Anatomy Pt 1 Flashcards
(140 cards)
1
Q
What is the proper caliper placement for assessing the portal vein diameter?
A. Inner wall to inner wall at the point the portal vein crosses the IVC
B. Inner wall to inner wall at the junction of the splenic vein and portal vein
C. Outer wall to outer wall at the point the portal vein crosses the IVC
D. Outer wall to outer wall at the junction of the splenic vein and portal vein
A
A
The portal vein should be assessed with the patient supine and with quiet respiration. The measurement should be obtained at the point the portal vein crosses the IVC.
2
Q
The ECA is normally \_\_\_\_\_\_\_ to the ICA. A. Lateral B. Medial C. Superior D. Inferior
A
B
The ECA usually courses anteriorly and medially in the neck to feed structures including the face, tongue and scalp. The ICA usually courses posteriorly and laterally to enter the skull and feed the cerebral tissues.
3
Q
Which of the following statements regarding a duplex exam of the upper extremity veins is false?
A. The cephalic vein is easily compressed with light probe pressure, which can be an exam limitation.
B. The subclavian and innominate veins normally demonstrate continuous flow.
C. Inspiration will cause an increase in flow within the larger upper extremity veins.
D. The internal jugular vein is usually part of the upper extremity evaluation.
A
B
Proper compression of the subclavian vein is normally inhibited by the clavicle. The subclavian and innominate veins usually demonstrate pulsatile, physic flow.
4
Q
A mesenteric to aortic ratio is considered normal when it is \_\_\_\_\_\_. A. > 1.0 B. 1.0 or less C. > 3.0 D. < 3.0
A
B
The mesenteric velocity should be similar to the aortic velocity, which would yield a ratio of around 1.0. As the stenosis in the SMA increases, the velocity increases and the ratio increases. SMA/aortic ratio > 3.0 indicates significant stenosis.
5
Q
Which of the following is an expected change in flow in the brachial artery that occurs when the patient clenches their fist during the Doppler exam?
A. Decreased resistive index
B. Increased pulsatility index
C. Triphasic to Monophasic waveform change
D. Increased diastolic flow
A
B
Clenching the fist causes an increase in distal resistance. The brachial artery will show increased pulsatility and resistance with decreased diastolic flow.
6
Q
Respiration and \_\_\_\_\_\_\_\_\_ are responsible for venous blood flow. A. Vessel recoil B. Valsalva maneuvers C. The calf muscle pump D. The tunica media layer of the wall
A
C
Respiration and the calf muscle pump are responsible for moving venous blood through the body.
7
Q
Which vessel wall layer is thicker in arteries than in veins? A. Tunica media B. Tunica externa C. Vasa vasorum D. Tunica intima
A
A
The muscular layer is thicker in the arteries to help maintain their shape and to handle the higher pressure blood flow within.
8
Q
Which of the following structures is supplied by branches of the internal carotid artery?
A. Lateral nose only
B. Parietal lobe only
C. Eyes and lateral nose, but not the parietal lobe
D. Eyes, lateral nose and parietal lobe
A
D
Branches of the internal carotid artery supply the eyes, lateral nose and parietal lobe.
9
Q
Which of the following is not normally a branch of the ophthalmic artery? A. Supraorbital artery B. Frontal artery C. Posterior auricular artery D. Nasal artery
A
C
The posterior auricular artery branches from the ECA and supplies the ear with oxygenated blood.
10
Q
Which vein(s) originates at the ankle and courses along the medial border of the fibula to join the posterior tibial veins just distal to the popliteal fossa? A. Small saphenous vein (SSV) B. Peroneal veins (PER) C. Great saphenous vein (GSV) D. Deep femoral veins (DFV)
A
B
The peroneal vein originates at the ankle and courses along the medial border of the fibula to join the PTV just distal to the popliteal fossa.
11
Q
Which of the following veins originates at the medial wrist and courses up the medial arm to join the axillary vein? A. Radial vein B. Basilic vein C. Ulnar vein D. Cephalic vein
A
B
The radial veins join the ulnar veins at the elbow to form the brachial vein(s). The cephalic vein originates near the base of the wrist and travels up the lateral side of the arm to empty into the subclavian vein.
12
Q
Which of the following normal vessels will collapse when you ask the patient to sniff quickly with moderate exertion? A. Common femoral vein B. Basilic vein C. Subclavian vein D. Cephalic vein
A
C
The quick change in intrathoracic pressure with a sniff should cause the normal subclavian vein to collapse quickly due to the increased outflow into the innominate vein.
13
Q
Which blood vessel courses anterior to the aorta and posterior to the SMA? A. Right renal vein B. Inferior mesenteric vein C. Superior mesenteric vein D. Left renal vein
A
D
The left renal vein courses from the left kidney across the abdomen between the aorta and SMA to reach the IVC.
14
Q
An effective calf pump causes ___________ in the pressure in the deep veins of the calf.
A. An increase in cardiac output and an increase
B. A decrease
C. An increase
D. Little change
A
B
Effective calf pump reduces blood stasis/pooling, decreases venous volume and pressure in the calf veins. Ineffective calf pump leads to increased stasis, venous volume and pressure in the calf veins; reflux is a contributing factor.
15
Q
An ineffective calf muscle pump causes:
A. The pressure in the deep veins to drop
B. Flow to move through the perforators into the deep system
C. The pressure in the superficial veins to drop
D. The pressure in the deep calf veins to increase
A
D
Effective calf pump reduces blood stasis/pooling, decreases venous volume and pressure in the calf veins. Ineffective calf pump leads to increased stasis, venous volume and pressure in the calf veins; reflux is a contributing factor.
16
Q
Which of the following terms can be used to describe the normal Doppler waveform in the portal vein?
A. Continuous with mild pulsatility
B. Blunted with respiratory phasicity
C. Prominent respiratory phasicity and mild pulsatility
D. Continuous with minimal respiratory phasicity
A
D
Venous flow in the portal system normally demonstrates no cardiac pulsatility with minimal respiratory phasicity due to the increased thickness of the vessel walls and location in the abdomen.
17
Q
What term refers to the capability of the vascular beds to alter the resistance to flow to maintain the levels of flow needed for normal function? A. Laminar flow B. Autoregulation C. Vasodilation D. Vasoconstriction
A
B
Vasoconstriction and vasodilation are ways the vascular beds auto regulate the flow.
18
Q
Which of the following statements is true regarding the vertebral arteries?
