Vascular Final Flashcards
Which two vessels complete the circle of Willis by connecting the right and left components of the circle?
a) The right and left vertebral arteries
b) The anterior and posterior communicating arteries
c) The superior and inferior cerebellar arteries
d) The right and left cerebellar arteries
b) The anterior and posterior communicating arteries
Based in this waveform, what vessel is being sampled?
a) Proximal ICA
b) Proximal ECA
c) Carotid Bulb
d) Distal CCA
b) Proximal ECA
The ___________________atery is the first branch of the ECA.
a) Superior thyroid
b) Opthalmic
c) Lingual
d) Facial
a) Superior thyroid
List 3 symptoms of a CVA
Numbness,
difficulty speaking,
weakness,
difficulty walking,
facial drooping
Which of the following is not a window used in transcrainial doppler imaging?
a) nasal
b) temporal
c) suboccipital
d) submandibular
a) nasal
Describe the circle of Willis and explain it purpose.
The circle of Willis is a roughly circular anastomosis of arteries located at the base of the brain. It protects blood flow to the brain by providing a connection for blood to take alternate paths in the event of a blockage.
Which vessel is not included in the Circle of Willis.
a) basilar artery
b) anterior communicating artery
c) terminal ICA
d) posterior cerebral artery
a) basilar artery
What vessel is being sampled with spectral doppler in this image of the extracranial carotid system?
a) Distal CCA
b) Proximal ICA
c) Proximal ECA
d) Proximal CCA
a) Distal CCA
Which of the following is an abnormal spectral Doppler interpretation?
a) “filling in “ of the spectral window
b) high resistant ECA signal
c) low resistant signal from the vertebral artery
d) open spectral window
a) “filling in “ of the spectral window
What vessel can be visualized by using the suboccipatal window during a transcranial doppler exam?
a) MCA
b) ACA
c) Distal ICA
d) Basilar
d) Basilar
Which of the following vessels is a branch of the extracranial internal carotid artery?
a) opthalmic artery
b) superior thyroid artery
c) middle cerebral artery
d) none of the above
d) none of the above
Match the number with the appropriate anatomy. 1
Anterior Communicating Artery
Match the number with the appropriate anatomy. 2
Anterior Cerebral Artery
Match the number with the appropriate anatomy. 3
Posterior Communicating Artery
Match the number with the appropriate anatomy. 4
Posterior cerebral Artery
Match the number with the appropriate anatomy. 5
Basilar Artery
Match the number with the appropriate anatomy. 6
Vertebral Artery
Match the number with the appropriate anatomy. 12
Terminal ICA
Match the number with the appropriate anatomy. 13
Middle Cerebral Artery
Which type/frequency of transducer is most appropriate for the majority of carotid duplex ultrasound studies?
a) 4 to 1 MHz sector
b) 5 to 3 MHz linear
c) 5 to 2 MHz curvilinear
d) 12 to 3 MHz linear
d) 12 to 3 MHz linear
Transient monocular blindness; hemianopsia: loss of field of vision, unilateral, or bilateral; double vision is termed________________.
a) Ataxia
b) Amaurosis fugax
c) Dysarthria
d) Claudication
b) Amaurosis fugax
Explain the difference between TCD and TCDI. What are the transducer frequencies used for each? What is a benefit of each?
TCD is a non-imaging technique to evaluate intracranial vessels. Transducer frequency is 1-2 MHZ. Benefit is able to use for continuous monitoring transducer is smaller.
TCDI is an imaging technique to evaluate the intracranial vessels. Transducer frequency 1-5 MHZ. Benefit is vessel identification with imaging.
