Upgrade to remove ads
Only $35.99/year

VAS3; exam 2

Terms in this set (104)

To be considered an aneurysm; the diameter increases by ____% when compared to the adjacent segment
50
a diameter of _______ is considered aneurysmal
> 1.5
atherosclerosis can affect the lumen of the vessel by creating a stenosis (narrowing) or fully blocking (occlusion) and coming from that atherosclerosis that can generate an _________
emboli
An arterial embolism can be the result in _________
ischemia
iliac aneurysms are commonly seen bilateral/unilateral
bilateral
State the 3 complications of iliac aneurysms:
rupture, compression of the ureter, bladder compression (when large bilateral aneurysms are present)
One of the complications of iliac aneurysms is bladder compression this can occur when:
large bilateral aneurysms are present
A tear in the intima lining of the artery wall is ___________
dissection
a true lumen is:
where blood flows through
a false lumen is where blood should NOT be flowing, this is the space between the _______ & _______
intima and media
what 2 factors may cause propagation(growing in size or length, spread of dissection) of a dissection?
pulsatile flow, high blood pressure
if blood is inside the false lumen what can occur?
clotting
state a dissection typical patient
hypertensive 40-60 year old man
what is the most common dissection symptom?
excruciating pain radiating to the back
______________ is connective tissue disorder.
It's in joints ligaments ribcage and walls of vessels, where there is too much connective tissue it becomes stretchy and also mitral valve prolapse, aneurysm and dissections.
marfans syndrome
Dissection is associated with _________ syndrome
marfans
The key finding when looking for a dissection is a hyperechoic line called the _____________
intimal flap
The debakey dissection classification has how many types?
3
The DEBAKEY dissection classification; state the type below;

originates in ascending aorta, propagates at least to the aortic arch and often beyond it distally
type 1
The DEBAKEY dissection classification; state the type below;

originates in and is confined to the ascending aorta
type 2
The DEBAKEY dissection classification; state the type below;

originates in descending aorta, rarely extends proximally but will extend distally
type 3
TYPE 1 of the Debakey originates in the ____(1)_______ and propagates to the _____(2)____ and often beyond it
1. ascending aorta
2. aortic arch
Debakey type 2 originates in the _________ and is confined there (only one location)
ascending aorta
Debakey type 3 originates in the ____(1)____ and extends distally (rarely proximally)
descending aorta
____________ is a vascular mass that results from a hole in the arterial wall with circulating blood flow that is confined by soft tissue
pseudoaneurysm
a pseudoaneursym forms due to trauma to all 3 layers of the ____________
arterial wall
a pseudoaneurysm forms due to __________
trauma
How many layers of the arterial wall are affected by a pseudoanuerysm caused by trauma?
3
State the most common locations for a pseudoaneurysm to occur
CFA, abdominal aorta
what are the etiologies (causes of) of a pseudoaneurysm

((think: T.I.P.S))
Trauma, Infection, Post Catheterization, Surgery
A Pseudoaneurysm is a hematoma; it receives its blood supply from a ___________
neck
describe the findings of a pseudoaneurysm:

1. the spectral finding is a __________
2. the color flow finding will be a ____________
1. to and fro wave
2. yin yang sign
Evaluation of pseudoaneurysm reveals that at the highest velocities occurs at the _______________
neck
Evaluation of pseudoaneurysm reveals that turbulence occurs in the ___________
dilated segment
Evaluation of a pseudoaneurysm:

1. ________ & _______ of the lesion
2. presence of _________ flow in the neck
3. ________ &_________ of the neck
4. _________________ of thrombus and flowing blood
1. size and location
2. to and fro
3.. length and diameter
4. proportion
In an ultrasound of a pseudoaneurysm a round or oval mass is revealed. The mass is connected to the artery by means of a __________
neck
When dopplering a psuedoaneurysm where is the sample volume gate placed?
the neck
What is the medical treatment of pseudoaneurysm?
ultrasound guided thrombin injection, duplex guided compression repair
FOLLOW UP is needed if size of psuedoaneurysm is _______cm in size
< 2
The surgical treatment for pseudoaneurysm is:
open repair to evacuate hematoma and repair arterial wall,
resection of pseudo site and surrounding graft in hemodialysis conduits
interpretation of findings of a pseudoaneurysm:
what does the tech determine? (5 things)
arterial diameters,
spectral waveform changes,
PSV and flow direction,
Vr ratio,
location/characteristics of thrombus
what is the VR ratio formula?
vr= v2/v1

(v1= max PSV of stenosis. V2= PSV proximal normal segment)
Vr= V2/V1

identify:
1. V1= ___________
2. V2= ___________
1. max psv of stenosis
2. psv proximal normal segment
what's the unit to a Vr Ratio?
(Vr=v1/v2)
NO UNIT
arterial diameters:
mild dilation is ___ -____ cm
>2.0-<3.0
arterial diameters:
moderate aneurysm is ____-___cm
3-5
arterial diameters:
severe aneurysmal is _______ cm
>5.0
arterial diameters:
mild dilation is >2.0 and <3.0 cm and is considered ________
ectatic
arterial diameters:
severe aneurysmal is >5.0 cm this results in needing _________________
intermediate intervention
a NORMAL velocity ratio is ______cm
< 2.0
an ABNORMAL velocity ratio is ________cm
> 2.0
For flow velocities; a stenosis of > 50% will at least double the velocity of the distal/proximal artery segment
proximal
For flow velocities; a stenosis of _____% will at least double the velocity of the proximal artery segment
>50
in the dilated area of the aneurysm the blood flow increases/decreases?
decreases
describe the interpretation of an abnormal doppler waveform for psuedoaneurysm:

