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Vascular-Arterial > Hard Study Questions > Flashcards

Hard Study Questions Flashcards

1
Q

Celiac artery compression/stenosis happens when? How is it relieved?

A

Happens with expiration, goes away with inspiration

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2
Q

The Arc of Rolan can serve as a collateral for what to vessels?

A

IMA and SMA

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3
Q

What acceleration time in a RAS study is consistent with high-grade stenosis?

A

> 100

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4
Q

Which one of these 3 are not related to mesenteric angina?

SMA/IMA
Celiac
Lt Gastric

A

Lt Gastric

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5
Q

If a patient has an ABI of 0.6 , what disease range does that indicate?

A

claudication

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6
Q

What PBI (penile) cutoff defines abnormality?

A

less than 0.65

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7
Q

The Hunter’s canal represents the termination of what artery?

A

SFA

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8
Q

The inguinal ligament represents the termination of what artery

A

hypogastric artery (internal iliac)

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9
Q

If a 35 year old man came in smelling like cigarettes, and had scabs on his fingers and said that they hurt, what would we think he had?

A

Buergers syndrome

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10
Q

Celiac artery compression syndrome is the exstrinic compression of the celiac artery due to

A

median arcuate ligament

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11
Q

In the presence of a celiac artery stenosis, what vessel may have retrograde flow?

A

hepatic artery

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12
Q

What are normal velocities in a normal functioning dialysis access graft?

A

PSV- 250 EDV-100

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13
Q

What is a normal acceleration time in a normal functioning kidney?

A

70 msec

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14
Q

The right gastric is a branch off the celiac artery,

True or False

A

False

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15
Q

Resistance is inversely related to the radius of a vessel. True OR False

A

True

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16
Q

What is the ideal vessel diameter for a radial artery mapping for coronary grafts?

A

2 mm or greater

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17
Q

If we hear a bruit over the subclavian artery when we are doing an arterial mapping for TRAM flap procedure, why is that worrisome?

A

The intramammary artery is a branch off the subclavian.

The intramammary artery is what is harvested to do a TRAM procedure so it may be compromised if there is an occlusion of the subclavian.

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18
Q

The RAR provides useful info if there is plaque or thrombus in the artery

True or False

A

True

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19
Q

What does the Allen’s test for?

A

to test patency of the palmar arch

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20
Q

If a patient goes through an in-situ bypass, what is a common complication?

A

fistula formation

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21
Q

Which layer of the artery contains the vasa vasorum?

A

the external layer

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22
Q

What is the FIRST branches of the aorta?

A

coronary arteries

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23
Q

The innominate then branches off into what two arteries?

A

CCA and Right Subclavian

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24
Q

Name the arteries of the aortic arch in order of right to le

A

Right innominate, left CCA, left subclavian

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25
Q

The celiac artery branches off into what three vessels?

A

Left gastric, Hepatic, and Splenic artery

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26
Q

What is the first branch of the Pop Artery?

A

the anterior tibs

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27
Q

What is the landmark for finding the external iliac artery?

A

Major Psoas

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28
Q

What artery supplies the base of the foot?

A

posterior tibs

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29
Q

What is the average speed of Ultrasound through soft tissue?

A

1540 cm/s

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30
Q

The Doppler shif is the difference between the wave frequency directed into tissues and what returns.

True or False

A

True

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31
Q

ABI’s are an example of ____ continuous wave ultrasound

A

analog

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32
Q

Which is the better of the two Continuous wave ultrasound? Analog or Digitial?

A

DIGITAL - like FFT

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33
Q

Does PW Doppler have depth resolution?

A

Yes

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34
Q

What is the nyquist limit? What does it cause if we go above it?

A

1/2 greater than the PRF, aliasing

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35
Q

The smaller the sample volume the ____ spectral broadening will occur.

A

LESS.

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36
Q

What is the appropriate sample volume size?

A

1.5-2.5 mm

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37
Q

How come CW will more likely have spectral broadening compared to a Pulse Wave?

A

because the CW doesn’t have depth resolution andhas a larger sample volume

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38
Q

The deeper the vessel of interest, the longer the pulse sent out, the frame rate will _____

Increase or Decrease?

A

decrease,

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39
Q

Why would we see the “mirroring” artifact ?

A

results in apparent flow in opposite direction

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40
Q

When do we consider arterial occlusions a medical emergency?