A. The right vertebral artery is the first branch of the aortic arch
B. The right vertebral artery is normally smaller than the left
C. Vertebral artery flow is normally biphasic due to turbulence at their junction with the basilar artery.
D. The right and left vertebral arteries empty their blood into the right and left basilar arteries.
A
B
The right vertebral artery is normally smaller than the left vertebral artery.
19
Q
The ICA terminates into which two branches of the Circle of Willis?
A. MCA and ACA
B. Vertebral and basilar arteries
C. MCA and posterior communicator arteries
D. PCA and ACA
A
A
Bilateral ICAs course superiorly to join the Circle of Willis on the lateral aspect of each side of the brain. In most patients, they terminate at the origination of the MCA and ACA. The PCoA is branch of the distal ICA.
20
Q
Increased transducer pressure during a venous evaluation can have what negative effect on the exam? A. Demonstrate compression of a vein B. Increased beam intensity C. Non-visualization of normal veins D. Increase beam penetration
A
C
If the transducer pressure is too great, normal superficial veins could be compressed causing non-visualization. Beam intensity does not change with transducer pressure. Transducer compression should be performed to assess vein compression (not a negative effect).
21
Q
The gastrocnemius veins empty into the \_\_\_\_\_\_\_\_\_. A. Distal SFV B. Distal profunda vein C. Popliteal vein D. Great saphenous vein
A
C
The gastrocnemius veins are part of the venous system of the calf muscles. Together with the soleal sinuses, they provide a venous reservoir for extremity blood.
22
Q
Proximal augmentation during an extremity Doppler evaluation is used to assess: A. Arterial insufficiency B. For the presence of CHF C. Vein compressibility D. Venous insufficiency
A
D
Proximal augmentation and distal augmentation techniques are used to assess for venous insufficiency. Distal augmentation is also used in the DVT evaluation.
23
Q
The posterior communicating arteries connect the: A. PCA and MCA B. ACA and PCA C. Basilar and PCA D. Vertebral and basilar
A
A
The posterior communicating arteries connect the ipsilateral PCA and MCA.
24
Q
Once the pressure in the deep venous system consistently exceeds the pressure in the superficial system,
A. Perforators will exhibit stasis of flow and thrombus formation
B. Perforators will dilate and allow flow to only move into the deep system.
C. Perforators will constrict forcing flow reversal into the superficial system
D. Perforators will dilate leading to bi-directional flow
A
D
Once pressure in the deep venous system consistently exceeds the pressure in the superficial system, perforators will dilate leading to bi-directional flow.
25
```
Which of the following is a direct branch of the aortic arch?
A. Right carotid
B. Left vertebral
C. Left carotid
D. Right vertebral
```
C
The three main branches of the aortic arch are the innominate artery, left common carotid artery and left subclavian artery.
26
```
The normal flow profile within the aorta is termed:
A. Phasic flow
B. Plug flow
C. Recoil flow
D. Continuous flow
```
B
The layers of blood flow in the aorta move relatively the same speed and this is called plug flow. Laminar flow patterns occur in smaller vessels. The velocity of the layers of blood flow in these vessels vary slightly by decreasing as they near the vessel wall.
27
__________ receives the blood from the posterior tibial perforators and plays a major role in venous stasis of the lower extremity.
A. The lateral perforator
B. The anterior accessory saphenous vein
C. The posterior accessory saphenous vein
D. The posterior venous arch
D
Posterior arch vein extends superior from the ankle to the GSV in the mid-calf; plays a major role in venous stasis; connected to 3 ankle perforators called posterior tibial perforators (formerly Cockett’s Perforators).
28
The Supraorbital artery is a branch of the _________. Branches of the supraorbital artery connect with branches of the ___________, which is a branch of the ECA. This is a common collateral pathway from the ECA to the ICA.
A. ICA, facial artery
B. ICA, ophthalmic artery
C. Ophthalmic artery, maxillary artery
D. Ophthalmic artery, superficial temporal artery
D
The supraorbital artery is a branch of the ophthalmic artery. Branches for the supraorbital artery connect with branches of the superficial temporal artery, which is a branch of the ECA. This is a common collateral pathway from the ECA to the ICA.
29
```
Which of the following will increase spectral broadening on the image?
A. Increased sample volume size
B. Increased wall filter
C. More laminar flow
D. Increased PRF
```
A
Increasing sample volume size on pulse wave Doppler will allow for sampling of more blood cells moving at different velocities. The increase in the number of velocities displayed will cause fill in of the spectral window.
30
Which of the following veins are part of the superficial venous system in the lower extremity?
A. Small saphenous vein and peroneal veins
B. Posterior tibial vein
C. Great saphenous vein and femoral vein
D. Great and small saphenous veins
D
| The great and small saphenous veins make up the superficial venous drainage system of the lower extremity.
31
Which of the following is NOT normally a part of a test for vasculogenic impotence?
A. Obtain Doppler samples of the cavernous arteries and veins in the penis
B. Obtain Doppler samples of the CFA, PTA and DPA.
C. Measure the length of the cavernous arteries
D. Obtain blood pressures in the arms and ankles
C
When performing a penile Doppler exam, obtain Doppler samples of the CFA, cavernous arteries and veins in the penis. Doppler sample will also be taken in the PTA and DPA while performing ankle pressures. The ABI should be evaluated to determine if PAD can be causing the erectile dysfunction. The diameter of the Caverness arteries should be measured.
32
Which of the following statements is true regarding the Tunica intima?
A. The vasa vasorum forms within the intimal layer.
B. An intimal dissection requires generation of a preliminary report and a stat review by a physician. 
C. The intimal layer of the artery will become less prominent with age and more difficult to visualize sonographically.
D. The Tunica intima is responsible for holding the vessel shape and allowing for wall flexibility.
B
An intimal dissection requires generation of a preliminary report and a stat review by a physician. It is considered a critical finding. The vasa vasorum surrounds the outer wall of the vessel to supply the walls with blood. The tunica media is responsible for holding the vessel shape and allowing for wall flexibility. The intimal layer of the artery will become more prominent with age and more easily visualized sonographically.
33
Which of the following characteristics is/are seen in a normal hepatic vein Doppler tracing?
A. Cardiac Pulsatility and respiratory phasicity
B. Respiratory Phasicity only
C. Monophasic flow and respiratory phasicity
D. Cardiac pulsatility only
A
Cardiac pulsatility is normally seen in the hepatic veins and upper abdominal portion of the IVC. The motion of the heart causes vibrations within the chest that are carried throughout the adjacent structures. The flexibility of the IVC and hepatic veins allow the vibrations to affect the flow inside causing pulsatility. As the diaphragm moves up and down with respiration, the intra-abdominal pressure is affected. Inspiration causes the diaphragm to move down which increases the intra-abdominal pressure. This causes flow in the abdomen and lower extremities to decrease or cease movement. The diaphragm moves upward with expiration and the intra-abdominal pressure decreases allowing flow to move toward the heart again.
