Term
| what is the first branch off the aortic arch? |
|
Definition
| the innominate/brachiocephalic artery |
|
|
Term
| what is the 2nd branch off the aorta? |
|
Definition
| left common carotid artery |
|
|
Term
| what is the 3rd branch off the aorta? |
|
Definition
|
|
Term
| the subclavian artery becomes the ______ artery |
|
Definition
|
|
Term
| the axillary artery becomes the ______ artery |
|
Definition
|
|
Term
| which artery splits into the radial and ulnar arteries? |
|
Definition
|
|
Term
| the aorta arises from the ____ _____ of the heart |
|
Definition
|
|
Term
| what are the two branches of the ascending aorta? |
|
Definition
| right and left coronary arteries |
|
|
Term
| the celiac artery branches into what three arteries? |
|
Definition
| left gastric, splenic, common hepatic |
|
|
Term
| which vessel is located 1 cm distal to the celiac artery? |
|
Definition
|
|
Term
| which artery feeds the stomach, liver, pancreas, duodenum, and spleen? |
|
Definition
|
|
Term
| which vessel feeds the small intestine, cecum, ascending colon, and part of the transverse colon? |
|
Definition
|
|
Term
| which renal vein crosses the aorta anteriorly and is positioned above it's respective artery? |
|
Definition
|
|
Term
| does the right renal vein cross over or under the IVC? |
|
Definition
|
|
Term
| which artery supplies the left half of transverse colon, descending colon, iliac, sigmoid, and part of rectum? |
|
Definition
|
|
Term
| the three major parietal branches of the abdominal aorta are what? |
|
Definition
| inferior phrenic artery, lumbar arteries, and middle sacral artery |
|
|
Term
| what are the hypogastric arteries? |
|
Definition
| the internal iliac arteries |
|
|
Term
| which vessels are larger, the internal or external iliac arteries? |
|
Definition
|
|
Term
| at the inguinal ligament, the external iliac artery becomes the ________. |
|
Definition
|
|
Term
| the common femoral artery divides into what two arteries? |
|
Definition
| SFA and Deep femoral artery |
|
|
Term
| the popliteal artery is a distal continuation of the _____. |
|
Definition
|
|
Term
| what is the first branch off the distal popliteal artery? |
|
Definition
|
|
Term
| the anterior tibial artery runs in the front of the leg, and becomes the _____ artery at the ankle. |
|
Definition
|
|
Term
| the second branch of the distal popliteal artery is the _____. |
|
Definition
|
|
Term
| the tibioperoneal trunk splits immediately into what two arteries? |
|
Definition
| posterior tibial, peroneal |
|
|
Term
| the posterior tibial artery extends down the _____ side of the leg. |
|
Definition
|
|
Term
| the peroneal artery extends toward the ____ to supply the lateral side of the leg and calcaneus. |
|
Definition
|
|
Term
| what are the three arteries that make up the plantar arch, which supplies the digits? |
|
Definition
| deep plantar artery, lateral plantar artery, dorsal metatarsal arteries |
|
|
Term
| these vessels of microcirculation are 1mm long. |
|
Definition
|
|
Term
| what two types of tissue are the tunica intima made up of? |
|
Definition
| smooth endothelium, connective tissue |
|
|
Term
| what two tissue types compose the tunica media? |
|
Definition
| smooth muscle, connective tissue |
|
|
Term
| what two tissue types compose the tunica adventitia? |
|
Definition
| white fibrous connective tissue, smooth muscle fibers |
|
|
Term
| which arterial layer contains the vasa vasorum? |
|
Definition
|
|
Term
| each heartbeat pumps about ___ of blood into the aorta. |
|
Definition
|
|
Term
| the greater the energy difference, and the lower the resistance, the _____ the flow rate. |
|
Definition
|
|
Term
| _____ energy is energy in motion. |
|
Definition
|
|
Term
| ______ _______ is gravitational energy. |
|
Definition
|
|
Term
| hydrostatic pressure is __ mmHg when supine. |
|
Definition
|
|
Term
| the tendency of objects to maintain their status quo is _____ |
|
Definition
|
|
Term
| layered, streamline blood flow, where the velocity is highest in the center is termed ______ flow. |
|
Definition
|
|
Term
| what are the two types of laminar flow? define them. |
|
Definition
parabolic flow (bullet shaped, velocity highest in center)
plug flow (layers travel at same velocity) |
|
|
Term
| where is plug flow usually seen? |
|
Definition
|
|
Term
| the ______the conduit, the higher the pressure |
|
Definition
|
|
Term
| increased viscosity = ______ velocity |
|
Definition
|
|
Term
| what is an example of a patient with high viscosity in the circulatory system? |
|
Definition
| patient with an elevated hematocrit (high RBC's) |
|
|
Term
| vessel _______ has the most drastic effect on resistance. |
|
Definition
|
|
Term
| what is an example of an inertial loss of energy in the circulatory system? |
|
Definition
| changes in direction and turbulent flow (exit of stenosis) |
|
|
Term
Poiseuille's law defines the relationship between ____, ____, and _____.
