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Vascular US > Cerebrovascular Lessons > Flashcards

Cerebrovascular Lessons Flashcards

(67 cards)

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1
Q

Which artery supplies both, brain and face

A

CCA

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2
Q

risk factors for stroke (5)

A 
age (2x every decade after 55)
HTN (most significant)
Race (African)
gender (women)
DM
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3
Q

components of duplex exam (4)

A

history
equipment set up
b mode/color/spectral
establish criteria

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4
Q

indication for carotid duplex (anterior circulation/ICA)

4

A

amaurosis fugax (loss of vision/window shade)
hemiparesis (contralateral)
paresthesia (tingling, numbness, burning)
aphasia (inability to speak)

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5
Q

amaurosis fugax

A

partial or complete loss of vision
window shade
classical sign of stroke

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6
Q

hemiparesis

A

weakness or loss of function in one side of the body

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7
Q

paresthesia

A

tingling, numbness, burning

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8
Q

aphasia

A

inability to speak

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9
Q

indication for carotid duplex (posterior circulation/verterbrobasilar) (7)

A 
ataxia (lack of muscle coordination, walking, swallowing, speech)
confusion/dizziness
diplopia (2x vision)
drop attack (sudden fall)
dusphagia (difficulty swalliwong)
headache/synchope/vertigo
motor sensory disturbances
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10
Q

most common reason for carotid US referral

A

headache, syncope, vertigo

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11
Q

syncope

A

fainting

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12
Q

ataxia

A

lack of muscle coordination can affect walking, swallowing and speech

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13
Q

diplopia

A

double vision

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14
Q

dysphagia

A

difficulty swallowing

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15
Q

unilateral body damage comes from ______

A

anterior circulation (ICA)

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16
Q

bilateral body damage comes from _____

A

posterior circulation/vertebrals

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17
Q

TIA

A

transient ischemic attack

resolve w/in 24 hours

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18
Q

RIND

A

reversible ischemic neurological deficit

last >24 hours

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19
Q

CVA

A

cerebrovascilar accident

do not resolve and cause permanent damage

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20
Q

what is stroke

A

permanent neurologic deficit

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21
Q

ischemic stroke

A

result of obstruction w/in a blood vessel to brain. most common

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22
Q

hemorrhagic stroke

A

ruptured blood vessels in brain such as aneurysms and arteriovenous malformation

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23
Q

cryptogenic stroke

A

unknown cause

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24
Q

which type of stroke can cause aphasia

A

hemorrhagic

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25
most common arterial disease
atherosclerosis
26
what is hemodynamically significant obstruction
stenosis or occlusion causing decreased pressure and flow distal to obstruction
27
what is needed to do carotid exam (5)
``` grayscale image color flow spectral doppler linear high frequency array knowledge of Doppler and hemodynamics ```
28
what is b mode used for
anatomical survey of CCA, ICA, and ECA | plaque
29
5 things you should note about plaque
location, extent, shape, echogenicity, diameter reduction
30
normal b mode exam (4)
smooth borders (no intraluminal projections) smooth surface contour thin walls with low level echoes evaluation of long and short axis
31
characteristics of soft plaque (5)
``` low echogenicity fuzzy/filmy localized or diffuse in the system internal homogenous echoes smooth/no irregularity ```
32
types of plaque
homogenous/soft heterogenous heterogenous with calcifications
33
heterogenous plaque
irregular and heterogenous | prone to fragmentation and embolization
34
calcified plaque
results in shadowing underestimated stenosis tardus parvus distally
35
ulcerative plaque (4)
surface irregularity platelet aggregation thromboembolic formation flow reversal in crater or crypt
36
system set-up color Doppler (3)
color direction PRF settings overall color gain
37
normal carotid color (3)
complete fill during systole smooth filling w/o irregularities laminar flow during systole
38
what do you compare ECA and ICA waveforms to
CCA
39
measurements obtained in spectral analysis (5)
``` PSV EDV flow direction spectral broadening velocity ratios ```
40
primary parameters for grading stenosis
ICA PSV and Presence of plaque
41
most accurate predictor of severity of stenosis
ICA PSV
42
normal ICA PSV
43
Normal ICA criteria (5)
PSV
44
systolic velocity ratio between ICA and distal CCA
45
PSV is severe stenosis (50-79%)
>125 but
46
EDV in severe stenosis (50-79%)
increased but
47
PSV and EDV in critical stenosis (80-99%)
PSV >250cm/sec | EDV >140 cm/sec
48
doppler in total occlusion (4)
Doppler silence in occluded segment pulsatile Doppler proximal to occlusion ECA similar signal as ICA "to and fro" flow or thud flow
49
no diastolic flow in ICA signifies _____
occlusion downstream
50
Flow in CCA with ipsilateral ICA occlusion
blunted PSV lack of diastolic flow distal CCA prior to occlusion may be reversed
51
what is a subclavian steal?
stenosis in the subclavian where pressure decreases and flow in vertebrals reverses
52
ICA/CCA ratio consistent with >70% stenosis
>4
53
surgical candidate = ______ diameter reduction and ______
>70% | post stenotic turbulence
54
what is a carotid tumor called
paraganglioma
55
history/progression of LE arterial disease (4)
claudication rest pain ulceration gangrene
56
PAD
peripheral arterial disease
57
most common symptom of LE arterial disease
claudication
58
claudiation
pain with exercise | relieved by rest
59
ischemic rest pain (3)
progression of claudication always in the foot only at night
60
pain while standing indicates problems in ________ system
nervous
61
what questions should you ask a patient with LE arterial disease (3)
where does it hurt (disease around area of pain) how far can you walk (extent of disease) is there pain at rest
62
what areas should be examined in lower extremity eval
abdominal aorta to dorsalis pedis
63
absence of a pulse signifies arterial obstruction ______ to the area
proximal
64
what probe is used for ao and iliac duplex
curved
65
what does b-mode tell you in duplex imaging
whether there's plaque, what type it is and it's extent
66
normally, PSV _____ between iliacs and popliteal
decreases
67
in minimal arterial disease, theres _______ without ________
increase in broadening without increase in velocities

Vascular US (1 decks)

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