Vascular Ultrasound Exam 2023 Answered

Dysarthria - ANSWER-Difficulty with speech caused by impairment of the tongue or muscles essential to speech Common Carotid Artery (CCA) - ANSWER-Arises from the aortic arch on the left side and from the innominate artery on the right side Bruit - ANSWER-Noise caused by tissue vibration produced by turbulence that cause flow disturbance Dysphagia - ANSWER-Inability to swallow or difficulty in swallowing Ataxia - ANSWER-Impaired ability to coordinate movement, especially disturbances in gait Vertigo - ANSWER-Sensation of having objects move about the person or sensation of moving around in space Internal Carotid Artery (ICA) - ANSWER-Larger of the two terminal branches that arise from the common carotid artery Vertebral Artery - ANSWER-Larger branches of the subclavian artery that merge to form the basilar artery Amaurosis Fugax - ANSWER-Transient partial or complete loss of vision in one eye Reversible Ischemic Neurologic Deficit - ANSWER-Cerebral infarct that lasts longer than 24 hours but less than 72 hours Hemiparesis - ANSWER-Unilateral partial or complete paralysis Collateral pathway - ANSWER-Develops because of vessel obstruction; smaller side branches of the vessel provide alternative flow pathways Aphasia - ANSWER-Inability to communicate by speech or writing Cerebrovascular accident - ANSWER-Abnormal condition of the brain characterized by occlusion by and embolus, thrombus, cerebrovascular hemorrhage, or vasospasm that results in ischemia of brain tissues normally perfused by the damaged vessels External Carotid Artery - ANSWER-Smaller of the two terminal branches of the common carotid artery Transient Ischemic Attack - ANSWER-Episode of cerebrovascular insufficiency, usually associated with partial occlusion of a cerebral artery by an artherosclerotic plaque or an embolus Diplopia - ANSWER-Double vision The ascending aorta originates from the _____ ventricle of the heart - ANSWER-left Three main branches arise from the super convexity of the arch in its normal configuration: the _____ trunk (innominate artery) is the first branch; the _____ common carotid artery the second; and the left _____ artery the third branch in approximately 70% of cases. - ANSWER-brachiocephalic; left; subclavian The right CCA and the right subclavian artery are divided by the _____ artery, which gives rise to the right vertebral artery. - ANSWER-innominate Each CCA ascends through the superior mediastinum anteriolaterally in the neck and lies _____ to the jugular vein - ANSWER-medial The left common carotid is usually _____ than the right, because it originates from the aortic arch. - ANSWER-longer The termination of the CCA is the carotid _____, which is the origin of the ICA and the ECA. - ANSWER-bifurcation The ECA originates at the midcervical level and is usually the _____ of the two terminal branches of the CCA - ANSWER-smaller The larger of the CCA terminal branches is usually the _____ - ANSWER-ICA Identify the four main segments into which the ICA can be divided: - ANSWER-cervical, petrous, cavernous, and cerebral In most individuals, the ICA lies _____ to the ECA and courses medially as it ascends in the neck - ANSWER-posterolateral The vertebral arteries are large branches of the _____ arteries - ANSWER-subclavian The _____ segment of the vertebral artery courses superiorly and medially from its subclavian origin to enter the transverse foramen of the sixth cervical vertebra - ANSWER-extravertebral A stroke or "brain attack is cause by an _____ of blood flow to the brain (ischemic stroke) or by a ruptured intracranial blood vessel (intracranial hemorrhage) - ANSWER-interruption Approximately 80% of all known strokes are _____, and the remaining 20% are hemorrhagic. - ANSWER-ischemic Nonmodifiable risk factors for stroke include: - ANSWER-Age, sex, and race Modifiable, or controllable, risk factors of stroke: - ANSWER-Hypertension, atrial fibrillation, cardiac disease, diabetes mellitus, elevated cholesterol, smoking, and sedentary lifestyle Symptoms of weakness or numbness of a leg or arm on one side of the body indicate disease in the _____ carotid system - ANSWER-contralateral Ocular symptoms suggest disease in the _____ carotid system - ANSWER-ipsilateral Other cerebrovascular symptoms are _____ (transient partial or complete loss of vision in one eye); _____ (unilateral partial or complete paralysis); _____ (difficulty with speech cuased by impairment of the tongue or muscles essential to speech); _____ (inability to communicate by speech or writing); _____ (inability or difficulty swallowing); _____ (gait disturbances); _____ (double vision); and _____ (sensation or having objects move about the person or sensation or moving around in space. - ANSWER-amaurosis fagux; hemiparesis; dysarthria; aphasia; dysphagia; ataxia; diplopia; vertigo Arm pressures are recorded, and a difference of _____ mmHg pressure between arms suggests a proximal stenosis and/or occlusion of the subclavian or innominate artery on the side of the lower pressure. - ANSWER-> or = 20mmHg In the normal setting, the CCA spectral waveform will demonstrate a _____ resistance pattern (end diastole above the zero baseline) because blood travels from the CCA to the brain via the ICA - ANSWER-low The CCA doppler signal will display a _____ doppler shift throughout the cardiac cycle - ANSWER-positive The ICA demonstrates blood flow velocity that is _____ and _____ the zero baseline throughout the cardiac cycle - ANSWER-continuous; above The normal color pattern of the ICA will have _____ color throughout the cardiac cycle because the ICA has diastolic blood flow caused by the low peripheral resistance of the brain - ANSWER-continuous The ECA demonstrates a more _____ doppler signal (minimum diastolic flow) because it supplies blood to the skin and the muscular bed of the scalp and face - ANSWER-pulsitile The ECA usually has a ______ slope to peak systole and blood flow velocity at or very close to zero in late diastole - ANSWER-faster The vertebral arteries are located by angline the transducer slightly _____ from a longitudinal view of the middle or proximal CCA - ANSWER-laterally The _____ velocity obtained from an ICA stenosis is used to classify the degree of narrowing - ANSWER-highest A _____ _____ is present if reversal of vertebral artery blood flow direction occurs secondary to a significant obstruction proximal to the origin of the vertebral artery in the ipsilateral subclavian or innominate artery - ANSWER-subclavian steal Evaluation of normal subclavian arteries produces _____ high-resistance dopper signals - ANSWER-multiphasic Information that should be included in the interpretation of a carotid duplex imaging exam: - ANSWER-Location of stenosis; extent of plaque and patency of distal ICA; presence of tortuosity or kinking of vessel; and plaque characteristics Carotid duplex imaging performed after carotid endarterectomy may reveal _____ or _____ stenosis in the ipsilateral ICA and disease progression in the contralateral ICA - ANSWER-residual; recurrent The echogenicity of plaque is usually described as _____ if it demonstrates a uniform level of echogenicity and texture throughout the plaque, and as _____ if the plaque has mixed areas of echogenicity and textures. - ANSWER-homogeneous; heterogeneous A _____ plaque is usually visualized with an accompanying acoustic shadow that obscures imaging information deep to it. - ANSWER-calcified When describing whether the ICA is occluded, the color PRF should be _____ to document the presence of an slow moving blood flow, and the color gain should be _____ to enhance an blood flow that may be present - ANSWER-decreased; increased The ICA should be sampled at _____ sites with doppler - ANSWER-multiple a nonartherosclerotic disease that usually affects the media of the arterial wall is _____ _____ - ANSWER-fibromuscular dysplasia Dorsalis Pedis Artery - ANSWER-Continuation of the anterior tibial artery on the top of the foot Pseudoaneurysm - ANSWER-Perivascular collection (hematoma) that communicates with an artery or graft; pulsating blood is entering the collection