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Vascular 2 MidTerm
Terms in this set (80)
The total energy of the vascular system has two primary components, which are ?
a. potential and kinetic engr.
b. potential and gravitational energy
c. gravitational and inertial energy
d. inertial and kinetic energy
a. potential and kinetic energy
Which statement about pressure in the vascular system is correct?
a. pressure is the highest at the carotid arteries and lowest at the ankle level veins
b. pressure is highest at the left atrium and lowest at the left ventricle
c. pressure is highest at the left ventricle and lowest at the right atrium
d. pressure is highest at the right ventricle and lowest at the left atrium
c. pressure is highest at the left ventricle and lowest at the right atrium
According to the Bernoulli principle, if the velocity of blood goes up, what must happen?
a. there must be an increase in pressure
b. there must be a pressure decrease
c. there must be an increase in cross-sectional area
d. there must be a decrease in total volume flow
b. there must be a pressure decrease
In the vascular system, which are the main two factors that result in "energy losses"?
a. inertia and viscosity
b. turbulence at valves and viscosity
c. friction between layers of blood flow and biscuits
d. inertia and the number of branches
a. inertia and viscosity
Which of the following cannot be a unit of volume flow?
Assuming volume flow remains the same, if the area of a blood vessel decreases then what must happen?
a. the velocity must decrease
b. the resistance must decrease
c. the mean velocity is unchanged
d. the velocity must increase
the velocity must increase
Which term is not a component within the definition of Poiseuille's law?
c. vessel length
d. vessel radius
A change in which of the following components will have the greatest change in blood flow?
a. the length of the vessel
b. the pressure difference across a vessel
c. the radius of a vessel
d. the blood viscosity
the radius of a vessel
If a collateral vessel develops in parallel to a stenosis, what impact will this have on the total resistance of the system?
a. the collateral will lower the total resistance
b. the collateral will have no impact on the total resistance
c. the collateral will increase the total resistance
d. the resistance of the collateral vessel will be directly added to the resistance of the stenotic vessel
the collateral will lower the total resistance
Which of these statements is correct about low resistance arteries?
a. they will display a slight flow reversal in early diastole
b. they will display a slight flow reversal at the end of systole
c. they will display constant forward throughout the cardiac cycle
d. they will display no forward flow through diastole
they will display constant forward throughout the cardiac cycle
The appearance of a "reflected wave" is a result of
a. reactive hyperemia
b. an arteriovenous fistula
c. a high-resistance arteriolar bed
d. decreased vasomotor tone
a high-resistance arteriolar bed
Which of the following statements is correct?
a. exercise induced vasodilation
b. exercise creates a high-resistance bed
c. exercise results in a slight reversal of flow
d. exercise increase vasomotor tone
exercise induced vasodilation
The Reynolds number is used to define
a. pressure across a stenosis
b. the viscosity of blood
c. the resistance in a vessel
Why is hydraulic filtering important?
a. it removes wastes from bloodstream
b. reduces hydrostatic pressure
c. converts pulsatile output of heart into steady flow through capillaries
d. mainstains pulsatile flow of heart throughout the arteries and veins until blood returns to the heart
converts pulsatile output of heart into steady flow through capillaries
Which of the following is considered to be part of the nervous system's control of peripheral blood flow?
a. potassium ions
c. carbon dioxide
d. hydrogen ions
Which of the statements concerning energy losses at a stenosis is correct?
a. the greatest inertial energy losses occur as blood exits a stenosis
b. more energy is lost with a gradual tapering of blood vessel wall
c. the greatest inertial energy losses occur at the entrance of a stenosis
d. inertial energy is lost due to potential energy lost in the turbulent jet
greatest inertial energy losses occur as blood exits a stenosis
On average in a normal individual, blood flow will increase with exercise to what extent?
a. blood flow will increase by 50%
b. blood flow will double
c. blood flow will increase 3-5 times resting flow
d. blood flow will increase 8-10 times resting flow
blood flow will increase 3-4 times resting flow
Which of these statements about collateral vessels is not true?
a. vasodilator drugs have little affect on collaterals
b. exercise will significantly decrease the resistance of collateral beds
c. collateral vessels are preexisting pathways
d. sympathectomy will have little affect on collaterals
exercise will significantly decrease the resistance of collateral beds
A critical stenosis is one where
a. pressure decreases but flow is unchanged
b. flow decreases but pressure is unchanged
c. flow decreases but resistance is unchanged
d. both pressure and flow decrease
both pressure and flow decrease
A doubling in the length of a stenosis results in
a. 50% increase in energy losses across the stenosis
b. a 2-fold increase in energy losses across the stenosis
c. 4-fold increase in energy losses across the stenosis
d. 16-fold increase in energy losses across the stenosis
2-fold increase in energy losses across the stenosis
Which type/frequency of transducer is most appropriate for the majority of carotid duplex US studies?