A

if no collaterilization

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41
Q

In arterial dissections, do we often see active flow in both the false lumen and true lumen>?

A

Yes.

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42
Q

What is a dissecting aneurysm

A

when the vessel dilates

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43
Q

What are S/S of Coarctation of the aorta?

A

high blood pressure and absent LE pulses and pain

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44
Q

A man comes in in his 40’s with a pack of cigs in his hand. What disease does he likely have and what are his signs and symptoms?

A

Buegers,

occlusion of fingers and rest pain/ ulcerations/ gangrene

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45
Q

What can result from a patient having a pop artery entrapment?

A

stenosis, aneurysm or occlusion.

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46
Q

What are the symptoms of thoracic outlet syndrome?

A

numbness, tingling of arm, pain aching of arm and shoulder in certain arm positions.

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47
Q

If a man comes in with absent femoral pulses, pain in ips, thighs, calves, what should we suspect?

A

Leriche syndrome

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48
Q

With claudication, where is the actual disease probably located ?

A

prox to area of claudication

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49
Q

Ischemic pain is pain at _____

A

Pain at rest

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50
Q

Ischemic pain INDICATES SEVERE disease

True or False

A

true

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51
Q

What does pallor mean?

A

white / pale

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52
Q

What is the capillary refill techique and when is it useful?

A

Its when you squeeze on the patients toe, and when you release, the toe should go back to its normal color.

should happen in less than 3 seconds

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53
Q

What are the 6 P’s of arterial occlusion acute?

A

pain, pulselessness, paralysis, pallor, paresethesia, and cold (Polar)

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54
Q

What Is the difference between inflow collaterals and out flow collaterals when it comes arterial occlusion

A

The inflow collaterals are located at the point of vessel reconstitution or were the vessel opens distally

the outflow collaterals are where the point of occlusion is

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55
Q

When we see a common iliac artery occlusion, explain why there would be retrograde flow in the internal Iliacs?

A

The flow reversed in order to supply the external iliacs.

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56
Q

When we are doing a stenosis interpretation profile, what are we comparing?

A

Pre stenotic velocity to the intranstenotic velocity

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57
Q

If we see a patient who has an apparent aortic occlusion, what would the CFA waveform look like? And what we diagnose he or she with?

A

He’d have Leriche syndrome which is an aortic iliac occlusion,

He’d have bilateral hip butt pain with claudications

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58
Q

What are three common sites you’d feel the pulses?

A

Brachial radial ulnar

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59
Q

What is the most common aneurysm in the upper extremity?

A

Subclavian artery aneurysm

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60
Q

What would be the cause of an ulnar artery aneurysm?

A

hypothenar hammer syndrome !

Basically repetitive blunt trauma to the superficial palmar arch of the ulnar artery.

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61
Q

What symptoms would a patient with hammer hand syndrome have clinically?

A

Embolization to digits

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62
Q

If we saw an arterial occlusion in the arm,what wave forms would we see proximal and distal to this?

A

Would go from high resistive proximally to a low resistance monophasic distally

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63
Q

When we see increased diastolic flow wheee it’s not normally found, what does that indicate?

A

That’s not normal. That means that distally there is a decreased distal peripheral resistance

Page 67

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64
Q

If the room is cold during a Doppler waveform analysis, what can that do to the vessel?

A

Vasoconstriction- make the vessel smaller

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65
Q

If we see a waveform that would normally be triphasic, be monophasic with a rounded appearance, what would we think?

A

Occlusion with POOR collaterals

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66
Q

A patient with a Pulsatility Index of 5.0 is considered normal or abnormal?

A

Normal

Should be 4.0 or more

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67
Q

A patient with a PI of 4.2 is considered normal or abnormal?

A

Normal

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68
Q

If we see a patient with a PI of 3.6, that is normal or abnormal?

A

Abnormal. Should be 4.0 or greater

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69
Q

If we see a patient with a PI of 3.0 , what percentage of stenosis is noted?

A

60%

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70
Q

The slower the acceleration time, the more the disease.

A

True

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71
Q

A patient with an acceleration time of 155 milliseconds is considered normal

A

No that’s abnormal

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72
Q

What is the limits of normal and abnormal acceleration time?

A

Normal is less than 133 milliseconds

Abnormal is more than 133 milliseconds

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73
Q

If we see an acceleration time of 170 milliseconds and dampened flow in the SFA, Where would the disease be?

