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Abdominal Vascular Studies Flashcards

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1
Q

The gonadal arteries arise from the aorta how?

A

Anterolaterally

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2
Q

Is the celiac axis part of the mesenteric arteries?

A

yes

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3
Q

Common iliacs typically measure:

A

<1.5cm

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4
Q

Saccular aneurysms occur more often in the:

A

thoracic aorta

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5
Q

Pseudoaneurysms involve all three layers

A

false

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6
Q

What measurement do they intervene with aneurysms?

A

> 5.5cm

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7
Q

What’s the preferred method of treatment for AAA?

A

EVAR – endovascular aneurysm repair. A stent is inserted via a groin vessel

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8
Q

What can be seen after an EVAR procedure?

A

endoleaks

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9
Q

What types of endoleaks are most common?

A

Type 1- flow is leaking proximally or distally at an attachment point due to a poor seal at one end
Type 2- retrograde flow is leaking into the aneurysmal sac via a branch vessel

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10
Q

If you see flow in what two vessels indicates an endoleak?

A

IMA and lumbar arteries

These should be occluded as a result of the graft

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11
Q

What disease makes one prone to thoracic aorta dissection?

A

Marfan’s

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12
Q

Which lumen is bigger, true or false?

A

False

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13
Q

Aorta measurements should be :

A

outer to outer

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14
Q

Aorta velocities?

A

40-100cm/s

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15
Q

Where does the SMA and IMA provide blood to?

A 
SMA= small and large bowel
IMA= large bowel
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16
Q

Mesenteric arteries aka

A

Splanchic

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17
Q

Most common form of mesenteric iscemia is? What are the main causes?

A

Chronic mesenteric ischemia – 2/3 vessels need to be severely occluded before symptoms arise. Atherosclerosis is main cause

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18
Q

Which is more serious, acute or chronic mesenteric ischemia?

A

Acute – is caused by thrombus, embolus or external compression, and mimics the same as Gb disease, etc. Mortality rate of 50%

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19
Q

In the mesenteric vessels, where is the most likely area for an aneurysm ?

A

splenic artery, usually found incidentally

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20
Q

Where does the celiac primarily supply blood to?

A

liver and spleen

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21
Q

Arterial perfusion relies on:

A

cardiac output
blood pressure
blood volume

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22
Q

Normal ICA/CCA PSV ratio

A

<2

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23
Q

The _______ in ankle systolic pressure after exercise is an indicator of severity of PAD

A

Fall

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24
Q

After a patient has been on the treadmill for 3 minutes, they come off an get pressures taken. They have a high fall in pressure, what does this indicate?