A/An______________ is described as an abnormal “blowing” or “swishing” sound heard with a stethoscope while auscultating over an artery.
a) bruit
b) arrhythmia
c) regurgitation
d) augmentation
a) bruit
Based on the waveform what vessel is being sampled in this image?
a) Carotid Bulb
b) Proximal ICA
c) Proximal ECA
d) Distal CCA
b) Proximal ICA
Doppler waveform from the intracranial vessels are similar to those obtained from the:
a) internal carotid artery
b) external carotid artery
c) brachial artery
d) subclavian artery
a) internal carotid artery
What is the best description of this waveform?
a) low resistance laminar flow away from the transducer
b) low resistance laminar flow towards the transducer
c) high resistance laminar flow towards the transducer
d) high resistance laminar flow away from the transducer
a) low resistance laminar flow away from the transducer
Which of the following is an indication for a transcranial dopper exam?
a) subarachnoid hemorrhage
b) hyperlipidemia
c) hypertension
d) tachycardia
a) subarachnoid hemorrhage
One advantage of transcranial duplex imaging is:
a) may overestimate or underestimate the severity of disease
b) can assess plaque characteristics
c) accurate vessel identification
d) small foot-print compared to TCD
c) accurate vessel identification
Which of these statements is correct about low resistance arteries?
a) They will display a slight flow reversal in early diastole
b) They will display a slight flow reversal at the end of systole
c) They will display constant forward throughout the cardiac cycle
d) They will display no forward flow through diastole
c) They will display constant forward throughout the cardiac cycle
What is the normal number of branches off the external carotid artery?
a) 8
b) 6
c) 10
d) 9
a) 8
A severe neurological deficit which does not reverse itself is classified as a:
a) stroke
b) stenosis
c) transient ischemic attack
d) resolving ischemic neurological deficit
a) stroke
Which of the following is a symptom of a problem with the basilar blood flow to the brain?
a) Dizziness
b) Amaurosis Fugax
c) Slurred Speech
d) Dysphasia
a) Dizziness
Match the number with the correct vessel on this diagram of the right extracranial arterial system. 12
right subclavian artery
Match the number with the correct vessel on this diagram of the right extracranial arterial system. 15
vertebral artery
Match the number with the correct vessel on this diagram of the right extracranial arterial system. 8
proximal CCA
Match the number with the correct vessel on this diagram of the right extracranial arterial system. 4
ECA
Match the number with the correct vessel on this diagram of the right extracranial arterial system. 16
distal ICA
Match the number with the correct vessel on this diagram of the right extracranial arterial system. 6
Superior Thyroid Artery
Match the number with the correct vessel on this diagram of the right extracranial arterial system. 9
Brachiocephalic Artery
An episode of stroke-like neurologic symptoms that typically lasts for a few minutes to several hours and resoves completley describes a/an ____________________.
a) Transient ischemic attack
b) Cerebrovascular accident
c) RIND
d) Amaurosis Fugax
a) Transient ischemic attack
Where is the carotid siphon located?
a) at the carotid bifurcation
b) at the proximal portion where the carotid first originates
c) distally, in the cranium
d) at the level where the external carotid enters the face
c) distally, in the cranium
What are 3 symptoms of a DVT?
pain,
redness,
swelling,
venous distention,
palpable cord
the risk factor with the associated vascular system pathology would occur: end-stage renal disease
arterial
the risk factor with the associated vascular system pathology would occur: cancer
venous
What are 2 indications for performing a lower arterial duplex exam that are not related to PAOD.
palpable mass,
trauma,
aneurysm,
iatrogenic injury
What is the meaning of a dicrotic notch if seen on a pulse volume waveform?
a) Reflected wave of reversed flow
b) Delayed transmission of blood flow
c) Patient movement transmitted through the cuff
d) Presence of a proximal arterial occlusion
a) Reflected wave of reversed flow
Why should a pulse volume recording cuff be inflated to 55 to 65 mm Hg to record arterial waveforms?
a) To ensure good contact to the skin
b) So that venous outflow is occluded
c) To eliminate very low pressures
d) To differentiate forward from reverse flow
b) So that venous outflow is occluded
the anatomical markers and their correct identification: Anatomical marker for common femoral artery start
The inguinal ligament
the anatomical markers and their correct identification:
Anatomical marker for beginning of the axillary vein
The junction of the brachial and basilic veins
t he anatomical markers and their correct identification: Anatomical marker for distinguishing axillary from subclavian vein
The termination of the cephalic vein
Describe the characteristics of a normal spectral waveform from a lower extremity vein.
A normal spectral waveform from a lower extremity vein typically displays phasic flow patterns with spontaneous changes in flow
Explain the consequences of improper blood pressure cuff size utilization during a vascular extremity examination.
