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Carotid Review (Theory) > Carotid Review > Flashcards

Carotid Review Flashcards

1
Q

For Moving structures…. Transmitted frequency is ___________ than returning frequency.

A

Different

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2
Q

Doppler equation

A

Returning frequency - transmitted frequency

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3
Q

Shift is Positive moving __________ & negative moving _________.

A

Toward

Away

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4
Q

Which is the best angle to get maximum shift? why?

A

0 degrees, when beam is parallel to flow

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5
Q

What Is the worst angle ? why?

A

90 degrees, because it is perpendicular to flow so no shift is detected.

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6
Q

What angle do we aim for ?

A

60 degrees or less ( heel & toe)

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7
Q

What is represented by color?

A

Speed & direction

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8
Q

The top portion of the color map represents what?

A

Toward flow (positive shift)

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9
Q

The bottom portion of the color map represents what?

A

Away flow (negative shift)

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10
Q

The Black bar represents what?

A

No shift

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11
Q

Frequency shift Increases with __________________.

A

With smaller numeric angles.

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12
Q

In spectral tracing Flow towards is _______ the baseline & flow away is ________ the baseline.

A

Above

Below

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13
Q

Assume no velocity change within a vessel. Angle 1 is 30 degrees to wall and Angle 2 is 60 degrees to the wall…. which angle will have a more True doppler shift?

A

30 degrees

The smaller angle has a more true doppler shift because its closer to 0 degrees than the other angle.

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14
Q

What is being displayed in the Spectral?

A

Different range of velocities of RBCs

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15
Q

Plug flow in Systole

A

Narrow band

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16
Q

Parabolic flow in Diastole

A

Wider band

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17
Q

Peak , Mean, Low Frequencies are displayed on Spectral.

A

That’s all.

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18
Q

If spectral doppler gain is too high than it could mimic what?

A

Turbulent flow

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19
Q

Cerebrovascular Symptoms

A

Cerebrovascular Accident (CVA), Transient Ischemic attack(TIA), Reversible ischemic neurologic deficit (RIND)

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20
Q

Describe (CVA): cerebrovascular accident

A

No recovery from symptoms, completed brain stroke

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21
Q

Describe Transient ischemic attack (TIA)

A

Mini, undetected stroke, symptoms will resolve fully within 24 hrs

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22
Q

Describe Reversible ischemic neurologic deficit( RIND)

A

Symptoms will resolve fully but takes longer than 24 hrs

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23
Q

Two types of Stroke- describe them

A

Ischemic: blockage downstream
Hemorrhage: internal or external bleeding

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24
Q

Causes to Cerebrovascular symptoms

A

Embolism, thrombosis, hemorrhage

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25
Q

Define Aphasia ?

What is the affected area?

A

Inability to speak or express one self

Dominant hemisphere

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26
Q

Define Dysphasia?

What is the affected area?

A

Impaired or uncoordinated speech

Dominant hemisphere

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27
Q

Define Dysarthria ?

What is the affected area?

A

Poor articulation

Any number of brain centers

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28
Q

Define Lateralized Paresthesia?

What is the affected area?

A

tingling and numbness of a limb

contralateral hemisphere

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29
Q

Define Hemiparesis ?

What is the affected area?

A

Lateralized weakness

Contralateral hemisphere

30
Q

Define Hemiplegia?

What is the affected area?

A

Lateralized paralysis

Contralateral hemisphere

31
Q

Define Amaurosis Fugax ?

What is the affected area?

A

transient blindness in one eye

Ipsilateral artery

32
Q

Define Ataxia ?

What is the affected area?

A

Incoordinate muscle movements

Contralateral Hemisphere

33
Q

Define Diplopia?

What type of symptoms?

A

double vision

Vertebral - basilar

34
Q

Define Vertigo ?

What type of symptom?

A

Sensation room is moving around you

Vertebral - basilar

35
Q

Define Syncope ?

What type of symptom ?

A

fainting

Vertebral - basilar

36
Q

Define Dizziness?

What type of symptom?

A

sensation you are moving

Vertebral - basilar

37
Q

Define Drop attacks?

What type of symptom?

A

spontaneous fall with recovery

Vertebral - basilar

38
Q

Define Binocular blindness?

What type of symptom?

A

both eyes affected

Vertebral - basilar

39
Q

First portion to the Carotid - to the bulb is what type of signal?

A

Combo of the ICA & ECA signal

40
Q

Describe 3 things about the Carotid Bulb?

