Chapter 17: Cerebrovascular Testing

Question 1

What is the TIA time frame?

Answer 1

Less than 24 hours

Question 2

What is the RIND time frame

Answer 2

More than 24 hours

Question 3

Which strokes are transient?

Answer 3

TIA and RIND

Question 4

What is the time frame for CVA?

Answer 4

More than 24 hours, complete recovery does not occur.

Question 5

When hematocrit drops what happens to blood flow?

Answer 5

It increases because resistance decreases.

Question 6

Where does atherosclerosis form

Answer 6

Within or beneath the intima

Question 7

What is atheromatous plaque

Answer 7

A form of arteriosclerosis; localized accumulations of lipid-contains material(atheroma), smooth muscle cells, collagen fibrin and platelets.

Question 8

What causes thickening, hardening, and loss of elasticity if walls in arteries?

Answer 8

Atherosclerosis

Question 9

What can result from atherosclerosis

Answer 9

Decreased perfusion to the brain

Question 10

What is a fatty streak in atheromatous plaque?

Answer 10

A thin layer of lipid material on the intimal layer

Question 11

What is fibrous plaque

Answer 11

The accumulation of lipids

Question 12

What is a complicated lesion

Answer 12

A fibrous plaque that includes fibrous tissue, more collagen.

Question 13

What is an ulcerative lesion

Answer 13

When a fibrous cap deteriorates-emboli

Question 14

Types of atheromatous plaque

Answer 14

Fatty streak

Fibrous plaque

Complicated Lesion

Ulcerative Lesion

Intra-Plaque Hemorrhage

Question 15

Where is the most likely location for plaque to form?

Answer 15

At bifurcations

Question 16

What is a thromboembolic

Answer 16

The obstruction of a blood vessel by a piece of thrombus

Question 17

What is a thrombus

Answer 17

Large amounts of red blood cells trapped within a fibrin network; clumps of playlets may also be evident

Question 18

What is an embolism

Answer 18

A piece of thrombus that breaks loose and travels until it lodged in a small vessel

Question 19

What is an aneurysm

Answer 19

Localized dilation of a blood vessel due to congenital defects or weekends of the wall

Question 20

Where is an aneurysm rarely seen?

Answer 20

Cervical carotid artery

Question 21

What is the usual culprit for a pulsating neck mass?

Answer 21

A very tortuous CCA

Question 22

What is a dissection

Answer 22

A sudden tear that can be spontaneous or the result of trauma

Question 23

What does a dissection create

Answer 23

A false lumen that may extend prodigally or distally

Question 24

What may form in the false lumen of a dissection

Answer 24

Thrombus

Question 25

What kind of flow is seen in the blind pouch of a dissection

Answer 25

High resistant flow

Question 26

What is the most common cause of fibromuscular dysplasia

Answer 26

Dysplasia(abnormal cellular growth) in the media of the mid/distal ICA

Question 27

What appearance is characteristic of fibromuscular dysplasia on angiography

Answer 27

Bead-like

Question 28

What demographic is fibromuscular dysplasia typically seen in?

Answer 28

Young women

Question 29

What is a carotid body tumor

Answer 29

A small structure located just above the carotid bifurcation that is highly vascular and usually fed by the ECA

Question 30

What is the treatment for a carotid body tumor

Answer 30

Ligation if the feeding vessel (usually the ECA)

Question 31

What is Neointimal hyperplasia

Answer 31

Intimal thickening from rapid production of smooth muscle cells

Question 32

What can be a response to vascular injury or reconstruction E.g. post carotid endarterectomy

Answer 32

Neointimal hyperplasia

Question 33

With Neointimal hyperplasia significant stenosis May occur within ______

Answer 33

6-24 months

Question 34

With Neointimal hyperplasia, denuding of endothelium leads to...

Answer 34

Platelet accumulation, endothelium regeneration, and smooth muscle cell proliferation.

Question 35

What are common arterial sites to palpate

Answer 35

Common carotid, superficial temporal, subclavian, and axillary arteries

Question 36

Which finger are used to palpate

Answer 36

2nd,3rd, and sometimes 4th

Question 37

What is auscultation

Answer 37

Listening through a stethoscope

Question 38

What is a bruit

Answer 38

A noise heard during auscultation that is the result of turbulent flow

Question 39

Bruit may not be evident with a stenosis of what caliber?

Answer 39

A tight stenosis, > 90%

Question 40

What are common sites for bruit evaluation?

Answer 40

Carotid and subclavian

Question 41

What on physical examination is associated with a hemodynamics significant lesion

Answer 41

Bruit

Question 42

What is recommended to detect proximal obstruction

Answer 42

Bilateral pressures

Question 43

Left hemispheric CVA results in neurological deficits on the____ side of the body

Answer 43

Right

Question 44

Specifics eye symptoms like amaurosis fugax are suggestive of

Answer 44

Ipsilateral ICA disease

Question 45

Unilateral paresis Unilateral parethesia Aphasia Amaurosis fugax

Answer 45

ICA lesions

Question 46

Aphasia or dysphasia More severe facial or arm hemiparesis or hemiplegia Behavioral changes Think arm/face

Answer 46

MCA lesions

Question 47

More severe leg hemiparesis or hemiplegia Incontinence Loss of coordination Think leg

Answer 47

ACA lesions

Question 48

Myopia is commonly referred to as

Answer 48

Nearsightedness

Question 49

What is homonymous hemianopia?

Answer 49

Defective vision or blindness in the right or left half of the visual fields. ( not always relates to ICA lesions)

Question 50

``` Vertigo Ataxia Bilateral visual blurring or double vision( diplopia) Bilateral parenthesis or anesthesia Drop attack ```

Answer 50

Vertebrobasilar lesions

Question 51

Dyslexia | Coma

Answer 51

PCA lesions

Question 52

Dizziness Syncope Severe headache

Answer 52

Non-localizing symptoms