Improper blood pressure cuff sizes can lead to inaccurate pressure readings due to either overestimation or underestimation, which can impact the diagnosis and treatment of vascular conditions.
the vascular condition with its corresponding description: Varicose veins
Dilated, twisted veins that result from malfunctioning valves
the vascular condition with its corresponding description: Arterial thrombosis
Formation of a blood clot in an artery
the vascular condition with its corresponding description: Venous stasis
Impaired blood flow in the venous circulation
the vascular condition with its corresponding description:
Arteriosclerosis
Thickening and hardening of the arterial walls
What is the main cause of superficial venous insufficiency?
a) Valve incompetence
b) Lack of oxygen in the blood
c) Excessive exercise
d) High blood pressure
a) Valve incompetence
the vascular terminology with its corresponding description: Ischemia
Inadequate blood supply to a part of the body
the vascular terminology with its corresponding description: Thrombosis
Formation of a blood clot inside a blood vessel
the vascular terminology with its corresponding description:
Embolism
Obstruction of a blood vessel by a dislodged thrombus or other foreign particle
the vascular terminology with its corresponding description: Aneurysm
An abnormal bulge or dilation in the wall of a blood vessel
Arterial pressure cuffs should be how much wider than the diameter of the underlying limb segment?
a) 10%
b) 20%
c) 30%
d) 40%
b) 20%
All of the following are normal venous gray scale findings except:
a) The walls appear thin
b) The walls are smooth
c) The vein diameter may change slightly with respiration
d) The lumen is hyperechoic
d) The lumen is hyperechoic
The normal spectral waveform from an upper extremity artery has:
a) A sharp systolic upstroke with no flow through diastole
b) A sharp systolic upstroke with antegrade flow throughout diastole
c) A sharp upstroke with a brief period of flow reversal in early diastole
d) A sharp upstroke with flow reversal throughout diastole
c) A sharp upstroke with a brief period of flow reversal in early diastole
What are the consequences of using a blood pressure cuff too narrow for the segment of the limb being measured?
a) Measurement will be more painful to the patient
b) Pressure will be artifactually low
c) Pressure will be artifactually high
d) No diagnostically important consequence is expected
c) Pressure will be artifactually high
What is the main determinant of Doppler waveform characteristics?
a) Mean arterial flow
b) Peripheral resistance
c) Diameter of individual vessel
d) Difference between inflow and outflow
b) Peripheral resistance
What is the main function of the superficial veins?
a) Supply blood to the leg
b) Connect deep veins to other deep veins
c) Assist with temperature regulation
d) Drain into the soleal veins
c) Assist with temperature regulation
What is the proper patient position for performing a physiological arterial examination of the lower extremities?
a) Supine, head on a pillow
b) Supine, head above heart level
c) Supine, patient rotated to ipsilateral side
d) Seated quietly, legs extended
a) Supine, head on a pillow
Which of the following is not considered a deep vein?
a) The small saphenous vein
b) The profunda femoris vein
c) The anterior tibial vein
d) The peroneal vein
a) The small saphenous vein
Why is it important to maintain a comfortable exam room temperature when performing upper extremity arterial testing?
a) Too cold a room will cause vasoconstriction impacting Doppler spectral waveforms
b) Too cold a room will cause vasoconstriction making it not possible to record any PPG waveforms
c) Too warm a room will elevate the wrist-brachial index
d) Too warm a room will increase the resistive index in upper extremity vessels
a) Too cold a room will cause vasoconstriction impacting Doppler spectral waveforms
The small saphenous vein is a continuation of what vessel?
a) The medial segment of the plantar venous arch of the foot
b) The lateral segment of the dorsal venous arch of the foot
c) The lateral accessory vein of the great saphenous vein
d) The medial and lateral terminal branches of the peroneal veins
b) The lateral segment of the dorsal venous arch of the foot
Which statement best describes the anatomical arrangement of the common femoral artery (CFA) and the common femoral vein (CFV)?
a) The CFV is lateral to the CFA
b) The CFV is anterior to the CFA
c) The CFV is both anterior and lateral to the CFA
d) The CFV is medial to the CFA
d) The CFV is medial to the CFA
List the 5 vessels examined in an upper extremity arterial duplex exam.
subclavian,
axillary,
brachial,
radial,
ulnar
List the three conditions that make up Virchows Triad.
