Download Vascular Anatomy and Hemodynamics and more Exams Advanced Education in PDF only on Docsity!
Vascular Registry Review 2 - URR Stuff
Questions And Answers 2023
____ refers to a collection of mucinous material within the adventitial wall layer of affected vessel - Correct Answer-adventitial cyst This is a rare, nonatherosclerotic, fluid collection in lumen of artery - mostly in popliteal artery - Correct Answer-cystic adventitial disease The supraorbital artery originates from the opthalmic artery and joins what branch of the ECA? - Correct Answer-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? - Correct Answer-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? - Correct Answer-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 P segment of the PCA? - Correct Answer-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? - Correct Answer-internal pudendal artery What will decrease with acute renal allograft rejection? - Correct Answer-diastolic flow in the segmental arteries will decrease because the RI will be increased When does blue toe syndrome occur? - Correct Answer-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 - Correct Answer-
30%
What can lead to systolic flow reversal in the hepatic veins? - Correct Answer-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 _____ - Correct Answer-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. - Correct Answer-Takayasu Arteritis Why is an acute arterial occlusion in the lower extremity considered a critical finding? - Correct Answer-collaterals have not had time to form to redistribute the blood Which iliac artery demonstrates a lower resistance flow than the other? - Correct Answer-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? - Correct Answer-hepatic vein anastomosis Describe example of cerebral cross-over collateralization - Correct Answer-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 ____ ____ - Correct Answer-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 - Correct Answer-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? - Correct Answer-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
May Thurner syndrome involves the compression of the _____common iliac vein against the lumbar vertebrae by the overlying _____common iliac artery. - Correct Answer-left; right Fibromuscular dysplasia is associated with stenosis of the _________ - Correct Answer-renal arteries Renal artery stenosis > 60% is indicated when the PSV is greater than _____ and the renal aortic ratio is over 3.5. - Correct Answer-1.8 m/s Secondary Raynaud phenomenon occurs in patients with _____ - Correct Answer- obstructed vascular system; Primary - NL vascular system, intermittent bilateral digital arterial spasm, excellent prognosis; Raynaud syndrome or disease Secondary - ABNL obstructed system with vasoconstriction causes constant ischemia, may be unilateral; Raynaud phenomenon In a post-phlebitic patient with perforator disease, what happens to the venous pressure in the small saphenous vein with calf muscle contraction? - Correct Answer-increases Which of the following is associated with CREST syndrome? A. Superficial phlebitis; B. Aortic aneurysm; C. Secondary Raynaud phenomenon; D. Primary Raynaud disease - Correct Answer-C. Secondary Raynaud phenomenon; In contrast to Raynaud disease, Raynaud phenomenon presents concurrently with CREST syndrome, in which tissue necrosis results from spastic and occlusive disease. CREST syndrome involves symptoms of generalized calcinosis, Raynaud phenomenon, esophageal dysfunction, scleroderma, and telangiectasia. Blue Toe Syndrome can be a complication of which of the following? A. Abdominal aortic aneurysm; B. Deep venous thrombosis; C. Thoracic outlet syndrome; D. Raynaud Phenomenon - Correct Answer-A. Abdominal aortic aneurysm; Blue toe syndrome is caused by emboli reaching the small digital arteries and causing obstruction/ischemia. The ischemic toe tissue becomes discolored and cyanotic in appearance. AAA formation usually leads to thrombus accumulation in the affected area of the vessel. This thrombus poses a risk of emboli formation and distal ischemia. All of the following are potential causes of a false negative diagnosis of ICA stenosis, except: ; A. tortuosity; B. improper Doppler angle; C. CHF;