|
|
Definition
| pressure, volume flow, resistance |
|
|
Term
| Poiseuille's Law states that as vessel radius decreases, resistance _____. |
|
Definition
|
|
Term
| the Reynolds number describes the point at which ______ _____. |
|
Definition
|
|
Term
| when the Reynolds number exceeds ______, laminar flow becomes disturbed |
|
Definition
|
|
Term
| What is another term for the law of conservation of energy? |
|
Definition
|
|
Term
| the Bernoulli equation states that as pressure goes up, velocity ______. |
|
Definition
| goes down. and vice versa |
|
|
Term
| which region has the highest total energy sum? prestenosis, stenosis, poststenosis |
|
Definition
|
|
Term
| the fasting SMA is a ___ resistance vessel |
|
Definition
|
|
Term
| the ICA is a ____ resistance vessel |
|
Definition
|
|
Term
| the ECA is a ____ resistance vessel |
|
Definition
|
|
Term
| the vertebral, renal, celiac, splenic, and hepatic arteries are all _____ resistance arteries |
|
Definition
|
|
Term
| the subclavian and iliac arteries are ____ resistance. |
|
Definition
|
|
Term
| all of the extremity arteries are _____ resistance. |
|
Definition
|
|
Term
| the aorta is considered a ____ resistance vessel |
|
Definition
|
|
Term
| normally high resistance bi/triphasic waveforms may become monophasic _____ to a stenosis. |
|
Definition
|
|
Term
| extremity arteries will lose pulsatility when vasoconstricted/vasodilated? |
|
Definition
|
|
Term
| T or F. vasoconstriction occurs as a result of stenosis to maintain flow in the high resistance vessels. |
|
Definition
| False. vasodilation occurs. |
|
|
Term
| name four conditions in which the vessels may vasoconstrict or dilate. |
|
Definition
| heat, cold, tobacco use, emotional stress |
|
|
Term
| the best vasodilator of high resistance vessels is _____. |
|
Definition
|
|
Term
| T or F. increased blood pressure causes vasodilation. |
|
Definition
| False. it causes vasoconstriction |
|
|
Term
| cold vasoconstricted extremities will have ______ signals, while warm vasodilated extremities will have ______ signals. |
|
Definition
pulsatile (vasoconstricted)
continuous/steady (vasodilated) |
|
|
Term
| a hemodynamically significant stenosis occurs with a ___% area reduction or a ___% diamter reduction. |
|
Definition
|
|
Term
| in critical stenosis, pressure and flow volume ____. |
|
Definition
|
|
Term
| velocities will be dampened _______ to a stenosis. |
|
Definition
|
|
Term
| inside a stenosis, the velocities will be ______ |
|
Definition
|
|
Term
| turbulent flow is seen ______ to a stenosis |
|
Definition
|
|
Term
| spectral broadening will occur at what point? |
|
Definition
| entering, exiting, and inside a stenosis |
|
|
Term
| as the diameter of a vessel decreases, what happens to the velocity? |
|
Definition
|
|
Term
| pain in the muscles occuring during exercise but subsiding with rest is called what? |
|
Definition
|
|
Term
| T or F. claudication is predictable, and it disappears within minutes of exercise cessation. |
|
Definition
|
|
Term
match the following:
1. buttock claudication---------A. external iliac/CFA dx
2. unilateral buttock claudication------B. iliofemoral dx
3. thigh claudication------------C. femoral/popliteal dx
4. calf claudication-----------------------D. aortoiliac dx
|
|
Definition
|
|
Term
| Rest pain usually occurs when the limb is sleeping. symptoms usually occur where? |
|
Definition
|
|
Term
| T or F. rest pain does NOT occur in the calf. |
|
Definition
|
|
Term
list in order of severity:
ischeic rest pain
necrosis
claudication |
|
Definition
| claudication, rest pain, necrosis |
|
|
Term
| the 5 p's are symptoms of what? |
|
Definition
|
|
Term
|
Definition
-pain
-pallor
-pulselessness
-parasthesia
-paralysis
-polar (cold)
-purplish (cyanosis- blue foot) |
|
|
Term
| pallor, cyanosis, and rubor are skin color changes associated with _______ disease. |
|
Definition
|
|
Term
a condition of intermittent ischemia of the fingers or toes in response to cold or stress is _______ ______.