34
```
Which of the following is considered an abnormality that causes turbulence in a vessel?
A. Bifurcation
B. Tortuosity
C. Eccentric change in vessel course
D. Myointimal hyperplasia
```
D
Abnormal causes of turbulence are acquired. Myointimal hyperplasia occurs with stent or bypass graft placement. Atherosclerosis formation or bypass graphs are acquired causes of turbulent flow in a vessel. The other choices offered are normal anatomic variants that can cause turbulence.
35
```
Which of the following terms would be used to describe abnormal venous flow in the deep veins of the thigh?
A. Phasic
B. Spontaneous
C. Pulsatile
D. Low velocity
```
C
The term pulsatile refers to arterial flow changes that occur with cardiac systole and diastole. Venous flow varies with respiration and normally has very low velocity. Spontaneous flow should also be present (without any augmentation maneuvers applied). If venous flow is pulsatile in the lower extremities, cardiac complications, like CHF or severe tricuspid regurgitation, should be suspected.
36
```
The __________ course(s) Between the tibial and fibular head to empty blood into the popliteal vein.
A. Peroneal veins
B. Small saphenous vein
C. Anterior tibial veins
D. Posterior tibial veins
```
C
ATVs course anterolaterally to the tibial bone across the interosseous membrane of the calf and through space between the tibial and fibular head to empty into the popliteal vein.
37
Where are the venous sinusoids in the lower extremity?
A. Between the soleal and gastrocnemius muscle
B. Within the adductor canal
C. Within the quadriceps
D. Popliteal fossa
A
The venous sinusoids serve as blood reservoirs in the calf and are an important part of the calf pump mechanism. They are located between the soleal and gastrocnemius muscle.
38
```
What two veins converge to form the superior vena cava?
A. Right and left subclavian
B. Axillary and cephalic
C. Right subclavian and innominate
D. Right and left innominate
```
D
| The right and left innominate veins converge to form the superior vena cava.
39
```
The radial and ulnar veins merge to form the ________ at the _____________ fossa.
A. Axillary vein, antecubital
B. Axillary vein, axillary
C. Brachial vein, antecubital
D. Brachial vein, popliteal
```
C
| The radial and ulnar veins merge to form the brachial vein at the anti-cubital fossa.
40
```
Which of the following vessels supply the majority of blood to the cerebellum?
A. Vertebral and basilar
B. ICA and Vertebral
C. ECA and Basilar
D. ICA and ECA
```
A
The cerebellum is located in the posterior fossa of the skull. The vertebral arteries course between the vertebral pedicles to converge into the basilar artery. Branches from the vertebral and basilar arteries feed the cerebellum and portions of the brain stem.
41
```
Which of the following veins does not normally contain any functioning valves?
A. Innominate vein
B. Axillary vein
C. Peroneal veins
D. Small saphenous
```
A
Lower extremity veins that do not contain valves = IVC, iliac veins and soleal sinuses; upper extremity veins that do NOT contain valves = SVC and innominate veins.
42
Where should the Doppler sample be placed to obtain the highest velocity when evaluating laminar flow?
A. In the center of the vessel
B. Adjacent to the posterior wall
C. Adjacent to be anterior wall
D. Varies with the type of vessel evaluated
A
The Doppler sample should be placed in the center of the vessel to obtain the highest velocity when evaluating laminar flow.
43
The small saphenous vein:
A. Originates immediately posterior to the Achilles’ tendon attachment at the heel and it ascends along the midline aspect of the posterior calf
B. Originates posterior to the lateral malleolus and ascends along the midline aspect of the posterior calf
C. Originates posterior to the medial malleolus and it ascends along the midline aspect of the posterior calf
D.  originates anterior to the lateral malleolus and ascends along the midline aspect of the posterior calf
B
The small saphenous vein originates posterior to the lateral malleolus and ascends along the midline aspect of the posterior calf.
44
```
What is the primary factor that determines the resistance characteristics of the arterial signal displayed by pulse wave Doppler?
A. Origin of blood
B. Branch number
C. Vessel course and location
D. Part it is supplying
```
D
Example: renal artery is low resistance for a normal kidney. Organs need constant flow throughout the cardiac cycle. The femoral artery is high resistance for a normal leg. Extremities do not need constant flow throughout the cardiac cycle.
45
The great saphenous vein originates _____________
A. At the dorsum of the foot and courses anterior to the medial malleolus.
B.  at the great toe and courses along the ventral aspect of the foot to reach the medial ankle and extend up the leg.
C. At the dorsum of the foot and courses anterior to the lateral malleolus.
D. At the great toe and courses along the ventral aspect of the foot to reach the lateral ankle and extend up the leg.
A
| The great saphenous vein originates at the dorsum of the foot and courses anterior to the medial malleolus.
46
All of the following are limitations of the 2D evaluation of the extremity veins, except:
A. Location of the subclavian vein
B. Increased transducer pressure
C. Increased amount of fibrous tissues and ligaments in the adductor canal
D. Inability to visualize the vessels immediately posterior to the inguinal ligament
D
The inguinal ligament is not normally visible on ultrasound evaluation and it does not cause non-visualization of adjacent anatomy. The adductor canal contains several ligaments and connective tissues that limit compression of the distal femoral vein. Increased transducer pressure can cause non-visualization of normal veins. The subclavian vein courses posterior to the clavicle, which limits manual compression.
47
```
Paired veins that accompany an artery of the same name are called:
A. Venae comitantes
B. Klippel Trenauney Weber syndrome
C. Duplicated veins
D. Posterior arch veins
```
A
48
Which of the following describes the probe placement for a Doppler evaluation of the frontal artery?
A. near the outer canthus of the eye
B. Just above the mid-point of the eyebrow
C. Approximately 2cm above the zygomatic arch
D. Near the inner canthus of the eye
D
Periorbital Doppler is a CW Doppler evaluation of the frontal artery (branch of the ophthalmic artery). An 8-10MHz pencil probe is placed near the inner canthus of the eye. Normal flow direction will be toward the probe.
49
```
The most cephalic branch of the abdominal aorta is:
A. Common hepatic artery
B. Celiac axis
C. Splenic artery
D. SMA
```
B
The celiac axis is the first abdominal branch of the aorta followed by the origin of the SMA approximately 2 cm more distal on the aorta. The renal arteries are the next distal branch followed by the IMA.