D. decreased cardiac output - Correct Answer-A. tortuosity; A curved vessel will cause increased velocities at the "kinked" location(s). This can cause a false positive diagnosis of stenosis. Which of the following causes an increase in the resistive index(RI) of the distal common carotid artery? A. proximal ICA stenosis; B. Valsalva maneuver; C. proximal CCA stenosis; D. aortic valve insufficiency - Correct Answer-A. proximal ICA stenosis; An occlusion of the ICA will lead to increased resistance to the flow in the ipsilateral common carotid artery. While performing a TCD exam using the left transtemporal window, you identify flow moving away from the transducer with a mean flow velocity of 95cm/s in the A segment of the left anterior cerebral artery. From the right temporal window, the A segment of the right anterior cerebral artery demonstrates flow moving toward the transducer with a mean flow velocity of 30cm/s. What explains these findings? - Correct Answer-occlusion of the right A1 segment at its origin from the ICA; A high grade stenosis or occlusion of the right distal ICA or right proximal ACA will produce these findings. From the transtemporal window, normal flow in both of the ACAs should be moving away from the probe and toward the anterior cranium. If the right proximal ACA is obstructed, little to no flow will move into the A1 segment. The flow in the left A1 segment will increase in velocity to pass through the anterior communicator artery to enter the right A1 segment. This will lead to flow reversal in the right A1 segment as flow moves from the anterior brain to the mid brain (toward the probe at the temporal window). Congestive heart failure causes increased pulsatility in all of the following, except? A. hepatic veins; B. portal vein; C. superficial femoral artery; D. iliac veins - Correct Answer-C. superficial femoral artery; The decreased cardiac output can decrease pulsatility in the distal arterial system. If there is a 70-99% stenosis in the left carotid siphon, which of the following is true? - Correct Answer-left ICA flow will be high resistance; Distal stenosis will lead to high resistance flow proximally = ICA high resistance with siphon stenosis Collagen disease, such as lupus, is usually associated with what type of disease? - Correct Answer-Buerger Disease/Thromboangiitis Obliterans; The disease first affects the plantar or palmar arteries then moves centrally. Common symptoms include ischemic rest pain and distal dry, painful ulcers. Evaluation can be performed by Duplex and PPG techniques.
D. direct connection between a single artery and vein - Correct Answer-D. direct connection between a single artery and vein; An AVM is a congenital malformation with multiple connections between the arterioles and venules without a capillary bed in between. Venous collaterals will develop and dilate over time. The arterial inflow and venous outflow will demonstrate the same hemodynamic characteristics of an AVF, low resistance arterial inflow and pulsatile, turbulent venous outflow. What vessel supplies blood to a carotid body tumor? - Correct Answer-ECA Most common symptom of PAD - Correct Answer-claudication Broca's aphasia can be defined as: - Correct Answer-Inability to speak but can understand and follow directions What is the minimum % ICA stenosis that is considered hemodynamically significant and treatment is recommended? - Correct Answer-70% Which of the following terms would be used to describe flow identified just proximal to a 95% ICA stenosis? A. low resistance; B. laminar; C. tardus parvus; D. dampened - Correct Answer-D. dampened; Pre-Stenotic Zone: Increased resistance and resistive index, Flow velocity may be dampened with loss of diastolic flow, Short acceleration time Pulsatile venous flow in the deep veins of the lower extremity indicates increased venous pressures (venous HTN). CHF, electrolyte imbalance and kidney dysfunction can lead to venous HTN. Continuous flow patterns in the veins can be a sign of chronic obstruction proximally. - Correct Answer-know this Venous flow proximal to an AV fistula becomes ________________ due to the inflow of arterial flow distally - Correct Answer-pulsatile ____________________ cause primary varicose veins, while ___________________ cause secondary varicose veins. - Correct Answer-incompetent valves, elevated deep venous pressures Venous perforators with a diameter of _______________ or greater will usually demonstrate reflux. - Correct Answer-4mm; Normal perforator diameter is 2mm. If the P1 segment of the PCA is occluded on the left side, how will flow reach the P segment of the PCA? - Correct Answer-flow reversal within the left posterior communicator artery
Vertigo can be a common symptom related to disease of which of the following vessels?
