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SON 250 Vascular > Carotid > Flashcards

Carotid Flashcards

1
Q

6 vessels that make up the circle of willis

A

MCA, ACA, PCA, ICA, vertebrals, basilar

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2
Q

Four indications for a carotid ultrasound:

A

stroke/TIA, bruit, trauma, pulsatile neck mass

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3
Q

First branch of the ICA is:

A

opthalmic artery

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4
Q

ICA has a more ____ location

A

posterior

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5
Q

ICA originates from the _____

A

bulb

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6
Q

ICA waveform:

A

low resistant

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7
Q

1st branch off the ECA

A

superior thyroid artery

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8
Q

ICA supplies blood to the:

A

anterior brain, eyes forehead, nose

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9
Q

ECA supplies blood to the:

A

neck, face, scalp

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10
Q

ECA has a more _____ location

A

anterior, medial

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11
Q

Ways to differentiate ECA from ICA

A

ECA has multiple branches, more prominent dicrotic notch, is smaller than the ICA, and has a high resistant waveform.

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12
Q

Located in the wall of the sinus; causes slowing of the heart, vasodilation, and fall in blood pressure

A

pressoreceptors

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13
Q

Protocol for area of stenosis:

A

more than one velocity, distal to the site to document disturbed flow, scan through vessel, transverse image for diameter ms., use power doppler

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14
Q

Mild disease classified as:

A

less than 50% diameter reduction; benefit from therapy

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15
Q

moderate to high end disease classified as

A

50 - 70 % diameter stenosis; treated medically and follow-up

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16
Q

severe disease classified as

A

over 70 % diameter reduction; benefit from surgery

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17
Q

ICA/CCA velocity ratio 2 - 4 =

A

50 - 69% stenosis

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18
Q

ICA/CCA velocity ratio of 4 or greater =

A

70% and over stenosis

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19
Q

Where should you measure velocity for ICA/CCA ratio

A

mid - dist CCA; Prox ICA

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20
Q

ICA end diastolic of 40 - 100 cm/s and PSV 125 - 230 cm/s =

A

50 - 69% stenosis

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21
Q

ICA end diastolic of >100 and PSV >230 cm/s =

A

80 - 99% stenosis

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22
Q

Risk factors for carotid disease

A

HTN, diabetes, smoking, family hx, obesity

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23
Q

Criteria for TIA

A

Symptoms last

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24
Q

Criteria for RIND

A

symptoms >24 hrs,

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25
Q

Criteria for complete stroke/ CVA

A

Symptoms >72 hrs, residual effects, usually ischemic

26
Q

most stroke fatalities from ______

A

hemorrhagic stroke (blood vessel in head bursts)

27
Q

Post endarterectomy early occlusion due to thrombus happens:

A

within 24 - 48 hrs and is extremely urgent.

28
Q

Post enarterectomy stenosis:

A

results from neointimal hyperplasia, develops within 12 - 18 months

29
Q

Differentials for a pulsatile neck mass?

A

prominent carotid artery, dilated carotid, aneurysm of carotid

30
Q

may develop from trauma to the neck or secondary to iatrogenic

A

carotid dissection

31
Q

fibroplasia of the intima, media, or adventitia of an artery describes

A

fibromuscular dysplasia (growth of fibrous tissue in wall of artery - causes narrowing)

32
Q

Fibromuscular dysplasia affects

A

medium and large arteries, young to middle aged women

33
Q

Symptoms of fibromuscular dysplasia related to ___

A

ischemic events

34
Q

Fibromuscular dysplasia most often affects; second most frequent location?

A

renal arteries (middle and distal thirds); ICA

35
Q

Most common cause of renovascular HTN in young adults

A

fibromuscular dysplasia

36
Q

May present as cerebral ischemia/TIA and is associated with _______

A

Fibromuscular dysplasia; cerebral aneurysms

37
Q

most common type of fibromuscular dysplasia of the ICA

A

medial fibroplasia (renal). string of beads appearance.

38
Q

Fibromuscular dysplasia may be associated with

A

carotid artery dissection

39
Q

Most FMD lesions occur at

A

level of 1st/2nd vertebra

40
Q

flow reducing lesion in the innominate or subclavian artery prox. to the vertebral

A

subclavian steal

41
Q

arm with the lowest brachail pressure is the

A

postive side (w/ subclavian disease)

42
Q

High blood pressure can cause

A

plaque to break off and emoblize

43
Q

Stenosis is described as

A

narrowing to vessel lumen; usually d/t atherosclerosis

44
Q

Thin layer of lipid material on intimal layer

A

fatty streak

45
Q

accumulation of lipids covered by lips, collagen, elastic fiber deposits

A

fibroud plaque

46
Q

contains fibrous tissue, collagen, and calcium

A

complicated lesion

47
Q

deterioration of smooth surface of the fibrous cap

A

ulcerative lesion

48
Q

Possible causes of cerebrovascular symptoms

A

carotid artery disease, cardiac arrhythmias, hypotensive episodes

49
Q

Lower body symptoms for ICA occur on the ____

A

contralateral side

50
Q

Rt side hemiparesis means

A

Lt ICA is suspect

51
Q

Visual symptoms for ICA occur on the ____

A

ipsilateral side

52
Q

Symptoms for ICA lesion

A

paresis, aphasia, amaurosis fugax

53
Q

transient loss of vision in one eye

A

amaurosis fugax

54
Q

speaking disorder due to brain dysfunction

A

aphasia

55
Q

lack of muscular coordination

A

ataxia

56
Q

inability to produce clear speech

A

dysarthria

57
Q

weakness

A

paresis

58
Q

abnormal tingling sensations

A

paresthesia

59
Q

Symptomatic patients that benefit most from intervention have

A

disease of 70 - 99%

60
Q

Symptomatic patietns with modest benefit from intervention have

A

50 - 70% disease

61
Q

With less than 50%, treatment includes

A

blood thinners and behavior modification

62
Q

____ is less invasive than carotid endarterectomy

A

carotid stenting

SON 250 Vascular (6 decks)

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