Week 8 - Duplex exam scanning

Question 1

What is most common LE arterial disease?

Answer 1

Atherosclerosis

Question 2

Describe atherosclerosis

Answer 2

Thick, hard arteries
decreased elasticity
Plaque blocking flow

Question 3

Where is the most common location for AS in the LE?

Answer 3

SFA at adductor canal

Question 4

An aneurysm at the aorta commonly results in ________.

Answer 4

Rupture

Question 5

An aneurysm at the popliteal commonly results in _____.

Answer 5

Embolism

Question 6

Describe an aortic coarctation

Answer 6

Narrowing of the aorta causing HTN
Commonly seen in young people with HTN
Results in decreased perfusion to LE and kidneys

Question 7

A disease typically seen in young people at the popliteal artery that occludes the artery and can be seen on duplex

Answer 7

Cystic Adventitial Disease

Question 8

Describe Arteritis

Answer 8

Inflammation of the artery

Thick wall or Halo around artery

Question 9

Arteritis of the aortic arch and large branches with narrowing or occlusion is know as what?

Answer 9

Takayasu’s Arteritis

Question 10

Disease most common in male smokers <40 yo

Occlusion of distal arteries, rest pain, and ulcers

Answer 10

Buerger’s Dz

Question 11

What are the indications for LE arterial duplex?

Answer 11

Claudication, rest pain, gangrene

Question 12

What is the advantage of using duplex for a LE arterial exam instead of just ABIs with pedal waveforms?

Answer 12

Duplex can discern stenosis from occlusion

Question 13

What are the components of a basic LE arterial exam?

Answer 13

ABIs
CW Doppler
Segs, VPR, CW of proximal arteries
Exercise testing (as needed)
Toe pressures (as needed)
Duplex exam (as needed) LOCATION OF DISEASE

Question 14

What are the 4 obstruction categories?

Answer 14

Normal
<50% stenosis
>50% stenosis
Occlusion

Question 15

What is the PSV velocity ratio?

Answer 15

Highest velocity at stenosis / Pre-stenotic velocity

Question 16

What is a hemodynamically significant PSV ratio?

Answer 16

> 2.0 (Velocity at stenosis needs to be at least double of pre-stenotic velocity)

Question 17

If there is no color to help you find the artery, what can you use as a landmark to find the occluded artery?

Answer 17

Veins

Question 18

What could an enlarged DFA indicate?

Answer 18

SFA occlusion, DFA acting as collateral

Question 19

Many collaterals may enter at distal end of occlusion to ____________ the artery.

Answer 19

reconstitute

Question 20

Describe pre, at, and post stenosis waves

Answer 20

Pre = Normal wave (tri), lower PSV, No diastolic flow
In = Increased PSV (2x)
Post = Turbulence directly after, Waveform change (bi or mono)

Question 21

What color should you see at an occluded artery?

Answer 21

None at occlusion, color before / after, and at collaterals

Question 22

What signal should you see at an occluded artery?

Answer 22

None, Change distally, usually monphasic

Question 23

What causes biphasic waveforms without velocity increase?

Answer 23

Diffuse Disease

Question 24

A collateral vessel normally comes off at _____ to an artery.

Answer 24

90º

Question 25

Any waveform without ____________ in end systole / early diastole is abnormal

Answer 25

reversed flow pattern

Question 26

A _______________ in a waveform from one point to the next indicates an obstruction.

Answer 26

marked change

Question 27

Severity of disease is measure with __________ and _________.

Answer 27

ABIs and Waveforms

Question 28

Location of disease is measured with _________.

Answer 28

Duplex

Question 29

Duplex can see if a disease is a ____________ or a ______________.

Answer 29

Stenosis, occlusion