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Vascular Registry Review 2 - URR Stuff
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Vascular Registry Review 2 - URR Stuff
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VASCULAR REGISTRY REVIEW 2 - URRSTUFF COMPLETE DETAILED CASE
STUDY
h____ refers to a collection of mucinous material within the adventitial wall layer of affected vessel -
adventitial cyst
This is a rare, nonatherosclerotic, fluid collection in lumen of artery - mostly in popliteal artery - cystic
adventitial disease
The supraorbital artery originates from the opthalmic artery and joins what branch of the ECA? -
superficial temporal artery; this arrangement allows for collateral flow to occur on the same side of the
body if the ICA is obstructed
What is a possible collateral pathway for obstruction in the vertebral system or ICA system on the same
side? - occipital artery; branch of the ECA, which connects to branches of vertebral arteries to allow
collateral flow from anterior circulation to posterior circulation
Which vessels would most likely be occluded in a patient with Plegmasia Alba Dolens? - femoral vein,
deep calf veins, popliteal veins; Plegmasia Alba Dolens refers to condition where all deep venous vessels
are occluded in extremity causing reduced arterial flow. Leg has a milky white appearance due to severe
outflow obstruction and markedly reducing arterial inflow. Leads to ischemia in entire extremity with
severe pain.
If the P1 segment of the PCA is occluded on left side, how will flow reach the P2 segment of the PCA? -
flow reversal within the left posterior communicating artery; this flow will travel posterior from the left
distal ICA to reach the P2 segment
Which artery supplies the penis with blood through the penile artery and its branches? - internal
pudendal artery
,What will decrease with acute renal allograft rejection? - diastolic flow in the segmental arteries will
decrease because the RI will be increased
When does blue toe syndrome occur? - occurs due to distal embolism from a recent invasive procedure,
atherosclerotic plaque, or thrombus in the aorta or lower extremity artery
In the circle of Willis, if a difference of ____% is present between the velocities taken in the same vessel
on both sides, this can indicate intracerebral disease - >30%
What can lead to systolic flow reversal in the hepatic veins? - significant tricuspid regurgitation; where
blood flows back into the right atrium. It can cause right atrium to dilate and pressure increases. If
pressure increases, inflow from IVC and hepatic veins will be disrupted and flow reversal in systole can
occur
When the effective calf muscle pump contracts, the pressure in the deep calf veins _____ - increases;
contracts = increased deep venous pressure prevents flow from superfical system through perforators;
relaxes = decreased deep venous pressure allowing for refill from superficial system through perforators
This disease presents as hypertorphic areas of inflamed tissue found in the aorta and its branches. It is
commonly associated with supravalvular aortic stenosis and aortic coarctation. It can also affect the
renal and subclavian arteries. Most commonly seen in young females. - Takayasu Arteritis
Why is an acute arterial occlusion in the lower extremity considered a critical finding? - collaterals have
not had time to form to redistribute the blood
Which iliac artery demonstrates a lower resistance flow than the other? - internal iliac artery is less
resistant because it supplies the pelvic organs with blood
A patient presents for a follow up for the TIPSS located between the right portal vein and right hepatic
vein. The chart indicates an abnormal bruit and stenosis is suspected. Where should you look first for the
stenosis because it is the most common site of stenosis in a TIPSS? - hepatic vein anastomosis
,Describe example of cerebral cross-over collateralization - flow from the left ACA to the right ACA
through the anterior communicating artery
If you detect flow toward the transducer in the right ACA while using a transtemporal window, there is
most likely an occlusion of the ____ ____ - right ICA
The supraorbital artery is a branch of the _____. Branches for the supraobital artery connect with
branches of the ____, which is a branch of the ECA. This is a common collateral pathway from the ECA to
ICA - ophthalmic artery (ICA); superficial temporal artery (ECA)
What correctly describes the effects of walking on the deep venous pressure in the lower extremity in a
patient with post phlebitic syndrome? - Walking causes an immediate, quick drop in pressure in the deep
veins at the onset of exercise that quickly returns to pre-exercise levels once the patient stops walking
Describe what Ascending and Descending Venography are used for - Ascending is used to assess DVT;
Descending is used to assess venous valvular compentency
All of the following findings are commonly identified with a left subclavian steal, except:
A. right vert artery increases in size;
B. increased resistance in left axillary artery;
C. increased flow volume and velocity in the right vertebral artery;
D. flow reversal in left vertebral artery - B. increased resistance in left axillary artery;
If the left subclavian artery is obstructed, flow will move from the right vertebral into the left vertebral
artery. Flow in the right vertebral artery will increase with increased velocity as it tries to meet the
increased demands. This usually causes the artery to dilate. Flow in the left vertebral artery is reversed
and the flow enters the left subclavian artery distal to the obstruction. The flow in arteries of the left arm
will demonstrate reduced resistance and a monophasic flow pattern.
Which of the following vessels can act as a collateral vessel to redistribute flow from one side of the
brain to the other side?
A. anterior communicating artery only;
B. middle cerebral artery only;
C. posterior communicator artery only;
, D. anterior communicator and basilar artery; - D. anterior communicator and basilar artery;
If left ICA is occluded, flow from right ICA enters brain and travels to right ACA. Flow then moves through
communicator to fill left ACA in a retrograde fashion.
Obstruction of the IVC will cause flow in the iliacs to become ____. - Continuous;
Continuous hvenous hflow hcan hindicate ha hproximal hobstruction.
TCD hexam; hYou hidentify hflow hmoving haway hfrom htransducer hat h90cm/s hwith hdecreased hpulsatility hin
hright hophthalmic hartery. hThe hleft hophthalmic hartery hdemonstrates hflow hmoving htoward htransducer
hwith ha hvelocity hof h45cm/s. hWhat his hindicated hby hthese hfindings?
A. hPosterior hto hanterior hcollateralization;
B. hNormal hflow hparameters, hno hcollateralization hpresent;
C. hCross hover hcollateralization;
D. hECA hto hICA hcollateralization h- hD. hECA hto hICA hcollateralization;
The hsuperficial htemporal hartery hand hinferior hmaxillary hartery hare hbranches hof hECA hthat
hcommunicate hwith hbranches hof hthe hophthalmic hartery. hFlow hmoves hfrom hthe hECA hto hthese
hbranches hand hrefills hthe hophthalmic hartery hto hsend hflow hback hinto hthe hareas haffected hby hthe
hipsilateral hICA hocclusion.
Arterial hflow hproximal hto han hAV hfistula hwill hbe h__________ h- hlow hresistance
May hThurner hsyndrome hinvolves hthe hcompression hof hthe h_____common hiliac hvein hagainst hthe
hlumbar hvertebrae hby hthe hoverlying h_____common hiliac hartery. h- hleft; hright
Fibromuscular hdysplasia his hassociated hwith hstenosis hof hthe h_________ h- hrenal harteries
Renal hartery hstenosis h> h60% his hindicated hwhen hthe hPSV his hgreater hthan h_____ hand hthe hrenal haortic
hratio his hover h3.5. h- h1.8 hm/s
Secondary hRaynaud hphenomenon hoccurs hin hpatients hwith h_____ h- hobstructed hvascular hsystem;
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