|
|
Definition
|
|
Term
| diabetics have a higher incidence of occlusive disease of the ____ and ____ arteries |
|
Definition
| distal popliteal and tibial |
|
|
Term
| T or F. hypertension is a risk factor for atherosclerosis. |
|
Definition
|
|
Term
| T or F. hyperlipidemia is associated with development of atherosclerosis. |
|
Definition
|
|
Term
| T or F. smoking, age, family history, and male gender are risk factors for atherosclerosis |
|
Definition
|
|
Term
| atherosclerosis occurs in the tunica _____ and tunica _____ layers. |
|
Definition
|
|
Term
| T or F. an embolism is the obstruction of a blood vessel by a solid substance. |
|
Definition
| false- it may be from solid, liquid, or gas |
|
|
Term
| blue toe may be caused by what 3 things. |
|
Definition
-ulcers/atherosclerosis
-arteritis
-embolization |
|
|
Term
| T or F. a true aneurysm is a dilatation of the intima. |
|
Definition
| false- all three layers. a false aneurysm does not contain all wall layers |
|
|
Term
| possible locations for aneurysms are |
|
Definition
-infrarenal aorta
-popliteal artery
-carotid artery
-renal artery
-splenic artery |
|
|
Term
| which aneurysm is commonly bilateral? |
|
Definition
|
|
Term
| what are the two major complications of aneurysm |
|
Definition
-rupture
-thrombus/embolization
-dissection |
|
|
Term
| a dissection begins with a tear in which arterial layer? |
|
Definition
|
|
Term
| where does a dissecting aneurysm most often occur? |
|
Definition
|
|
Term
| arteritis often results in ______ of the vessel |
|
Definition
|
|
Term
| the most common type of arteritis is _____? AKA? |
|
Definition
| Buerger's disease (thromboangitis obliterans) |
|
|
Term
| Buerger's disease often occurs in which sex? what is it commonly associated with? |
|
Definition
| Men, heavy cigarette smoking |
|
|
Term
| 4 types of arteritis are... |
|
Definition
-Takayasu's
-Buerger's disease
-temporal arteritis
-polyarteritis |
|
|
Term
| what is coarctation of the aorta? |
|
Definition
| a congenital stricture of the thoracic aorta |
|
|
Term
| which type of Raynaud's is idiopathic? (3 terms) |
|
Definition
-primary Raynaud's phenomenon
-spastic Raynaud's syndrome
-Raynaud's disease
|
|
|
Term
| which type of raynaud's consists of normal vasoconstrictive responses of the arterioles superimposed on a fixed arterial obstruction? (2 terms) |
|
Definition
-secondary Raynaud's phenomenon
-obstructive Raynaud's syndrome |
|
|
Term
| which type of Raynaud's is usually bilateral and may be hereditary? |
|
Definition
|
|
Term
| which type of Raynaud's has a better prognosis? |
|
Definition
|
|
Term
| what causes popliteal artery entrapment syndrom? |
|
Definition
| compression of the popliteal artery by the medial head of the gastroc muscle. |
|
|
Term
| popliteal entrapment syndrome is found commonly in ____ _____ |
|
Definition
|
|
Term
| popliteal entrapment is bilateral in ___ of the cases |
|
Definition
|
|
Term
| what is Livedo Reticularis. what causes it? |
|
Definition
| purple patches on dorsum of foot. result of dilated capillary/venule filling, NOT arterial obstruction |
|
|
Term
|
Definition
| reactive hyperemia or infection causes damaged/dilated vessels |
|
|
Term
|
Definition
| concentration of deoxygenated hemoglobin |
|
|
Term
|
Definition
|
|
Term
| ulcers that are deep, painful, and found on the ankle/tibia are from venous or arterial insufficiency? |
|
Definition
|
|
Term
| what are three examples of trophic changes? |
|
Definition
| loss of hair on extremity, shiny/skaly skin, thickened toenails |
|
|
Term
| what causes hair loss on an extremity? |
|
Definition
| poor nutritional state from decreased circulation. |
|
|
Term
| T or F. after manual compression, the normal skin color should return immediately upon release. |
|
Definition
| TRUE. an increase in capillary refill time denotes decreased arterial perfusion |
|
|
Term
paleness of skin caused by elevating the extremity is called ________. the return of extremity to dependent position causes slow return to normality followed by a red discoloration. what is this called?