A

Iliac obstruction proximal to the SFA

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74
Q

Aorto-iliac disease is considered in-flow or out-flow disease?

A

Inflow, that’s where the blood is coming from (prox is closer to the heart)

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75
Q

Normally, which pressure is often higher than the other?

Ankle systolic pressure or brachial

A

Ankle is usually greater than or equal to the brachial

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76
Q

How can a patient segmental pressure be limited when they have medial calcinosis (calcified vessels)

A

Calcified vessels can result in falsely elevated pressure

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77
Q

What’s the main difference between the four cuff and three cuff segmental method?

A

Using the 4 cuff can determine whether disease is prox or distal.

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78
Q

Often when using the 4 cuff method, the 20% rule is violated and the thigh pressures are often ___ mmhg higher

A

30 mmhg

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79
Q

List the follow on whether they are normal or abnormal ABIs,

Greater than 1.0 
0.9-1.0 
O.8
0.5
0.3
A

Greater than 1.0 is Normal

  1. 9-1.0 probably abnormal
  2. 6-0.8 -Claudication single level
  3. 5 -multilevel disease
  4. 3 -ischemic rest pain
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80
Q

If we see 20-30 mmhg or greater pressure drop from one level to another, we should suspect?

A

A normal ABI, proximal disease

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81
Q

If a Patient has a wound and we do the wound healing oximetry, what levels would indicate good chances healing and which would indicate bad chances of healing.

A

Toe pressure—

Greater than 30 mmhg- good healing

Less than 30 mmhg- bad healing

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82
Q

If there is a 15-20 prsssure difference in the upper extremity, this is abnormal

A

True

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83
Q

What is an example of pseudo-claudication?

A

arthritic pain

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84
Q

If we see a >20mm/hg drop in the ankle pressures after exercise, we are safe to assume what?

A

claudication

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85
Q

If the ankle pressure returns back to the resting state in 2-6 minutes this indicates a __ level disease.

Single or multilevel?

A

single

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86
Q

Air-plethysmography is used to measure the ____ change.

A

Volume

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87
Q

Why is photo plethysmography used?

A

to eval flow in digits where a Doppler would be hard to see bc of the small size of vessels.

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88
Q

When interpreting digit arterial plethymography waveforms, which ones are considered obstructive?

A

Organic / fixed

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89
Q

Photo-plethysmography is when we put the sensor on the toe during an ABI

A

True

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90
Q

If we see a “peaked”waveform on PPG, what should we think?

A

Raynauds

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91
Q

What is the cold stress test?

A

Used on patients (raynauds), submersed hand for 3 minutes, and you take their measurements, then do it again in 5 minutes and repeat.

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92
Q

A person has cold sensitivity if after ___ minutes after the cold stress test, the waveforms don’t go back to normal.

A

5 minutes

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93
Q

What are the three vessels we look at during a penile study

A

dorsal arteries, cavernosal arteries, and dorsal vein (superficial and deep)

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94
Q

Penile arteries can have limited flow if there is an obstruction in what arteries?

A

Iliac disease

95
Q

If there is a Penile Brachial index of 0.65 or less, that is consistent with?

A

abnormal, there is vasculogenic impotence

96
Q

Out of all of the veins imaged, the___ vein is only obtained post- medication injection.

A

Dorsal vein flow

97
Q

What is a disease in which a “extra-anatomic” bypass graft would be used?

A

iliac disease

98
Q

In which autogenous vein bypass graft is the valves NOT removed?

A

reversed saph vein graft

99
Q

What would be an indication to look at a bypass graft?

A

loss of pulse and decreased ABIs

100
Q

In the “in-situ” bypass grafts, what part of the vessel may become a AVF?

A

the retained tributaries

101
Q

If we see high velocities within the stents, what should we think?

A

nothing, its normal to see higher velocity within a stent

102
Q

Is the ulnar or the radial the bigger supplier to the hand?

A

the ulnar due to the palmar arch

103
Q

When performing the Allen’s test, the blood flow should return in how many seconds?

A

10 seconds

104
Q

Why would there be reversed retrograde flow in the common hepatic artery in the instance that there is a celiac artery occlusion

A

to supply the spleen

105
Q

What is a Normal RAR

A

Less than 3.5

106
Q

How do we calculate the RAR

A

divide the highest renal artery PSV by the aorta psv

107
Q

What is the normal peak systolic velocity for a RAs

A

Less than 180 mmhg

108
Q

What is a normal RI

A

Less than 0.8

109
Q

The AT time in a RAS study is a little different. This is obtained at the distal renal artery. The normal limits are

A

Less than 100 milliseconds

110
Q

What should the cortex of the kidney measure?

