Arterial / Extracranial Ultrasound

Front 1

______ is the inner layer of the artery made of endothelial cells and connective tissue

Back 1

Tunica Intima

Front 2

_____ seperates the intima and the media

Back 2

internal elastic membrane

Front 3

____ is the middle layer made up of elastin, collagen and smooth muscle. Its the thickest layer in the artery.

Back 3

Tunica Media

Front 4

_____ is the outer arterial layer consisting of collagen and elastin

Back 4

Tunica Adventitia

Front 5

______ are vessles that supply the adventitia and outer media

Back 5

Vasa Vasorum (vessels of Vessels)

Front 6

_____ control muscular activity within the media

Back 6

Sympathetic nerve fibers

Front 7

_____ perfuses the eyes and the front top and sides of the cerebral hemispheres

Back 7

Anterior Circulation

Front 8

Anterior Circulation is an aka for _____

Back 8

Carotid circulation

Front 9

____ perfuses the brainstem, cerebellum and the back and undersurface of the hemispheres

Back 9

posterior circulation

Front 10

Posterior circulation is synonomous with _____

Back 10

vertebrobasilar circulation

Front 11

_____ is located outside the cranium

Back 11

Extracranial Circulation (Intracranial is inside the cranium)

Front 12

What are the branches of the ascending aorta

Back 12

Coronary Arterys

Front 13

What are the branches of the aortic arch?

Back 13

Brachiocephalic trunk, Left common carotid, and left subclavian

Front 14

What are the branches of the descending aorta

Back 14

Celiac, SMA, IMA and renal arteries

Front 15

The Aorta bifurcates into Left and Right common iliac arteries where

Back 15

L4

Front 16

The brachiocephalic trunk is on the _____ side of the body

Back 16

right

Front 17

What is an AKA for brachiocephalic trunk

Back 17

inominate artery

Front 18

The brachiocephalic trunk divides into _____ and _____

Back 18

right common carotid and right subclavian artery

Front 19

The branches of the right subclavian are ______

Back 19

1. vertebtal artery
2. thyrocervical trunk
3. internal thoracic artery (mammary)
4. Intercostals
5. costocervical trunks

Front 20

______ is the second branch ot the aortic arch

Back 20

Left CCA

Front 21

Carotid bifurcation occurs at ____

Back 21

C4

Front 22

What are the four sections of the internal carotid

Back 22

Cervical
Petrous
Cavernous
Supraclinoic

Front 23

What are the branches of the petrous segment

Back 23

typanic artery

Front 24

The cavernous segment is also known as

Back 24

carotid siphon

Front 25

What are the branches of the cavernous segment of the ICA

Back 25

Opthalmic artery (and its branches)
Supratrachlear artery
Supraorbital artery
Others: anterior and posterior ethmoidal and lacrimal

Front 26

______ is the ICA layer that begins at dural layer forming roof of the cavernous sinus, courses posteriorly superiorly and laterally to to bifurcation and into the anterior and middle cerebral artery

Back 26

Supraclinoic (cebrebral) segment

Front 27

What are the branches of the supraclinoic segment of the ICA?

Back 27

Posterior communicating artery, anterior choroid, anterior cerebral artery and middle cerebral artery

Front 28

_____ primarily profuse the face and the scalp

Back 28

external carotid artery

Front 29

What are the 8 primary branches of the ECA?

Back 29

Anterior:superior thyroid artery, lingual artery, facial artery
Posterior: occipital, posterior auricular
Ascending: Ascending Pharyngeal
Terminal:Superficial temporal, internal maxillary artery

Front 30

______ perfuse the brainstem cerebellum and back and under surface of the cerebral hemispheres

Back 30

vertebral arteries

Front 31

What are the four segments of the vertebral arteries

Back 31

1. Extravertebral Segment
2. Intravertebral Segment
3. Horizontal Segment
4. Intracranial Segment

Front 32

____ arises off the upper and back portion of the first part of the subclavian artery and ascends to the entrance of the transverse foramina of c6

Back 32

extravertebral segment (prevertebral)

Front 33

_____ ascends through the transverse foramina of cervical vertebra. Begins at the entrance of transverse foramina of c6 and terminates shortly after exiting the transverse foramina of c1.

Back 33

intravertebral (cervical Segment)

Front 34

____ courses along the superior surface of the posterior arch of the atlas

Back 34

horizontal (atlantic) segment

Front 35

What are the branches of the horizontal segment of the vertebral artery?

Back 35

1. posterior meningeal
2. muscular branches

Front 36

_______ ascends from dura mater anteromedial through the foramen magnum joining with the opposite verebral artery to form the basilar

Back 36

Intracranial (intradural) segment

Front 37

What are the branches of the intracranial portion of the vertebral artery?

Back 37

1. posterior spinal
2. posterior inferior cerebellar
3. anterior spinal
4. bulbar

Front 38

___ is the smaller of the 2 terminal branches of the ICA

Back 38

Anterior Cerebral Artery

Front 39

_____ is the larger of the 2 ICA branches

Back 39

Middle Cerebral Artery

Front 40

_____ are reletively short arterys connecting the two ACA's. Provides potential collateral flow between the 2 halves of the anterior circulation

Back 40

anterior communicating artery
(AcoA)

Front 41

______ originates from the confluence of the two verts at the level of the pontomeduallary sulcus

Back 41

Basilar artery

Front 42

______ are the terminal branches of the basilar artery

Back 42

Posterior Cerebral Arteries

Front 43

_____ arise from the supraclinoid ICA and course posteriorly to anastamose with the PCA

Back 43

Posterior Communicating Artery (PcoA)