|
|
Definition
| cadaveric pallor, dependent rubor |
|
|
Term
| what are the five pulse grades? |
|
Definition
0- none
1-weak
2-good
3-strong
4-bounding |
|
|
Term
| T or F. aneurysms are usually not palpable |
|
Definition
| false- they are and the pulses are bounding |
|
|
Term
| a thrill or bruit may indicate one of these three things. |
|
Definition
-poststenotic turbulence
-patent dialysis graft
-AV fistula |
|
|
Term
| T or F. the peroneal artery cannot be palpated. |
|
Definition
|
|
Term
| what are the five palpable pulses other than brachial and carotid? |
|
Definition
-aorta
-femoral
-popliteal
-dorsalis pedis
-posterior tibial |
|
|
Term
| are bruits low or high frequency sounds? |
|
Definition
|
|
Term
| what are the three grades of bruit? |
|
Definition
1-mild
2-moderate
3-severe |
|
|
Term
| bruits will usually disappear after a ___% stenosis occurs |
|
Definition
|
|
Term
| CHF may cause ______ waveforms |
|
Definition
|
|
Term
| During a doppler exam, what type of u/s is used? |
|
Definition
|
|
Term
| what is the advantage of auditory doppler? |
|
Definition
| it contains all the frequencies |
|
|
Term
| _____ doppler uses a zero-crossing frequency meter display the signals graphically on strip-chart recorder |
|
Definition
|
|
Term
| analog tends to _____ high velocities and _____ low velocites. |
|
Definition
| underestimate, overestimate |
|
|
Term
| spectral analysis exhibits _____ on the vertical axis, and ____ on the horizontal axis. In addition, ____ is displayed at any point on the graph. |
|
Definition
frequency/velocity, time
-amplitude |
|
|
Term
| the dorsalis pedis artery is recorded where? |
|
Definition
|
|
Term
| the posterior tibial artery is recorded where? |
|
Definition
|
|
Term
| the peroneal artery is recorded at the _____? |
|
Definition
|
|
Term
| true or false. biphasic waveforms in the lower extremity can be abnormal |
|
Definition
|
|
Term
| are signals in the lower extremity arteries pulsatile normally? |
|
Definition
|
|
Term
| monophasic dampened signals can be seen proximal or distal to a stenosis? |
|
Definition
|
|
Term
| after exercise all components of the waveform will normally appear ____ the baseline |
|
Definition
|
|
Term
| abnormally after exercise the waveform may lose it's ____ quality |
|
Definition
| phasic. becoming monophasic is abnormal. it should |
|
|
Term
| T or F. Post exercise waveforms should maintain the same quality as preexercise |
|
Definition
|
|
Term
| the abnormal _______ artery is similar in appearance to the waveforms of abnormal lower extremity arteries |
|
Definition
|
|
Term
| ___ resistance flow is pulsatile |
|
Definition
|
|
Term
| inverse damping factor is the ratio of the ______ to the ____. |
|
Definition
| distal pulsatility index, proximal pulsatility index |
|
|
Term
| acceleration time is prolonged when there is disease _____ to the probe |
|
Definition
|
|
Term
| if the cuff is too large, blood pressure will be artifactually ______ |
|
Definition
|
|
Term
| a narrow cuff will produce an artifactually ____ blood pressure |
|
Definition
|
|
Term
| what is the purpose of doppler segmental pressure studies? |
|
Definition
to r/o arterial occlusive dx
|
|
|
Term
| if the blood pressure cuff is too large, the blood pressure will be artifactually _____ |
|
Definition
|
|
Term
| if the blood pressure is too narrow, the blood pressure will be artifactually _____ |
|
Definition
|
|
Term
| the cuff should be at least _____ greater than the diameter of limb |
|
Definition
|
|
Term
| how does the pressure at the high thigh compare to the highest brachial pressure normally |
|
Definition
|
|
Term
| t or f. segmental pressures are taken bilaterally simultaneously |
|
Definition
|
|
Term
| which arteries are used at the ankle level? |
|
Definition
| posterior tibial and dorsalis pedis |
|
|
Term
| which arteries are used at the below knee/calf region, above knee region, and high thigh region? |
|
Definition
| higher of posterior tibial artery and dorsalis pedis |
|
|
Term
|
Definition
|
|
Term