A

Severe PAD

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25
What's the alternative to the treadmill test?
Reactive hyperemia test
26
Plethysmography aka
pulse volume recording
27
In reactive hyperemia, a decrease of _____ or more indicates PAD
50%
28
When an occlusion occurs in the ICA, flow in the ophthalmic artery becomes ______ in order to supply the brain
retrograde
29
With penile Dopplers, PSV is an indicator of? and EDV?
PSV- arterial dysfunction | EDV- venous dysfunction
30
If patients are going through chemo or radiation, what can they experience?
Takayasus arteritiis: inflammation of vessel walls
31
Carotid body tumor aka
paraganglioma, highly vascular tumor
32
What's the treatment for plaque in arteries?
endarterectomy
33
PSV is the first thing to be affected in a stenosis. In critical stenosis it’s EDV
True
34
The higher the stenosis, the ______ the EDV
higher
35
Normal flow velocities for SCA, CCA, ICA, ECA and vertebrals:
``` SCA: 140cm/s CCA: 80-100cm/s ICA: <125cm/s ECA: <120cm/s Vertes: 20-60cm/s ```
36
What bumps up stenosis from moderate to severe?
EDV
37
When we see an ICA waveform in the ECA, what does this mean?
Internalization -- when the ICA is occluded, the ECA takes on the job
38
When do we see water hammer sign:
With aortic regurgitation -- signifies that something is going on distally Rapid forward flow, and then a little bit of reversal
39
Risk factors for atherosclerosis:
``` Smoking Obesity Hyperlipidemia Hypertension Diabetes Family hx Psychosocial factors Unhealthy diet Gender Age ```
40
HDL and LDL levels
HDL- >60mg/dl is good | LDL- >160mg/dl is too high
41
What's the most devastating area of a stroke? Cerbellar, RT side, Brain stem or LT side
Brainstem
42
Within _____cm of the carotid bulb do most stenoses occur?
2cm
43
What are the gold standards for strokes?
MRA and CT
44
Stent's can cause
an increase in velocity within. Gradual but not abrupt. Up to 150cm/s
45
What ratio indicates restenosis in a stent?
2:1
46
What is the criteria of stenosis for CAS and CEA?
>50-99% stenosis for symptomatic >60-99% for asymptomatic risk must be under 3% But also the notes say they don't put stents in asymptomatic pt's rn?
47
Yin - yang appearance
Pseudoaneurysm
48
Where is aortic coaractation most common? Is it acquired or congenital?
Congenital -- most often in aortic arch
49
Risk factors for DVT:
Hereditary -- blood disorders | Acquired- age, obesity, malignany, pregnancy, OC use, trauma, immobilization, recent surgery
50
What is the Homan's sign?
Pain on dorsiflexion of foot
51
What are the 3 main symptoms of DVT:
Swollen, warm and painful legs | + Homan's sign
52
What does D-dimer test measure? When is it not helpful?
D-dimer measures the fibrin that accumulate in the blood | Not helpful for pt's over 80, pregnant, or hospitalized
53
It is the simplest, noninvasive way to monitor the percentage of hemoglobin that is saturated with oxygen
Pulse oximeter <95% is abnormal
54
Post thrombotic syndrome symptoms:
chronic leg swelling, ankle pigmentation and ulceration
55
What causes skin pigmentation?
Breakdown of hemoglobin
56
Difference in mobile vs immobile patients with clots:
mobile (mild) cases, the body's normal thrombolytic mechanisms will clear it up immobile patients, the clot will increase in size
57
If patients are obese and you cannot see the vein, what can help you with a diagnosis?
Loss of phasicity and poor augmentation response
58
What's the most common cause of an upper extremitiy DVT?
placement of a central venous catheter or pacemaker lead
59
What are some symptoms of UEVT?
``` asymptomatic facial/arm edema neck/shoulder pain blurred vision (SVC) head fullness (SVC) vertigo/blurred vision (SVC) ```
60
If you see an abnormal signal in one vessel, what should you do?
Compare with the other side
61
Paget-Schroetter syndrome: | primary UEDVT= are PSS + TOS
Heavy exertion from activities such as wrestling, weight lifting, etc. causes microtrauma to vessel intima, which leads to coagulation issues. UEDVT in young healthy individuals
62
Secondary DVT:
Caused by VAD and/or cancer. Incorrectly placed catheters are the cause. central catheters should be placed in lower third of SVC by RA
63
Where are more central venous access devices placed? Which side is preferred?
SCV and IJV. Right IJV is preferred because of it's straight course to the heart
64
What increases the pulsatility of the doppler waveform in the EIV and CFV?
Tricuspid valve regurgitation and/or right heart failure
65
Renals should measure:
<2cm
66
Superficial thrombophlebitis most commonly occurs in:
varicose veins
67
Clinical signs of superficial thrombophlebitis?
Severe pain and redness, inflammation, swelling, pyrexia and palpable cord
68
Lower limb artery stenoses criteria:
``` <1.5:1 - normal 1.5-2:1- 25-50% 2-4:1- 50-75% 4:1- >75% No flow: occluded ```
69
What's a good predictor of renal artery disease? Is US the gold standard?
RI. No, CTA or MRA
70
Where does FMD most commonly affect the RA?
Mid to dst portion
71
Is FMD bilateral?
Yes
72
Do we use angle correct on RAR
Not on intrarenal vessels
73
What can cause RV thrombosis?
underlying diseases, dehydration, hyper-coagulability | tumors, extrinsic compression
74
What happens if FMD is left untreated?
Potential dissection
75
Most common organs for infarct
Spleen and kidney
76
After a transplant, what would likely occur first? Occlusion or stenosis?
Occlusion
77
Where do we measure the aorta in the RAR?
Just before renals
78
Resistant index aka
Pourcelot index
79
What vessels do we use for the RAR
Segmental or arcute in UP, mid and LP
80
RAR value? RI value?
RAR- >3.5 | RI- >0.7
81
The most common location for a incompetent perforating vein?
2/3 down the thigh, Hunterian perforator
82
Is the valsalva a useful tool in the lower leg?
No
83
Abnormal calf & thigh perforator measurement
3mm calf | 4mm thigh

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