A

Greater than 1 cm.. less would be cortical thinning

111
Q

In a renal transplant patient, the renal artery is anastomoses to the ____ or ____ _____ veins

A

Internal or external

112
Q

What does the vertebral artery supply?

A

The back of the brain

113
Q

What is the first branch off the external carotid artery

A

The superior thyroid artery

114
Q

The right and left ICA, And the right and left vetebrals joint into the ____ ____ ______\

A

Circle of Willis

115
Q

Fibromusculsr dysphasia is most commonly found in what vessel?

A

The distal ica

116
Q

If a patient had an endarectomomy 9 months ago, and they come in with intimal ticketing and a higher velocity , what should we suspect?

A

Neointimal thickening

117
Q

What’s another word for a paraanglioma?

A

Carotid body tumor

118
Q

there is usually (high/low) resistance flow in the false lumen of a dissection

A

High

119
Q

What’s the time difference between a RINd and a TIA

A

TIA lasts up to 24 hours

RIND lasts longer than 24 but will resolve

120
Q

If a patient comes in and has left sided weakness and they suspect a stroke, what hemisphere would be effected

A

The right side because hemispheric symptoms are contralateral

121
Q

If an ICA embolizes to the ANTERIOR CEREBRAL ARTERY, the (leg /arm) is more affect

A

Leg

122
Q

If an ICA lesion embolizes to the MIDDLE Cerebral ARTERY; the (arm/leg) would be more affect

A

Arm

123
Q

What are the 5 Ds for vertebrobasilar lesions (think of the circle of Willis that’s at the posterior portion of the brain)

A 
Dizziness 
Ataxia (lack of muscular coordination) 
Drop attack
Dyslexia
Diplopia double vision.
124
Q

If a patient comes in complaining of “fleeting vision” what is that called and what’s it mean

A

Amaurosis FUgax

Transient loss of vision in one eye

If we see a right ICA embolus to the RIGHT opthalamic artery would result in RIGHT amaurosis fugax

125
Q

If a patient loses the right field of view in BOTH eyes, that’s called?

A

Homonymous hemianipia

126
Q

If we hear bruits in multiple areas (carotid , subclavian) what should we suspect?

A

Cardiac source disease

127
Q

What is the temporal tap?

A

It helps differentiate the ica with the eca.

Tapping on the temporal artery can create oscillation of the ECA

128
Q

In carotid scanning ,

An END diastolic velocity of 140 or greater indicates what?

A

80% or more

129
Q

Is subclavian steal more common the left or the right?

A

Left

130
Q

If a patient has an ICA/ECA ratio higher than 4.0 and is symptomatic, he need an endarectomy

A

True

131
Q

The opthalmaic artery branches off the terminal____

A

Ica

132
Q

Tamv is used not the PSV in TCDs.

A

True

133
Q

Brain death is apparent when we see that the ICA MCA AND ACA All have high resistive To no flow.

A

True

134
Q

If there’s a collateral pathway between the external carotid and the internal carotid, there would be retrograde flow in the ____ artery

A

Opthalmaic

135
Q

normally, ankle systolic pressure is _____ (greater or lesser) than the brachial pressure?

A

GREATER THAN OR EQUAL TO

136
Q

When a patient has medial calcinosis, how can this affect segmental pressures?

A

it will create falsely elevated pressures. This is often seen in diabetics

137
Q

Where should we put the cuff bladder when doing segmental pressures?

A

over the artery so inflation quickly transmits the pressure into the tissue to compress the artery.

138
Q

Does the three cuff method follow the 20% rule when it comes to segmental pressures?

A

YES

139
Q

Does the four cuff method follow the 20% rule when it comes to segmental pressures?

A

NO. It artificially has higher elevated pressures (around 30 mm/hg higher.

140
Q

In what order should we do segmental pressures?

A

Arm, ankle, calf above knee and then thigh. If we do this out of order it may affect and give us incorrect segmental pressures.

141
Q

A pressure gradient of 20-30 mmhg or greater in a leg segmental pressure indicates what?

(when doing segmentals)

A

ABNORMAL ABI, proximal obstruction

142
Q

When doing an upper exremity segmental pressure, what is the abnormal pressure gradient?