- Correct Answer-basilar Tip for remembering the difference between Cerulea Dolens and Alba Dolens, "C"erulea causes "C"yanosis of the leg, while Alba Dolens results in pallor. - Correct Answer-know this Which of the following is the most accurate way to measure diameter and area stenosis in the carotid arteries? - Correct Answer-Transverse view on ultrasound; The longitudinal view used in ultrasound is not as accurate for diameter stenosis as a transverse view because of the possibility of off axis images and plaque distribution in the artery. The longitudinal view cannot be used to assess area stenosis. When evaluating suspected thoracic outlet syndrome, a PPG exam can be performed with the sensor placed on the _________________ or a Doppler exam can be performed with the transducer placed _______________________. - Correct Answer- 2nd digit, on the radial artery What is the preferred patient position for performing an upper extremity arterial duplex exam? - Correct Answer-arm abducted 45 degrees and externally rotated Abnormal results for an arterial segmental pressure evaluation with exercise will include which of the following characteristic(s): - Correct Answer-25% or greater decrease in ankle pressure post-exercise with basal pressure recovery time > 3min Transcranial Doppler most commonly uses which Doppler measurement to evaluate flow in the cerebral vessels? - Correct Answer-time average maximum velocity Which of the following is not a characteristic of a normal PVR tracing of the lower extremity? A. anacrotic limb; B. diastolic flow reversal; C. peaked amplitude; D. dicrotic notch - Correct Answer-B. diastolic flow reversal; PVR waveforms do not have a flow reversal component. The tracing represents volume which never goes into the negative. The preferred imaging plane to measure the AP dimension of the aorta is: - Correct Answer-sagittal When performing serial exams on an in situ venous bypass graft, _________________ indicates significant graft failure. - Correct Answer-a decrease in peak systolic velocity of 30cm/s from the last exam
Abnormal results for a penile Doppler evaluation that suggest impotence include _______________ peak systolic flow velocity and a peak pressure ____________. - Correct Answer-<25cm/s, <60mmHg An AV fistula is present connecting the femoral artery and vein at the right groin. The Doppler evaluation of the CFA will demonstrate what flow pattern? - Correct Answer- monophasic with increased diastolic flow; The low resistance venous connection causes decreased resistance and monophasic flow proximal to the fistula. When performing the four cuff method of obtaining segmental pressures, the blood pressure in the proximal thigh normally exceeds the brachial systolic pressure by 30- 40mmHg. The three cuff method yields a thigh pressure that should be equivalent to the brachial pressure in a normal pressure - Correct Answer-know this A patient presents with an order for a lower extremity venous Doppler exam to rule out DVT. This patient should be evaluated in the _____________ position in order to _______________ - Correct Answer-semi-erect, increase hydrostatic pressure Which renal arteries are evaluated with Doppler in an ultrasound exam that is used to perform an indirect evaluation for renal artery stenosis? - Correct Answer-segmental and arcuate arteries The minimum peak systolic velocity in the ICA that indicates a significant stenosis (70- 99%) is ____________ - Correct Answer-230 cm/s Hemodialysis requires native vein >2.5mm for AVF; native artery >2mm; native vein >4mm for synthetic graft - Correct Answer-know this Thrombin injection is more effective than compression techniques in pseudoaneurysms with large diameter stalks. Ankle pressure should be monitored during compression techniques to avoid changes in distal flow from extrinsic compression. - Correct Answer- know this The volume flow measurement uses a ____Doppler sample volume to assess the amount of flow moving through the graft. - Correct Answer-wide The lower extremity segmental pressure exam is most commonly performed with a/an ___________________ to obtain the Doppler signal for the pressure measurements at the ankle. - Correct Answer-8-10MHz CW Doppler probe; The dedicated CW probe is used to obtain the Doppler signal at the ankle while pressure measurements are obtained in the leg.
