Vascular Final Flashcards
What are the layers of the vessel
tunica intima, tunica media, tunica adventitia
3 branches of aortic arch and location
lt subclavian, lt common carotid, rt brachiocephalic
What vessel forms the DPA at the ankle
ATA
T/F. Low resistance vessels have continuous forward flow
false, antegrade/forward through entire cardiac cycle
What is Reynold’s number used to measure
turbulent flow
What chamber of the heart is used in reference to hydrostatic pressure
right atrium
What shape is the vessel with low transluminal pressure
eliptical/dumbbell
During thrombosis, what is the flow when leg pressure exceeds intra-abdominal pressure
continuous signal
What is the pressure when arms are raised above the head
negative/reduced pressure
MHz and probe for carotid
linear, 7-4 MHz
What is temporal tap used for and where is the tap performed
ECA, superficial temporal artery anterior to the ear
What is the time for RIND (reversible ischemia neurological deficit
24-72 hours
What does reverberation of IJV look like on 2D carotid exam
mobile white line echo
How would you evaluate for string flow (occlusion/little flow)
power doppler for distal flow
For string flow, what would you do for scale? Doppler gain?
decrease, increase
What part of a tortuous vessel should not be sampled
curves
Where is carotid body found? What’s the size?
bifurcation at adventitia, 1-1.5mm
What causes a PSA (pseudo aneurysm)
penetrating trauma, itragenic injury, surgery, illness
What is the color pattern with PSA
red & blue (yin yang) turbulent flow
What causes onset of blindness in an older patient
temporal arteritis/giant cell
How does a surgical patch prevent stenosis
it opens the vessel
In a vessel with a stent, what is the velocity and why
increased, reduced arterial compliance
What artery is formed by the 2 vertebrals
basilar
What do you do to the power for transorbital exam and why
decrease to limit exposure to the eye
What are HITS
microembolic signals
What are signs of peripheral arterial disease
intermittent claudication, discolored skin, thickening toenails, gangrene
What happens to blood pressure when cuff is too narrow
falsely elevated
How do you calculate ABI
ankle systolic pressure divided by highest brachial systolic pressures
What flow should be occluded with plethsmography exam
venous is restricted, not arterial
What is the flow for normal plethymography (digit)
rapid upstroke with well defined peak, dicrotic notch, bends toward baseline through diastole
How much do you inflate a cuff
20mmHg above point where signal disappears
What artery doesn’t compress
peroneals
Would a long plane ride affect veins or arteries
veins
Color pattern for raynauds disease
white to blue to red
What does Beurgers disease affect
small vessels of the hands and feet
What vessels are used for bypass
GSV, SSV, cephalic v
After bypass, what symptoms would we look for
swelling, redness, warmth, drainage, fever, pain/numbness
Procedures to open vessels back up
percutaneous transluminal angioplasty
Most common vascular procedure
percutaneous transluminal angioplasty
Most common reason for in stent restenosis
intimal hyperplasia
How to calculate VR (velocity ration) for stenosis
PSV at stenosis divided by PSV prox to stenosis
Would thrombus/occlusion show on an exam after intervention
yes, re-intervention within 1st year
What are endovascular treatments
procedured to open vessels back up (PTA)
If a patient had peripheral vascular disease and they came in for ABI, what should ABI do
increase greater than >0.15
Thromboangitis obliterans affects which vessels and leads to what
small and medium, ischemic digits
Define pseudoaneurysm
Perforation in arterial wall allowing blood to extravascate into surrounding tissue, pulsating encapsulated hematoma
Is a palpable thrill assosciated with an AV fistula
yes
Can you determine actual age of clot
no, just an estimate
Is SSV deep or superficial
superficial
What type of vessel is the ATV and where is it located
deep vein, calf
Do superficial veins help with temperature regulation
yes
Where is clot more at risk
deep/larger veins, risk of pulmonary embolism
Common flow of venous system
spontaneous, phasic, pulsatile near heart
Are normal veins pulsatile
yes, near the heart
What is the main cause for clot in upper extremity
injury to vessel wall
What does the cephalic terminate into
axillary
Differences of veins from arteries
thin/smooth walls, respiratory phasicity, compressible, anechoic
Does hyrdrostatic pressure affect the subclavian vein
yes, when supine, it removes the impact of hydrostatic pressure which tends to collapse veins
How do we treat veins with clot
anticoagulants, thrombolytic therapy
Which upper extremity veins show pulsatile flow
IJV, subclavian, brachiocephalic
Brachial + basilic=
axillary
Is a normal GSV pulsatile
no
What is the flow in the GSV with clot
continuous
Varicosities are
tortuous, dilated, superficial
What is the saphenofemoral junction
CFV and GSV
venous valves
bicuspid, go in direction of flow
How is superficial venous disease treated
stripping/ligation, endovenous thermal ablation, chemical ablation (sclerotherapy), phlebectomy (microincision)
Flow in incompetent valves
retrograde
Fibrous strands are seen with
chronic venous obstruction
What is the most common risk with aortic endovascular repair (EVAR)
PSA, hematoma, stenosis
What is an endoleak
flow present within aneurysm sac after intervention (4 types)
What does clot look like in 2D
calcifications, rigid
Where do you scan aorta/renal arteries for an aneurysm
infrarenal (distal aorta)
When measuring the aorta, how should the transducer lay in relation to the aorta
perpendicular
Color flow imaging is helpful in what ways
presence/absence of flow, direction, patency
How do saccular aneurysms appear sonographically and which vessel layers are involved
asymmetric outpouching dilations, all 3 layers
Where does FMD occur in relation to renal arteries
mid-to-distal segment
What are the signs for renal artery stenosis
renal insufficiency, chronic hypertension, hypertensive children, azotemia
When measuring the kidneys what size difference indicates a discrepancy and what does this indicate
> 3cm, compromised flow in smaller kidney
FMD sonographic appearance
string of beads
What would happen to flow in stented renal artery and why
increase, reduction in arterial compliance
Normal characteristics of IVC
thin, smooth, phasic, dilates, echogenic/muscular walls
Where do IVC/iliac vein tumors arise from
hepatic/renal veins
IVC filter for clot is most likely to be placed
distal to renal veins, right renal vein/IVC
Dialysis access grafts are placed where. Why
distal, preserve proximal portion for future use
Earliest exam for contrast and what kind of contrast
echocardiography, agitated saline
What vessels should be calculated for ABI
bilateral brachial, PTA, DPA
Normal spectral waveform in an upper extremity artery
triphasic, sharp systolic peak, brief period of diastolic flow reversal, minimal continued forward flow in diastole
Landmark to distinguish the axillary vein from subclavian vein
cephalic vein because it terminates into subclavian after it passes under the clavicle
What does egyptian eye refer to
GSV in saphenous compartment
Characteristics of flow-reducing renal artery stenosis
PSV increases above 180 cm/sec, post stenotic turbulence, dampened distal waveforms
Lateral tributaries of the IVC
renal veins
Normal venous doppler patterns of the IVC
phasic distal, pulsatile more proximal
Harmonic frequency definition
creation of an image from sound reflections at twice the frequency of the transmitted sound
Harmonic signal-to-noise ratio
increases signal-to-noise ratio
