VASCULAR ARDMS BOARDS EXAM

What's the first major arterial branch of the aorta is the? - ANSWER-Innominate artery or brachiocephalic artery The vertebral artery usually arises from the: - ANSWER-Subclavian Artery The incidence of new strokes per year is: - ANSWER-from 500,000 to 700,000 The abbreviation TIA stands for: - ANSWER-Transient Ischemic Attack A TIA of the right anterior hemisphere of the brain will likely affect: - ANSWER-The left side of the body - affects the side of the body opposite that of the ischemic hemisphere Amaurosis Fugax related to an internal carotid lesion will cause: - ANSWER-Temporary blindness or shadowing of the ipsilateral eye. affects same side since thromboembolic activity from ulcerated ipsilateral carotid atheroma is suspected A transient ischemic attack: - ANSWER-Resolves within 24 hours. TIA often last just a few minutes Simultaneous bilateral ocular symptoms in the patient with suspected cerebrovascular disease generally originate form: - ANSWER-The vertebrobasilar arteries . usually originate in the posterior circulation , as the visual cortex is in the occipital lobe. The specific binocular symptom of homonymous hemianopia results from obstruction of a middle cerebral artery branch, not the vertebrobasilar system What are symptoms when vertebrobasilar circulation is effected? - ANSWER-Vertigo, dizziness, ataxia, or other bilateral or global symptoms . What are symptoms when anterior circulation is effected? - ANSWER-Facial Asymmetry, unilateral What accurately defines RIND also called stroke with recovery? - ANSWER-A neurologic ischemic deficit that resolves completely after 24 hours. Describes an intracranial ischemic event that does not resolve within 24 hours but thereafter completely resolves. A 56- year old patient reports loss of vision in her left eye two days ago, with total resolution in 10 minutes. Yesterday morning she developed weakness and numbness in her right hand and was unable to hold her coffee cup. This afternoon her hand strength is about 90% normal, with normal sensation. Clinically she has: - ANSWER-Stroke because it has persisted longer than 24 hours and has not resolved completely The infraorbital artery is a terminal branch of the: - ANSWER-Maxillary Artery . It creates one of the potential anastomoses with orbital branches that can provide collateral pathways in the even of carotid obstruction Amaurosis Fugax can be interpreted as a: - ANSWER-Transient Ischemic Attack of the eye. Dysphagia is : - ANSWER-Difficulty swallowing. Symptom associated with vertebrobasilar insufficiency. A binocular disturbance that disrupts vision in half the visual field of both eyes is called: - ANSWER-Homonymous Hemianopia Paresthesia refers to: - ANSWER-tingling sensation A patient describes a 30-minute episode of garbled speech. This is called: - ANSWER-Dysphasia . Aphasia is widely used as well but technically this is incorrect, since it means "absence of speech." A right-handed patient experiences a 30-minute episode of dysphasia. Which area of circulation is suspect? - ANSWER-Left hemisphere . The speech area of the cortex is in the temporal lobe of the dominant hemisphere What is true regarding subclavian steal? - ANSWER-It is usually a harmless hemodynamic phenomenon. It is caused by arterial obstruction proximal to the origin of the vertebral artery. This creates an abnormal pressure gradient that pulls or "steals" flow from the vertebral artery to perfuse the ipsilateral upper extremity. Subclavian steal occurs: - ANSWER-more often on left side . A hemispheric stroke usually affects: - ANSWER-The middle cerebral artery distribution and the contralateral side of the body Stenosis of the following vessel presents the highest risk for a TIA: - ANSWER-Internal Carotid Artery The vertebral arteries branch from the subclavian arteries to unite and form the: - ANSWER-Basilar Artery . This system is called the vertebrobasilar system and is responsible for the circulation to the posterior portion of the brain . A decreased pulse at mid neck is suggestive of: - ANSWER-Common Carotid stenosis if the contralateral pulse is normal. Sometimes the right neck pulse can feel reduced because of the larger muscles overlying the carotid. Occasionally the right neck feels stronger due to tortuosity of the common carotid Artery.