TCD exams can diagnose which of the following? - Correct Answer-carotid siphon stenosis, vasospasm, brain death How can the P1 and P2 segments of the posterior cerebral artery be differentiated on a transtemporal evaluation during a TCD exam? - Correct Answer-P1 demonstrates flow moving toward the transducer and P2 demonstrates flow moving away from the transducer Which of the following correctly describes steal syndrome in a patient with a Brescia- Cimino graft? - Correct Answer-pain and pallor in the hand that increases with exercise Which of the following is considered a normal finding in a patient with a brachiobasilic hemodialysis graft? - Correct Answer-Dilated brachial artery proximal to the graft with low resistance monophasic flow; The connection between the artery and the vein will cause the resistance in the brachial artery to decrease and become monophasic. The basilic vein will exhibit pulsatile, high velocity venous flow in the area of the graft due to the arterial inflow. A patient presents with an order for a lower extremity venous Doppler exam to rule out venous insufficiency. This patient should be evaluated in the _____________ position in order to _______________. - Correct Answer-standing, increase hydrostatic pressure; The standing position will increase hydrostatic or gravitational pressure, which slows lower extremity venous return. This will fill the veins of the legs with blood making the US and Doppler evaluation much easier. It will also cause superficial varicosities to engorge with blood for better visualization. Parenchymal Resistance Ratio or End Diastolic Ratio is used to assess parenchymal resistance in renal transplant cases. PRR <0.2 indicates increased resistance and possible rejection. PRR = EDV / PSV = 6 / 36 = 0.17 - Correct Answer-know this The soleal vessels drain into the ______________ - Correct Answer-peroneal and posterior tibial veins of the calf. Which of the following describes the 2D appearance of acute renal allograft rejection on ultrasound? - Correct Answer-Increased echogenicity and size You are performing a 3 month follow up aortic ultrasound on a patient with placement of an endovascular aortic graft in the distal aorta. Which of the following findings would indicate there is a problem with the graft? - Correct Answer-increase in transverse diameter of the distal aorta; If the AAA diameter increases after placement of the graft, an endoleak should be suspected. Turbulent flow in the fistula is an expected finding. Velocities below 400 cm/s are considered normal. The arterial inflow is normally low resistance and very turbulent. The
If greater saphenous venous flow velocity is approximately 20cm/s and appears continuous, which other vessel should be evaluated for a cause for the flow abnormality? - Correct Answer-femoral and popliteal vein; Venous perforators normally send flow from the superficial system into the deep system. If the deep system of the thigh/popliteal fossa has occlusive thrombus, the flow in the GSV will be rerouted to the groin to enter the common femoral vein. The increased flow will increase the velocity in the GSV and cause a continuous flow pattern. Recanalization of a thrombus from DVT in lower extremity usually occurs around ______ after formation occurred - Correct Answer-5 days Which of the following requires a normal Allen test in order to proceed? A. radial artery bypass graft harvesting; B. cephalic vein bypass graft harvesting; C. insertion of hemodialysis graft; D. A and C; E. all of the above - Correct Answer-D. A and C If the peak velocity in a transjugular intrahepatic portosystemic shunt at the portal vein anastomosis is 50cm/s and the mid graft velocity is 25cm/s, what is indicated? A. There is most likely an occlusion in the graft at the proximal end. B. The mid graft velocity is very low and indicates impending failure of the shunt. C. There is approximately a 50% stenosis at the portal anastomosis. D. The velocities indicate normal flow within the shunt. - Correct Answer-B. The mid graft velocity is very low and indicates impending failure of the shunt. Flow velocity <50cm/s in the intrahepatic shunt indicates impending failure. Velocities in a reversed vein graft are usually higher at the proximal anastomosis because it is the smaller end of the vein. - Correct Answer-know this A venous bypass graft exam must include the evaluation of any patent branches because: A. of the increased risk of stenosis in the branch; B. of the potential for AV fistula formation; C. of increased risk for the formation of an AV malformation; D. they are necessary for proper graft function - Correct Answer-B. of the potential for AV fistula formation; In situ and reversed vein grafts should have all branches ligated before being placed as a bypass conduit. This process is more effectively performed on the reversed vein graft because it is removed from the leg before it is placed as a graft. An AV fistula is the most common complication of an in situ vein graft. If the external iliac artery is occluded, what vessels provide the potential for collateral flow to the extremity? A. medial and lateral plantar arteries;