50
```
_____________ drain(s) blood from the GSV in the proximal thigh into the proximal and mid femoral vein.
A. Thigh perforators
B. Posterior tibial perforators
C. Posterior venous arch
D. Paratibial perforators
```
A
Hunterian’s perforators drain blood from the GSV in the proximal/mid-thigh into the femoral vein. They are also referred to as proximal thigh perforators.
51
```
Which transcranial window is most commonly used to evaluate the carotid siphon and the ophthalmic artery?
A. Temporal
B. Submandibular
C. Orbital
D. Occipital
```
C
| The orbital window is used to evaluate the carotid siphon and the ophthalmic artery.
52
Which of the following statements can be used to describe a normal renal artery waveform?
A. Low resistance with increased diastolic flow
B. Increased diastolic flow reversal
C. Biphasic with mild diastolic flow reversal
D. Pulsus alternans
A
Blood flow into organs is normally continuous throughout the cardiac cycle. The flow is described as low resistance or monophasic and demonstrates increased ante grade flow in diastole.
53
Which of the following describes how to correctly measure the width of the iliac artery?
A. Transverse view, outer wall to outer wall
B. Transverse view, outer wall to inner wall
C. Longitudinal view, outer wall to outer wall
D. Longitudinal view, outer wall to inner wall
A
When evaluating the diameter of the aorta and iliac arteries AP dimensions are obtained in longitudinal plane, from outer wall to outer wall of the vessel. Width dimensions are obtained in the transverse plane, from outer wall to outer wall of the vessel.
54
```
A normal peak velocity in the cavernosa arteries after a papaverine injection would be ____________
A. At least 50 cm/s
B. > 30 cm/s
C. < 20 cm/s
D. < 40 cm/s
```
B
A normal peak velocity in the cavernosa arteries after a papaverine injection would be > 30 cm/s. Reduced velocity indicates vasculogenic impotence.
55
Which of the following factors are related to potential hemodynamic changes within a vessel?
A. Vessel length and blood viscosity, but not vessel radius
B. Blood viscosity and vessel radius, but not vessel length
C. Vessel length and vessel radius, but not blood viscosity
D. Vessel length, vessel radius and blood viscosity
D
Changes in vessel length, vessel radius and blood viscosity are related to potential hemodynamic changes within a vessel.
56
The transducer is placed over the mid femoral vein while calf compression is performed. The Doppler waveform demonstrates spontaneous flow with an increase in a forward flow with the calf compression. Which of the following describes the findings?
A. The flow response is normal for the femoral vein.
B. Heart disease is most likely present which causes the abnormal flow response.
C. The popliteal and distal femoral veins have incompetent valves.
D. The popliteal vein has incompetent valves.
A
Normal response to distal augmentation is an increase in forward flow with the calf compression and NO flow reversal after the increase in flow.
57
```
The weight of the column of blood within the veins when standing is called?
A. Systemic pressure
B. Hydrostatic pressure
C. Pulmonary pressure
D. Transmural pressure
```
B
The systemic blood pressure is related to the arterial pressures within the body. The pulmonary pressure is related to the pressure within the pulmonary arteries.
58
```
The release of norepinephrine in the bloodstream has what affect on the arterioles?
A. Stenosis
B. Vasodilation
C. Vasoconstriction
D. Decreased flow resistance
```
C
| Norepinephrine causes vasoconstriction and adrenaline causes vasodilation. 
59
In the Circle of Willis there is/are:
A. 1 ACA communicator artery and 2 PCA communicator arteries
B. 2 ACA communicator arteries and 1 MCA communicator artery
C. 1 ACA communicator artery and 2 MCA communicator arteries
D. 2 ACA communicator arteries and 1 PCA communicator artery
A
| In the Circle of Willis there is 1 ACA communicator artery and 2 PCA communicator arteries.
60
Hydrostatic venous pressure ________ when a patient goes from standing to the supine position.
A. Decreases
B. Will show little change
C. Increases
D. Shows a quick decrease before returning to 100mmHg
A
Hydrostatic pressure refers to the weight of the column of blood within the veins when a patient is standing. The pressure is 0mmHg at the level of the heart and increases more distally to a level of 100mmHg at the ankles. When a patient lies down, the pressure in the “column” is eliminated.
61
```
Which of the arteries is supplied with blood from the ECA?
A. Posterior communicator artery
B. Anterior choroid artery
C. Maxillary artery
D. Ophthalmic artery
```
C
| The maxillary artery is a branch of the ECA. The other choices are fed by the ICA.
62
```
The primary mechanisms that control arterial flow volume changes during the cardiac cycle are:
A. Vessel length, peripheral resistance
B. Viscosity, vessel radius
C. Cardiac output, viscosity
D. Cardiac output, peripheral resistance
```
D
The primary mechanisms that control arterial flow volume changes during the cardiac cycle are cardiac output and peripheral resistance.
63
```
Which of the following vessels does not drain into the IVC?
A. Right gonadal vein
B. Right renal vein
C. Left hepatic vein
D. Splenic vein
```
D
The left gonadal vein empties into the left renal vein while the right gonadal vein empties directly into the IVC. The splenic vein is part of the portal system.
64
```
When evaluating the carotid siphon from the submandibular window, the sample depth should be set to value between:
A. 30-50mm
B. 40-60mm
C. 60-80mm
D. 80-110mm
```
C
| The carotid siphon is evaluated when the sample depth is placed at an approximate depth of 70mm (between 60-80mm).
65
The carotid siphon:
A. Is an area of flow separation due to the increase in vessel diameter at the bulb.
B. Causes an area of decreased resistance to flow in the distal ICA.
C. Usually forms a complete circle around the distal ECA before joining the circle of willis
D. Supplies blood to the ophthalmic artery.
D
ICA Siphon Area - distal ICA courses anteriorly then medially, then posteriorly forming an “S”; reduces flow, increases resistance flow, causes turbulence and has increased risk for flow reducing lesions such as atheroma and thrombus.
66
```
Which artery supplies the brain stem with arterial blood?
A. Anterior cerebral artery
B. Posterior cerebral artery
C. Posterior communicating artery
D. Basilar artery
```
D
| Branches from the vertebral and basilar arteries feed the cerebellum and portions of the brain stem.
67
```
The angular artery is the terminal branch of the __________.
A. Ophthalmic artery
B. Nasal artery
C. Anterior cerebral artery
D. Facial artery
```
D
| The angular artery is a terminal branch of the facial artery.
