Vascular: Chapt 2 Pt.1 Flashcards
permanent or semi-permanent impairment
Cerebrovascular accident
symptoms resolve within 24 hrs
Transient Ischemic Attack- TIA
weakness on one side of body, face, arm, leg
Hemiparesis
total paralysis of one half of body, face, arm, leg
Hemiplegia
numbness and tingling of extremities
Parenthesis
cebrovascular symptoms
- Cerebrovascular accident– CVA- stroke
2. Transient Ischemic Attack- TIA
what are 5 cebrovascular symptoms
- hemiparesis
- hemiplegia
- Parenthesis
- general weakness/ motor dysfunction
- visual disturbances
Ipsilateral symptom
“shade being drawn over one eye field of view”
Amaurosis Fugax
what are the three speech difficulties
- aphasia
- dysphasia
- dysarthria
what is aphasia
inability to speak or express onself
what is dysphasia
impairment of speech, failure to arrange words correctly
what is dysarthia
imperfect articulation, due to disturbances in muscle control
what are the 4 symtoms of cartoid distribution
- speech difficulty- usually left hemishphere
- Sudden confusion, trouble speaking or understanding speech.
- Sudden severe headache with no known cause.
- Death
what are the 7 vertebral basilar symptoms
- Drop attacks
- Blackouts
- Syncope
- Memory loss
- Vertigo
- Dizziness
- Diplopia (double vision)
CVA causes(3)
- Cardiac
- emboli
- cessation of perfusion - Carotid etiology ≈ 50%
- thrombosis- occlusion
- emboli to brain - Aneurysm rupture
- Intracranial hemorrhage
- Vasospasm
What is “The Room of Doom”
ulceration/ source of an emboli
what may not be catastrophic, and may only causing minor, transient symptoms
Small emboli to distal middle cerebral artery branch
what may cause a major infarct
Large emboli
what are the 6 cebrovascular risk factors
- Family history of PAD, Heart Disease
- Smoking
- Old Age
- Diabetes mellitus
- Hypertension
- High cholesterol
what is another name for ICA
Syphon
what are 2 Circle of Willis Anomalies
- Only 50% of population have an intact and functioning circle (estimated).
- Only 25 % have the classic configuration
what % of population have a intact and functioning Circle of Willis
50
what % of population have the classic configuration of the circle of willis
25
what is the protocol for vascular scanning
1.Patient history
2.Transverse imaging
3.Longitudinal imaging
4.Color Doppler
5.Spectral Doppler
“mapping” of any areas of flow disturbance
what is a good scan position?
Hand and arm must be stable, you must be able to scan from
Posteriolateral plane.
what is the best approach to scanning the ICA
posterior lateral
what is the common imaging error amoung beginner scanners
using anterior- lateral approach for ICA
what 3 approaches should be used when getting a transverse image
anterior, posterior and lateral approaches.
when scanning transverse right neck for the CCA, what should be to the rt. of the CCA
Thyroid
What is before the bifurcation of the ICA
the bulb
what should be to the left of the CCA when scanning transverse left side neck
thyroid
low resistance
ICA
high resistance
ECA
which has branches, ICA or ECA
ECA
which is not reliable when diseased, ICA or ECA
ICA
Which has a posterior position, ICA or ECA
ICA
From the distal CCA, pivot the transducer towards the chin to view what?
ECA
From the distal CCA, pivot the transducer towards the bed to view what?
ICA
what lies deep or superficial to the ECA
ICA
what is an anatomic feature to help differentiate ICA from ECA
the shape of the proximal ICA or Bulb
what can be a useful tool in identifying the ECA, but it is often unreliable
temporal tap
in which view can plaque be made to appear more or less stenotic
longitudinal view
what is altered in a carotid exam?
color doppler
name 3 color doppler contols
- Beam Steering (lcr)
- Color scale
- Color Gain
The bottom corner of the box should be steered in the ________ direction that the vessel is going deep
same
Arterial color scale is around
30
Venous color scale is around
12
what fills vessel but doesn’t speckle outside of the box
color gain
smaller color box helps what?
frame rate
where should you position the color box?
over the vessel of interest
Color saturation is based on ______ flow within the vessel
mean
What is Color Doppler Flow Imaging?
presence of flow
direction of flow
quality of flow
What do you need to know about Color Doppler in order to use it CORRECTLY
- Must have an angle
- Must know the direction of flow (perpendicular incidence)
- Understand color orientation & color bar
- Know how to steer the color box
- Know appropriate way to adjust color scale
- Know appropriate way to adjust the color gain
- Know how to adjust additional color controls
No angle means what
No flow
Two ways to acquire angle of color doppler
- Heel-toe (rock) the transducer
2. Steer the color box
when using color doppler why would both red and blue be seen?
vessel is perpendicular
using color doppler;color on bottom represents what
represents flow going away from the beam signal
using color doppler; color on top represents what
represents flow coming toward the beam signal
where is the color baseline
maintained in the center
-positive and negative flow scales will be equal
Red over blue
Flow towards signal will be red
Flow away from the signal will be blue
what are the color doppler rules?
- know the direction of flow
2. steer the box
artery flow goes what way in the neck
from right side of screen to left side of screen
veins will go opposite direction
vein flows in what direction in the abdomen
right to left
- arteries go in opposite direction
transverse imagaing the color box will be steered in what direction
centered
By not steering the doppler, what may be improved
depth penetration
when diving deep what way should you steer the colored box?
centered
color doppler protocol
1.Regions of flow disturbance noted
-Indicates turbulence, increased velocities, Aliasing
2. For low flow:
-Ex: occlusions suspected, sometimes distal ICA, sometimes vertebral
Decrease the Scale, Increase the Gain
which is more sensitive color doppler or power doppler
power doppler
what is power doppler disadvantage?
Removes hemodynamic information
info on Power Doppler
- More sensitive to flow than color Doppler
- Very low dependence on angle
-Based on the amplitude of the returning Doppler signal
Greater the amplitude of the returning signal the better the representation of flow
No directional information
Flow is encoded one color, independent of direction
Some manufacturers are engineering directional power Doppler into their machines
Subject to “blooming” of the display due to very high sensitivity
in low flow you will _______the scale and ______the gain
decrease the scale, increase the gain