a. 7-4 MHz linear
b. 4-1 MHz sector
c. 9-15 MHz linear
d. 5-2 MHz curvilinear
7-4 MHz linear
Which finding would rule out a hemodynamically significant subclavian artery stenosis?
a. elevated flow velocity with poststenotic turbulence
b. abnormal vertebral artery Doppler waveform contour
c. asymmetrical brachial systolic pressures
d. absence of spectral broadening in the waveform
absence of spectral broadening in the waveform
Which of the following parameters does not distinguish between intimal dissection and internal jugular vein wall artifact in the common carotid artery?
a. findings of Doppler flow velocity less than 125 cm/s in the mid common carotid artery
b. presence of uniform Doppler waveform contour throughout the vessel
c. absence of "yin and yang" color flow pattern in transverse view
d. absence of "wall thump" in the doppler waveform contour
findings of Doppler flow velocity less than 125 cm/s in the mid common carotid artery
Doppler waveform contour is not directly related to
a. vessel compliance
b. blood viscosity
c. peripheral resistance
d. cardiac output
What are the factors that help to positively identify the external carotid artery (vs. the internal carotid artery)?
a. ECA is more superficial than the ICA
b. the ECA has higher diastolic flow than the internal carotid
c. the ECA responds to temporal tap and the ICA does not
d. the ECA has lower peak systolic velocity than the ICA
the external carotid responds to temporal tap and the internal carotid does not
What does the Doppler waveform term "trades and parvus" describe?
a. low velocity flow with delayed acceleration
b. high velocity jet with poststenotic turbulence
c. low velocity flow with doppler bruit
d. high resistance string sign flow
low velocity flow with delayed acceleration
What does a high resistance flow pattern in the internal carotid artery indicate?
a. middle cerebral and anterior cerebral arteries are total occluded
b. dense network of patent collateral arteries distally
c. innominate or common carotid artery ever stenosis
d. a severe stenosis or occlusion distal to the segment being insonated
a severe stenosis or occlusion distal to the segment being insonated
What does the Doppler waveform term "hesitant" describe?
a. antegrade flow with deep flow-reversal notch at mid-cardiac cycle
b. retrograde, high resistance flow throughout the cardiac cycle
c. antegrade, low velocity flow with delayed acceleration
d. retrograde flow with deep flow-reversal notch at mid-cardiac cycle
antegrade flow with deep flow-reversal notch at mid-cardiac cycle
What is the most accurate Doppler angle to use when performing carotid duplex ultrasound?
a. the angle that was used to calibrate the ultrasound transducer with the phantom
b. the angle chosen by the ultrasound manufacture, transducer-specific
c. the angel that was used to validate the diagnostic criteria being applied
d. the angle is not a factor that affects Doppler US accuracy
the angle that was used to validate the diagnostic criteria being applied
What doppler findings indicate a proximatl erebral artery severe stenosis?
a. antegrade, dampened doppler flow within the vertebral artery at mid and distal neck
b. retrograde doppler flow within the vertebral artery a completed subclavian steal
c. antegrade, hesistant Doppler flow within the vertebral artery, a latent subclavian steal
d. antegrade, high resistance doppler flow within the vertebral artery at mid and distal neck
antegrade, dampened Doppler flow within the vertebral artery at mid and distal neck
What is the minimum brachial systolic pressure gradient (difference bt the 2 sides) that would indicate a hemodynamically significant stenosis in a proximal subclavian artery?
a. 5 mmHg
b. 10 mmHg
c. 15 mmHg
d. 20 mmHg
What does spectral broadening in the Doppler waveform generally represent?
a. turbulent flow
b. hesitant flow
c. dampened flow
d. laminar flow
A RIND or reversible ischemic neurologic deficit can be described as
a. a neurologic symptom which lasts less than 1 hour
b. a neurologic symptom which lasts between 1 and 24 hrs
c. a neurologic symptom which lasts between 24 and 72 hours
d. a neurologic symptom which lasts between 3 and 7 days
a neurologic symptom which lasts between 24 and 72 hours
A mobile-appearing white line echo that can be seen in the common carotid after is
a. ring down artifact from trachea
b. reveberation artifact from the internal jugular vein
c. twinkling artifact from calcification
d. side-lobe artifact from the carotid walls
reverberation artifact from the internal jugular vein
Homogenous plaque can be defined as
a. mixed echogenicity with high lipid content
b. high lipid content with echo lucent regions
c. echolucent regions with lipid or hemorrhage
d. low echogenicity with high lipid content
low echogenicity with high lipid content
A plaque develops and starts to fill the carotid bulb
a. flow separation disappears
b. doppler waveforms will demonstrate flow reversal
c. arterial waveforms contours will be highly irregular
d. the vessel will be less uniform in diameter
flow separation disappears
doppler waveform features proximal to a severe stenosis with limited collaterals will display
a. tardus-parvus pattern
b. low resistance pattern with high velocity diastolic flow
c. a high resistance pattern with low or absent diastolic flow
d. a high velocity flow pattern in both systole and diastole
a high resistance pattern with low or absent diastolic flow
all of the following techniques should be utilized to differentiate string sign flow form complete vessel occlusion except
a. high color gain
b. low color scale
c. power doppler
d. high wall filters
high wall filters
an unusual waveform with two prominent peak separated by mid-systolic retraction is called
b. atrial fibrillation
c. pulsus bisferiens
d. atrial flutter
What test can be used to change a subclavian steal from the "latent" stage to the "complete" stage?