68
```
When a patient performs the Valsalva strain, the intra-abdominal pressure _________ and the intrathoracic pressure _________.
A. Increases, increases
B. Decreased, increases
C. Increases, decreases
D. Does not change, increases
```
A
When a patient performs the Valsalva strain, the intra-abdominal pressure increases and the intrathoracic pressure increases.
69
```
Which of the following vessels is evaluated using the submandibular TCD window?
A. ACA
B. Distal ICA
C. MCA
D. Vertebral arteries
```
B
| The distal ICA can be evaluated using the submandibular approach.
70
```
The left and right innominate veins merge to form the __________.
A. Brachiocephalic vein
B. Superior vena cava (SVC)
C. Right atrium
D. Inferior vena cava (IVC)
```
B
| The right and left innominate veins merge to form the SVC.
71
```
Which imaging plane can produce a longitudinal image of the IVC and the aorta on the same image?
A. Mid sagital
B. Coronal and transverse
C. Coronal
D. Transverse
```
C
Placing the patient in the decubitus position and placing the probe on the lateral aspect of the abdomen will demonstrate a longitudinal view of the aorta and IVC side-by-side on the image. A transverse view can also demonstrate both great vessels on the same image but will not provide a longitudinal view.
72
```
Which of the following locations has a direct connection between the deep and superficial veins of the leg?
A. Adductor canal
B. Groin
C. Hunter’s canal
D. Ankle
```
B
| The greater saphenous vein joins the common femoral vein in the groin area, adjacent to the inguinal ligament.
73
```
The ACA and its branches feed which of the following lobes of the brain?
A. Occipital and frontal
B. Occipital and parietal
C. Frontal only
D. Parietal and frontal
```
D
74
Using the suboccipital window, the normal Basilar and Vertebral arteries __________.
A.  Will demonstrate bidirectional flow
B. Cannot be evaluated using this transcranial window
C. Will demonstrate flow away from the probe
D. Will demonstrate flow toward the probe
C
The suboccipital window is performed by placing the transducer at the base of the skull and Cephalad into the cranium. The normal Basilar and Vertebral arteries will demonstrate flow away from the probe.
75
```
Poiseuille’s Law states that the __________ has the most significant effect on the blood flow in the vessel.
A. Vessel radius
B. Vessel length
C. Fluid viscosity
D. Pressure gradient
```
A
| A small change in vessel radius causes a dramatic change in the blood flow within.
76
Ohm’s Law of electrical current is also used to describe:
A. Arterial blood flow volumes
B. Venous capacitance
C. Arterial phasicity related to vessel recoil
D. The appearance of the flow vortices distal to a stenosis
A
Ohm’s Law of electrical current is also used to describe arterial blood flow volumes. Current = voltage / resistance which equates to flow volume = pressure / resistance
77
If the systemic blood pressure rises but flow remains constant, what happened to the resistance in the vascular beds?
A. No change
B. Increases
C. Unable to determine without knowing the flow velocity
D. Decreases
B
Resistance and pressure are directly related. If pressure goes up, resistance must go up to maintain a consistent amount of flow.
78
At what level in the neck does the common carotid artery normally bifurcate?
A. At the lower border of the larynx
B. At the upper level of the thyrocervical trunk
C. At the upper border of the thyroid cartilage
D. At the angle of the mandible
C
| The common carotid artery normally bifurcates at the level of the upper border of the thyroid cartilage.
79
```
Which superficial vein listed forms a connection at the elbow between the two main upper extremity superficial veins?
A. Radial vein
B. Cephalic vein
C. Antecubital vein
D. Basilic vein
```
C
| The antecubital vein (AKA median cubital vein) forms a connection at the elbow between the basilic and cephalic veins.
80
Which statement below is true regarding the normal CCA Doppler tracing?
A. The waveform is a combination of external and internal carotid characteristics. High resistance peaks with increased diastolic flow.
B. The waveform exhibits a sharp upstroke and minimal diastolic flow velocities.
C. The waveform exhibits triphasic pattern of flow.
D. None of the above
A
The waveform is a combination of external and internal carotid characteristics. High resistance peaks with increased diastolic flow.
81
```
____________ carry(s) the blood from the GSV in the distal thigh into the distal femoral vein.
A. Posterior venous arch
B. Thigh perforators
C. Paratibial perforators
D. Lateral perforators
```
B
The distal thigh perforators, formerly known as Dodd’s perforators, drain blood from the GSV in the distal thigh into the distal femoral vein.
82
```
Pressure in the venules does not normally exceed __________.
A. 20mmHg
B. 50mmHg
C. 0mmHg
D. 80mmHg
```
A
| Pressure in the venules does not normally exceed 20mmHg.
83
Which of the following describes the best technique used to visualize and locate the inferior mesenteric artery?
A. Transverse approach, locate renal arteries and slide inferiorly
B. Coronal approach on the left side mid flank
C. Sagital approach to the right of midline near umbilicus
D. Sagital approach to the left of midline near umbilicus
A
The best technique used to visualize and locate the inferior mesenteric artery is to use a transverse approach to evaluate the aorta. After locating the renal artery origins, slide inferiorly to look for the IMA. The IMA originates from the anterior aorta just distal to the renal artery origins.
84
Which gonadal vein empties directly into the IVC?
A. right gonadal vein
B. left gonadal vein
C. right and left gonadal veins
D. neither gonadal vein empties directly into the IVC
A
| The right gonadal vein empties into the IVC, while the left gonadal vein empties into the left renal vein.
85
Which of the following statements about the IVC is correct?
A. congestive heart failure and pulmonary HTN can cause IVC dilatation.
B. the IVC should normally maintain a relatively constant diameter with respiration.
C. The IVC is the most posterior vessel in the abdomen.
D. The IVC empties blood into the left atrium.
A
The IVC courses anterior to the level of the aorta and empties blood into the right atrium. The IVC should normally change diameter with respiration. The aorta maintains a constant diameter with respiration. Congestive heart failure, significant tricuspid regurgitation and pulmonary HTN can cause IVC dilatation.
86
Which of the following describes a cardiovascular application of the Bernoulli Principle?
A. explains the turbulence and layers of flow separation within the carotid bulb
B. explains the reason for increased resistance to flow at an area of focal stenosis.
C. explains the relationship of vessel radius and flow volume
D. explains the reason for aliasing of the Doppler signal at high velocities
A
| Bernoulli Principle explains the turbulence and layers of flow separation within the carotid bulb.
87
Which statement is true regarding the internal thoracic artery?
