3

Front 1

what are the risk factors for stroke that cannot be changed?

Back 1

SHAP:
Sex-males over females
Heredity-black and family Hx
Aging=over 65
Prior stroke-recognize signs

Front 2

what are the risk factors for stroke that can be changed?

Back 2

CHAD HIS C
-Cigarette smoking-causes constriction of arteries
-High Blood pressure-most NB-increased wall stress causes atherosclerosis
-A-fib-cause blood to pool and clot
-Diabetes Mellitis-hardening of arterial walls

-Hyperlipidemia-saturation of fat contributes to atheromatous plaque
-Inactivity
-Sickel cell anemeia-cells stick to walls

-Carotid stenosis

Front 3

What is the difference btw a TIA and a RIND?

Back 3

THe symptoms of a TIA go away before 24 hours, but a RIND(Reversable ischemic neurological deficit) lasts longer than 24 hours but less than a CVA.

Front 4

What are the symptoms of TIA, and RIND

Back 4

-monocular blindness known as amaurosis fugax
-dysphasia or aphasia of communication
-contralateral hemiparesis
-behavioral disturbances

Front 5

What is VBI?

Back 5

vertebrobasilar insufficiency:
-caused by flow disturbances in the vertebrobasilar arteries. The symptoms are:
-ataxia(inability to coordinate
-limb weakness or drop attacks
-paresthesia(tingling or numbness)
-vertigo
-diplopia(double vision)

Front 6

what is a CVA? WHat are the symptoms of one?

Back 6

cerebral vascular accident:
-dysphasia, aphasia(inability or partial ability to speak
-heiparesis
-miscellaneous neuroligical deficits
-death!!

Front 7

what are the non-localized symtoms of a VBI?

Back 7

-dizzines
-syncope
-headache
-confusion
-difficulty w/ speech

Front 8

what is viscosity?
if there is high viscosity what happens to friction?
-how is velocity related to hematocrit?

Back 8

Viscosity-the property of fluid that resists flow. (stickiness)
-the higher the viscosity, the higher the resistance to flow
-the higher the hamatocrit, the higher the viscosity

Front 9

how do the dimentions of a vessels determine the amount of friction?

Back 9

smaller the radius, the more friction, and less flow.

Front 10

what is inertia?

Back 10

the property of blood flow that cuases blood to resist a change in direction or speed.

Front 11

how does a change in radius affect the change in flow?

Back 11

-small changes in radius produce a large change in flow

Front 12

how does PG affect flow?

Back 12

the greater the pressure gradient, the greater the flow.

Front 13

what is the equation for poiseullie's equation in regards to resistance?

Back 13

R=8Ln/r4(pie)

Front 14

if there is an increase in resisitance, pressure, what happens to flow?
If there is an increase in ressistance, what happens to pressure?

Back 14

-increase resistance causes decreased flow
-increased pressure cause increased flow
-an increase in resistance causes an increase in pressure

Front 15

what is the formula for velocity?
what happens to velocity as flow increas or as area increases?

Back 15

velicity=flow/area
velocity increases as flow increases
velocity increases as areas increases

Front 16

why does pulsitile flow occur?

Back 16

due to cardiac contraction that creates a pressure wave and resistance to flow from the distal vascular bed.

Front 17

what is pulse pressure amplitute? explain it.

Back 17

pulse pressure amplitude-the difference btw systolic and diastolic pressure
-is affected by SV, time of ventricular ejection, resistance, and stiffness of walls

Front 18

how does flow change btw systole and diastole?

Back 18

there is plug flow in systole, and parabolic flow in diastole

Front 19

what is reynolds number used to determine?

Back 19

when turbulence is likely to occur and is determined by flow velocity and viscosity of fluid

Front 20

what is the formula for reynolds number? when reynalds number meets or exceeds what is there turbulence?

Back 20

Re=Vq2r/n

Front 21

what are the most influential factors for tubulence?

Back 21

velocity ad the radius of the vessel

Front 22

what happens to energy and velocity distal to a stenosis?

Back 22

they drop, and turbulence occurs

Front 23

how is turbulence displayed on spectral doppler?

Back 23

broadening of spectral waveform, and a filling in of the spetral window.

Front 24

what is a hemodynamically significant stenosis?

Back 24

one that causes a reduction in pressure across the stenosis and flow disturbance in the form of turbulence

Front 25

what is the formula for velocity?

Back 25

v=Q/A (flow/area)

Front 26

what do hemodynamic abnormalities depend on?

Back 26

-length and diameter of narrow segment
-rouhness of endothelial surface
-irregularity of narrowing
-rate of flow
-arterio-venous PG
-peripheral resistance

Front 27

how may resistance play a factor in velicties proximal to a stenosis?

Back 27

in ca critical stenosis, the lesion may cause an increase i ressitance to flow just proximal to the stenosis. This is seen in some instances as a slight decrease in velocity in systole or diastole.

Front 28

where might there be an icrease in reverse flow component in late systole?