*Venous stasis
*Vessel wall injury
*Hypercoagulable state
This is a transverse image taken in the groin area. Identify which side of the body is being imaged and identify the anatomy identified at numbers 1, 2, 3, 4.
- SFJ/GSV
- CFV
- SFA
- DFA
The soleal sinuses drains into which vein?
a) gastrocnemius
b) posterior tibial
c) great saphenous
d) popliteal
b) posterior tibial
What vessels form the popliteal vein?
a) anterior and posterior tibial veins
b) anterior tibial vein and tibeoperoneal trunk
c) lesser saphenous vein and anterior tibila vein
d) small saphenous and great saphenous veins
b) anterior tibial vein and tibeoperoneal trunk
Which vein may not normally have a spontaneous Doppler signal?
a)popliteal
b) posterior tibial
c) external iliac
d) femoral
b) posterior tibial
Which of the following is not a branch off of the aortic arch?
a) innominate
b) left subcalvian
c) celiac axis
d) brachiocephalic
c) celiac axis
The radial artery terminates at the ________________.
a) digital artery
b) superficial palmar arch
c) brachial artery
d) deep palmar arch
d) deep palmar arch
Pulse volume recording is a form of which of the following methods/techniques?
a) segmental pressures
b) photophethysmography
c) impedance phethysmography
d) air plethysmography
d) air plethysmography
Which of the following indications shows medical necessity for a lower extremity arterial exam?
a) claudication
b) unilateral swelling
c) fever
d) chest pain
a) claudication
What is a normal finding when scanning the neck veins with the patient in a sitting position?
a) the viens dilate
b) the veins lose pulsatility
c) the veins are unchanged
d) the veins collapse
d) the veins collapse
What is the opening of the thoracic cavity that is bordered by the clavicle and the first rib?
a) thoracic outlet
b) brachial plexus
c) hunters canal
d) adductor canal
a) thoracic outlet
Which of the following would be a normal ankle brachial index?
a) 1
b) 0.5
c) 1.5
d) 2
a) 1
Which of the following is not a risk factor for aterial disease?
a) pregnancy
b) age
c) diabetes
d) hyperlipidemia
a) pregnancy
A patient with symptoms of claudication would most likely present with:
a) pain in toes when sleeping
b) decreasing pain with prolonged exercise
c) pain calf when walking two blocks and then subsides with rest
d) red, hot, painful leg
c) pain calf when walking two blocks and then subsides with rest
Which statement best describes the anatomical arrangement of the common femoral artery (CFA) and the common femoral vein (CFV)?
a) The CFV is lateral to the CFA
b) The CFV is anterior to the CFA
c) The CFV is both anterior and lateral to the CFA
d) The CFV is medial to the CFA
d) The CFV is medial to the CFA
What is the anatomical marker used to distinguish the start of the common femoral artery?
a) The inguinal ligament
b) The fourth lumbar vertebrae
c) The groin crease
d) The bifurcation of the hypogastric artery
a) The inguinal ligament
What anatomical marker can be used to note the beginning of the axillary vein?
a) The junction of the radial, ulnar, and interosseous veins
b) The outer border of the first rib
c) The termination of the cephalic vein
d) The junction of the brachial and basilic veins
d) The junction of the brachial and basilic veins
As compared to arteries, which of the following statements are true about veins?
a) Veins have the same laminar structure as arteries and are more muscular
b) Veins have only a tunica intima and tunica adventitia because they lack the muscular layer found in arteries
c) Veins have the same laminar structure as arteries, although they are not as muscular
d) Veins have the same laminar structure as arteries, but their walls are thicker when compared with arteries of similar size
c) Veins have the same laminar structure as arteries, although they are not as muscular
Patients with ischemic rest pain will typically do what to relieve their symptoms?
a) Take aspirin
b) Elevate the affected leg
c) Apply heat
d) Hang the leg over the bedside
d) Hang the leg over the bedside
The correct order for the various layers of a blood vessel wall from the innermost (in contact with the blood) to the outermost (closest to the surrounding tissue) is:
a) Tunica intima, tunica media, tunica adventitia
b) Tunica adventitia, tunica media, tunica intima
c) Tunica media, tunica adventitia, tunica intima
d) Tunica media, tunica intima, tunica adventitia
a) Tunica intima, tunica media, tunica adventitia
The normal spectral waveform from an upper extremity artery has:
a) A sharp systolic upstroke with no flow through diastole
b) A sharp systolic upstroke with antegrade flow throughout diastole
c) A sharp upstroke with a brief period of flow reversal in early diastole
d) A sharp upstroke with flow reversal throughout diastole
c) A sharp upstroke with a brief period of flow reversal in early diastole
Name the vessels at 1.,2. and 3.
