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Flashcards in Cerebrovascular Test Q&A Deck (43):
1

80-99% stenosis. critical

Peak systolic velocity: >250 cm/s

End diastolic velocity: >100 cm/s

Systolic velocity ratio: >3.7

Diastolic velocity ratio: >5.5

2

A contralateral ICA occlusion may cause what to the ipsilateral side? 

increased flow to the side with the lesser stenosis. causes PSV to be higher than expected. (pg 80)

3

The carotid body assists in regulating all what?

blood to the internal and external carotid arteries

4

What are the warning signs of a stroke?

aphasia

dysphasia- impairment of speech, arrange words

dysphagia

dysarthria- slurring due to lack of muscle control

lateralized paresthesia- tingling and numbness

hemiparesis- lateralized weakness

hemiplegia- lateralized paralysis

transient monocular blindness (TMB)

amaurosis fugax- shade being drawn (pg 33)

5

Most common visualized branch of the ECA is what?

superior thyroid (pg 36)

6

The inability to speak or express oneself?

aphasia (pg 33)

7

The innominate artery divides into two arteries, what are they?

common carotid and subclavian (pg 35)

8

60-79% stenosis, severe

Peak systolic velocity: >130

End diastolic velocity: >40

Systolic velocity ratio: >1.8

Diastolic velocity ratio: >2.6

9

vertebral- basilar symptoms

drop attacks

syncope

vertigo

dizziness

diplopia

binocular blindness (pg 33)

10

An abnormal spectral waveform from the ICA suggests what?

stenosis

11

Vertebral arteries bilaterally are typically the same, this means they are____

antegrade (pg 92)

12

The Doppler sample volume should be kept where in the vessel?

in the middle of the lumen (pg 55)

when plaque is present, sample at site of max stenosis (pg 75)

13

Vertebral waveform

14

A systolic velocity recorded from the origin of the ICA is < 125 cm/s, according to the chart, what does this tell us?

40-59% stenosis, moderate

15

What is retrograde and what are the causes?

reverse of flow within a vessel

subclavian steal

occlusion

16

What disorder has symptoms resolved but not within 24 hrs?

reversible ischemic neurologic deficit (RIND)

(pg 33)

17

CCA waveform

18

Transient partial or complete loss of vision is what?

binocular blindness (pg 33)

19

What are ultrasound findings of an ICA occlusion?

Use color Doppler at normal and low PRF

Establish no flow in multiple sites

ICA may be contracted inappearence

Rule out technical problems

ECA may function as a collateral pathway to the distal ICA. Facial and superfical temporal arteries are well developed.  Blood flow in a retrograde fashion to reconsitute.  ECA waveform changes and may demonstrate low resistance. (pg 76)

 

20

The union of vertebral arteries forms to join what vessel?

basilar artery (pg 35)

21

What is CVA and what does it cause?

Cerebrovascular accident

completed brain stroke (pg 33)

22

The degree of stenosis at the origin of the ICA is determined by?

NASCET (pg 69)

23

A difference of 20 mmHg of pressure between both arms suggests disease of what vessel?

subclavian stenosis on the side with low pressure (pg 94)

24

40-59% stenosis, moderate

peak systolic velocity: <130

End diastolic velocity: <40

systolic velocity ratio: <1.8

diastolic velocity ratio: <2.6

25

ischemia

an inadequate blood supply to an organ or part of the body, especially the heart muscles

26

An ultrasound finding of a Doppler signal from the ECA, what kind of flow?

high resistance (pg 53)

27

contralateral

relating to the side of the body opposite to that on which a particular structure or condition occurs.

28

ipsilateral

belonging to or occuring on the same side of the body

29

0-39% stenosis, mild

Peak systolic velocity: < 110 cm/s

End diastolic velocity: < 40 cm/s

Systolic velocity ratio: < 1.8

Diastolic velocity ratio: < 2.6 

30

Name the disorder that symptoms occur and are resolved within 24 hrs?

transient ischemic attack (TIA) (pg 33)

31

If you see a sonolucent area within plaque, what could it represent?

intraplaque hemorrhage (pg 84)

32

When determing the ICA/CCA ratio, the CCA should be determined from what portion of the CCA?

mid/distal CCA (pg 52)

33

100% occlusion

No flow

34

What is there to know about tortuous vessels?

composed of twists and turns

associated with fibromuscular dysplasia

fibrous thickening of the intima, media, or adventa

usually bilateral

associated with hypertension

prox and dist ICA spared

 more common in women

35

A normal flow disturbance along the posterior surface of the bulb is what separation?

external and internal carotid

36

What is TIA and what is the long term outcomes?

Transient Ischemic Attack

Symptoms resolve within 24 hrs (pg 33)

37

What is a characteristic of a subclavian steal?

  • more common on left side
  • prox subclavian stenosis can cause ipsilateral vert flow to reverse to supply blood to arm.  controlateral vert flow increases to provide flow to arm
  • usually does not cause neurological symptoms
  • with severe carotid disease, flow in basilar may reverse causing neurologic symptoms, subclavian steal syndrome
  • retrograde flow in rt vert and prox subclavian usually indicates innominate obstruction.

38

when you put the doppler sample in a vessel it should be parallel to what?

the vessel wall

39

What is the most valuable tool for us when determining a stenosis?

color and spectral doppler (pgs 49 & 51)

duplex imaging

40

The North American Symptomatic Carotid Endarterectomy Trial

(NASCET)

Published in 1991 showed benefit from endartectomy vs medical treatment in patients with > 70 % stenosis.  Used a new standardized method of measuring stenosis on carotid angiograms.  Residual lumen at max stenosis was measured with calipers and compared to the diameter of the distal lumen of the ICA. (pg 70)

41

What kind of flow pattern is the ICA?

low resistance (pg 53)

42

ICA waveform

43

ECA waveform