TCD wk 2(test 1)

Question 1

Reasons for TCD to have gaps on screen

Answer 1

Tortuous vessel
Bad window
Alternative attempts to better insonate can suggest incomplete circle.

Question 2

Vessels not in trans-temporal window

Answer 2

OA- Orbital, 40-60 mm, T
CarSiph-orbital, 60-80mm,
VA-foraminal, 60-90mm, A
BA-foraminal, 80-120mm, A

Question 3

Diagnosing stenosis

Answer 3

Can’t definitively diagnose stenosis since TCD not gold standard, and blindly assessing vessels.

Question 4

Transtemporal window

Answer 4

MCA>ACA>PCA

Question 5

Transforaminal window

Answer 5

VA=BA

AKA suboccipital

Question 6

Vertebral Artery (VA)

Answer 6

Transforamenal
Start from midline of post neck groove.
Aim towards nose, sweep laterally.
60-80mm.
Away, can change with disease (SSS)

Question 7

Magnum foramen

Answer 7

Where vertebrals join to from basilar artery

Question 8

Basilar artery (BA)

Answer 8

Transforamenal
Start midline post neck at groove.
Aim towards nose.
80-100mm
Away, can change with disease (SSS)

Question 9

Transorbital window

Answer 9

OA

CSA

Question 10

Opthalmic artery (OA)

Answer 10

Transorbital
Lateral portion of orbit.
Aim medally.
40-60mm. 
Towards, can change with disease.
1st ICA branch. 
High resistance.

Question 11

Carotid siphon (CS)

Answer 11

transorbital
Lateral to orbit.
Aim towards nose.
60-80mm.
Bidirectional-tortuous.
Low resistance.

Question 12

Submandibular window

Answer 12

ICA

Question 13

Internal carotid artery (ICA)

Answer 13

Submandibular
Start at angle of mandible.
Aim superiorly.
40-70,m.
Away.
Low resistance (high=ECA).
Used to calculate lindegaard ratio.

Question 14

TCD originally used for

Answer 14

vasospasms after hemorrhage.

Question 15

TCD aids in the detection of

Answer 15

Rt-LT shunts.
Vasomotor reactivity.
Diagnosis and monitoring vasospams in subarachnoid hemorrhage.
Supplemental test for brain death confirmation.

Question 16

Trans-cranial color-coded duplex (TCCD)

Answer 16

Visualization of intracranial structures with blood flow patterns.
Phased array proe.
Picks up parenchymal imaging with map of vessels (images).
Insufficient window esp in elderly.

Question 17

When was M-mode created?

Answer 17

2002

Question 18

How much of the beam is attenuated with skull bone?

Answer 18

90%

Question 19

Disadvantages of TCCD?

Answer 19

Small window.

Attenuation effects ability to assess vessels.

Question 20

Pattern circle of willis communicates?

Answer 20

RT-LT and Ant-Post.

Question 21

Vessels insonated in temporal window?

Answer 21

MCA
ACA
PCA
Pcom

Question 22

Vessels insonated in transforaminal window?

Answer 22

BA
VA
CS

Question 23

Vessels insonated in transorbital window?

Answer 23

OA

CS

Question 24

Vessels insonated in sub-mandibular window?

Answer 24

ICA

Question 25

Red on M-mode represents

Answer 25

Flow towards beam

Question 26

Blue on M-mode represents

Answer 26

Flow away from beam

Question 27

Ipsilateral

Answer 27

Same side

Question 28

Contralateral

Answer 28

Opposite side

Question 29

Recommended power going through transorbital?

Answer 29

decreased by 10%