse repetition frequency
b - increase the gain
Poor cardiac function has no effect on the PSV’s of the carotid arteries
False
A 35 year old women presents with neck pain and left arm paresthesia post MVA. What is the most likely vascular diagnosis? A Whiplash B Muscle spasm C Carotid dissection D Hemodynamically significant carotid stenosis
C - carotid dissection
Increase in the Doppler shift indicates a worsening stenosis?
True
Which of the following indicates a hemodynamically significant stenosis?
A
Vessel narrowing producing an area reduction of 50%
B
Stenosis that necessitates immediate surgical intervention
C
Vessel narrowing that causes a reduction in pressure and flow
D
Vessel barrowing that has limited effect on pressure and flow
C
When scanning a lower extremity bypass graft the Vr of the body of the graft is 3.5. What would be the logical course of treatment? A Exercise B Amputation C Medical intervention D Increase ultrasound surveillance
C - medical intervention
The mid-graft segment of a hemodialysis graft is the most likely location of a stenosis?
False - venous anastomoses
Which of the following vessels would have a waveform most similar to the femoral artery? A Renal artery B Axillary artery C Innominate artery D External carotid artery
Axillary Artery
Bruit is another name for the tissue vibration that is caused by a hemodynamically significant stenosis.
True
You perform a carotid study and get the following PSV's: Right CCA - 61cm/s, Right ECA - 98 cm/s and Right ICA - 132 cm/s. What is the category of disease? A 1-15% B 30-50% C 50-69% D 70-99%
C - 50-69%
What waveform would you expect to see distal to a stenosis?
Tardus parvus
When interrogating for a pseudoaneurysm what is the most important diagnostic criteria?
Communicating tract is seen
Which characteristic of a waveform may indicate that a small amount of atheroma is present at the sample site? A Low pulstatility B Increased velocities C Mild spectral broadening D Delayed acceleration time
C - mild spectral broadening
A patient has a left ABI of 0.75 with intermittent claudication. The left popliteal spectral tracing was biphasic with a PSV of 70 cm/s and the left DPA waveform was monophasic. What is most likely happening? A Tibial disease B Multi-level outflow disease C Significant popliteal disease D Lower extremity inflow disease
A - tibial disease
What is the most frequent location of atherosclerosis in the lower extremity?
Adductor canal - distal FA
Resistivity is the qualitative observation of the relationship between the PSV and EDV. (T/f)
True
The anastomosis of the vertebral arteries forms which vessel?
Basilar Artery
The temporal tap requires tapping which vessel?
Superficial temporal artery
Tunica media is the:
Middle layer of an artery or vein
A patient presents with amaurosis fugax of the left eye and intermittent right hemiparesis. Which intracranial vessels are most likely involved?
A
Right ophthalmic artery and left middle cerebral artery
B
Left internal carotid artery and left middle cerebral artery
C
Right ophthalmic artery and right middle cerebral artery
D
Left ophthalmic artery and left middle cerebral artery
D
Which of the following symptoms originate from the posterior territory? A Aphasia B Dysphagia C Hemiparesis D Homonomous hemianopia
B- dysphagia
What type of plaque consists mainly of collagen and is of moderate to strong echogenicity? A Calcific B Fibrous C Fibrofatty D Complicated
Fibrous
Aphasia is the inability for on to control one’s gait?
False - ataxia is.
If there is systolic flow reversal in the vertebral waveform, what does it indicate? A Partial steal B Complete steal C Severe vertebral stenosis D Compensatory vertebral flow
A - partial steal
What happens to the pulsatility index as you move from the central arteries to the peripheral arteries? A Decrease B Increase C No change D Doubles
Increase
Loss of the reverse component is the first observable change in the waveform when evaluating significant disease in the peripheral arteries.
T/F
T
A 60 year old lady had loss of vision in her right eye 1 week ago. 3 days ago her left hand developed numbness and weakness. Today she visited her doctor and her left hand strength was found to be 25% of normal. What is the most likely diagnosis? A Migraine B Left hemispheric stroke C Right hemispheric stroke D Transient ischemic attack
C - right hemispheric stroke
Anomalous location of the DPA is the most common anatomic variant of the lower extremity.
False - hypoplasia/aplasia of the ATA
Which of the following plaque would have the greatest risk of embolizing? A Calcific B Thickened intima C Smooth, mostly hypoechoic D Heterogenous, mostly echogenic
C - smooth, mostly hypoechoic (FRESH)
Which two factors are used to interpret the results of treadmill testing?
A
Treadmill speed and time for the pressure to return to baseline
B
Treadmill incline and the degree of pressure change post exercise
C
Time for the patient’s symptoms to reappear and degree of pressure change post exercise
D
Degree of pressure change post exercise and the time required to return to baseline
D
A tortuous vessel may be a cause of non-atheromatous turbulent flow in the carotid arteries (T/F)
False - Fibromuscular dysplasia may cause turbulent flow and is NOT atherosclerosis
What is the most common cause of bypass graft failure between 30days to 2 years? A Graft kink B Intimal hyperplasia C Remnant valve leaflet D Progression of atherosclerosis
B - intimate hyperplasia
A Vr of 2.5 at the proximal anastomosis would be considered a normal finding.
False - 2.0 (2.5 at the distal anastomoses would be normal)
Which of the following is a type of Thromboangitis obliterans? A Buerger's B Takayasu's C Raynaud's D Diabetic neuropathy
A
Which of the following describes moderate pulsatility
A
Tall, sharp peak with little diastolic flow
B
Broad systolic peak with forward flow throughout diastole
C
Narrow systolic peak, flow reversal in early diastole, little or absent late diastolic flow
D
Constant forward flow in systole and diastole with a diastolic component well above the baseline
A - tall, sharp peak with little diastolic flow
Synthetic hemodialysis grafts last longer and are less susceptible to thrombosis than an AV fistula graft.
False!!!
Steal syndrome with a hemodialysis graft involves reversal of flow in the ulnar or radial artery as the graft “steals” blood from the hand due to a lower pressure upstream.
True