A
  1. area of widening before the bifurcation
  2. Common area of plaque build up
  3. Area of flow separation is normal
41
Q

-After bifurcation
-Usually smaller than the ICA
-Supplies face, neck, thyroid
-Has branches
-Highly resistive signal
-Flashy color
-Dichrotic notch
-Temporal tap
-More antero-medial
What am I?

A

ECA

42
Q

-After the bifurcation
-Usually larger
-Goes directly to the Brain
-No branches in neck
-More postero-lateral
-First branch is opthalmic artery
-Low resistance wave form
-Continuous color flow
What Am I?

A

ICA

43
Q

-Originates postero-lateral to CCA
-Used to evaluate for subclavian steal syndrome
-Low resistance
-Should flow in same direction as CCA
What am I?

A

Vertebral Artery

44
Q

(TL -RL) / TL x 100%

What does this formula determine?

A

% Diameter reduction
TL = true lumen
RL = Residual lumen

45
Q

NASCET’s method of measuring angiogram to determine % stenosis formula.

A

100 x (1- (RL / Normalized distal Diameter) )

46
Q

Which is more accurate; Bulb method or Nascet Method?

A

Bulb method

47
Q

What is the Bulb Method Formula?

A

100 x (1 - (RL / TL) )

48
Q

Carotid criteria is meaningless unless there is …..

A

Focal velocity acceleration, plaque , post stenotic turbulence

49
Q

Criteria is for ___________ stenosis, not for determining __________.

A

grading

normalcy

50
Q 
Visualization of plaque
Focal velocity acceleration
Post stenotic turbulence
PSV at max stenosis > 140 cm/s
EDV less than 100 cm/sec
- What generalization can you make from this criteria?
A

50-69% diameter stenosis

51
Q 
Visualization of plaque
Focal velocity acceleration
Post stenotic turbulence
EDV greater  than 100 cm/sec
ICA/CCA ratio > 4.0
-What generalization can you make from this criteria ?
A

70-95 % diameter stenosis

52
Q

How would you try to diagnose a High grade stenosis? >95% stenosis

A
  • try to find any flow ( color) will see trickle flow/string sign
  • Difficult to obtain a spectral tracing from region of Max stenosis
  • Low velocity displayed distal to stenosis ( tardus parvus)
53
Q

If ICA is occluded, What is lost on the ipsilateral CCA?

A

The low resistant component

54
Q

If CCA has a Stenosis, and at the region of the stenosis velocity doubled & We have post stenotic turbulence, what can we determine?

A

The CCA is >50% stenosis.

55
Q

If we have an Occluded CCA how does flow get to the brain?

A

The ECA on the same side flows retrograde & feeds the ICA to feed the brain.

56
Q

Carotid Stenting is alternative to what ?

A

Carotid endarterectomy ( cleaning out of the vessel)

57
Q

What are 4 Complications to Carotid Stenting?

A
  • Intimal Hyperplasia(thickening) causing re-stenosis
  • progression of atheromatous disease(atherosclerosis) beyond the stent
  • Stent not fully deployed
  • stent shifting or kinking
58
Q

Patient has a Stent…The criteria changes for the evaluation for the re-stenosis ….
What is it for 50-69% stenosis

A

PSV : >225 cm/s

Ratio: >2.0

59
Q

Patient has a Stent…The criteria changes for the evaluation for the re-stenosis ….
What is it for >70% stenosis?

A

PSV: >350 cm/s
Ratio: >4.75

60
Q

Morphology, echo density, surface characteristics are all characterizations of what?

A

Plaque characteristics

61
Q

Echogenicity looks for….

A

different echogenicity within the plaque

such as Hyperechoic, Hypoechoic, isoechoic, echoic, anechoic

62
Q

Homogeneity looks for ….

A

similar shades of gray throughout vs many shades of gray, cystic areas, areas of calcification.

63
Q

Contour looks for…

A

Surface shape- smooth, regular, irregular, ulcerated

64
Q

Which plaque is more likely to be symptomatic?

A

Hypoechoic plaques

65
Q

Plaques with ___________ & or ____________________ are more likely to be symptomatic.

A

Ulceration

Intraplaque hemorrhage

66
Q

Which plaque is more likely to have a stroke with?

A

Risky plaque

67
Q

What is the first indicator of subclavian artery disease?

A

abnormal vertebral waveform

68
Q

Another way to determine subclavian artery disease is…..

A

20 mmHg or greater pressure gradient between right and left arm.
The lower number arm is the abnormal one.

69
Q

Neurologic symptoms related to posterior hemisphere present. Occurs in the presence of Subclavian AND severe carotid disease .

A

Subclavian steal Syndrome

70
Q

Usually ____________ alone does not cause neurological symptoms.

A

Subclavian Steal

Carotid Review (Theory) (1 decks)

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