a. reactive hyperemia
b. adson's maneuver
c. venous occlusion cuff with rapid release
d. costoclavicular maneuver
angulation within the internal carotid artery can be found in what percentage of adults?
5, 10, 15, 25
Which area should not be used to record a doppler spectral waveform in a tortuous vessel?
a. area just before a curve
b. area just after the curve
c. area at the point of the tightest curve
d. straight area adjacent to the curve
area at the point of the tightest curve
What feature must be present to confirm the presence of a significant stenosis in a tortuous vessel?
a. high peak systolic velocity
b. high end diastolic velocity
c. an elevated ICA/CCA peak systolic velocity ratio
d. poststenotic turbulence
Some dissections may be associated with all of the following additional complication except
d. second intimal tear
A true lumen and the false lumen of a vessel with a dissection can display which of the following flow profiles except:
a. normal flow patterns in both lumens
b. antegrade flow in both lumens
c. antegrade flow in the true lumen and retrograde flow in the false lumen
d. antegrade flow in the true lumen and "to and for" in the false lumen
normal flow patterns in both lumens
Which of the following diseases can be associated with a carotid dissection?
a. Takayasu's arteritis
b. radiation injury
c. marfan syndrome
d. fibromuscular dysplasia
In a dissection with only one tear and a blind end, flow in the false lumen will be
a. low resistance pattern
b. high resistance pattern
c. normal antegrade flow
d. no flow signal
high resistance pattern
Which group below has the highest incidence of FMD?
a. male, caucasians, 25-50 yrs old
b. male, asian, 25-50yrs old
c. female, caucasians, 25-50 yrs old
d. female asian, 25-50 yrs old
female, caucasians, 25-50 yrs old
Which of the following statements represents findings that are likely associated with FMD?
a. sudden turbulence and high velocities in the distal ICA
b. tardus-parvus waveforms within he pro ICA
c. increased resistance within the distal ICA waveform
d. turbulence and high velocities in the prox ICA
sudden turbulence and high velocities in the distal ICA
What are the most common presenting symptoms of patients with FMD?
a. bruit or palpable mass in mid-neck region
b. asympotmatic or bruit
c. pain in upper neck or pain while turning neck
d. TIA or asymptomatic
asymptomatic or bruit
When attempting to confirm the presence of FMD, which of the following procedures/techniques would be least helpful?
a use power doppler
b. switch to lower frequency transducer
c. turn off harmonic imaging and use fundamental imaging
d. closely examine the B-mode image of changes in vessel diameter
turn off harmonic imaging and use fundamental imaging
Where is the carotid body located?
a. within adventitial portion of the vessel walls at the carotid bifurcation
b. along the endothelial-blood interface at the carotid bifurcaiton
c. along the adventitial portion of the prox and mid common carotid artery
d. within the distal internal carotid artery blood vessel wall
within adventitial portion of the vessel walls at the carotid bifurcation
A patient presents with a 2cm homogenous mass between the ICA and ECA. Color imaging of this mass reveals both arterial and venous signals within a network or small vessels. Which is the most likely cause of these symptoms?
a. lymph node
c. neovascularizaiton of an adjacent thrombosed vein
d. carotid body tumor
carotid body tumor
carotid aneurysms that result from infection are called
b. enteric aneurysms
c. mycotic aneurysms
d. saccular aneurysms
Hoarseness in a patients voice may be a symptom of
a. cranial nerve dysfunction caused by carotid artery aneurysm
b. cranial nerve dysfunction caused by FMD
c. vagal nerve dysfunction caused by CBT
d. vagal nerve dysfunction caused by radiation arteritis
cranial nerve dysfunction caused by carotid artery aneurysm
A carotid pseudo aneurysm may form with all of the following except:
a. at a crotid endartectomy site
b. at the site of generating trauma
c. at the site of radiation injury arteritis
d. at the site of a carotid bypass anastomosis
at the site of radiation injury arteritis
The color pattern within a carotid psuedoaneurysm will appear as
a. red color filling during systole with no color during diastole
b. red and blue color filling within different portions of the sac
c. high velocity color aliasing thorough the cardiac cycle
d.c onstant antegrade color flow
red and blue color filling within different portions of the sac
injury to the vas vasorum in the medial layer f a blood vessel leading to fibrosis is a condition caused yb
b. iatrogenic injury
c. therapeutic irradiation
d. pagent-schroetter disease
70yr old woman presents for a carotid US with sudden onset of blinds. What nonatherosclerotic pathology would be the most likely cause of these symptoms?
