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Vas > Ch. 2, 3, 37 > Flashcards

Ch. 2, 3, 37 Flashcards

1
Q

Which normal cerebrovascular vessel demonstrates the highest flow resistance?

A

external carotid artery

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2
Q

which of the following best describes the position of the ICA in the neck?

A

It lies more posterior to the ECA.

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3
Q

A high resistance flow pattern in the distal portion of the ICA Suggests which of the following conditions?

A

severe distal ICA stenosis

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4
Q

A stroke symptom when a patient cannot speak or express themselves is called?

A

Aphasis

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5
Q

in the following sonogrophic image, how would you describe the arterial wall?
(look at image)

A

Homogeneous plaque with smooth surface characteristics.

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6
Q

what is the first branch of the ICA

A

ophthalmic artery

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7
Q

The NASCET study clearly demonstrated benefits of carotid endarterectomy over medical Management in patients who are symptomatic and have stenosis greater than or equal to %

A

70

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8
Q

What is the first branch of the ECA

A

Superior thyroid artery

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9
Q

A patient presents with the classic Cerebrovascular Symptom of left amaurosis fugax. of the choices below what is the most likely cause?

A

atheroemboli from the left ICA

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10
Q

which of the following is the most common cause of re-stenosis following carotid enarterectomy

A

Neointimal hyperplasia

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11
Q

which of the following is a non-atherosclerotic disease involving the mid segment of the ICA and found predominately in females

A

fibromuscular dysplasia

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12
Q

which of the following is angiographic measurement method recommended by the SRU consensus conference of 2003, also known as the NASCET method?

A

the distal ICA lumen compared to the residual ICA lumen.

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13
Q

A longitudinal image of carotid plaque can sometimes be misleading as to the diameter reduction due to which of the following?

A

Slice thickness of the beam.

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14
Q

A patient with a ICA plaque has a 2mm residual lumen. The distal ICA lumen is 6mm. what is the percent stenosis (via NASCET method)?

A

67%

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15
Q

In this example, the ICA velocities may underestimate the category of stenosis. Why?
(look at image)

A

sample was not obtained at maximum stenosis.

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16
Q

A warning sing of stroke is:

A. severe neck pain
B. loss of smell
C. temporary blindness in one eye
D. unilateral leg pain

A

c
(Warning sings include: sudden numbness or weakness of the face, arm, or leg; sudden confusion; trouble speaking; sudden vision troubles; loss of balance or coordination; sudden headache.)

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17
Q

A difference of greater than 20 mmHg pressure between arms suggests disease of the:

A. common carotid artery
B. Internal carotid artery
C. Vertebral artery
D. Subclavian artery

A

d
(A difference of greater than 20 mmHg pressure between arms suggests disease of the subclavian or I nominate artery.)

18
Q

An ultrasound finding of the Doppler signal from an external carotid artery (ECA) Is:

A. Low resistance
B. High resistance
C. Triphasic
D. Tardus parvus

A

b
(The ECA reflects a high-resistance waveform.)

19
Q

An ultrasound characteristic of the internal carotid artery (ICA) includes:

A. Originates anterior and medial at the bifurcation
B. Low-resistance Doppler signal
C. Cervical branches
D. Smaller lumen

A

b
(The ICA reflects a low-resistance waveform.)

20
Q

Which of the following is not an ultrasound finding of an ICA occlusion:

A. Echogenic material filling the lumen
B. Lack of arterial pulsations
C. Loss of diastolic flow in the common carotid artery (CCA)
D. Reduced diastolic flow pattern

A

d
(An occluded ICA does not demonstrate any blood flow.)

21
Q

Which of the following phrases describes a transient ischemic attack (TIA)?

A. A permanent loss of vision bilaterally.
B. Residual neurologic deficit.
C. Duration less than 24 hrs.
D. Loss of consciousness.

A

c
(A neurologic deficit that lasts less than 24 hrs is termed a TIA.)

22
Q

Which of the following should be used to classify a greater than 80% diameter reduction of the origin of the ICA?

A. Peak systolic velocity less than 140 cm/sec
B. Peak systolic velocity greater than 140 cm/sec
C. End diastolic velocity less than 155 cm/sec
D. End diastolic velocity greater than 155 cm/sec

A

d
(A stenosis of greater than 80%diameter reduction demonstrates an end diastolic velocity of greater than 155 cm/sec.)

23
Q

Normal vertebral arteries:

A. Are asymmetrical
B. Are branches of the axillary artery
C. Demonstrate a high-resistance Doppler signal
D. Demonstrate an alternating blood flow pattern.

A

a
(Asymmetry of the vertebral arteries is common. Only 25% of cases demonstrate equal vertebral arteries.)

