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Vascular Surgery > Carotid Artery Disease > Flashcards

Carotid Artery Disease Flashcards

1
Q

What level does the common carotid artery bifurcate?

A

C4 - occurs in the carotid triangle

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2
Q

What is the carotid sinus?

A

Dilated area of the common carotid and internal carotid

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3
Q

How many branches are there of the ECA?

A

8

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4
Q

What are the branches of the ECA?

A 
Superior thyroid artery 
Lingual artery 
Facial artery 
Ascending pharyngeal artery
Occipital artery 
Posterior auricular artery 
Maxillary artery (terminal branch)
Superficial temporal artery (terminal branch)
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5
Q

How many branches are there of the ICA?

A

0

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6
Q

What are the stages of atherosclerosis?

A

Fatty strea
Accumulation of lipid core
Fibrous cap
Rupture

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7
Q

What level of the vessel wall does atherosclerosis affect?

A

Intima

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8
Q

Why does atherosclerosis commonly affect the carotids?

A

Bifurcation causes turbulence which disrupts one part of Virchow’s triad so only need one other factor

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9
Q

What are clinical features of carotid artery stenosis?

A

Often asymptomatic

Cervical bruit
Focal neurology
Transient visual symptoms
Anterior circulation stroke

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10
Q

What are investigations for suspected carotid artery stenosis?

A

ECG - check for AF

Carotid duplex ultrasound
CT angiogram of head + neck

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11
Q

How can carotid artery stenosis be managed using lifestyle modifications?

A

Smoking cessation
Weight loss
Decrease alcohol intake
BP control <140/90

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12
Q

How can carotid artery stenosis be managed medically?

A

High dose statin (80mg atorvastatin)

Antiplatelet (300mg aspirin)

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13
Q

How can carotid artery stenosis be managed surgically?

A

Carotid endarterectomy

Stenting

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14
Q

What is the carotid body?

A

Cluster of nervous cells external to the carotid sinus

Chemoreceptor cells

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15
Q

What does the carotid body detect?

A

Detects O2/CO2/pH changes

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16
Q

What level of the vessel wall is the carotid body?

A

Adventitia

17
Q

What are clinical features of a carotid body tumour?

A

Neck swelling - pulsates
Pain
Neuroendocrine syndrome

18
Q

What are features of neuroendocrine syndrome?

A

Flushing

Arrhythmias

19
Q

What are investigations for a suspected carotid body tumour?

A

ECG
Dupplex ultrasound
CT angiogram `

20
Q

How are carotid body tumours managed?

A

Surgically

21
Q

What is a carotid artery dissection?

A

Tear in the intima of the internal carotid

22
Q

What are the symptoms of carotid artery dissection?

A 
Ipsilateral neck pain 
Headache
Weakness
Nerve palsies (CNIII, IV, VI)
Amaurosis fugax 
Homonymous hemianopia
23
Q

What are the investigations for a carotid artery dissection?

A

CT angiography

Dupplex ultrasound

24
Q

How is carotid artery dissection managed?

A

Anticoagulation

Vascular Surgery (10 decks)

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