1. swirling of blood is seen in the __________ area
2. waveform will demonstrate a post stenotic _______________
3. a Vr of _______ is present
4. what wave form will most likely be seen be seen?
1. dilated
2. turbulence
3. >2.0
4. biphasic and monophasic
identify if it is abnormal or normal interpretation with gray scale and color:

Mural thrombus in aneurysm; creates a residual lumen
abnormal
identify if it is abnormal or normal interpretation with gray scale and color:

Intraluminal echoes are visualized with atherosclerosis and luminal reduction
abnormal
identify if it is abnormal or normal interpretation with gray scale and color:

Color does not fill the entire lumen
A color bruit may be observed
abnormal
normally __________ walls is antithrombotic!
venous
venous walls are antithrombotic, there is a balance between _______ and __________
coagulation and anticoagulation
a theory behind how a thrombus is formed is ____________
Virchow's Triad
What are the 3 stages to the virchows triad?
wall injury, stasis, Hypercoagulable state
virchows triad, wall injury is trauma to which wall layer?
endothelial
endolitheial layer is responsible for:
allowing all the layers of blood cells to slide on top of walls (acts as lubrication)
slow movement or non movement of blood is known as __________
stasis
virchows triad:

Hypercoagulable state is;
excessive clotting
which one of the 3 stages of the virchows triad's theory is the most common cause for LOWER EXTREMITY venous thrombosis?
[wall inury, stasis, Hypercoagulable state]
stasis
stasis is the most common cause of LE venous thrombosis because of :
hydrostatic pressure
When standing vessels will dilate and flow velocity decreases/increases?

(this is why stasis is the common cause of LE venous thrombosis)
decreases
which one of the 3 stages of the virchows triad's theory is the most common cause for UPPER EXTREMITY venous thrombosis?

[wall inury, stasis, hypercoagublale state]
wall injury
which one the stages of virchows triad will cause an acute thrombosis?
Hypercoagulable state
Why is acute thrombosis dangerous?
not attached to the wall can dislodge and become an embolism
Slow onset growth and well attached to the wall is acute/chronic thrombosis
chronic
what 3 things can occur to a thrombus?
stabilize, propagate, embolism
a thrombus can either stabilize, propagate or embolize
what does it mean to stabilize?
attaches to venous wall
a thrombus can either stabilize, propagate or embolize
what does it mean to propagate?
grow in size or location
a thrombus can either stabilize, propagate or embolize
what does it mean to embolize?
the clot is traveling
Venous emboli leads to ______(1)______, and arterial emboli leads to _____(2)_________
1. pulmonary embolism
2. ischemia
state the risk factors of thrombosis

(there's 12)
age, immobilization, genetic clotting disorders, post op, catheters, female, pregnancy, birth control, estrogen replacement, cancer, previous DVT, heart complications
What are the 2 different types of thrombosis?
acute, chronic
state whether its an acute or chronic thrombus;

lightly echogenic or anechoic clot
acute
state whether its an acute or chronic thrombus;

less than 14 days that it will form
acute
state whether its an acute or chronic thrombus;

Spongy texture which is Limited compression
acute
state whether its an acute or chronic thrombus;

Poorly attached/ free floating
acute
state whether its an acute or chronic thrombus;

takes several weeks or months to form
chronic
state whether its an acute or chronic thrombus;

Brightly echogenic or heterogeneous surface
chronic
state whether its an acute or chronic thrombus;

Irregular surface texture
chronic
state whether its an acute or chronic thrombus;

well attached to the wall
chronic
state whether its an acute or chronic thrombus;

Collateral veins may be observed adjacent to the affected vein
chronic
state whether its an acute or chronic thrombus;

More solid structure which results in no compression
chronic
risk factor: immobilization will lead to ________

(one of the virchows triad stages)
stasis
risk factor: genetic clotting disorders will lead to _________

(one of the virchows triad stages)
Hypercoagulable state
ricks factor: post op and catheters will cause ________

(one of the virchows triad stages)
wall injury
correctly state which one is bilateral and unilateral:

if you have a thrombus in the IVC it is ____(1)_____
if you have a thrombus in the LE it is ___(2)____
1. bilateral
2. unilateral
define hemoptysis
coughing up blood
list the indications of thrombosis:


[there is 6]
edema, limb pain/tenderness, symptoms of PE, Hypercoagulable state, IVC filter insertion guided by ultrasoud, pre/post op
What are the 4 symptoms of Pulmonary embolism that are also considered indications of thrombosis
chest pain, hemoptysis,, tachypnea, tachycardia
IVC filters are positioned below the _____(1)____ and above the _____(2)__
1. renal veins
2. iliac bifurcation
what is iVC filters used for?
protection from PE
define extrinsic compression
compression of a vessel from outside source
extrinsic compression of the IVC can come from _____________
masses or tumors
when continuous flow and increased venous velocities are noted ____________ secondary to the compression is suspected
stenosis
stenosis is suspected as a secondary factor to extrinsic compression when ________ flow and decreased/increased venous velocity is present
continuous, increased
Neoplastic Obstruction: intraluminal tumors typically arise from ________ or ______veins and may secondarily obstruct or thrombose the IVC.
hepatic or renal
Other sets by this creator