A

15-20 or greater is abnormal

143
Q

What is pseudo-claudication?

A

things such as neurospinal compression or arthritic pain on exertion…basically its not due to arterial disease, but something else therefore PSEUDO.

144
Q

Exercise testing allows differentiation of vasculogenic claudication from PSEUDO claudication… true or false?

A

TRUE

145
Q

What are a few reasons why we WOULDNT do exercise testing when doing segmental pressures?

A

an ABI of < 0.3 (severe disease is evident no need for exercise)

shortness of breath, hypertension

ISCHEMIC ULCERATION

POOR AMBULATORS

If rest of study is normal and symptoms are only “resting” symptoms

146
Q

When doing exercise testing for segmental pressures, we like to evaluate how long it takes the segmental pressures to get back to normal…

if it takes 2-6 minutes for patients pressures to go back, this indicates…?

A

single level disease

147
Q

When doing exercise testing for segmental pressures, we like to evaluate how long it takes the segmental pressures to get back to normal…

if it takes 6-12 minutes for patients pressures to go back, this indicates…

A

multi-level disease

148
Q

What is post-occlusive reactive hyperemia? (PORH)

A

this is alternative method instead of doing the “exercise portion” of an ABI/ segmental pressures.

149
Q

What is considered an abnormal Penile Brachial Index?

A

less than 0.6

150
Q

If a patient with Leriche syndrome ( aortoiliac obstruction) what could this do to the inflow to the penis?

A

limit the amount of flow going to the penis. Iliac artery disease.

151
Q

If a patient has an abnormal Penile brachial index, what can this indicate?

A

obviously limited flow to the penis, but this usually indicates aorto-iliac disease.

152
Q

WHat vessel is the main supplier of an erection ( THIS WAS ON THE REGISTRy but not in edelman book)

A

Internal pudendal artery

153
Q

Explain the process of doing a penile brachial index scan. Which arteries are imaged?

A

The cavernosal artery AP diameter is measured, as well as PSV/EDV,

The penis is enjected with a vasodilator, and an erection is induced.

Measrment of cavernosal artery is again looked at as well as the DORSAL vein flow

154
Q

The dorsal vein is only measured before the penile brachial index scan, not after.

T/F

A

FALSE. we scan the cavernosal artery first, then the dorsal vein after the erection is induced by the physician.

155
Q

When doing a penile brachial index scan, should the cavernosal arteries increase or decrease after post injection ?

A

INCREASE by greater than 30 cm/sec

156
Q

If the dorsal vein velocities increase in a penile brachial index, that is suggestive of a venous leak

A

True

157
Q

What is thoracic outlet syndrome a result of?

A

an extra cervical rib or an old fracture of the collarbone that reduces the space for the vessels and nerves.

158
Q

What are the common symptoms of thoracic outlet syndrome?

A

numbness, tingling, pain/aching of the shoulder and arm which is worse when they raise their arm

159
Q

What is popliteal artery entrapment syndrome (PAES)?

A

a SYMPTOMATIC compression or occlusion of the popliteal artery due to an abnormal relationship with the medial head of the gastrocnemius.

160
Q

If a 28 year old male basketball player comes in complaining of intermittent claudication, what should we suspect?

A

POPLITEAL artery entrapment syndrome

161
Q

If left untreated, popliteal artery entrapment syndrome can lead to??

A

stenosis, aneurysm or thrombus formation

162
Q

What kind of patients typically have buergers disease?

A

40 year old male who heavily smokes

163
Q

What are the symptoms of buergers disease?

A

affects the small vessels in the upper and lower extremities.

foot ischemia, rest pain or ulceration

164
Q

Does takayasu arteritis affect larger vessels or smaller vessels?

A

larger such as aorta and its branches

165
Q

What would a patient with takayasu arteritis complain of?

A

pulseless disease

no pulse in the upper extremities as well as renal hypertension if renal is affected.

166
Q

if gone untreated, temporal arteritis can leave a patient blind.

True or False

A

True

167
Q

What is the most common site for a pseudoaneurysm?

A

CFA because it often used for arterial access

168
Q

Describe a pseudo aneurysm

A

A defect of hole in the arterial wall typically from trauma. Not an actaul real aneursym bc it doesn’t involve all three layers

169
Q

What is the typical treatment for a pseudo aneursym?