a. radiation-induced arteritis
b. temporal arteritis
d. carotid artery aneurysm
Takayasu's arterisis will display which of the following US characteristics?
a. focal stenosis followed by dilation, repeat to create a string of beads appearance
b. focall,e ccentric fibrotic lesion with calcification
c. long area of concentric wall thickening
d. echolucent halo surrounding small areas of the temporal artery
long area of concentric wall thickening
Cavernous portion of the ICA is referred to as the
a. carotid bulb
b. terminal ICA
c. cerebral portion
d. carotid siphon
Which statement correctly describes the segments of the intracranial posterior circulation?
a. basilar artery is formed at the junction of the two posterior communicating arteries
b. basilar artery is formed at the junction of the two vertebral arteries
c. basilar artery terminates into two primary branches, the vertebral arteries
d. the basilar arty terminates into two primary branches, the posterior communication arteries
basilar artery is formed at eh junction of the two vertebral artrieres
what approx highest reported rate of variations in the circle of Willis 10, 25, 33, 50
Transcranial spectral waveforms are analyzed for all of the following except
a. time-average peak velocity
b. pulsatility index
c. peak systolic velocity
d. waveform morphology
peak systolic velocity
High velocities and turbulent can be detected with all of the following except
a. prox to an occlusion
b. severe sentosis
d. hyperdynamic flow states
prox to an occlusion
other than the standard 4 approached used during TCD or TCDI, what is a fight approach that is sometimes used to obtain vertebral artery signals?
b. at the atlas loop
c. at the zygomatic process
d. at the mastoid process
What equipment setting must be reduced during a transorbital examination?
a. sample size
d. power intensity
using a submandibular approach, velocities are taken from the retromandibular ICA in order to calculate
a. GOslin's pulsatility index
b. Lindegaard ratio
c. Sviri ratio
d. ICA resistive index
In general which statement describes flow velocities in the Intracranial vessels?
MCA > ACA > PCA = BA = VA
Which of the following are not normal findings of the ophthalmic artery?
a. its visualized bweteen 40 & 60 mm using a transorbital approach
b. it normally displays from the brain toward the orbit of the eye
c. if providing collateral flow from the ECA to the brain, flow is directed from the ye orbit toward the brian
d. it normally displays high velocity diastolic flow
it normally displays high velocity diastolic flow
This vessel normally can display flow toward, away or bidirectional depending on the orientation of the vessel to the transducer.
a. ICA at the carotid siphon
b. retromandibular ICA
c. posterior communicaiton ing artery
d. basilar artery
ICA at carotid siphon
From a transtemporal wind, which statement concerning the posterior cerebral artery (PCA) is correct?
a. the direction of flow in the ipsilateral P1 and prox P2 segments is toward the transducer
b. the direction of flow in the ipsilateral P1 segment is toward and way in the pro P2 segment
c. the direction of flow in the ipsilateral P1 segment is away and toward in the pro P2 segment
d. direction of flow in both the right and left P1 segments is toward the transducer
the direction of flow in the ipsilateral P1 and pro P2 segments is toward the transducer
The depth of the vertebral artery confluence is approximately: 50, 60, 70, 80 mm
This calculated hemodynamic parameter is useful in differentiating increased volume flow from decreased vessel diameter when high velocities are encountered
a. Sviri ratio
b. lindegaard ratio
c. MCA resistive index
Gosling's pulsatility index
Which of the following is not a diagnostic finding with ECA to ICA collateral flow through reversed ophthalmic artery?
retrograde flow int he phjthalmic artery
b. decreased pulsatitlity in the ophthalmic artery
c. reversal of flow in the ophthalmic artery with impression of ECA branches
d. increased resistive index in the ophthalmic artery
increased resistive index int eh ophthalmic artery
Which of the following is not a cause of intracranial stenosis?
b. moya maya disease
c. buerger disease
all of the following can influence intracranial velocities except
c. CO2 levels
Severe vasospasm is associated with middle cerebral artery mean velocities of greater than: 100, 125, 150, 200 cm/s
> 200 cm/s
TCD monitoring for emboli is commonly employed for all of the following procedures except:
carotid endartectomy, carotid stenting abdominal aortic aneurysm surgery, coronary artery bypass graft surgery
abdominal aortic aneurysm surgery
Microemboli signals detected during a TCD exam is also referred to as
HITS, MITS PFOS, STOP
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