- cephalic
- brachical
- basilic
List 4 indications for a carotid duplex exam.
*Asymptomatic neck bruit
*Hemispheric cerebral or ocular transient ischemic attacks (TIAs)
*History of stroke
*Screening prior to surgery
*Follow-up after carotid endarterectomy or stenting
the number with the correct vessel: 1
right subclavian artery
the number with the correct vessel: 2
vertebral artery
the number with the correct vessel: 3
proximal CCA
the number with the correct vessel: 4
proximal ECA
the number with the correct vessel: 5
proximal ICA
the number with the correct vessel: 6
innominate artery
Which of the following best describes the position of the ICA in the neck?
a) It is situated lateral to the ECA.
b) It is situated anterior to the ECA.
c) It is situated medial to the ECA.
d) It is situated posterior to the vertebral artery
a) It is situated lateral to the ECA.
What are the factors that help to positively identify the external carotid artery (vs. the internal carotid artery)?
a) The external carotid has higher diastolic flow than the internal carotid
b) The external carotid is more superficial than the internal carotid
c) The external carotid has lower peak systolic velocity than the internal carotid
d) The external carotid responds to temporal tap and the internal carotid does not
d) The external carotid responds to temporal tap and the internal carotid does not
What is the first branch of the ECA?
Superior Thyroid Artery
What is the first branch of the ICA?
ophthalmic artery
List 3 symptoms of vertebral basilar disease.
dizziness,
diplopia,
ataxia
A RIND or reversible ischemic neurologic deficit can be described as:
a) A neurologic symptom which lasts between 1 and 24 hours
b) A neurologic symptom which lasts less than 1 hour
c) A neurologic symptom which last between 3 and 7 days
d) A neurologic symptom which lasts between 24 and 72 hours
d) A neurologic symptom which lasts between 24 and 72 hours
Which statement lists the branches of the aortic arch in order from the first branch to the last?
a) Left subclavian artery, left common carotid artery, brachiocephalic artery
b) Brachiocephalic artery, left subclavian artery, left common carotid artery
c) Brachiocephalic artery, left common carotid artery, left subclavian artery
d) Left common carotid artery, left subclavian artery, brachiocephalic artery
c) Brachiocephalic artery, left common carotid artery, left subclavian artery
what vessel with this waveform.
CCA
what vessel with this waveform.
ICA
what vessel with this waveform.
ECA
What is the most accurate Doppler angle to use when performing carotid duplex ultrasound?
a) 0 degrees
b) 30 degrees
c) 45 degrees
d) 60 degrees
d) 60 degrees
Elastic compression stockings help to reduce venous volume by:
a) Decreasing hydrostatic pressure
b) Decreasing transmural pressure
c) Decreasing tissue pressure
d) Decreasing dynamic pressure
b) Decreasing transmural pressure
Which of these statements is correct about low resistance arteries?
