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Vascular sonography
ThePoint QUESTIONS
| Question | Answer |
|---|---|
| What best defines a capillary? | The part of the vascular system where the exchange of nutrients and waste |
| What best describes the walls of a capillary? | Primarily composed of a single layer of endothelial cells |
| Circular smooth muscle is in this part of a blood vessel wall: | Tunica Media |
| The principle point of the resistance to blood flow within the vascular system is supplied by the what? | Arterioles |
| The Arterioles are also known as what? | Stopcocks |
| What is a correct statement about venous valves? | They're inward projections of tunica Intima |
| Where does the right cca originate from? | The brachiocephalic |
| What is the first branch off of the cerebral ICA | The opthalamic artery |
| What is not part of the circle of willis? | Anterior Chorodial |
| What arteries supply most of the pelvic organs? | Internal iliac arteries |
| The profunda femoral artery (deep femoral) is what to the Superficial femoral artery (SFA)? | Posterior and lateral |
| What is the opening in the leg where the superficial femoral artery passes though as it courses toward the ankle? | The adductor canal |
| What does the Tibial-peroneal trunk artery arise from? | The popliteal artery |
| A patient with left thigh claudication will most likely have disease present at which level? | Left iliofemoral level |
| A patient with thigh & calf pain that's associated with exercise & also with standing that can be RELIEVED with SITTING or by moving in a different position is most likely due to what? | Spinal Stenosis NOT intermittent claudication because of the relieved by sitting part |
| What is a contraindication to immersing the hands in ice water to detect cold sensitivity? | Secondary Raynaud's |
| What is the max time for digit temps to return to pre-cold water immersion levels, to rule out cold sensitivity? | <10 mins |
| Measuring the systolic pressure with the point of measurement at the same horizontal level as the heart helps avoid artifact due to what? | Hydrostatic pressure |
| What is the NORMAL drop in mean arterial pressure from the heart to the ankle? | 10 mmHg |
| What is a correct statement about the 4-cuff method vs. the 3-cuff method of determining segmental pressures? | The 4-cuff method allows the separation of the iliofemoral disease from superfical femoral artery disease |
| A brachial blood pressure differences >20 mmHg is associated with what? | A >75% diameter reduction in either the subclavian or proximal axillary arteries |
| A treadmill exercise stress test is typically conducted using the following parameters? | 0% to 10% grade and 1 to 2 mph |
| What is not a contraindication to the treadmill exercise stress test? | Age >75 years old |
| What is a technique that can be used to reduce interference from adjacent veins during acquisition of Doppler waveforms? | Have the patient hold their breath for a few cardiac cycles |
| What is the proper transducer angle to use while obtaining Doppler waveforms? | 45 degrees to the skin surface |
| What is an incorrect statement about flow reversal in the peripheral artery? | Flow reversal is maintained in the presence of a functioning dialysis graft |
| What does Pulse Volume Recording (PVR) reflect? | The total perfusion in the underlying segment under the cuff |
| What is an incorrect statement about photoplethysmography? | They detect total limb blood flow |
| What is not a possible etiology for secondary raynaud's? | Takayasu's Arteritis |
| A patient with chronic arterial ischemia will not have what symptom? | Paralysis |
| What transducer is best in examining the Femoral, Popliteal, & Tibial vessels? | A 4-7 MHz linear array transducer |
| Which statement correctly describes the standard approach to scanning the deep femoral or profunda femoral artery? | Only the first few centimeters of the PFA is scanned |
| What CANNOT the use of color during the arterial ultrasound do? | It CANNOT determine the percent of stenosis |
| Prox to a stenosis PSV=98, At the stenosis PSV= 233, Distal to the stenosis PSV= 76, what is the correct velocity ratio for this stenosis? | 233/98=2.4, because the formula is PSV @ stenosis/PSV prox to stenosis |
| In addition to assessing the degree of narrowing, which of the following is the LEAST helpful prior to angioplasty &/or stent placement? | Vessel depth |
| What method will not help overcome the technical challenges of vessel calcification? | Increasing PRF |
| Which feature should be closely examined to aid in assessing the age of an occlusion? | Adjacent wall vessels |
| The presence of what most increases the embolic risk of an aneurysm? | Thrombus within an aneurysm |
| What is not associated with stenosis? | Uniform color in the vessel |
| What characteristic will a NORMAL lower extremity arterial waveform not have? | An early systolic peak slightly before the highest peak velocity |
| Continuous antegrade flow through diastole in a peripheral artery can normally be observed proximal to what? | An atriovenous fistula |
| What is NOT an advantage of duplex ultrasound over contrast angiography? | Provides better visualization of collateral networks |
| What waveform type presents proximal to an occlusion or near an occlusion? | High resistance pattern with only antegrade flow during systole and NO flow during diastole |
| The majority of the Anterior Tibial Artery (ATA) can be followed using what approach? | Anterolateral |
| What describes primary indicators for the type of intervention planned in patients with peripheral arterial disease? | Disease location and extent |
| What is the preferred treatment for a short stenosis that is <5cm in length? | An endovascular intervention |
| What is not linked to angioplasty failure? | The patient's age |
| When examining the CFA there are several characteristics that will signal the need to exam the iliac segment, what would indicate that the iliac artery should be examined? | A MONOPHASIC waveform |
| What will not be documented in a common B-mode finding at an angioplasty site? | Pseudoaneurysm formation |
| What has the highest incidence of residual stenosis? | Atherectomy |
| What hemodynamic valve is consistent with a > 70% stenosis? | A velocity ratio >3.5 and PSV >300 cm/s |
| What will not lead to PSV elevation within a stented vessel thus impacting the accuracy of disease classification? | The number of run-off vessels |
| This known risk for stenosis and thrombosis within a stent CANNOT be identified by suplex ultrasound imaging, what is it? | Stent fracture |
| A <50% stenosis within the aortoiliac segment will result in what finding at the CFA? | A multiphasic velocity waveform |
| What percentage of limbs after angioplasty will demonstrate >50% stenosis on duplex ultrasound during the first 12 months of surveillance? | 20% to 40% |
| What is the minimal PSV associated with a >50% stenosis at the endovascular site? | 180 cm/s |
| The functional significance of a stenosis at an angioplasty site is best determined by what? | Exercise testing with measurement of ankle pressure changes |
| Duplex ultrasound findings of a diffuse in-stent stenosis should NOT include what? | Decreased acceleration time |
| What is the minimum outcome criteria for clinical improvement following endovascular intervention? | An ABI increase >0.15 |
Created by:
EmilyGriffin
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