Vascular Intro

Question 1

this plaque restricts flow

Answer 1

hemodynamically significant lesions

Question 2

this plaque sends small clots into the distal circulation

Answer 2

thromboembolic plaque

Question 3

what is the carotid bifurcation

Answer 3

where the common carotid artery divides into internal carotid and external carotid.

Question 4

a common site of stenosis (in our vascular ppt)

Answer 4

carotid bifurcation

Question 5

what is collateral circulation?

Answer 5

alternate pathways of blood flow that become functional in the event of arterial or venous obstruction

Question 6

hemodynamics… what is that?

Answer 6

the study of blood flow characteristics

Question 7

an object traveling through the circulation that may lodge in a vessel and cause occlusion.

Answer 7

embolus

Question 8

types of emboli:

Answer 8

thrombus, air, tumor cells, clumps of fat, even bullets

Question 9

thromboembolic activity - ulcerated plaques or aneurysms… is that arterial or venous circulation?

Answer 9

arterial

Question 10

thromboembolic activity - emboli arising from deep venous thrombosis of lower extremity… is that arterial or venous circulation?

Answer 10

venous

Question 11

define spectral analysis

Answer 11

the return Doppler signal broken down into the component frequency shift (vertical axis) and the amplitudes at those frequencies (pixel brightness or darkness - depends on display).

information of pixel brightness or darkness is swept over time to produce a waveform that suggest character of blood flow.

Question 12

in spectral analysis more blood creates what and causes what?

Answer 12

frequency shift, brighter pixels

(less blood would create another frequency shift and cause darker pixels).

Question 13

in spectral analysis more blood creates what and causes what?

Answer 13

frequency shift, brighter pixels

(less blood would create another frequency shift and cause darker pixels).

Question 14

characteristic features of certain plaque. This plaque shows up as bright echoes in the lumen. Of the two that create brighter echoes, one may not create acoustic shadowing while the other would.

Answer 14

calcific plaque
dense plaque

calcific plaque creates acoustic shadowing!!
dense MAY or MAY NOT

Question 15

characteristic features of certain plaque. This plaque produces darker echoes.

Answer 15

Soft plaque
Fibrous plaque

Question 16

this word is usually put in front of the word “occlusion” to distinguish it from partial obstruction

Answer 16

“TOTAL” as in “total occlusion”

Question 17

orderly, nonturbulent flow

Answer 17

laminar

Question 18

when evaluating arteries, what is missing when naming these two arteries… anterior cerebellar artery and posterior cerebellar artery

Answer 18

anterior INFERIOR cerebellar artery
posterior INFERIOR cerebellar artery

Question 19

when looking at arterial supply in the brain from the inferior surface, what are the two carotid arteries?

Answer 19

right INTERNAL carotid artery
left INTERNAL carotid artery

Question 20

In vascular, we are looking for atherosclerosis. To put more simply:

Answer 20

Plaque

Question 21

hypoperfusion is what

Answer 21

not enough blood flow

Question 22

the true lumen is

Answer 22

the widest part of the vessel (vein/artery) where blood travels

Question 23

if blood is antegrade, it means blood flow is

Answer 23

going in a NORMAL direction

Question 24

if blood is retrograde, it means blood flow is

Answer 24

going against the grain, wrong way.

Question 25

you cannot get plaque in a vein, true or false

Answer 25

TRUE! plaque is an arterial disease

Question 26

The optimum angle for Doppler (although impossible) would technically be how many degrees?

Answer 26

ZERO degrees!

Question 27

the angle of the Doppler beam is also called

Answer 27

the angle of incidence
angle theta (from Doppler equation)

Question 28

the reason everyone in the sonography field shoots for 45-60 degree angles in vascular scanning is to eliminate

Answer 28

error! and have consistency across multiple examinations, because if you scanned one place and then went to another and they scanned in radically different angles, it wouldn’t be beneficial to the patient - wouldn’t be able to tell the status of the plaque for example, if it had worsened or gotten better.

Question 29

horizontal axis velocities (spectral analysis)

Answer 29

time

Question 30

vertical axis velocities (spectral analysis)

Answer 30

frequency shifts

Question 31

difference between obstruction and occlusion

Answer 31

obstruction just means “narrowed” while occlusion means “blocked”

Question 32

stenosis is synonymous with

Answer 32

OBSTRUCTION

Question 33

in the CENTER of the vessel, blood flow is fastest. True or false?

Answer 33

TRUE

Question 34

in extremity arteries, mostly dealing with MULTIPHASIC or MONOPHASIC waveform?

Answer 34

MULTIPHASIC
(multiphasic meaning blood flow changes direction during one cardiac cycle)

Question 35

in carotid arteries, mostly dealing with MULTIPHASIC or MONOPHASIC waveform?

Answer 35

MONOPHASIC
(we want one-way blood flow to the brain, brain is an oxygen/blood whore!)

Question 36

what flows can aliasing occur on

Answer 36

color flow AND pulsed wave

Question 37

in terms of differences of anatomy between arterial and venous walls, venous walls are lacking a _______ layer.

Answer 37

medial.

Question 38

your brachiocephalic or innominate artery bifurcates into

Answer 38

rt common carotid and right subclavian

Question 39

when does the thoracic aorta become the abdominal aorta?

Answer 39

when it hits the level of the DIAPHRAGM

Question 40

First artery that branches off the abdominal aorta is the

Answer 40

CELIAC ACCESS OR CELIAC ARTERY

Question 41

The celiac artery branches into what

Answer 41

left gastric, splenic (going toward left side), common hepatic artery (going toward right side)

Question 42

these are continuations of the common iliac artery

Answer 42

external iliacs

Question 43

the R and L external iliac arteries become the _______ R and L artery after passing under this ligament.

Answer 43

common femoral artery after passing under the inguinal ligament

Question 44

capillaries have THESE as walls

Answer 44

endothelial cells that are one cell thick

Question 45

left common carotid branches from where and right common branches off from where

Answer 45

left common carotid branches DIRECTLY off aortic arch.

right common carotid branches off at bifurcation of innominate or brachiocephalic artery

Question 46

branching of either of the ICAs doesn’t happen until it enters the

Answer 46

SKULL!

Question 47

the Circle of Willis is a backup safety guard for the brain. explain.

Answer 47

your brain metabolizes oxygen so fast. it doesn’t have an ability to reserve o2 if blood is compromised. has an ability to shunt blood from one side to the other in case of restriction of flow (stenosis, aneurysm, etc). really important COLLATERAL PATHWAYS!!!

Question 48

how do you reference where the “proximal” part of an artery is?

Answer 48

proximal is always going to be the part of the artery from where it originates!

Question 49

In lower extremity arterial (LEA) evaluation, DIRECT evaluation gives NO information on:

Answer 49

COLLATERAL BLOOD FLOW, or how an obstruction is affecting the patient

Question 50

In a patient AT REST, lower and upper extremity waveforms should be MONOPHASIC or MULTIPHASIC??? (key word at rest)

Answer 50

MULTIPHASIC

Question 51

why do they say “put your feet up” at the end of the day

Answer 51

it aids in your venous circulation, and getting that blood flow to drain back towards the heart. helping your venous valves

Question 52

higher velocities in ________ and lower velocities in ________.

Answer 52

higher velocities in arteries
lower velocities in veins