B. genicular arteries; C. inferior epigastric artery and deep circumflex artery; D. internal thoracic artery and lumbosacral artery - Correct Answer-C. inferior epigastric artery and deep circumflex artery; Lateral branches of the EIA include the inferior epigastric artery and deep circumflex artery that supply the abdominal wall muscles/skin. They also provide potential for collateralization with obstruction of the EIA When using the transtemporal window, the probe is angled slightly posterior and the depth set at 60mm. Monophasic flow is identified moving toward the transducer with a mean flow velocity of 45cm/s. Which of the following correctly describes the findings? - Correct Answer-The waveform demonstrates normal flow for the PCA P1 segment from this acoustic window Where is the most common location for the surgeon to place a renal allograft? A. right iliac fossa; B. 2-4cm below the umbilicus; C. left iliac fossa; D. 2-4cm above the urinary bladder - Correct Answer-A. right iliac fossa In a patient with a patent brachiobasilic AV graft, the axillary vein will: A. demonstrate biphasic flow with the majority of antegrade flow occurring during diastole; B. demonstrate a loss of spontaneous and phasic flow and will require distal augmentation to assess patency; C. demonstrate low velocity continuous flow; D. demonstrate high velocity pulsatile flow - Correct Answer-D. demonstrate high velocity pulsatile flow; The basilic vein connects to the axillary vein in the upper arm/axilla. The arterial inflow into the basilic vein from the AVG will transmit a pulsatile waveform with high velocities into the axillary vein. Auscultation of a hemodialysis graft is performed to assess patency. Normally turbulent flow will be detected if the graft is patent. A thumping sound can be heard with occlusion. The graft is palpated to assess for the expected thrill over a patent graft. The distal forearm arteries are assessed to confirm blood is reaching the distal arm/hand. NEVER take the blood pressure in an arm with a hemodialysis graft. - Correct Answer- know this The body of the pseudo aneurysm will demonstrate a low resistance "swirling" of flow on the Doppler tracing. The neck/stalk of the pseudo aneurysm is normally very narrow and will demonstrate a high resistance, biphasic waveform. - Correct Answer-know this Which of the following patients would undergo reactive hyperemia for a lower extremity exam to evaluate new onset of left leg claudication? A. Prior history of synthetic graft in the right leg;
A follow up exam after radiofrequency ablation of the GSV should be performed 2 weeks after the procedure to confirm contraction/occlusion of the GSV and absence of thrombus in the deep system. If the systolic brachial pressure is 116mmHg, the toe pressure would be considered normal if it is ____________ or greater. A. 80mmHg; B. 60mmHg; C. 100mmHg; D. 70mmHg - Correct Answer-D. 70mmHg; The normal pressure in the lower extremity digits is normally at least 60% of the brachial pressure. 116 x 0.60 = 70mmHg. The toe pressure is considered normal if it is 70mmHg or higher. High resistance flow in the ICA indicates increased resistance downstream. Obstruction of the siphon can cause increased resistance in the mid/distal ICA. - Correct Answer- know this What are the standard windows used for a complete transcranial Doppler exam? - Correct Answer-The three standard windows used for a TCD exam are the suboccipital, transtemporal, ophthalmic window. The submandibular window is a supplemental view used to assess the distal ICA. Which of the following measurements is used to differentiate inflow from outflow disease in the lower extremity arteries? A. Pulsatility index; B. Acceleration time; C. S/D ratio; D. Resistive index - Correct Answer-B. Acceleration time; Acceleration Time is measured to differentiate inflow from outflow disease in the lower extremity. Measure the time from the onset of systole to the peak of systole on the waveform. >140ms indicates inflow disease. If the AT in the common femoral artery is
140ms, iliac disease is suspected. If the AT in both of the common femoral arteries is 140ms, aortic disease is suspected. During a TCD exam the depth is set to 100mm while using the suboccipital window. What vessel will be interrogated and what direction will the flow be moving? - Correct Answer-basilar, away from the transducer A patient presents for a lower extremity venous Doppler exam due to a history of May- Thurner Syndrome. What vessel should you closely evaluate for related findings? A. bilateral popliteal veins; B. right iliac vein; C. left iliac vein;