A

Ultrasound Guided Thrombin- Puts thrombin into the PSA sac and slowly injects until the thrombosis occurs.

170
Q

What is an arteriovenous fistula?

A

abnormal connection between the high pressure arterial system and the low pressure venous system

171
Q

Why is an arteriovenous fistula near the heart most dangerous?

A

increased risk for cardiac failure

172
Q

What are some symptoms of compartment syndrome?q

A

tenderness pain, paresethesia and foot drop.

173
Q

Why does compartment syndrome occur and what can be done as treatment?

A

occurs when excessive pressure builds up inside the compartments of muscles–can lead to death

Fasciotomy is when the fascia is cut to relieve tension or pressure .

174
Q

What is the point of the allen’s test?

A

to determine patency of palmar arch

175
Q

explain how the allen’s test works

A

manually compress the radial and ulnar, patient makes fist then releases so hand appears blanched.

176
Q

Normal color should return in around 10 seconds when doing the allen’s test

True or False

A

True

177
Q

Radial artery mapping studies are often done to determine suitability for us as a graft for what type of bypass?

A

coronary artery bypass

178
Q

What should the radial artery measure when doing a radial artery mapping study?

A

greater than 2 mm

179
Q

Epigastric artery mapping is used to identify adequate arterial supplied muscle section for what type of procedure?

A

autogenous breast reconstriction.

180
Q

The internal mammary artery arises off the arch of what artery?

A

subclavian

181
Q

For what instance would we do an internal mammary artery mapping ?

A

often used to do the TRAM flap for autogenous breast reconstriction AND coronary bypass grafting.

182
Q

In the upper arm, when we are doing a mapping of the basilic and cephalic arteries, what should they measure to fit criteria for surgery?

A

2-3 mm

183
Q

If we get a patient that comes in with crampy abdominal pain 15-30 minutes after eating is suspected for what disease?

A

mesenteric ischemia due to stenosis or occlusion limiting the blood flow necessary needed to aid in digestion.

184
Q

If we see a large inferior mesenteric artery, what should w esuspect?

A

collateralization!

185
Q

What are the two possible connections between the sma and ima?

A

1) marginal artery of colon

2) Arc of Riolan

186
Q

The IMA often severes as a collateral to the iliac arteries via branches of the ____ artery

A

internal iliac artery

187
Q

What is arcuate liagment compression surgery what is it often called?

A

often called celiac axis compression syndrome

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

188
Q

Whats the main reason we would do the renal artery stenosis studies

A

hypertension

189
Q

What is arcuate ligament compression syndrome?

A

compression of the celiac artery by the median arcuate ligament of the diaphrag

190
Q

Explain the process of arcuate ligament compression. How is it resolved, what symptoms

A

Clinically we wil feel an abdominal bruit that goes away with deep breaths

When we expire, thats when the stenosis occurs, and the diaphragm compresses the celiac and makes it have an S shape. Spikes the PSV high abot 200 cm/sec

When we take a deep breath in, it releases the comperssion and the celiac goes back to normal.

191
Q

Why does renal artery stenosis cause renovascular hypertension?

A

The RAS causes the release of renin causing vasoconstriction and high blood pressure. This results in RENAL FAILURE.

192
Q

If a patient has renal artery stenosis, where is most of the disease originate from?

A

@ origin of vessel

193
Q

When it comes to acceleration time in a RAS stidy, what is considered normal and abnormal?

A

Normal - LESS THAN 100 milliseconds

Abnormal GREATER than 100 milliseconds

194
Q

Where do we take the acceleration time in regards to a RAS study

A

At the distal renal artery

195
Q

Transplant kidneys are usually anastomosed to what vessel?

A

External or internal iliac

196
Q

What name describes a radial artery to cephalic vein fistula?

A

Breccia-cemino fistula

197
Q

How does native autogenous fistula work?

A

They Create a connection between a artery and vein. The vein will dilate in response to the arterial pressure

198
Q

If we feel a bruit or thrill on a dialysis grafts what should we think?

A

Trick question! This is normal and a dialysis access graft

199
Q

Where do most stenosis happen in a hemodialysis graft?

A

The outflow vein or anastomoses point

200
Q

The first beach off the ECA is the

A

Superior thyroid artery

201
Q

Fatty streak atherosceloric plaque is also called

A

INtimal thickening

202
Q

Rare condition resulting in abnormal growth in the walls of medium and large arteries

A

Fibromuscular dysphasia

203
Q

Which vessel is fibromuscular dysphasia often seen in?

