Week 5 - Lesson 2 (Part 1)

Question 1

Stenosis

Answer 1

The narrowing of the arterial lumen, causing a hemodynamically significant change in flow

Question 2

What can a significant stenosis cause?

Answer 2

Collateralization

- if its progressive

Question 3

Total occlusion

Answer 3

The complete blocking of flow within an arterial lumen

Question 4

When does collateralization occur?

Answer 4

If occlusion is not a sudden occurrence as with an emboli lodging in a small lumen

Question 5

Where does plaque commonly form?

Answer 5

At the common carotid bifurcation

- involves distal CCA, Prox ECA/bulb, Prox ICA

Question 6

How can plaque be characterized? (5)

Answer 6

1. Homogenous
2. Soft
3. Heterogenous
4. Ulcerated
5. Calcified

Question 7

What needs to be evaluated with plaque? (6)

Answer 7

1. Extent
2. Location
3. Surface contour
4. Texture
5. Assess degree of luminal stenosis
6. Evaluate in both transverse and sagittal projections

Question 8

What is the best way to evaluate and characterize plaque?

Answer 8

Gray scale US

Question 9

What is considered abnormal intima thickness?

Answer 9

> 0.9mm

Question 10

Homogenous plaque

Answer 10

Generally uniform echo pattern and smooth surface

- 80-85% of patients

Question 11

What does calcified plaque produce?

Answer 11

Posterior acoustic shadowing

Question 12

How does calcified plaque appear on US?

Answer 12

Very echogenic

Question 13

Does calcified plaque occur in symptomatic or asymptomatic patients?

Answer 13

Asymptomatic

Question 14

Heterogenous plaque (2)

Answer 14

1. Complex echo pattern
   - contains one or more sonolucent areas
2. Cauliflower calcification appearance

Question 15

Ulcerated plaque (4)

Answer 15

1. Focal depression or break in plaque surface
2. Irregular border contour
3. Emboli twinkle artifact
4. Hard plaque in the proximal ICA

Question 16

Fibromuscular Dysplasia

Answer 16

Abnormal growth of cells in vessel walls and causes areas of narrowing

Question 17

Where does fibromuscular dysplasia occur?

Answer 17

In the distal portion of the ICA

Question 18

Carotid pseudoaneurysm

Answer 18

Collection of blood that results from injuries

Question 19

Where does carotid pseudoaneurysm occur?

Answer 19

Between the medial and extra layer of the tissue layers

Question 20

Carotid/vertebral artery dissection

Answer 20

Intimal flap in the lumen of the vessel

Question 21

Where does carotid/vertebral artery dissection occur?

Answer 21

Usually in the carotid artery

Question 22

Takayasus

Answer 22

Inflammation of the vessel walls

- thick walls

Question 23

Where is takayasus seen?

Answer 23

Chemo or addictions

Question 24

Raynaud’s phenomenon

Answer 24

Condition where the blood flow reduces to the fingers and toes

Question 25

What are 2 symptoms of Raynaud’s phenomenon?

Answer 25

1. Discolouration | 2. Painful

Question 26

Where is carotid body tumour found?

Answer 26

At bifurcations

Question 27

What is another term for carotid body tumour?

Answer 27

Paragangliomas

Question 28

What does carotid body tumour cause?

Answer 28

Widening

Question 29

Are carotid body tumour highly vascular?

Answer 29

Yes

Question 30

Are carotid body tumour usually benign or malignant?

Answer 30

Benign | - 5-10% are malignant

Question 31

Thoracic outlet syndrome

Answer 31

Compression of nerves, artery or veins that usually happen from the clavicle and the 1st rib

Question 32

Endarterectomy

Answer 32

Surgical treatment for stenosis - US pre and post this surgery - incision in the artery and remove the intema or media layer

Question 33

Carotid stenting

Answer 33

Go through the artery with a balloon and try to open it up and widen it - treatment for narrowing - artificial tube (stent)