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RVT Review > Chapter 13 > Flashcards

Chapter 13 Flashcards

1
Q

what is a capability for duplex with aorto-iliac vessels?

A

evaluate vessels for stenosis, status of bypass grafts, aneurysmal disease

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2
Q

what is a capability for duplex with renal arteries?

A

to document >60% stenosis

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3
Q

what is a capability for duplex with mesenteric arteries?

A

to document significant stenosis, or evaluation of mesenteric bowel ischemia

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4
Q

what is a capability for duplex with kidneys?

A

to help in evaluation of nephrosclerotic disease and transplants

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5
Q

what is a capability for duplex with liver?

A

suspected portal HTN pre/post liver transplants, and other

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6
Q

what is some limitations for duplex of the abdomen?

A 
side of patient
bowel gas
previous abd surgery/ scar tissue
shortness of breath and rapid respirations 
patients in non-fasting state
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7
Q

what is patient positioning?

A

supine
RLD
LLD

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8
Q

what size transducer do you use?

A

5, 3, 2,25 MHz

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9
Q

what vessels do you observe for aortio-iliac arteries?

A 
celiac
SMA
Aorta (p, m, d)
CIA
ELA (prox-distal)
IIA
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10
Q

what is an aorto-iliac artery aneurysm?

A

a dilation >3cm or an increase in diameter of 50% greater than original artery

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11
Q

what are major AAA located?

A

infrarenal

they are atherosclerotic

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12
Q

what are the types of true aneurysms?

A

fusiform and saccular

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13
Q

what is the most frequent complication of a AAA?

A

rupture, embolization of the peripheral aneurysms

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14
Q

what will be patient history with a RAS?

A

patient will have HTN.

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15
Q

with HTN what kind of HTN is common with renals?

A

renovascular HTN

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16
Q

what is renovascular HTN?

A

RAS secondary to atherosclerosis, fibromuscular dysplasia) or occlusion

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17
Q

what vessels do you evalaute with RAS?

A 
celiac artery and SMa
aorta near SMA 
locate renal arteries 
renal artereies 
segmentals
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18
Q

what is a landmark to find the LRA?

A

LRV

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19
Q

are resistance are renal arteries?

A

low resistant

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20
Q

what resistance is the AO?

A

high resistant

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21
Q

what resistance is the SMA and IMA?

A

fasting high

non-fasting low

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22
Q

what should you obtain PSV and EDV for in a RAS?

A

renal artery- prox-distal

upper/ lower pole of kidney in segmental arteries

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23
Q

how do you calculate renal to aortic ratio (RAR)?

A

highest renal artery PSV/ Aorta PSV

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24
Q

what is normal RAS level?

A

<3.5

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25
Q

what is abnormal RAS Level?

A

> 3.5

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26
Q

what does a >3.5 suggest in a RAS?

A

> 60% diameter reduction

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27
Q

with which situations can you not use the RAR?

A

if AAA is present

if aorta PSV >90cm/s or <40cm/s

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28
Q

what is the normal measurement for kidneys?

A

10-12cm

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29
Q

when the RAS is looking abnormal what else should you look for?

A

look for a renal artery PSV of 180-200cm/s followed by post-stenotic turbulance

30
Q

what is end diastolic ratio?

A

parencynmal resistance ratio (PR)

end diastolic V
___________
PSV

31
Q

what is a normal EDR ratio?

A

> 0.2 or >20%

32
Q

what is an abnormal EDR ratio?

A

<0.2 or <20%

33
Q

what is the formula for resistivity index (RI)?

A

PSV-EDV
_______
PSV

34
Q

what is a normal RI?

A

<0.75 or .8

35
Q

what is an abnormal RI?

A

> 0.75 or .8

36
Q

what do abnormal renal measurements indicate?

A

abnormal calculations indicate an increase in distal resistance or nephrosclerotic disease

37
Q

what would happen to the waveform distally with a proximal high grade stenosis?