A. The Allen test must be performed to assess breast perfusion prior to harvesting the internal mammary artery.
B. It is a branch of the thoracic aorta.
C. It can be used as a coronary bypass graft.
D. It can be a source of collateral flow for the vertebrobasilar system.
C
The internal thoracic artery originates from the subclavian artery. The Allen test is used to evaluate the palmar arch when removing the radial artery.
88
```
When performing a lower extremity venous exam for insufficiency, you locate an incompetent vein connected to the GSV in the mid to upper calf by an incompetent perforator. Identify the vein.
A. Paratibial perforator
B. Vein of Giacomini
C. Small saphenous vein
D. Posterior arch vein
```
D
The posterior arch vein connects the posterior tibial perforators (Cockett's perforators) to the GSV in the mid to upper calf. This vein usually plays a major role in disease caused by venous stasis.
89
```
Which calf vessel's anatomic course has been referred to as a "stocking seam"?
A. small saphenous vein (SSV)
B. posterior tibial vein (PTV)
C. superficial femoral vein (SFV)
D. great saphenous vein (GSV)
```
A
The small saphenous vein originates very superficially in the distal posterior calf. It courses midline up the calf to reach the popliteal at or near the popliteal fossa. Its course has been said to resemble the seam of a type of pantyhose or stockings.
90
```
Which abdominal vessel arises from the anterior surface of the aorta approximately 2 cm distal to the celiac axis?
A. inferior mesenteric artery
B. superior mesenteric artery
C. gastroduodenal artery
D. common hepatic artery
```
B
| The SMA arises from the anterior surface of the aorta approximately 2cm distal to the celiac axis.
91
Which of the following arteries will be compressed when evaluating frontal artery flow for a periorbital Doppler exam?
A. external carotid artery and vertebral artery
B. ophthalmic artery and contralateral common carotid artery
C. superficial temporal artery and infraorbital artery
D. internal carotid artery and vertebral artery
C
A periorbital Doppler exam involves using CW Doppler to evaluate flow in the frontal artery (branch of the ophthalmic artery). Normal flow direction will be toward the probe. Flow moving away from the probe indicates a significant obstruction in the ipsilateral ICA. Compression of the infraorbital, facial and superficial temporal arteries is performed on both sides of the head, while monitoring the frontal artery flow. If compression of one of these arteries causes decreased or reversed flow in the frontal artery, the compressed vessel is being used as a collateral to fill the frontal artery (not the ICA).
92
```
Which vein courses from the lateral aspect of the wrist extending up the lateral arm to the shoulder to join the axillary vein?
A. cephalic
B. axillary
C. basilic
D. brachial
```
A
The cephalic vein courses from the lateral aspect of the wrist extending up the lateral arm to the shoulder to join the axillary vein to form the subclavian vein.
93
```
The gastrocnemius plexus is usually connected to the:
A. popliteal vein
B. great saphenous vein
C. profunda vein
D. superficial femoral vein
```
A
The gastrocnemius plexus is located in the calf muscle and drains into the popliteal veins. It acts as a reservoir for blood when sitting and standing etc.
94
Which of the following describes the normal appearance of a waveform obtained in the MCA?
A. low resistance flow that varies with patient respiration
B. low resistance, laminar flow with clear spectral window
C. low resistance with spectral broadening
D. low resistance, low velocity with small flow reversal component in diastole
C
| The intracranial arteries normally demonstrate spectral broadening due to the small size of the vessels.
95
```
A normal penile brachial index is:
A. >0.5
B. >0.8
C. >0.75
D. >0.6
```
C
The PBI is considered normal if it is greater than 0.75. Vasculogenic impotence is diagnosed when the PBI falls below 0.65. A PBI between 0.65 and 0.75 is considered suspicious for vasculogenic impotence but further evaluation is necessary.
96
Venous valve leaflets:
A. are composed of muscle cells.
B. are extensions of the vessel's intimal layer.
C. are small flaps of connective tissue within the veins.
D. are muscular flaps that control backflow within the venous lumen.
B
| Venous valve leaflets are extensions of the vessel's intimal layer.
97
```
Which of the following is directly related to the peak Doppler shift detected in an artery?
A. Valsalva
B. patient position
C. transducer frequency
D. sample size
```
C
Transducer frequency is directly related to the Doppler velocity. Increasing the transducer frequency will increase the detected Doppler shift. Because of calculations done inside the machine, it will still produce a waveform with the same velocity no matter what transducer frequency is used.
98
The innominate vein is formed by the junction of:
A. superior vena cava and inferior vena cava
B. subclavian vein and internal jugular vein
C. subclavian vein and cephalic vein
D. internal jugular vein and superior vena cava
B
| The innominate vein is formed by the junction of subclavian vein and internal jugular vein.
99
Where is the marginal artery of Drummond located?
A. connects the SMA and IMA through the mesentery
B. at the splenic hilum
C. part of the cerebrovascular circulatory system
D. connect the dorsalis pedis artery to the posterior tibial artery in the foot
A
The marginal artery of Drummond connects the SMA and IMA through the mesentery and is a possible pathway for collateral flow.
100
```
The hepatic artery carries _____ of the blood entering the liver.
A. 20-30%
B. 50-60%
C. 80-90%
D. 100%
```
A
The portal vein carries 70-80% of the blood entering the liver, but it is lower in oxygen saturation at 85%. The hepatic artery carries 20-30% of the blood into the liver and it has a 95% oxygen saturation. The portal venous system supplies just over half of the oxygen to the liver tissue because of the high volume of flow. The hepatic artery supplies just under half of the oxygen of the liver tissues.
101
```
The Achilles tendon is a landmark for which deep calf vein?
A. anterior tibial vein
B. peroneal vein
C. posterior tibial vein
D. small saphenous vein
```
C
The Achilles tendon is identified at the area of the medial malleolus. The posterior tibial veins drains blood from the plantar arches and then course cephalad laying anterior to the tendon and posterior to the medial malleolus/tibial bone. The SSV is located posterior to the tendon but it is a superficial vein.
102
```
Resistance to flow ______ as blood travels distally through the abdominal aorta.
A. increases
B. remains constant
C. decreases by 50%
D. decreases slightly
```
A
The proximal portion of the aorta demonstrates lower resistance, when compared with the distal portion. The branches of the upper and mid aorta feed low resistance capillary beds in the organs which affects the aortic flow causing it to be biphasic. The distal aorta branches into vessels that supply muscles and supporting structures of the legs. These tissues provide a much higher resistance to flow than the abdominal organs, causing triphasic flow in the distal aorta.
103
```
The seagull sign refers to which of the following vessels?