Front 44

______ is an ischemic neurological deficit that resolves after 24 hours

Back 44

RIND

Front 45

_____ is a permanent ischemic neurological deficit

Back 45

Stroke or cerebrovascular accident

Front 46

____ is transient partial or complete loss of vision in 1 eye. It implicates carotid system on the same side

Back 46

Amourosis Fugax
"shade pulled over eye"

Front 47

______ is unilateral numbness, prickling, tingling or heightened sensitivity. Oposite side of brain as affected side of the body

Back 47

Mono or hemiparesthesia

Front 48

______ is unilateral partial or complete paralysis

Back 48

mono or hemiparesis

Front 49

_____ is abscent or impaired ability to communicate either through speech or writing. Implicates the carotid of dominant hemisphere

Back 49

asphasia

Front 50

____ are difficulties w/ speech due to tounge impairment. (MCA)

Back 50

dysarthria

Front 51

____ is partial loss of vision in both eyes

Back 51

hemianopia

Front 52

____ is sensation of moving around in space

Back 52

subjective vertigo

Front 53

_____ is sensation of having objects move about the person

Back 53

Objective vertigo

Front 54

_____ is gait disturbance

Back 54

ataxia

Front 55

____ is sudden muscular weakness without the loss of sonsiousness during which patient falls to the floor

Back 55

drop attacks

Front 56

____ is double vision

Back 56

diplopia

Front 57

_____ is inability to or difficulty swallowing

Back 57

dysphagia

Front 58

What are some nonspecific signs and symptokms of cerebrovascular abnormality?

Back 58

1.confusion
2. dizziness
3. headache
4. impaired mentation
5. loss of memory
6. syncope

Front 59

What are the risk factors for carotid artery problems?

Back 59

age, sex, hypertension, tobacco abuse, diabetes, obesity, high cholesterol, stress, family histoory, peripheral vascular disease, and coronary artery disease

Front 60

_____ is a narrowing in a blood vessel

Back 60

stenosis

Front 61

When does stenosis become hemodynamically significant?

Back 61

50% diameter reduction
75% area reduction

Front 62

_______ is an irregular surface or pronounced lesion within the surface of athersclerotic plaque

Back 62

ulceration

Front 63

____ is escape of blood fromk a vessel with in an athersclerotic plaque of a fibrous cap with intrusion of blood from lumen into plaque

Back 63

hemmorrhage

Front 64

_____ is obstruction of blood vessel by transported solid, liquid, gas material or other foriegn substance

Back 64

embolism

Front 65

____ is formation, development, or existance of blood clot or thrombus within a blood vessel

Back 65

thrombosis

Front 66

____ is reversal of verebral artery flow secondary to a significant obstruction in the ipsilateral subclavian or inominate arteries

Back 66

subclavian steel
(the lesion must be located proximal to the vertebral artery origin)

Front 67

_____ is seperation or tearing away from the remainder of blood vessel wall. Usualluy occurs in patients 45 or younger. Head neck pain and TIA or Stroke

Back 67

Dissection
(ICA disection is usually 2-4 above bif)

Front 68

Carotid Disection may represent an extension of aortic disection but spontanious may be related to _____

Back 68

blunt trauma

Front 69

What are the risk factors for disection?

Back 69

1. hypertension
2. tourtuosity
3. Marfan's syndrom
4. syphlis
5. arteriopathies
6. oral contraceptive

Front 70

disection accounts for _____% of all strokes

Back 70

2.5

Front 71

How do you treat disection

Back 71

heparin and coumadin

Front 72

What are the symptoms of a carotid body tumor

Back 72

1. enlarging neck mass
2. neck pain
3. dizziness
4. tinnitus
5. hoarseneess
6. dysphagia
7. syncope

Front 73

How is carotid body tumor treated

Back 73

with surgical resection

Front 74

______ abscent pulses indicate possible upper extremity ofr subclavian artery obstruction

Back 74

radial

Front 75

____ indicate possible carotid artery obstruction when absent or weak

Back 75

carotid pulses

Front 76

___ indicate possible ECA obstruction when absent or weak

Back 76

temporal pulses

Front 77

____ is a test which detects flow in the opthalamic fromtal and supra orbital arteries by scannning the eyelid and performing compressions

Back 77

periorbital doppler exam

Front 78

____ measures opthalmic artery systolic pressure using suction cups placed on the eye

Back 78

pressure occular plethsmography

Front 79

_____ plaque is most worrisome for emobolism

Back 79

soft

Front 80

____ plaque is homogenous

Back 80

soft plaque

Front 81

_____ plaque is heterogenous

Back 81

hard plaque

Front 82

____ is a non invasive method for obtaining blood flow velocities from the intracranial arteries

Back 82

transcranial doppler

Front 83

______ is injection of radiopaque material into an artrey

Back 83

arteriography

Front 84

_____ is a medical therepy that involves insonation CW TCD headset combined with thrombolytic agent. This procedure significantly acceleates the thrombolytic process and intracranial vessel recanalization

Back 84

sonothrombolysis

Front 85

______ inhibits platelet aggregation and may include what?

Back 85

antiplatelet
1.aspirin
2. dipyridamole

Front 86

______ is generally used to treat established thrombosis or to prevent it and embli. It's primarily used in patients requiring short term therapy

Back 86

anticoagulation/ antithrombotic medication

Front 87

_____ is surgical removal of athersclerotic plaque and intimal thickening

Back 87

carotid endarterectomy

Front 88

What are the indications for carotid endartarectomy

Back 88

1. ICA > 60% stenosis
2. TIA
3. Prior stroke with significant recovery

Front 89

What are nonsurgical interventions for arterial stenosis?

Back 89

angioplasty and artherectomy