a) They will display a slight flow reversal in early diastole
b) They will display a slight flow reversal at the end of systole
c) They will display constant forward throughout the cardiac cycle
d) They will display no forward flow through diastole
c) They will display constant forward throughout the cardiac cycle
The calf muscle pump acts to limit edema formation by:
a) Emptying the veins with the contraction of the calf muscles and decreasing venous pressure
b) Compressing the veins and the interstitial tissues to increase capillary pressure
c) Compressing all the blood vessels within the calf thus reducing the pressure difference across the capillary
d) Contracting the calf muscles increases the venous pressure to reduce capillary flow and the tendency toward edema formation
a) Emptying the veins with the contraction of the calf muscles and decreasing venous pressure
If a vein appears dumbbell shaped to elliptical shaped:
a) Interstitial pressure is low
b) Transmural pressure is low
c) Dynamic pressure is high
d) Transmural pressure is high
b) Transmural pressure is low
The correct order for the various layers of a blood vessel wall from the innermost (in contact with the blood) to the outermost (closest to the surrounding tissue) is:
a) Tunica adventitia, tunica media, tunica intima
b) Tunica intima, tunica media, tunica adventitia
c) Tunica media, tunica intima, tunica adventitia
d) Tunica media, tunica adventitia, tunica intima
b) Tunica intima, tunica media, tunica adventitia
Varicose veins may appear during pregnancy because of all of the following except:
a) Increased venous pressure due to the size of the gravid uterus
b) Increased venous distention
c) Increased venous compliance
d) Increased venous return
d) Increased venous return
The total energy of the vascular system has two primary components, which are:
a) Potential and kinetic energy
b) Potential and gravitational energy
c) Gravitational and inertial energy
d) Inertial and kinetic energy
a) Potential and kinetic energy
Which of the statements concerning energy losses at a stenosis is correct?
a) The greatest inertial energy losses occur as blood exits a stenosis
b) More energy is lost with a gradual tapering of the blood vessel wall
c) The greatest inertial energy losses occur at the entrance of a stenosis
d) Inertial energy is lost due to potential energy lost in the turbulent jet
a) The greatest inertial energy losses occur as blood exits a stenosis
In the human body, what is used as the reference point to measure hydrostatic pressure?
a) The right atrium
b) The left ventricle
c) The carotid sinus
d) The diaphragm
a) The right atrium
Describe this flow pattern and list 2 vessels that would have this pattern.
high resistance ,
subclavian artery,
CFA,
SFA,
popliteal artery
As compared to arteries, which of the following statements are true about veins?
a) Veins have only a tunica intima and tunica adventitia because they lack the muscular layer found in arteries
b) Veins have the same laminar structure as arteries and are more muscular
c) Veins have the same laminar structure as arteries, but their walls are thicker when compared with arteries of similar size
d) Veins have the same laminar structure as arteries, although they are not as muscular
d) Veins have the same laminar structure as arteries, although they are not as muscular
Which statement about pressure in the vascular system is correct?
a) Pressure is highest at the carotid arteries and lowest at the ankle level veins
b) Pressure is highest at the left atrium and lowest at the left ventricle
c) Pressure is highest at the left ventricle and lowest at the right atrium
d) Pressure is highest at the right ventricle and lowest at the left atrium
c) Pressure is highest at the left ventricle and lowest at the right atrium
According to the Bernoulli principle, if the velocity of blood goes up, what must happen?
a) There must be an increase in pressure
b) There must be a pressure decrease
c) There must be an increase in cross-sectional area
d) There must be decrease in total volume flow
b) There must be a pressure decrease
A change in which of the following components will have the greatest change in blood flow?
a) The length of the vessel
b) The pressure difference across a vessel
c) The radius of a vessel
d) The blood viscosity
c) The radius of a vessel
In the vascular system, which are the main two factors that result in “energy losses”?
a) Inertia and viscosity
b) Turbulence at valves and viscosity
c) Friction between layers of blood flow and viscosity
d) Inertia and the number of branches
a) Inertia and viscosity
Upon expiration, the diaphragm moves upward, what effect does this have on intra-abdominal pressure and lower extremity venous flow?
a) Intra-abdominal pressure increases and venous flow increases
b) Intra-abdominal pressure increases and venous flow decreases
c) Intra-abdominal pressure decreases and venous flow decreases
d) Intra-abdominal pressure decreases and venous flow increases
d) Intra-abdominal pressure decreases and venous flow increases
The appearance of a “reflected wave” is a result of:
a) Reactive hyperemia
b) An arteriovenous fistula
c) A high-resistance arteriolar bed
d) Decreased vasomotor tone
c) A high-resistance arteriolar bed
Describe the waveform and name 2 vessels that would have this type of flow pattern.
low resistance flow,
ICA,
CCA,
renal artery ,
hepatic artery,
vertebral artery,
Which of the following statements about hydrostatic pressure is not true?