A. bilateral renal origins
B. common femoral bifurcation
C. three hepatic veins
D. celiac axis
```
D
The celiac axis and the two branches visible on US form the seagull sign. The CHA and Splenic artery form the wings of the bird.
104
```
Normal flow in the splenic artery:
A. is laminar
B. demonstrates Reynold's number > 2000
C. is high resistant
D. is hepatopetal
```
B
The splenic artery is the most tortuous artery in the body and carries very turbulent flow. A Reynolds number over 2000 indicates the point where turbulence is identified on color Doppler.
105
```
Which of the following can be used to describe a normal waveform obtained from a CW Doppler evaluation of the femoral artery?
A. delayed deceleration
B. low amplitude
C. no diastolic flow reversal
D. rapid upslope
```
D
Normal waveforms are triphasic with rapid upslope, sharp peak, rapid downslope, a small peak below the baseline representing diastolic flow reversal, followed by a small peak of flow above the baseline.
106
```
Which intracranial artery courses within the sylvian fissure?
A. posterior cerebral artery
B. middle cerebral artery
C. anterior cerebral artery
D. basilar artery
```
B
| The M2 segment courses within the sylvian fissure toward the lateral aspect of the cranium.
107
```
Which of the following is a branch of the ICA?
A. Ophthalmic
B. Superior thyroidal
C. Lingual
D. Temporal
```
A
The ophthalmic artery feeds the eye and surrounding structures. This is the only branch of the ICA before it enters the Circle of Willis. The ECA is responsible for feeding extracranial structures including the face, portions of the throat and neck, tongue and scalp.
108
```
During a TCD exam the depth is set to 55mm with a slight anterior angulation while using the temporal window. What vessel will be interrogated and what direction will the flow be moving?
A. MCA, toward the transducer
B. ACA, away from the transducer
C. PCA, away from the transducer
D. MCA, away from the transducer
```
A
| MCA = 30-60mm depth at temporal window; normally demonstrates flow moving toward the transducer
109
```
Which of the following is supplied with arterial blood through branches of the ECA?
A. eyes only
B. thyroid only
C. lateral nose only
D. lateral nose and thyroid
```
B
The superior thyroidal artery is the first branch of the ECA. The other choices are supplied with blood through intracranial branches of the ICA.
110
What are the standard windows used for a complete transcranial Doppler exam?
A. transtemporal only, other views performed if abnormalities identified
B. suboccipital, transtemporal
C. suboccipital, transtemporal, ophthalmic window
D. subocciptial, transtemporal, ophthalmic window, submandibular
C
The three standard windows used for a TCD exam are the suboccipital, transtemporal, ophthalmic window. The submandibular window is a supplemental view used to assess the distal ICA.
111
What effect will increased hematocrit levels have on an arterial duplex exam?
A. decreased blood flow velocities
B. increased color flow display
C. hematocrit levels do not affect a Doppler evaluation
D. decreased blood viscosity
A
| Increased hematocrit levels = increased viscosity = decreased flow velocities
112
```
The vessel wall layer that is composed of fibrous connective tissue is called:
A. tunica externa
B. vasa vasorum
C. tunica media
D. tunica intima
```
A
The external layer is composed of connective tissue and adheres to the surrounding structures. The tunica media refers to the muscular layer of the vessel wall. The inner layer is the tunica intima which is composed of epithelial cells and covered by the basement membrane.
113
```
Venous perforators connect the deep and superficial systems of the leg at many locations including:
A. groin only
B. groin and knee only
C. groin and ankle only
D. groin, knee, ankle
```
D
114
```
Bradycardia is defined as a heart rate less than ____ bpm.
A. 45
B. 50
C. 60
D. 65
```
C
| Bradycardia is defined as a heart rate less than 60 bpm. Tachycardia is defined as a heart rate more than 100 bpm.
115
Which of the following terms can be used to describe the normal Doppler waveform in the proximal renal vein?
A. mild pulsatility only
B. respiratory phasicity and mild pulsatility
C. respiratory phasicity only
D. continuous only
B
Venous flow in the IVC, hepatic and proximal renal veins normally demonstrates respiratory phasicity and mild cardiac pulsatility. At the renal hilum, the flow is more continuous with minimal respiratory phasicity.
116
```
Which vessels allow for the exchange of nutrients and waste products between blood and tissue?
A. segmental arteries
B. distal arteries
C. plantar and palmar arches
D. capillaries
```
D
Capillaries are the smallest vessels in the circulatory system and they allow for the exchange of nutrients and waste products between blood and tissue.
117
```
Which of the following arteries does not usually have a pair of veins of the same name?
A. brachial artery
B. peroneal artery
C. femoral artery
D. gastrocnemius artery
```
C
Femoral veins can be duplicated but this is not a common finding and is considered a variant. The brachial artery, forearm and calf arteries have paired veins of the same name.
118
```
Which vein below is usually the longest vein in the body?
A. small saphenous vein
B. femoral vein
C. great saphenous vein
D. inferior vena cava
```
C
| The great saphenous vein originates at the ankle and courses cephalad to join the common femoral vein in the groin.
119
```
Which of the following is the best anatomic landmark used to locate the left renal artery?
A. origin of the celiac axis
B. iliac bifurcation
C. left renal vein
D. portal confluence
```
C
The left renal vein courses anterior to the aorta and posterior to the SMA to reach the IVC. The LRA can normally be identified immediately posterior to the left renal vein in the transverse view of the abdomen.
120
Blood within the pulmonary veins:
A. contains a high oxygen content and flows into the right atrium.
B. contains a low oxygen content and flows into the left atrium
C. contains high oxygen content and flows into the left atrium
D. is normally high resistance
C
| Blood within the pulmonary veins contains high oxygen content and flows into the left atrium.
121
```
Which of the following vessels is most commonly assessed for the presence of a bruit?
A. common femoral artery
B. common carotid artery
C. PTA/DPA
D. aorta
```
B
| The CCA is the artery that is most commonly assessed for a bruit.
122
```
Which branch of the Circle of Willis supplies the corpus callosum and the cavum septum pellucidum with arterial blood?
A. ACA
B. PCA
C. MCA
D. basilar artery
```
A
The corpus callosum and the cavum septum pellucidum are located along the midline in the anterior brain. Both structures are fed by the anterior cerebral artery.
123
```
What is the first branch of the ascending aorta?
A. coronary arteries
B. left carotid artery
C. subclavian artery
D. innominate artery
```
A
Keep in mind that the question asks for the first branch of the ascending aorta, not the arch. The coronary arteries originate just above the aortic valve in the heart.