| t or f. when taking pressures you must start at the ankle and move proximally |
|
Definition
|
|
Term
| what are the API and AAI? |
|
Definition
ankle/arm pressure index, ankle/arm index (aka's for ABI)
|
|
|
Term
| an ABI of greater than 1.3-1.5 is indicative of? |
|
Definition
|
|
Term
| what is the ABI range for claudication? |
|
Definition
| .5-.9 (below that is rest pain) |
|
|
Term
|
Definition
|
|
Term
| a decrease in 20 mmhg between two levels is considered what? |
|
Definition
| indicative of obstruction |
|
|
Term
| thigh pressure indeces of less than .8 indicate that ____ is likely. |
|
Definition
|
|
Term
| in foot/toe ulcers that won't heal, toe pressures would be less than ____ typically. |
|
Definition
|
|
Term
| reactive hyperemia is an alternative method for testing for arterial disease when treadmill testing is contraindicated. what major difference in results would one normally expect when doing reactive hyperemia? |
|
Definition
| a decrease in ankle systolic pressures normally after reactive hyperemia (17-34% decrease). this does not occur normally after treadmill exercise |
|
|
Term
| with reactive hyperemia, how can you distinguish between single-level and multi-level disease? |
|
Definition
| single level disease will be demonstrate less than a 50% drop in ankle pressure, multi-level will be more. |
|
|
Term
| after exercise testing, if ankle pressures reduce to a low level and increase after 2-6 min, it suggests what? |
|
Definition
| single level disease. multilevel if it remains for up to 12 minutes or longer |
|
|
Term
| a loose cuff will produce falsely _______ pressures. |
|
Definition
|
|
Term
| a 15-20 mmHg difference between brachial artery pressures would suggest what? |
|
Definition
| greater than 50% reduction of subclavian artery |
|
|
Term
| a 15-20mmHg difference in pressure between the upper and forearm suggests what? |
|
Definition
|
|
Term
| the Allen test evaluates patency of the wrist arteries and the ____. |
|
Definition
|
|
Term
| T or F. when performing the standard allen test, the sonographer will apply pressure to the ulnar artery. |
|
Definition
| false- you compress the radial artery to see if the palmar arch still gets blood supply without it. you are seeing if you can harvest the radial artery for a graft. |
|
|
Term
| the modified allen test uses what equipment? |
|
Definition
| photoplethysmographic (PPG) sensors applied to fingers |
|
|
Term
| what is laser doppler used for? |
|
Definition
| to determine the healing potential of a wound/ulcer |
|
|
Term
| for laser doppler, what would a normal SPP value be, indicating a wound is likely to heal? |
|
Definition
|
|
Term
| what are four possible techniques that can be used in detecting penile pressures? |
|
Definition
Photoplethysmography, pulse volume plethysmography, strain gauge, and CW doppler (blind techniques, non-imaging)
|
|
|
Term
| when taking penile pressures, what are the three sites you must record values from? |
|
Definition
| dorsal, ventral, and medial aspects |
|
|
Term
| for penile pressures, which technique is most commonly used? |
|
Definition
|
|
Term
| for penile pressure studies, what are the names of the drugs that may be administered? |
|
Definition
| Papaverine, Prostoglandin |
|
|
Term
| what are abnormal and normal values for a PBI (Penile brachial index)? |
|
Definition
normal is .75 or greater
abnormal is less than .65 |
|
|
Term
| a normal penile waveform will exhibit what? |
|
Definition
| a sharp, systolic peak with prominent DICROTIC NOTCH. this is important |
|
|
Term
| which arteries are examined during a penile pressure study? |
|
Definition
|
|
Term
| during a penile pressure study, which veins are evaluated? |
|
Definition
|
|
Term
| what is a normal velocity in the penile arteries? |
|
Definition
|
|
Term
| in the penile veins what can indicate a venous leak? |
|
Definition
| an increase to greater than 4 cm/sec |
|
|
Term
| reversal of flow in the veins of the spermatic cord following valsalva maneuver is diagnostic of what condition? |
|
Definition
|
|