A

Distal ICA. In women 40-60

204
Q

If a Patient had an. Endarectomy and comes in for a carotid ultrasound 6-24 months later, what is a complication we may see?

A

Neointimal hyperplasia

205
Q

When a Patient has a carotid body tumor where would this be located and what vessel may have decreased resistance due to the vascularity of the tumor?

A

Located At the bifurcation splaying the ICA and EcA. The ECA have decreased resistance due to feeding the tumor

206
Q

A TIA stroke lasts how long?

A

Less than 24 hours

207
Q

A RIND stroke lasts longer than ___ hours

A

24 hours

208
Q

If the anterior circulation of the circle of willis is affected (ICA, MCA, ACA, AComm) what type of symptoms will a patient preent with?

A

weakness, inability to speak, difficulty with speech, tingling, pins and needles

209
Q

Hemispheric symptoms pertaining to strokes are often contralateral. The right side of brain controls the left and the left side of brain controls the right.

T?F

A

True

210
Q

If there is a lesion affecting the posterior circulation (for strokes), what type of symptoms may occur?

A

dizziness, lack of coordination, double vision, fall, dyslesxia

211
Q

Sayyou have a stroke patient with left sided loss of vision. Where would you suspect an embolus to be?

RIght side of brain? or Left

A

right. vision symptoms are usually ipsilateral.

212
Q

When imaging a carotid stenosis, what PSV / EDV is considered 50-70% stenotic?

A

greater than 125 systolic

lessthan 140 diastolic

213
Q

When imaging a carotid stenosis, what PSV/EDV is considered 80%

A

Greater than 125 systolic and greater than 140 diastolic

214
Q

What is the first branch off the subclavian?

A

vertebral

215
Q

What is an endarterectomy used for?

A

surgical procedure in which artery is isolated and open, plaque from carotid is removed and suttered closed.

216
Q

What is the process of an arteriography?

A

contrast is inserted through a catheter that was placed in the vessel of interest. This can determine if there is a filling defect.

217
Q

Where is a vasospasm often seen in the circle of willis?

A

MCA with a mean velocity of greater than 120.

218
Q

What is a “cross over” collateral pathway in the circle of willis?

A

antegrade flow in the ACA ( supposed to be retrograde bc its going away from transducer), this happens because flow from the contralateral ACA collateralized from the Acom artery

219
Q

What is an external carotid to internal carotid collateral pathway?

A

Retrograde is seen in the opthalmic artery..

this is because the opthalmic artery is the first artery in the terminal ICA.

220
Q

What is a “posterior to anterior “ collateral pathway?

A

increased flow in the PCA with reversed flow in the posterior communicating artery.

221
Q

IF we see a cross over collateral pathway, where should we suspect theres an occlusion?

A

ICA occlusion on the contralateral side.

222
Q

Usually blood flows from anterior hemisphere to posterior hemisphere- so if we see reversed flow in the PCA or PComm , that is abnormal. True or False

A

True

223
Q

Mean velocity over 120 in the MCA indicates what?

A

vasospasm

224
Q

micro-emboli in the brain is often called HITS, which stands for?

A

high intension transient signals

225
Q

Where do micro-emboli in the brain often come from?

A

either carotid or cardiac sources.

226
Q

What is the foramen ovale?

A

is a hole between the right and left atrium, often closes at birth.

227
Q

What is a patent foramen ovale?

A

source of emboli from an open hole from the right and left atrium that was supposed to close at birth.

228
Q

syndrome in which there is acompression of the iliac vein

A

MAY - THURNER syndrome.

229
Q

The innominate vein is formed by what two vessels?

A

subclavian and IJVs

230
Q

What is klippel trenaunay?

A

multiple surficial varicosities and incomplete deep system

231
Q

What is the differencde between primary and secondary chronic venous insufficiency?

A

primary has a normal deep system but irregular superficial vein

secondary has an abnormal superficial and deep syste

232
Q

what is phlegmasia cerula dolens? Does this pertain to arteries or veins?

A

MILK LEG. means there is compromised arterial flow

233
Q

What is phlegmasia cerula dolens?

A

bluish discoloration due to severely limited venous outflow.

234
Q

Brawny skin changes can be related to arterial and venous disease.

True or False

A

NOPE brawny skin is related to venous disease.

Vascular-Arterial (22 decks)

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