124
```
The _______ is described as the segment of the vessel located between the distal ICA and the origin of the anterior communicating artery.
A. M3 segment of the MCA
B. A1 segment of the ACA
C. M1 segment of the MCA
D. A2 segment of the ACA
```
B
The A1 segment is located between the distal ICA and the origin of the anterior communicator artery. The A2 segment is located distal to the origin of the anterior communicator artery.
125
```
Which of the following is part of the deep venous system of the forearm?
A. radial vein
B. antecubital vein
C. basilic vein
D. cephalic vein
```
A
The basilic, cephalic and antecubital veins are superficial veins of the arm. The radial, ulnar, brachial and axillary veins are deep veins of the arm.
126
```
The femoral vein _____ the femoral artery.
A. courses anterior to
B. is harder to compress than
C. is usually much longer than
D. courses posterior to
```
D
127
Which of the following is true regarding the superficial veins of the lower extremity?
A. They are located 1-2cm below skin surface
B. They are more difficult to compress than the deep system
C. They do not contain valves
D. The superficial veins course cephalad to meet the profunda vein to form the common femoral vein
A
The superficial system of the legs contains numerous valves and the veins are very easy to compress because they are located 1-2cm below the skin surface.
128
How can you differentiate the anterior accessory saphenous vein (AASV) from the great saphenous vein (GSV)?
A. the GSV travels in the saphenous compartment but the AASV does not
B. the AASV courses through the lateral thigh and the GSV courses through the medial though
C. look for the alignment sign that is only associated with the AASV
D. the AASV travels in the saphenous compartment but the GSV does not
C
Alignment sign - the AASV is aligned with the femoral artery and it courses anterior to the femoral artery within the saphenous compartment. This characteristic differentiates it from the GSV because the GSV is medial to the femoral artery/vein in the saphenous compartment.
129
Which of the following describes the proper technique for evaluating the MCA through the temporal window using TCD?
A. sharp anterior angulation with 65mm depth
B. sharp anterior probe angulation, 50mm depth
C. Midline probe placement, slight anterior angulation with 70mm depth
D. midline probe placement, slight anterior angulation with 50mm depth
D
The MCA is best evaluated through the temporal window. The probe is placed midline on the side of the cranium. The MCA should be identified at an average depth of 50mm. Slight anterior angulation may be required.
130
Which of the following is not an expected characteristic of a normal ICA and its Doppler waveform?
A. carries majority of the blood to cerebrum
B. has no extracranial branch
C. has a high resistance waveform
D. is often a prime site for plaque formation
C
The brain requires constant blood flow throughout the cardiac cycle. The cerebral structures normally offer very little resistance to the incoming flow of blood. The ICA has no extracranial branches and does deliver the majority of the blood flow to the brain. The ICA also has an increased prevalence for atherosclerotic changes, when compared to the CCA and ECA.
131
```
The ____ is described as the segment of the vessel located between the distal basilar artery and the origin of the posterior communicator artery.
A. M1 segment of the MCA
B. P2 segment of the PCA
C. M3 segment of the MCA
D. P1 segment of the PCA
```
D
The P1 segment is located between the distal basilar artery and the origin of the posterior communicator artery. The P2 segment is located distal to the origin of the posterior communicator artery.
132
```
Where is the arc of Riolan found?
A. within the mesentery
B. within the kidney
C. at the popliteal fossa
D. within the brain
```
A
The arc of Riolan and the marginal artery of Drummond connect the SMA and IMA through the mesentery. They offer potential for collateral flow if a mesenteric obstruction occurs.
133
```
The term used to describe the thickness of blood is:
A. vasoconstriction
B. resistance
C. viscosity
D. impedance
```
C
| The higher the viscosity the thicker the fluid. Oil and honey have higher viscosity than water.
134
```
The soleal plexus is located:
A. In the forearm
B. In the Circle of Willis of the brain
C. In the neck
D. In the calf
```
D
| The soleal plexus is the venous drainage system/reservoir of the soleal muscle of the calf.
135
Normal hepatic venous flow will demonstrate:
A. Two large antegrade diastolic and systolic waves followed by a small retrograde component that corresponds with the atrial contraction
B. Two large antegrade diastolic and systolic waves followed by a small antegrade component that corresponds with the atrial contraction
C. Two large retrograde diastolic and systolic waves followed by a small antegrade component that corresponds with the atrial contraction
D. Two large retrograde diastolic and systolic waves followed by a small retrograde component that corresponds with the atrial contraction
A
Normal HV flow is considered triphasic. The tracing normally demonstrates respiratory phasicity and cardiac pulsatility. The majority of flow moves forward into the right atrium until the atrial “kick” occurs, the Doppler tracing will demonstrate two large antegrade diastolic and systolic waves followed by a small retrograde component that corresponds with the atrial contraction.
136
```
Which of the following arteries is not commonly evaluated is an arterial assessment of the lower extremity?
A. superficial femoral artery
B. anterior tibial artery
C. internal iliac artery
D. common femoral artery
```
C
The internal iliac artery supplies the pelvic organs and is much smaller in caliber than the external iliac artery that supplies the leg.
137
```
Which vein is best evaluated for compressibility by asking the patient to perform a quick, deep sniff?
A. axillary vein
B. distal IVC
C. subclavian vein
D. great saphenous vein
```
C
Manual compression of the subclavian vein is limited due to its position beneath the clavicle. If the patient performs a quick, deep sniff, the normal subclavian vein should demonstrate compression.
138
What is the most common waveform taken from a normal patient of the celiac axis on an abdominal Doppler exam when the vessel is re-evaluated after eating?
A. decreased resistance with no change in peak velocity
B. increased resistance and increased peak velocity
C. decreased resistance and increased peak velocity
D. no change in flow pattern
D
The celiac artery waveform is usually unchanged after eating in the normal patient. The CA mainly supplies the liver and spleen with blood and these organs are low resistance vascular beds. The fasting waveform and peak velocity on this patient are well within normal limits which indicates a normal celiac axis.
139
The posterior communicating artery connects the:
A. right and left vertebral arteries
B. ECA to the ICA
C. right and left sides of the circle of willis
D. anterior and posterior cerebral vessels
D
| The posterior communicators connect the posterior cerebral system to the anterior cerebral system (PCA and the MCA).
140
As pressure increases, resistance must ________ to maintain constant flow volume.
A. increase
B. decrease
C. resistance does not vary related to pressure and flow volume
D. stay constant
A
As pressure increases, flow will increase if there is no change in resistance. In order to maintain a constant flow, when pressure increases, resistance must increase.
