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A wide range of topics related to vascular anatomy and hemodynamics, including questions and answers on proximal/inflow, arterial palpitations, bow hunter's syndrome, subclavian steal phenomenon, segments of the internal carotid artery, middle cerebral artery, anterior cerebral artery, basilar artery, transcranial doppler, carotid plaque, carotid stenosis, carotid body tumors, abdominal aortic aneurysm, aortic dissection, endoleaks, chronic mesenteric ischemia, median arcuate ligament syndrome, splenic vein measurements, liver blood supply, renal arteries, vascular resistance, venous flow, transcranial doppler monitoring, and arteriovenous fistulas. A comprehensive overview of these vascular topics, making it potentially useful for students, researchers, or healthcare professionals interested in vascular anatomy and physiology.
Typology: Exams
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Brain Answer: Supplied by ICA & Vertebrals 2% of Body's weight 15% CO 20% Total blood supply
3 - 8 minutes of oxygen deprivation results in Answer: cellular death
Bovine Arch Answer: Common origin of Lt. CCA and Innominate
Answer: Terminates into MCA/ACA and feeds the brain, forehead, eyes, & nose- 70 - 80% from CCA
Answer: Does not feed brain unless needed as collateral circulation
ECA supplies Answer: Neck, face, scalp
ECA Branches Answer: Superior Thyroid Ascending Pharyngeal Lingual Facial Occipital Posterior Auricular Maxillary Superficial Thyroid
Vertebral supply Answer: Medulla/Inferior cerebellum
Physiologic/hemodynamic interrogation Answer: Spectral/Doppler best
Hemorrhagic Stroke Answer: Bleed; HTN
Ischemic Stroke Answer: Oxygen interruption; Blood clot/emboli from Atherosclerosis
Which stroke is known to be the 3rd leading cause of death? Answer: Ischemic Stroke
Small perforating artery obstruction Answer: Occurs in elderly/diabetics
Transient Ischemic Attack (TIA) Answer: HTN; Up to 24 hours; Unilateral symptoms-Contralateral hemipharesis
Reversible Ischemic Neurological Defects (RIND) Answer: Atherosclerosis; more then 24 hours; Unilateral symptoms-Contralateral hemipharesis
Vertebrobasilar Insufficiency (VBI) Answer: Obstruction of posterior circulation; Elderly/diabetic/poorly controlled HTN; Bilateral symptoms (DROP ATTACKS)
Cerebrovascular Accident (CVA) Answer: Complete stroke with permanent lasting neurological deficits
Plaque descriptions Answer: 1 - Fatty streak 2 - Fibrous (soft) plaque
Answer: High rupture risk
Answer: Distal/Residual
Answer: Bulb/Residual
Bisferious waveform in Carotid exam Answer: Double peak waveform signifying severe AI
If the CCA is occluded Answer: Verterbrals supply ECA and ECA supplies ICA through retrograde flow
What is the most common referral for asymptomatic cervical bruit?
Answer: Fibromuscular Dysplasia (FMD)
Neointimal Hyperplasia Answer: 6 - 24months post endarterectomy
Takayasu's Answer: Pulselessness (AI) Vasculitis that affects large arteries
Temporal Arteritis Answer: Halo/edema
Low velocity/low resistance Answer: Proximal/inflow
Low velocity/high resistance
First sign of subclavian steal Answer: change of flow in vertebral (bunny waveform)
Segments of the ICA Answer: Cervical Petrous Cavernous
Cervical ICA Answer: Bifurcation through petrous canal
Petrous ICA Answer: Petrous of temporal bone
Cavernous ICA Answer: Carotid Siphon (genu, parasellar, supraclinoid)
Supraclinoid Answer: Ophthalmic, distal
Answer: Longer and more lateral; 75-80% from ICA
Answer: Medial/midbrain
Basilar Answer: 3cm long
Answer: Freehand, 2MHz PW XDR at 0°
ICA/CCA ratio Answer: Fastest ICA/Distal CCA
Trickle flow Answer: 95% stenosis
Carotid Body Tumors Answer: AKA Chemodactoma/Paragangliomas; more common at higher altitudes
AAA growth rate Answer: 1 - 2mm/year until 3-4cm; 5 mm/yr >4cm
Aneurysm classification Answer: 2 - 3cm; 3-4cm for AAA
AAA Intervention Answer: 5.5cm (high risk for rupture-catastrophic)
Fusiform Answer: Concentric enlargement; All 3 layers intact
Saccular Answer: Eccentric enlargement; All 3 layers compromised; Less common (<1%); Usually in Thoracic Ao
Types of Saccular AAA Answer: 1 - Cannula Placement 2 - Mycotic aneurysm (bacterial infection Ao wall) 3 - Vasculitis (Inflammatory process) 4 - Penetrating ulcer rupture into media
Vasculitis/Aortitis
Chronic Mesenteric Ischemia Answer: "Fear of Food" 95% of Bowel Ischemia cases Atherosclerotic stenosis/occlusion in main mesenteric arteries: >70% stenosis in 2/3 of principle mesenteric arteries
Ischemia diagnosis criteria via Moneta Answer: Celiac >200cm/s SMA >275cm/s
Median Arcuate Ligament Syndrome (MALS) Answer: Arch impedes on Celiac during EXPIRATION (non-compressed during inhalation)
Measurement(s) of Splenic Vein Answer: 7 - 17 cm long; 5-10mm diameter
Portal vein diameter Answer: <13mm
Blood supply to liver Answer: 75% from Portal VEIN; 25% from Hepatic ARTERY
Portal vein carries ____________ to the liver Answer: Nutrients
Hepatic artery carries ______________ to the liver Answer: Oxygen
Portal Hypertension Answer: Extrahepatic, Hyperdynamic, Intrahepatic (more common)
Extrahepatic Portal HTN Answer: Prehepatic (Portal/splenic vein thrombus, Extrinsic compression of Potral vein) Posthepatic (IVC/Hepatic vein obstruction)
Answer: Pressure reservoirs
Vasodilation Answer: Stretch to absorb
Vasoconstriction Answer: shrink/squeeze
Energy and stenosis Answer: Prox- PE↑, KE↓(highest total energy) Within-PE↓, KE↑ (lower TE, Bernouille's) Distal-PE↑, KE↓ (lowest total energy)
A-Early Systole (Forward flow to periphery) B-Peak Systole (Store PE) C-Late Systole (Temporary reversal-Peripheral resistance) D-Early Diastole (Forward-reduced resistance) E-Late Diastole (Vessel Recoil/Vasoconstrict/PE turns KE) Answer:
Hollenhurst Plaque Answer: Ulceration in ICA causing negative affects in retinal artery
Distal carotid dissections Answer: are very narrow and have no visible plaque
Physiologic/Arterial Doppler Answer: Indirect approach
Duplex Imaging Answer: Direct approach
All segmental pressures Answer: should be equal or slightly greater than brachial with <20-30mmHg change in pressures
