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Vasculature > Week 5 - Lesson 2 (Part 3) > Flashcards

Week 5 - Lesson 2 (Part 3) Flashcards

1
Q

What does normal < 125 cm/s PSV mean?

A

Minimal or no spectral broadening

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2
Q

What does 1-15% - < 125 cm/s PSV mean?

A

Spectral broadening during deceleration phase of systole

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3
Q

What does 16-49% - < 125 cm/s PSV mean?

A

Spectral broadening throughout systole

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4
Q

What does 50-79% - < 125 cm/s PSV mean?

A

With end diastolic < 140cm/s and marked spectral broadening

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5
Q

What does 80-99% - < 125 cm/s PSV mean?

A

With end diastolic > 140 cm/s and marked spectral broadening

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6
Q

What does 100% - < 125 cm/s PSV mean?

A

Occlusion

  • no signal
  • blockage
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7
Q

What does end diastole do?

A

Bumps the stenosis from mild to severe/critical

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8
Q

Spectral broadening

A

Is the window beneath the waveform that is partially or completely filled in

  • seen in varying degrees of stenosis
  • also can be man made by us not being careful with doppler gain
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9
Q

What kind of diastolic flow does the ECA have?

A

Relatively little diastolic flow

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10
Q

What kind of diastolic flow does the ICA have?

A

Relatively high diastolic flow

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11
Q

What kind of characteristic flow does the CCA have?

A

Usually has both ECA and ICA flow pattern characteristics

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12
Q

Where is the highest velocity in the vessel?

A

In the centre of the lumen

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13
Q

Where is the lowest velocity in the vessel?

A

By the walls

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14
Q

Where is low resistance flow? (4)

A
  1. Brain
  2. ICA
  3. Kidneys
  4. Liver
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15
Q

What kind of resistant flow is forward flow in systole?

A

High

  • above the baseline
  • first stroke
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16
Q

What kind of resistant flow is diastole?

A

Low or reversed

  • below the baseline
  • second stroke
17
Q

What kind of flow is late diastole?

A

Forward flow

  • above the base line
  • third stroke
18
Q

Where is high resistance flow? (6)

A
  1. Face
  2. Scalp
  3. Muscles
    - not during exercise
  4. Eyes
  5. Arms
  6. Legs
19
Q

What is the flow in the bulb like?

A

Disturbed

20
Q

Why is the flow in the bulb disturbed flow?

A

Due to separation of flow as it enters the proximal ICA where it widens

21
Q

How does flow in the bulb appear on spectral doppler?

A

Above and below the baseline

- this is normal

22
Q

What does black indicate in the bulb on colour doppler?

A

It is the point of when it hinges from red to blue or blue to red
- no flow signal occurs here

23
Q

What are factors affecting the ICA waveform? (8)

A
  1. Atheroma/plaque
  2. Tortuosity
  3. Aortic valve disease
  4. Aortic arch/innominate disease
  5. Distal carotid siphon disease
  6. Intracranial vessel disease
  7. Contralateral carotid occlusion
  8. High cardiac output states
24
Q

What are problems and pitfalls with doppler? (6)

A
  1. Incorrect doppler sample volume (gate) position or size
  2. Doppler angle is too large
    - > 60 degrees
  3. Doppler settings are too high for low velocity
  4. Tortuous vessels
  5. High grade stenosis
  6. Calcified plaque
25
Q

How do you correctly set up doppler? (4)

A
  1. Angle correct is at 60 degrees
  2. Located centrally within vessel and parallel to walls
  3. Colour flow box angled correctly
  4. Spectral waveform set correctly with baseline and velocity scale
26
Q

What kind of sample gate do you want with a larger vessel?

A

Smaller sample gate

27
Q

What kind of sample gate do you want with a smaller vessel?

A

Wider sample gate

- need to let more through because the vessel is already small

28
Q

What can cause a stenosis?

A

Kinks in a vessel

- tortuous

29
Q

How can you tell if you have an ICA occlusion? (3)

A
  1. ICA will have no colour flow
  2. Visible plaque at origin
  3. Hypoechoic lumen
30
Q

Why do they only do surgery if the ICA is blocked, not the ECA?

A

It can cause a stoke because it supplies the brain

- ECA is just monitored

31
Q

What happens once a vessel is occluded?

A

It cant be opened again, so other routes are put in place for blood flow

32
Q

What are causes of pulsatile neck masses? (5)

A
  1. Normal but prominent carotid artery bulb
  2. Ectatic carotid,brachiocephalic or subclavian artery
  3. Aneurysm of carotid artery
  4. Carotid body tumour
  5. Enlarged lymph node adjacent to carotid sheath
33
Q

Ectatic

A

Jagged road

- due to vessel wall damage

Vasculature (45 decks)

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