a) When supine, hydrostatic pressure is negligible
b) Hydrostatic pressure is greater than dynamic pressure in leg veins
c) Hydrostatic pressure is greater in arteries when compared with veins at the same level
d) Hydrostatic pressure is reduced in an uplifted arm
c) Hydrostatic pressure is greater in arteries when compared with veins at the same level
The Reynolds number is used to define:
a) Pressure across a stenosis
b) The viscosity of blood
c) The resistance in a vessel
d) Turbulence
d) Turbulence
How do arterioles provide resistance to blood flow within the vascular system?
a) By contracting the smooth muscle cells in the wall
b) By reducing distal peripheral pressure
c) By decreasing vasomotor tone
d) By relaxing the smooth muscle cells in the wall
a) By contracting the smooth muscle cells in the wall
Which term is not a component within the definition of Poiseuille law?
a) Inertia
b) Viscosity
c) Vessel length
d) Vessel radius
a) Inertia
Which of the following terms is not a factor that is part of hydrostatic pressure?
a) The height of the column of blood
b) The viscosity of the blood
c) The density of the blood
d) The acceleration due to gravity
b) The viscosity of the blood
The veins hold what percentage of the total blood volume?
a) 30% to 35%
b) 50%
c) 60% to 65%
d) 75% to 80%
c) 60% to 65%
Why is hydraulic filtering important?
a) It removes wastes from the bloodstream
b) It reduces hydrostatic pressure
c) It converts the pulsatile output of the heart into steady flow through the capillaries
d) It maintains the pulsatile flow of the heart throughout the arteries and veins until blood returns to the heart
c) It converts the pulsatile output of the heart into steady flow through the capillaries
A doubling in the length of a stenosis results in:
a) A 50% increase in energy losses across the stenosis
b) A 2-fold increase in energy losses across the stenosis
c) A 4-fold increase in energy losses across the stenosis
d) A 16-fold increase in energy losses across the stenosis
b) A 2-fold increase in energy losses across the stenosis
A critical stenosis is one where:
a) Pressure decreases but flow is unchanged
b) Flow decreases but pressure is unchanged
c) Flow decreases but resistance is unchanged
d) Both pressure and flow decrease
d) Both pressure and flow decrease
Assuming volume flow remains the same, if the area of a blood vessel decreases then what must happen?
a) The velocity must decrease
b) The resistance must decrease
c) The mean velocity is unchanged
d) The velocity must increase
d) The velocity must increase
Which of the following cannot be determined by using venous duplex imaging?
a) Presence or absence of venous thrombosis
b) Exact age of a given thrombus
c) Exact location of a lower extremity thrombus
d) Valvular competence
b) Exact age of a given thrombus
Normal venous Doppler signals from the lower extremities exhibit all of the following characteristics except:
a) Phasic
b) Spontaneous
c) Augmentable
d) Pulsatile
d) Pulsatile
What is the proper patient position for performing a physiological arterial examination of the lower extremities?
a) Supine, head on a pillow
b) Supine, head above heart level
c) Supine, patient rotated to ipsilateral side
d) Seated quietly, legs extended
a) Supine, head on a pillow
What are the consequences of using a blood pressure cuff too narrow for the segment of the limb being measured?
a) Measurement will be more painful to the patient
b) Pressure will be artifactually low
c) Pressure will be artifactually high
d) No diagnostically important consequence is expected
c) Pressure will be artifactually high
What is the most common symptom associated with acute arterial ischemia?
a) Sudden severe pain in the limb
b) Fever and chills
c) Visual disturbances
d) Nausea and vomiting
a) Sudden severe pain in the limb
The area in the lower thigh where the superficial femoral artery moves from a more anteromedial position to a posterior position on the leg is called:
a) Scarpa’s canal
b) Guyon’s canal
c) Adductor canal
d) Femoral canal
c) Adductor canal
Hypercoagulability which can lead to venous thrombosis is associated with all of the following except:
a) Scleroderma
b) Cancer
c) Birth control pills
d) Hormone replacement therapy
a) Scleroderma
Idenitfy the anatomy at A, B and C.