24
Q

Placement of Doppler sample volume should be parallel to the:

A. Color jet
B. Plaque surface
C. Vessel walls
D. Skin surface

A

c
(Doppler interrogation of the carotid system is performed using a Doppler angle of 60° or less, with placement of the sample volume parallel to the vessel wall.)

25
Q

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

A. Echo characteristics of the plaque
B. The presence of acoustical shadowing
C. Peak systolic and end diastolic velocities.
D. ICA:ECA Peak systolic velocity ratio

A

c
(The degree of stenosis of the ICA is determined by the peak systolic and end diastolic velocities and ICA: CCA ratio.)

26
Q

Approximately __________ strokes occur each year in the United States.

A. 10,000
B. 100,000
C. 700, 000
D. 1,000,000

A

c
(Approximately 750,000 strokes occur each year; approximately 160,000 result in death.

27
Q

The I nominate artery divides into the ______ and _______ arteries.

A. Right common carotid; right subclavian
B. Left common corotid; left subclavian
C. Right subclavian; right vertebral
D. Left subclavian; left vertebral

A

a
(The innominate artery divides into the right common corotid and the right subclavian artery.)

28
Q

The Doppler sample volume should be kept _______ during a carotid duplex imaging examination.

A. Near the deep wall
B. Near the superficial wall
C. Large
D. Small

A

d
(The sample volume size should be small and placed in the center of the artery (or center stream).)

29
Q

An abnormal spectral Doppler waveform shape from the ICA suggests:

A. Contralateral disease
B. Arterial branches
C. Proximal or distal disease/occlusion
D. Venous thromnosis

A

c
(An abnormal waveform shape may indicate a more proximal (subclavian) or distal (intracranial) disease.)

30
Q

A contralateral ICA occlusion may cause the ipsilateral ICA velocities to be:

A. the same
B. reversed
C. increased
D. decreased

A

c
(In the pressence of an ICA occlusion, the velocity in the contralateral ICA may be elevated.)

31
Q

Which of the following ICA:CCA ratios determines a greater than 70% diameter reduction of the ICA?

A. 1.0
B. 4.0
C. 7.0
D. 10.0

A

b
(An ICA:CCA ratio of greater than 4.0 is demonstrated in an ICA stenosis of 70% to 95%)

32
Q

When determining the ICA:CCA ratio, the CCA velocity should be obtained from the:

A. proximal segment
B. mid-segment
C. distal straight segment
D. bulb

A

c
(When determining the ICA:CCA ratio, the CCA velocity should be obtained from the distal segment.)

33
Q

A characteristic of a subclavian steal is:

A. reversal of blood flow in the vertebral artery
B. equal blood pressure bilaterally
C. loss of diastolic flow
D. increased pulsatility

A

a
(A subclavian steal is present if there is a reversal of the vertebral flow direction secondary to obstruction of the ipsilateral subclavian or innominate artery.)

34
Q

A systolic velocity recorded from the origin of the ICA that is less than 125 cm/sec suggests:

A. no plaque present
B. a stenosis less than 50% diameter reduction
C. a stenosis greater than 50% diameter reduction
D. a stenosis greater than 80% diameter reduction

A

b
(A systolic velocity from the origin of the ICA less than 140 cm/sec suggests a stenosis less than 50% diameter reduction.)

35
Q

Intraoperative carotid duplex imaging identifies:

A. contralateral ICA disease
B. abnormal blood flow
C. increased blood pressure
D. the need for a carotid shunt

A

b
(Intraoperative carotid duplex imaging identifies abnormal flow, disturbed blood flow, and anatomic abnormalities.)

36
Q

Transient partial or complete loss of vision.

A. aphasia
B. ataxia
C. vertigo
D. amaurosis fugax

A

d
(Amaurosis fugax is a transient partial or complete loss of vision.)

37
Q

The carotid body assists in regulating all except:

A. balance
B. heart rate
C. blood pressure
D. respiration

A

a
(The carotid body assists in regulating heart rate, blood pressure, and respiration.)

38
Q

The most commonly visualized branch of the ECA is:

A. facial
B. superior thyroid
C. lingual
D. superficial temporal

A

b
(The superior thyroid artery is the most commonly visualized branch of the ECA.)

39
Q

Noise caused by tissue vibration produced by turbulent flow is:

A. boundary layer separation
B. aliasing
C. bruit
D. reverberation

A

c
(Noise caused by tissue vibration produced by turbulent flow is termed a bruit.)

40
Q

A normal flow disturbance along the posterior wall of the bulb is:

A. a bruit
B. aliasing
C. a boundary layer separation
D. a jet

A

c
(A boundary layer separation is a normal flow disturbance demonstrating transient reversal of blood flow along the posterior wall of the bulb.)

41
Q

FMD (fibromuscular dysplasia) typically affects which portion of the carotid artery

A

Mid portion of ICA

42
Q

Which portion of the ICA is evaluated during carotid duplex imaging scanning?

A

cervical

Vas (10 decks)

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