Back 28

in high resitance systems(ie. lower extremity arterial flow)

Front 29

how does a regular diameter reduction compare to a circumferential stenosis?

Back 29

a 75% area reduction equates to a 50% circumferential stenosis

Front 30

how do you determine percent diameter reduction

Back 30

measure the true diameter of the artery and then the resudual lumen and apply the following formula:
%D stenosis=1-(TLdivided by RL)x100

Front 31

what would cause peripheral resistance to change from high to low dynamicallyÉ

Back 31

ischemia
chemical, emotaional and envionmental influences

Front 32

what happens to high resistence vascular beds during exercise

Back 32

they become low resistance

Front 33

what flow is affected more by peripheral resistance

Back 33

diastolic flow

Front 34

why might a normally triphasic waveform appear biphasic

Back 34

if the patient recently exercised, the reversal component would be absent due to a decrease in peripheral resistance

Front 35

what may happen to blood flow in arterial occlusive diseaseÉ

Back 35

blood flow may increase in blanches of the arterial system to compensate for decreased blood flow in the diseased artery

Front 36

effects of exercise on the vascular system

Back 36

-vasodialation of arterioles
-reduced resistance and increase blood flow
-oxygen and metabolic nutrients are supplied
-if obstruction is present, inadequate flow volume and pressure drop

Front 37

occlusion

Back 37

-may occur by embolus or slow atherosclerotic progression
-no doppler or color
-blunted doppler signal and resistance proximal to occlusion
-compensory ipsilateral increased flow seen with ICA occlusion

Front 38

what happens to venous flow with expirationÉ

Back 38

external pressure on the IVC is reduced and flow out of lower extremities increases

Front 39

what happens to resistance when veins are collaped, and distendedÉ

Back 39

collapesd-higher resistance
distended-lower resistance

Front 40

what is hydrostatic pressureÉ

Back 40

pressure created by the weight of a volume of blood

Front 41

what is the hydrostatic pressure when a patient is supine compared to standingÉ

Back 41

supine-15mmHg
standing-80-100mmHg

Front 42

what can an increase in hydrostatic pressure causeÉ

Back 42

-high trasmural pressures
-venous distention distally
-filtration of fluids into extracellular spaces
-reduced venous return

Front 43

how does transmural pressure affect the shape of a veinÉ

Back 43

with low trasmural pressure, the vein is elliptical or dumbell shaped
-with high pressure, te vien expands and becomes rounded

Front 44

what is transmural pressureÉ

Back 44

the difference btw te pressure in the in the vein, and external pressure of the tissue.

Front 45

T or False-Transmural pressure in the legs is low when standing, and high when supine

Back 45

false

Front 46

what will obstruction of venous outflow in the legs or arms do to transmural pressureÉ

Back 46

it will cause an increase in transmural pressure

Front 47

what is edemaÉ

Back 47

a condition in which the body tissue contains excessive fluid: increased venous pressure reduces blood flow in capillary beds and forces fluid into the intersitial spaces

Front 48

what can chronic venous edema result inÉ

Back 48

stasis dermatitis and ulceration

Front 49

how does venous blood flow to the heartÉ

Back 49

semilunar valves in the deep and superficial systems and calf muscle veins allow blood to proceded in one direction; vales in the perforator veins allow blood flow in one direction, from superficial to deep veins.

Front 50

what are the primary calf muscle pumpsÉ

Back 50

the soleal and gastrocnemius muscle groups.

Front 51

during relaxation, what venous valves open and close

Back 51

proximal valves close due to hydrostatic pressure, and distal ad perforator valves open to allow blood to fill the empty venous segments

Front 52

what 3 factors are required for efficient pump actionÉ

Back 52

-musles in limbs must be able to contract and compress veins
-valves must operate correctly
-venous outflow ust be unobstructed.

Front 53

what is primary venous insufficencyÉ

Back 53

when ther eis congenital abscence of valvesor incomplete valve development.

Front 54

what is secondary venous incompotenceÉ

Back 54

valve damage due to DVT

Front 55

what happens to pressures with incompotent valves
-what is the effect of thisÉ

Back 55

when valves are incompetent, blood is forced towards the feet as well as towards the heart.
THis increases the intramural pressure distally and contributes to venous pooling, edema, and symptoms of venous insufficiency

Front 56

why do varicosities occurÉ

Back 56

incompotent perforator valves allow blood to be forced into the superficial system and veins becom e dialated and varicose.

Front 57

AV fistula

Back 57

-direct communication btw artery and venous systems
-can reduce resistance and increase flow into the feeding artery
-flow in the vein can become pulsitile

Front 58

what are the primary complications of hemodialysis grafts and fistulasÉ

Back 58

-stenosis
-occlusion
-pseudo-aneurysm
-arterial steal sydrome from distal perfusion

Front 59

Pseudoaneurysm

Back 59

-extravasion of blood flow out of an artery and into surrounding tissue
-often iatrogenic
-may occur due to trauma
-due not have arterial wall structure surrounding bleeding
-another cause is a bypass graft failure or rupture