A

dampened, weak doppler signal distally, but still of low resistant quality. or tardus-parvus

38
Q

what are patient symptoms for mesenteric ischemia?

A

history of dull, achy, crampy, abdominal pain 15-30min after meals

39
Q

what is the pain called with mesenteric ischemia?

A

mesenteric angina

40
Q

why does the pain messenteric angina occur?

A

due to stenosis or occlusion of the SMA, celiac, or IMA

41
Q

what exam do you use for a chronic/ acute mesenteric ishchemia?

A

arteriogram

42
Q

T/F you use a non fasting patient to do the mesenteric ischemia test on

A

false

fasting patient

43
Q

which vessels do you look at with mesenteric ischemia?

A

CA
SMA (p-d)
IMA
Aorta (check for abnormality)

44
Q

what is the food challenge?

A

patient ingest high caloric liquid (e.g Ensure) and you repeat the exam 20-30min later or sooner if symtpms arise

45
Q

when will hyperemic response being after the food challenge?

A

about 10min with max response in apprx 30 min

46
Q

post- prandially what do you obtain?

A

PSV and EDV of the SMA

47
Q

what should you document with the food challenge?

A

amount of high caloric liquid ingested (usually 1-2cans)
onset, type, and duration of symptoms
time began the post-prandial study

48
Q

what is the preprandial PSV, EDV, and Flow reversal for SMA?

A

PSV: high
EDV: low
flow reversal: yes

49
Q

what is the preprandial PSV, EDV, and Flow reversal for CA?

A

PSV: high
EDV: high
flow reversal : no

50
Q

what is the post-prandial PSV, EDV, and Flow reversal for SMA?

A

PSV: marked increase
EDV: marked increase
loss of flow reversal yes

51
Q

what is the post prandial PSV, EDV, and Flow reversal for CA?

A

PSV: no change
EDV: no change
loss of flow reversal NA

52
Q

what is the normal velocity for the SMA?

A

110-177cm/s

53
Q

what is the stenosis for SMA?

A

PSV >275cm/s

> 70% diameter reduction

54
Q

what is the normal velocity for CA?

A

50-160cm/s

55
Q

what is the stenosis for CA?

A

PSV >200cm/s

> 70% diameter reduction

56
Q

T/F the liver and spleen have fixed metabolic requirements so they are not influenced by post-prandial state

A

true

57
Q

what does the CA branch into?

A

hepatic, splenic and left gastric

58
Q

T/F the IMA is usually found on US

A

false

59
Q

why is it difficult to locate the IMA?

A

small

60
Q

if the IMA is easily observed what does that suggest?

A

SMA occlusion

61
Q

T/F IMA serves as a collateral

A

true

62
Q

what must happen to be consistent with a chronic mesenteric ischemia?

A

2 of 3 mesenteric vessels have to be abnormal

63
Q

what is the celiac band syndrome?

A

extrinsic compression of celiac artery origin by the median arcuate ligament of the diaphragm

64
Q

what happens with the celiac band syndrome?

A

reversible celiac artery stenosis occurs during expiration (ligament presses down over artery).
high velocity signals, indicative of stenosis, are improved with deep inspiration.

65
Q

what vessels do you look at with a liver transplant?

A

portal vein, hepatic veins, IVC, hepatic artery

66
Q

where can thrombus occur post op of the liver?

A

portal vein, IVC and/or hepatic artery which can lead to hepatic infarction

67
Q

what is the most common complication with liver transplant?

A

acute rejection which is a cellular process

68
Q

transplanted RA is anastomosed to what?

A

EIA or IIA

69
Q

transplanted RV is anastomosed to what?

A

EIV

70
Q

what does B-mode signs of kidney rejection include?

A

increased renal transplant size, increased cortical echogenicity

71
Q

what can acute kidney rejection do?

A

increases arterial resistance

72
Q

what do they confirm rejection?

A

biopsy

or indicator of increased arterial resistance

RVT Review (30 decks)

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