D. bilateral distal femoral veins - Correct Answer-C. left iliac vein; May - Thurner Syndrome refers to increased incidence of left DVT due to extrinsic compression by RIGHT iliac artery. Which of the following statements is true regarding collateral vessels in the lower extremities? A. Collateral vessels decrease the accuracy of arterial plethysmography studies of the lower extremities. B. Flow distal to an occlusion in the SFA in the thigh will be low velocity and triphasic. C. Collateral vessels have lower resistance due to smaller diameter and greater length. D. Any flow detected in a vessel distal to an occlusion must come from smaller, low resistance collateral vessels. - Correct Answer-A. Collateral vessels decrease the accuracy of arterial plethysmography studies of the lower extremities. Smaller vessels demonstrate increased resistance. Any flow detected in a vessel distal to an occlusion must come from smaller, high resistance collateral vessels. Collateral flow can mask significant disease in the main arteries when evaluating only the pressure/volume changes in the legs. Which intracranial artery courses within the sylvian fissure? A. middle cerebral artery; B. anterior cerebral artery; C. basilar artery; D. posterior cerebral artery - Correct Answer-A. middle cerebral artery The angular artery is the terminal branch of the A. Ophthalmic artery; B. Anterior cerebral artery; C. Nasal artery; D. Facial artery - Correct Answer-D. Facial artery Using the suboccipital window, the normal basilar and vertebral arteries ______________________. A. cannot be evaluated using this transcranial window; B. will demonstrate flow toward the probe; C. will demonstrate flow away from the probe; D. will demonstrate bidirectional flow - Correct Answer-C. will demonstrate flow away from the probe Norepinephrine causes vasoconstriction and adrenaline causes vasodilation. - Correct Answer-know this
D. Perforator flow is normally unidirectional but becomes bidirectional with exercise. - Correct Answer-D. Perforator flow is normally unidirectional but becomes bidirectional with exercise. Venous valves are designed to allow unidirectional flow. If the valves are damaged or the vein is dilated to prevent proper valve movement, flow reversal may occur. Flow in the perforators normally moves from the superficial to the deep system. At what level in the neck does the common carotid artery normally bifurcate? A. At the upper level of the thyrocervical trunk; B. At the lower border of the larynx; C. At the angle of the mandible; D. At the upper border of the thyroid cartilage - Correct Answer-D. At the upper border of the thyroid cartilage Where is the arc of Riolan found? A. within the brain; B. at the popliteal fossa; C. within the mesentery; D. within the kidney - Correct Answer-C. within the mesentery; The arc of Riolan and the marginal artery of Drummond connect the SMA and IMA through the mesentery. They offer potential for collateral flow if a mesenteric obstruction occurs. _________________________ receives the blood from the posterior tibial perforators and plays a major role in venous stasis of the lower extremity. A. The posterior accessory saphenous vein; B. The posterior venous arch; C. The lateral perforator; D. The anterior accessory saphenous vein - Correct Answer-Posterior arch vein extends superior from the ankle to the GSV in the mid-calf; plays a major role in venous stasis; connected to 3 ankle perforators called posterior tibial perforators (formerly Crockett's Perforators.) Flow through venous perforators is: A. normally unidirectional from the superficial to the deep venous system; B. normally unidirectional from the deep venous to the superficial system; C. normally bidirectional to help equalize pressures in the deep and superficial systems; D. normally absent unless the deep system becomes overloaded and forces the excess blood into the superficial system - Correct Answer-A. normally unidirectional from the superficial to the deep venous system
The posterior arch vein connects the posterior tibial perforators (Crockett's perforators) to the GSV in the mid to upper calf. This vein usually plays a major role in disease caused by venous stasis. - Correct Answer-know this Branches of the ___________________ connect to branches of the vertebral arteries to allow collateral flow from the anterior circulation to the posterior circulation. A. occipital artery; B. subclavian artery; C. basilar artery; D. ophthalmic artery - Correct Answer-A. occipital artery; The occipital artery is a branch of the ECA. Branches of the occipital artery meet branches of the vertebral artery. This is a possible collateral pathway for obstruction in the vertebral system or the ICA system on the same side. ______________ reflux will be normally seen in the lower extremity superficial system. A. No (0s); B. Less than 0.5s; C. Less than 1.5s; D. Less than 3s - Correct Answer-B. Less than 0.5s; small of amount of reflux (Less than 0.5s) may be seen in normal vessels with flow normalization following augmentation. Which of the following structures is supplied by branches of the internal carotid artery? A. lateral nose only; B. parietal lobe only; C. eyes and lateral nose, but not the parietal lobe; D. eyes, lateral nose and parietal lobe - Correct Answer-D. eyes, lateral nose and parietal lobe The supraorbital artery originates from the ophthalmic artery and joins the superficial temporal artery(branch of the ECA). This arrangement allows for collateral flow to occur on the same side of the body if the ICA is obstructed. - Correct Answer-know this Normal extremity venous flow will demonstrate all of the following Doppler characteristics, except: A. Phasic flow; B. Spontaneous flow; C. Continuous flow; D. All of the above are normal venous flow characteristics - Correct Answer-C. Continuous flow;
