Vascular Intro Flashcards
this plaque restricts flow
hemodynamically significant lesions
this plaque sends small clots into the distal circulation
thromboembolic plaque
what is the carotid bifurcation
where the common carotid artery divides into internal carotid and external carotid.
a common site of stenosis (in our vascular ppt)
carotid bifurcation
what is collateral circulation?
alternate pathways of blood flow that become functional in the event of arterial or venous obstruction
hemodynamics… what is that?
the study of blood flow characteristics
an object traveling through the circulation that may lodge in a vessel and cause occlusion.
embolus
types of emboli:
thrombus, air, tumor cells, clumps of fat, even bullets
thromboembolic activity - ulcerated plaques or aneurysms… is that arterial or venous circulation?
arterial
thromboembolic activity - emboli arising from deep venous thrombosis of lower extremity… is that arterial or venous circulation?
venous
define spectral analysis
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.
in spectral analysis more blood creates what and causes what?
frequency shift, brighter pixels
(less blood would create another frequency shift and cause darker pixels).
in spectral analysis more blood creates what and causes what?
frequency shift, brighter pixels
(less blood would create another frequency shift and cause darker pixels).
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.
calcific plaque
dense plaque
calcific plaque creates acoustic shadowing!!
dense MAY or MAY NOT
characteristic features of certain plaque. This plaque produces darker echoes.
Soft plaque
Fibrous plaque
this word is usually put in front of the word “occlusion” to distinguish it from partial obstruction
“TOTAL” as in “total occlusion”
orderly, nonturbulent flow
laminar
when evaluating arteries, what is missing when naming these two arteries… anterior cerebellar artery and posterior cerebellar artery
anterior INFERIOR cerebellar artery
posterior INFERIOR cerebellar artery
when looking at arterial supply in the brain from the inferior surface, what are the two carotid arteries?
right INTERNAL carotid artery
left INTERNAL carotid artery
In vascular, we are looking for atherosclerosis. To put more simply:
Plaque
hypoperfusion is what
not enough blood flow
the true lumen is
the widest part of the vessel (vein/artery) where blood travels
if blood is antegrade, it means blood flow is
going in a NORMAL direction
if blood is retrograde, it means blood flow is
going against the grain, wrong way.
you cannot get plaque in a vein, true or false
TRUE! plaque is an arterial disease
The optimum angle for Doppler (although impossible) would technically be how many degrees?
ZERO degrees!
the angle of the Doppler beam is also called
the angle of incidence
angle theta (from Doppler equation)
the reason everyone in the sonography field shoots for 45-60 degree angles in vascular scanning is to eliminate
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.
horizontal axis velocities (spectral analysis)
time
vertical axis velocities (spectral analysis)
frequency shifts
difference between obstruction and occlusion
obstruction just means “narrowed” while occlusion means “blocked”
stenosis is synonymous with
OBSTRUCTION
in the CENTER of the vessel, blood flow is fastest. True or false?
TRUE
in extremity arteries, mostly dealing with MULTIPHASIC or MONOPHASIC waveform?
MULTIPHASIC
(multiphasic meaning blood flow changes direction during one cardiac cycle)
in carotid arteries, mostly dealing with MULTIPHASIC or MONOPHASIC waveform?
MONOPHASIC
(we want one-way blood flow to the brain, brain is an oxygen/blood whore!)
what flows can aliasing occur on
color flow AND pulsed wave
in terms of differences of anatomy between arterial and venous walls, venous walls are lacking a _______ layer.
medial.
your brachiocephalic or innominate artery bifurcates into
rt common carotid and right subclavian
when does the thoracic aorta become the abdominal aorta?
when it hits the level of the DIAPHRAGM
First artery that branches off the abdominal aorta is the
CELIAC ACCESS OR CELIAC ARTERY
The celiac artery branches into what
left gastric, splenic (going toward left side), common hepatic artery (going toward right side)
these are continuations of the common iliac artery
external iliacs
the R and L external iliac arteries become the _______ R and L artery after passing under this ligament.
common femoral artery after passing under the inguinal ligament
capillaries have THESE as walls
endothelial cells that are one cell thick
left common carotid branches from where and right common branches off from where
left common carotid branches DIRECTLY off aortic arch.
right common carotid branches off at bifurcation of innominate or brachiocephalic artery
branching of either of the ICAs doesn’t happen until it enters the
SKULL!
the Circle of Willis is a backup safety guard for the brain. explain.
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!!!
how do you reference where the “proximal” part of an artery is?
proximal is always going to be the part of the artery from where it originates!
In lower extremity arterial (LEA) evaluation, DIRECT evaluation gives NO information on:
COLLATERAL BLOOD FLOW, or how an obstruction is affecting the patient
In a patient AT REST, lower and upper extremity waveforms should be MONOPHASIC or MULTIPHASIC??? (key word at rest)
MULTIPHASIC
why do they say “put your feet up” at the end of the day
it aids in your venous circulation, and getting that blood flow to drain back towards the heart. helping your venous valves
higher velocities in ________ and lower velocities in ________.
higher velocities in arteries
lower velocities in veins
