Vascular Scanning Flashcards
(97 cards)
1
Q
echogenic, heterogenous, old
A
chronic thrombosis
2
Q
occurs when velocities exceed the PRF
A
alaising
3
Q
free floating proximal end of a thrombus
A
tail
4
Q
this is a characteristic of a normal vein when applying probe pressure
A
compressible
5
Q
the assignment of colors for direction and frequency shift
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map
6
Q
a useful phrase when writing reports on a venous exam
A
no evidence of DVT
7
Q
to form a channel of flow through an old thrombus
A
recanalize
8
Q
softly echogenic, homogeneous, new
A
acute thrombosis
9
Q
many colors due to many different velocities and directions of flow
A
mosaic
10
Q
something the walls of the veins should do. to meet.
A
coapt
11
Q
obstructed, but not totally blocked
A
non-occlusive
12
Q
the way you should treat a patient
A
like a loved one
13
Q
on record
A
document
14
Q
color coding that shows a wide range of velocities
A
variance
15
Q
localized area of high velocity flow due to a stenosis
A
jet
16
Q
color assignment to signal flow at certain assigned velocities
A
tag
17
Q
transverse plane
A
horizontal, across
18
Q
sagital plane
A
median, divided by right and left
19
Q
coronal plane
A
frontal, divided by front and back
20
Q
oblique plane
A
any plane angle other than transverse, sagital, or coronal
21
Q
medial
A
toward the center line of the body
22
Q
lateral
A
away from the center line of the body
23
Q
proximal
A
closer to the point of attatchment or origin
24
Q
distal
A
farther away from the point of attatchment or origin
25
cephalad
toward the head
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caudal
toward the feet
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superior
above, toward the head
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inferior
below, toward the feet
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superficial
closer to the skin surface
30
deep
farther down from the skin surface
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anterior
toward the front of the body
32
posterior
toward the back of the body
33
ultrasound
use of high frequency sound waves for diagnostic purposes.Obtain images and flow signals from the sound waves bouncing off structures and moving blood inside the body
34
jargon
words shared by those in the same profession, used to communicate with, some words may be used differently by colleagues, the goal is to have a common vocabulary to communicate effectively and avoid confusion
35
echogenic
really bright, producing many or some echoes, also referred to as echodense, or hyperechoic
ex: old thrombus
36
anechoic
black, producing few or no echoes, also referred to as hypoechoic, ex: fresh thrombus, bakers cyst
37
suboptimal
crummy, difficult to image, a better approach may need to be utilized but may not always be an option. Ex: this study was less than optimal (suboptimal) due to patient confusion and restlessness
38
within normal limits, WNL
used rather than stating "normal", WNL is used often with the phrase Essentially. Ex: there is a mild turbulence in the ICA; possibly due to tortuosity, but the Doppler here is essentially WNL
39
appreciate
to discern (perceive or recognize) or distinguish something. ex: in the more posterior approach, we can better appreciate the crater-like formation at the origin of the ICA
40
proximal/distal limit
farthest possible point toward or away from the heart, reassures that you are imaging the vessel as far proximally or distally as you can. ex: this is the most distal limit of useful imaging in the ICA
41
characterizing lesions
plaque, calcific, dense, soft, fiberous, intimal thickening, fatty streak, minimal, mild, moderate, sever, circumferential, extensive, scattered, diffuse, true lumen vs residual lumen, homogeneous vs hetergeneous, smooth vs irregular, crater, crater-like, occlusion
42
plaque, atheroma, atheromata, areas of ateroma, areas of calcification, atheromatous development
atheroma- a greek word meaning porridge. used like "plaque" (different consistency). ex: there is extensive plaque/atheroma in this vessel. Atherosclerotic lesions of the arteries.
43
calcific, dense
type of plaque (characteristics), shows up as bright echoes in the lumen (echogenic), calcific plaque would produce a shadow, where dense plaque may not
44
soft, fibrous
describing features of certain plaque, appears darker than the calcific, dense plaque
45
intimal thickening
minimal soft plaque along the wall of the vessel, basically the same as fatty streak
46
fatty streak
minimal area of plaque on the wall of the vessel, basically the same as intimal thickening
47
minimal, mild, moderate, moderately severe, severe
grading for carotid stenosis (most common terms), generally you can categorize plaque as "appearing" minimal, mild, or moderate, to categorize plaque as moderately sever or sever is best done after using Doppler
48
circumferential
plaque around the entire circumference of the vessel, ONLY seen in transverse
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extensive
plaque along a lenghty segment of the artery, often misused as describing a severe stenosis
50
scattered diffuse
plaque found at several levels in the artery
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true lumen
the whole space inside a vessel
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residual lumen
the space inside the vessel that is left by plaque or clot
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homogeneous
used to describe plaque, one consistency
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heterogeneous
used to describe plaque, different consistencies/material (both soft and dense areas), more likely to have ulcerative activity than homogeneous plaque
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smooth vs irregular
used to characterize the surface appearance of plaque in an effort to indicate possible areas of ulceration
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crater/ crater-like in appearance
this is a shape that suggests there has been an ulceration of plaque
57
occlusion
used to describe a complete blockage, often used with the word total. ex: internal echoes, no color Doppler or signal = compatible with total occlusion
58
characterizing doppler findings
laminar, sharp vs dampened, multiphasic vs monophasic, antegrade vs retrograde, turbulance, spectral, broadening, disturbed flow, window filling, gross turbulance, elevated velocities, accelerated flow through stenosis, alaising, compatible with
59
laminar
normal, orderly, non-turbulant flow, faster in the center, parabolic flow and plug flow
60
sharp
characterize sound of Doppler and a shape of a waveform, swift up and down strokes, sharp peak
