Week 5 - Lesson 1 (Part 2)

Question 1

What is the sonographic appearance of an occlusion of the ICA? (2)

Answer 1

1. Monophasic

2. No windows

Question 2

What happens when the ICA is blocked?

Answer 2

The ECA takes over for it

- collateral flow

Question 3

What happens when the ECA takes over for the ICA?

Answer 3

It starts to take on qualities like the ICA

Question 4

What happens when the CCA is blocked?

Answer 4

The ECA reverses and loops back to feed the ICA (internalization of the ECA)
- so the ICA has normal flow

Question 5

How can you tell if you have internalization of ECA? (2)

Answer 5

1. Tardus Parvus
   - delayed systolic acceleration
2. Positive temporal tap maneuver

Question 6

What happens if you tap on the temporal artery?

Answer 6

It will shatter the diastolic flow of the ECA

- this does not happen in the ICA

Question 7

What happens when you have externalization of the CCA? (4)

Answer 7

1. Occlusion of ICA
2. Retrograde flow in stump of ICA
3. Absence of flow in ICA beyond
4. Higher velocities in the collateral arteries
   - because they are trying to help out

Question 8

What is also known as thud flow?

Answer 8

To and fro flow

Question 9

What is thud flow?

Answer 9

Damped systolic flow

- reversed flow in early diastole

Question 10

What kind of waveform is thud flow?

Answer 10

Biphasic

Question 11

Tardus parvus

Answer 11

High grade strong sign at the stenosis

Question 12

Tardus

Answer 12

Long rise time

Question 13

Parvus

Answer 13

Low peak systolic velocity

Question 14

PSV

Answer 14

Peak systolic velocity

Question 15

Where do you see tardus parvus?

Answer 15

Distal to the stenosis

- dampening

Question 16

What kind of waveflow is tardus parvus?

Answer 16

Monophasic

- continuous

Question 17

When do you get the water-hammer spectral appearance?

Answer 17

With CCA flow in severe aortic regurgitation

Question 18

What is the water-hammer spectral appearance? (3)

Answer 18

1. Normal or elevated PSV followed by a precipitous decline
2. Reversed flow during diastole
3. Flow should be above the baseline, and it’s not biphasic

Question 19

What is the normal PSV in CCA?

Answer 19

45-125 cm/sec

Question 20

What is considered high flow?

Answer 20

> 125 cm/sec

- in both CCAs

Question 21

Where do you see high cardiac output? (2)

Answer 21

1. Hypertensive patients

2. Young athletes

Question 22

What is considered low flow?

Answer 22

< 45 cm/sec

- in both CCAs

Question 23

Where do you see poor cardiac output? (3)

Answer 23

1. Cardiomyopathies
2. Valvular heart disease
3. Extensive myocardial infarction