extracranial cerebrovascular imagining/ IAHSS ADVANCED OFFICER
CERTIFICATIONS EXAMS |ACCURATE TESTING VERSIONS
Indications for an exam - ANSWER-bruit, TIA, history of stroke,
screening prior to major surgery (cardiac, peripheral vascular),
monitoring of known disease, follow up after carotid disease
intervention, stroke/tia symptoms.
Pre-exam protocols - ANSWER-introduce yourself, explain the
exam and how long it will be, get patient history and clinical
information.
auscultation - ANSWER-listening to the body with a stethoscope
bruit - ANSWER-abnormal sound caused by turbulent flow
patterns that set up a vibratory response in tissue.
patient prep - ANSWER-remove jewelry, tight clothing around
the neck, pt is in supine position, pillow under neck and
shoulders allowing chin to tilt up, patients head tilted away
from side being examined.
, Transducer selection - ANSWER-high frequency linear array (7-
4Mhz), could need curvilinear for a very deep vessel and or
large neck.
Protocol of exam - ANSWER-obtain pt history, start with
transverse imaging, longitudinal imaging, color doppler,
spectral doppler, "mapping" of any areas of flow disturbances.
Longitudinal: external carotid artery - ANSWER-evaluate with
grayscale, color, pulse wave. almost always located medially,
visible branches, often smaller in diameter than ICA, proceeds
anteriorly toward face, high resistance waveform, responsive to
temporal tap.
longitudinal: Internal carotid artery - ANSWER-evaluate
proximally with greyscale, pulse wave, and color. mid and distal
ica is usually imaged using just color and pulse wave (grey scale
is less diagnostic). usually larger in diameter than ECA, usually
lies more laterally course deep toward skull, lower resistance
waveform, lower resistance waveform.
CERTIFICATIONS EXAMS |ACCURATE TESTING VERSIONS
Indications for an exam - ANSWER-bruit, TIA, history of stroke,
screening prior to major surgery (cardiac, peripheral vascular),
monitoring of known disease, follow up after carotid disease
intervention, stroke/tia symptoms.
Pre-exam protocols - ANSWER-introduce yourself, explain the
exam and how long it will be, get patient history and clinical
information.
auscultation - ANSWER-listening to the body with a stethoscope
bruit - ANSWER-abnormal sound caused by turbulent flow
patterns that set up a vibratory response in tissue.
patient prep - ANSWER-remove jewelry, tight clothing around
the neck, pt is in supine position, pillow under neck and
shoulders allowing chin to tilt up, patients head tilted away
from side being examined.
, Transducer selection - ANSWER-high frequency linear array (7-
4Mhz), could need curvilinear for a very deep vessel and or
large neck.
Protocol of exam - ANSWER-obtain pt history, start with
transverse imaging, longitudinal imaging, color doppler,
spectral doppler, "mapping" of any areas of flow disturbances.
Longitudinal: external carotid artery - ANSWER-evaluate with
grayscale, color, pulse wave. almost always located medially,
visible branches, often smaller in diameter than ICA, proceeds
anteriorly toward face, high resistance waveform, responsive to
temporal tap.
longitudinal: Internal carotid artery - ANSWER-evaluate
proximally with greyscale, pulse wave, and color. mid and distal
ica is usually imaged using just color and pulse wave (grey scale
is less diagnostic). usually larger in diameter than ECA, usually
lies more laterally course deep toward skull, lower resistance
waveform, lower resistance waveform.