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dampened
characterizes sound of Doppler and shape of waveform, sluggish up and down strokes, rounded peak
62
multiphasic
normal arterial flow in the extremeties
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monophasic
an issue in the extremity arteries, suggests that energy has been "dampened" out of the flow
64
antegrade
flow in the expected direction
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retrograde
flow in the opposite direction as expected
66
turbulence, spectral broadening, disturbed flow, window filling, gross turbulence
all used to describe various degrees of flow disturbance as seen in the spectral analysis
67
elevated velocities (peak systolic/end diastolic), accelerated flow through stenosis
used to describe flow through a hemodynamically significantly lesion (blockage)
68
aliaising
nyquist limit, PRF/2, speed limit, results from high velocity blood flow; usually due to a fairly severe stenosis, use a lower frequency to eliminate aliasing
69
compatible with
a common phrase used to suggest your impression without being more definate than you should be, may also use phrases like "suggestive of, or Strongly suggestive of"
70
anatomic variant
double/multiple venous systems (common at superficial femoral level, & GSV), double renal arteries are common, variations of the carotid bifuracation (prox or distal, ICA/ECA could arise straight from the aortic arch, tortuous vessels
71
cerebrovascular collaterals
collateral develop slowly over time, collaterals develop because they have to, ability to develope collaterals is variable among individuals, contralateral hemisphere, posterior to anterior, ECA to ICA branches
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slow development
symptoms often dont show up for many years, as atherosclerosis continues to build up collaterals expand and take over, acute = no time for alternate pathways to develope
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collaterals pathways develope because they have to
alternate routing of blood, blood travels from higher pressure to lower pressure, obstruction = causes pressure gradients to change in surrounding vessels >over time > Ex: subclavian steal
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development varies
1/2 of population has a complete cirlce of willis, three major alternate pathways are contralateral hemisphere, posterior to anterior, and ECA to ICA branches
75
the patient
what test does the patient need, flow to be assessed, what type of patient (obese, thin, angry, calm)
76
probes
creates the ultrasound beam, mechanical steering, and electronic steering
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mechanical steering
use single fixed focus beam- move it around to create a real time 2 dimensional image. sector shape field of view
78
electronic steering
use a number of crystals to produce the beam, fires individual crystals in a timed sequence to direct and focus the beam creating the image. Linear - in a line, annular - in a ring, curved linear - in a line that is bowed out in the middle. Linear is used most
79
(probes cont) depth and resolution
* superficial vessels 7.5 to 10 MHz,
higher frequency = shorter wavelenght = distinguish smaller objects clearly
*deeper structures - lower frequency 2.5 to 3.5 MHz for abdominal vessels
lower frequency = longer wavelength = deeper penetration but less resolution
** MATCH THE PROBE FREQUENCY WITH THE TASK***
80
Duplex
ability to obtain both anatomic and physiologic information. (picture, color, and waveform at the same time)
81
scanner controls
controls should be grouped together based on their function but may be arranged differently on the scanner.
contrast, gain, depth, focus, pre/post processing, Doppler, measurement, annotation, color
82
brightness/contrast for the screen
NOT GAIN, brighter screen for brighter rooms, less contrast/ darker for darker rooms, works like the contrast on your TV or PC
83
master gain control
alters the amount of amplification throughout the image
84
transmit power
alters the strength of the outgoing signal being sent into the tissue (patient)
85
Depth Gain Control
| Time Gain Control
TGC, Controls the amount of gain in the image at different depths up or down in the field of view, slider switches in a row on one side
86
Focal Zone/ Transmit Zone
multielement probes (electronically steered) have this capability, set at depth you want to be most focused (keep adjusted at area of interest), may have more than one focal zone, decreases frame rate
87
pre processing
involves the computers assignment of gray scale levels to the return echoes, these are stored in the scan converter and then displayed on the screen
88
post processing
involves changing the gray scale values as they are brought out of the scan converters memory for display, can be manipulated to enhance certain features (ex: fresh thrombus thrombus
89
pre/post processing
control over the dynamic range of the gray scale. lower setting (less db) may be better for making a dark vessel lumen stand out
90
Doppler
Doppler on control - vary. may show just the waveform OR image and waveform
Doppler Gain control - to optimize the spectral display
Doppler Scale controls - allows to move baseline and to change scale of Doppler display to accomodate the waveform amplitude
91
Temporal Tap
an actual tap on the tempel
92
measurement controls
make measurements on the image (vessel diameter), and spectral display (peak systolic velocity). some machines may make some calculations for you and some machines may have a calculation package
93
field of veiw / magnify
zoom, change the size of the area imaged on the screen, reduce field of view = vessels look bigger on the screen, may create a grainier image
94
annotation
enter patient info and lable images on the screen, also has the feature of body marker on the side or arrow to point out area of interest
95
documentation systems
stored image for future reference and for the reading physician, polaroid or matrix camera, digital printer, and PACS
96
reading physician
relies on you to gather the best information possible so the reader can accurately interpret the study and have good info for the referring physician.
technologists do not diagnose although there may be situations when the tech would give a preliminary impression (ex: acute DVT)
interpretive skills take longer to learn than your scanning skills
97
referring physician
As a tech
*may be a source of education for the referring physician, may speak with them regarding a study
*may be an important source of education to the patient also
Ultrasound is very operator dependent!
