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RVT EXAM REVIEW > Transcranial Doppler (TCD) > Flashcards

Transcranial Doppler (TCD) Flashcards

(48 cards)

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1
Q

circle of willis is comprised of

A
  1. anterior communicating artery
  2. anterior cerebral arteries
  3. small portion of distal ICA
  4. posterior communicating artery
  5. posterior cerebral arteries
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2
Q

middle cerebral artery (MCA) is an extension of the ___ and NOT part of the circle of Willis

A

ICA

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3
Q

the ophthalmic artery divides into

A

supraorbital artery
frontal artery

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4
Q

the supraorbital artery travels ___ and ___ to the eye

A

anteriorly and superiorly

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5
Q

supraorbital artery joins the ECA via several branches, notably the ___

A

superficial temporal artery

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6
Q

the frontal artery exits the orbit medially to supply the ___

A

forehead

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7
Q

8 indications for TCD

A
  1. extracranial evaluation
  2. detect intracranial stenosis/occlusion
  3. assess collateral circulation
  4. evaluate patients with sickle cell disease
  5. evaluate vasoconstriction from subarachnoid hemorrhage
  6. evaluate the presence of intracranial arteriovenous malformations
  7. assess suspected brain death
  8. emboli detection
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8
Q

3 limitations of TCD

A
  1. inadequate US penetration/insonation of the temporal bone
  2. recent eye surgery
  3. inaccurate vessel identification
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9
Q

TCD uses ___ not PSV

A

timed average mean velocity

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10
Q

accurate vessel identification requires/determined by (4)

A
  1. depth of sample volume
  2. direction of blood flow
  3. velocity of blood flow
  4. relationship of flow patterns to one another
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11
Q

3 acoustic windows used for TCD

A

transtemporal
transorbital
transforamenal/suboccipital

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12
Q

transtemporal window

A

terminal ICA
MCA
ACA
PCA

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13
Q

transorbital window

A

ophthalmic artery
carotid siphon

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14
Q

transforamenal/suboccipital window

A

distal vertebral
basilar artery

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15
Q

MCA

window -
depth -
direction -
TAMV/mean -
transducer angulation -

A

MCA

window - temporal
depth - 30 to 60mm
direction - toward
TAMV - 55 (+/-12)
transducer angulation - ant & sup

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16
Q

terminal ICA

window -
depth -
direction -
TAMV/mean -
transducer angulation -

A

terminal ICA

window - temporal
depth - 55 to 65mm
direction - bidirectional
TAMV - 55 (+/-12)
transducer angulation - ant & sup

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17
Q

ACA

window -
depth -
direction -
TAMV -
transducer angulation -

A

ACA

window - temporal
depth - 60 to 80mm
direction - away
TAMV - 50 (+/-11)
transducer angulation - ant & sup

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18
Q

PCA

window -
depth -
direction -
TAMV -
transducer angulation -

A

PCA

window - temporal
depth - 60 to 70mm
direction - P1 towards, P2 away
TAMV - 39 (+/- 10)
transducer angulation - posterior

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19
Q

ophthalmic

window -
depth -
direction -
TAMV -
transducer angulation -

A

ophthalmic

window - orbital
depth - 40 to 60mm
direction - toward
TAMV - 21(+/-5)
transducer angulation - medial

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20
Q

ICA (siphon)

window -
depth -
direction -
TAMV -
transducer angulation -

Study These Flashcards
A

window - orbital
depth - 60 to 80mm
direction - supraclinoid away, genu bidirectional, parasellar toward
TAMV - 47 (+/-14)
transducer angulation - varies

21
Q

vertebral

window -
depth -
direction -
TAMV -
transducer angulation -

Study These Flashcards
A

vertebral

window - foramenal
depth - 60 to 90mm
direction - away
TAMV - 38 (+/-10)
transducer angulation - right & left of midline

22
Q

basilar

window -
depth -
direction -
TAMV -
transducer angulation -

Study These Flashcards
A

basilar

window - foramenal
depth - 80 to 120mm
direction - away
TAMV - 41 (+/-10)
transducer angulation - midline

23
Q

TCD interpretation is based on (2)

Study These Flashcards
A

flow characteristics and velocity

24
Q

5 factors that may alter intracranial blood flow

Study These Flashcards
A
  1. age
  2. sex
  3. hematocrit
  4. arterial blood gas
  5. metabolic demands
25
occlusion is most accurate in the ___ or ___
ICA or MCA
26
___ flow in ACA from cross-over collateralization
antegrade flow from contralateral AVA via ACoA
27
ECA-ICA ___ flow in the ophthalmic artery
retrograde
28
posterior-anterior collateral pathway increased flow in the PCA with reversed flow in the ___
PCoA
29
sickle cell disease blood cells can block a blood vessel resulting in ___
tissue and organ damage
30
one of the most common inherited blood anemias
sickle cell anemia
31
children with sickle cell disease are at risk of cerebral infarction secondary to ___
occlusive vasculopathy
32
STOP (stroke prevention trial in sickle cell anemia) study demonstrated children with an abnormal TCD has a ___% risk of stroke
10%
33
STOP study MCA/distal ICA mean velocity
> 200cm/sec or PSV > 250cm/sec
34
STOP study those treated with ___ reduced the risk of stroke to < 1%
hyper-transfusion
35
STOP study recommended TCD screening every 6 months for children between the ages ___
2 and 16 years old
36
vasospasm is most accurate in the ___
MCA
37
vasospasm mean velocity - severe vasospasm velocity -
mean velocity > 120cm/sec severe vasospasm velocity > 200cm/sec
38
arteriovenous malformation 1. ___ systolic and diastolic velocities 2. ___ pulsatility index 3. reduced altered waveform in ___
1. increased systolic and diastolic velocities 2. low pulsatility index 3. reduced flow altered waveform in adjacent arteries
39
with brain death, there is small systolic peak with no diastolic flow in the ___
ICA, MCA, or ACA
40
gaseous or solid microemboli within the MCA can be detected by TCD as ___
high-intensity transient signals (HITS) aka micro-embolic signals (MES)
41
micro-emboli detection duration
< 300ms
42
micro-emboli detection typically ___ and occur randomly
unidirectional
43
micro-emboli detection sounds like a ___ on audio
chirp or moan
44
___ allows blood/emboli to travel from the venous circulation into the arterial circulation
patent foramen ovale (PFO)
45
transmandibular acoustic window can assess the ___ and is used primarily for ___
assess mid and distal ICA used for emboli monitoring
46
intra-operative transcranial Doppler monitoring identifies ___ which may warrant a change in surgical technique
flow abnormalities
47
intra-operative transcranial Doppler monitoring significant disease in MCA flow velocity during cross-clamping of a vessel may indicate ___
the need for a shunt
48
intra-operative transcranial Doppler monitoring presence of ___ may indicate the need to alter the surgical technique
HITS/microemboli

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