A. Posterior Tibial Veins B. Peroneal Veins C. GSV
All of the following are normal venous gray scale findings except:
a) The walls appear thin
c) The walls are smooth
b) The vein diameter may change slightly with respiration
a) The lumen is hyperechoic
a) The lumen is hyperechoic
What is the primary purpose of performing a physiological arterial examination of the lower extremities?
a) Evaluate venous insufficiency
b) Measure blood pressure
c) Assess arterial blood flow and identify abnormalities
d) Determine heart rate
c) Assess arterial blood flow and identify abnormalities
Define: Thrombophlebitis
Inflammation of a vein with clot formation
Define: Collateral circulation
Extra blood supply to a body part, developing due to occlusion of the usual blood flow
Define: Edema
Swelling caused by excess fluid trapped in body tissues
Define: Stenosis
narrowing of vessel lumen
What is the main determinant of Doppler waveform characteristics?
a) Mean arterial flow
b) Peripheral resistance
c) Diameter of individual vessel
d) Difference between inflow and outflow
b) Peripheral resistance
Symptoms consistent with acute arterial ischemia include all except:
a) Pallor
b) Porphyria
c) Paresthesia
d) Pain
b) Porphyria
What is the main function of the superficial veins?
a) Supply blood to the leg
b) Connect deep veins to other deep veins
c) Assist with temperature regulation
d) Drain into the soleal veins
c) Assist with temperature regulation
A scoring system to determine the relative risk for a deep venous thrombosis is called the:
a) Virchow’s triad
b) Well’s criteria
c) Giacomini score
d) Thurner’s criteria
b) Well’s criteria
Which veins are routinely not included as part of a lower extremity venous duplex ultrasound examination?
a) Posterior tibial veins
b) Peroneal veins
c) Terminal portion of the great saphenous vein
d) Anterior tibial veins
d) Anterior tibial veins
Define: Arterial ischemia
Restriction in blood supply to tissues, leading to deficit of oxygen and nutrients
Define: Venous thrombosis
Formation of a blood clot in a vein
Define: Doppler waveform
Graphical representation of sound waves reflecting off moving objects
Define: Pulse volume recording
Measurement of changes in limb volume over time to assess arterial flow
List 3 methods of indirect arterial testing:
PPG
PVR
ABI
Symptoms of claudication can be relieved by which activity?
a) Sitting down
b) Elevating the legs
c) Standing quietly
d) Flexing the spine
c) Standing quietly
Name: A-D
A: SFA B: Pop. A, C: CFA, D: DFA
What is the meaning of a dicrotic notch if seen on a pulse volume waveform?
a) Reflected wave of reversed flow
b) Delayed transmission of blood flow
c) Patient movement transmitted through the cuff
d) Presence of a proximal arterial occlusion
a) Reflected wave of reversed flow
Why should a pulse volume recording cuff be inflated to 55 to 65 mm Hg to record arterial waveforms?
a) To ensure good contact to the skin
b) So that venous outflow is occluded
c) To eliminate very low pressures
d) To differentiate forward from reverse flow
b) So that venous outflow is occluded
T/F Perforator veins assist in returning blood from superficial veins to deep veins.
TRUE
Arterial pressure cuffs should be how much wider than the diameter of the underlying limb segment?
a) 10%
b) 20%
c) 30%
d) 40%
b) 20%
What are 3 symptoms of a DVT?
pain,
redness,
swelling,
venous
distention,
palpable cord
In the human body, what is used as the reference point to measure hydrostatic pressure?
a) The right atrium
b) The left ventricle
c) The carotid sinus
d) The diaphragm
a) The right atrium
A change in which of the following components will have the greatest change in blood flow?
a) The length of the vessel
b) The pressure difference across a vessel
c) The radius of a vessel
d) The blood viscosity
c) The radius of a vessel
Which statement about pressure in the vascular system is correct?
a) Pressure is highest at the carotid arteries and lowest at the ankle level veins
b) Pressure is highest at the left atrium and lowest at the left ventricle
c) Pressure is highest at the left ventricle and lowest at the right atrium
d) Pressure is highest at the right ventricle and lowest at the left atrium
c) Pressure is highest at the left ventricle and lowest at the right atrium
A doubling in the length of a stenosis results in:
a) A 50% increase in energy losses across the stenosis
b) A 2-fold increase in energy losses across the stenosis
c) A 4-fold increase in energy losses across the stenosis
d) A 16-fold increase in energy losses across the stenosis
b) A 2-fold increase in energy losses across the stenosis
