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Vascular sonography

Carotid part 2- Scanning and Protocol

QuestionAnswer
What are the goals of the Extracranial Duplex? Identify PTs who are at risk for stroke, Facilitate treatment, Document disease progression (plaque), Detection of non-atherosclerotic conditions, Follow-up PTs Post surgery
What type of Transducer should be used for Carotid scanning? 7-4 MHz Linear array, High Freq for image quality, adequate "footprint" for access and visualization
What are some alternative transducers that may be used? 8-5 MHz Curvilinear, 4-1 MHz sector, 5-2 MHz curvilinear
What anatomy is generally evaluated in a Carotid Duplex exam? Common Carotid arteries (CCAs), Internal Carotid arteries (ICAs), External Carotid arteries (ECAs), Vertebral arteries, and Subclavian arteries
What should you document on a Carotid exam? Any identified intraluminal echoes (plaque or other intimal defects), Document any other areas of interest
What are normal B-mode characteristics? Smooth vessel walls, Intimal-medial layer clearly visible and uniform(thin, white line on innermost part of vessel wall), Lumen is anechoic
What is the normal Intima-medial thickness measurement? less than or equal to 0.9 mm is considered normal
The IMT measurement is a predictor of what? Cardiovascular disease
The IMT measurement is measured where? Far wall on vessel, Often done at the Distal Common Carotid Artery (DCCA), and Proximal Internal Carotid Artery (PICA), Thickens with age
Turbulent flow produces a what color Doppler pattern? "mosaic"
What is Power Doppler extremely helpful in detecting? Extremely low flow velocities (trickle flow)
Spectral Doppler provides what? The most reliable means for assessing vessel patency and classifying degree of stenosis
Doppler Waveform contour is related to? Cardiac output, Vessel compliance, and Status of distal vascular bed
What are the Normal Doppler waveform contours (CCA, ICA, ECA)? Brisk systolic acceleration, Sharp systolic peak, Clear spectral waveform
ICA has the highest what? Diastolic velocities (Lowest resistance)
ECA has the lowest what? Diastolic velocities (Highest resistance)
CCA had intermediate what? Diastolic velocities (has characteristics of both ICA & ECA)
ICA facts? Typically larger (usually contains bulb), Typically lies posterior to ECA, No extracranial branches, typically
ECA facts? Multiple branches within the neck (extracranial), Spectral waveform will oscillate with "temporal tap", Typically smaller vessel, Tip TD face toward PT's face (typically on side where thyroid is located)
How is the ECA different from the ICA? More pulsatile (rapid upstroke and downstroke), Higher resistance waveform (low diastolic flow component-not much diastole present on waveform), Feeds face and scalp
The Vertebral has what kind of appearance? "H" appearance
Normal Vertebral artery flow is similar to ICA waveform pattern how? Low resistance, Antegrade flow throughout cardiac cycle, Brisk systolic acceleration, Sharp peak, and relatively high diastolic flow component, Usually lower velocity (lower scale-CF, spectral)
With a temporal tap the Doppler flow signal is affected by what? Oscillations on the ipsilateral temporal artery
What is the normal vertebral artery flow waveform patter? Low resistance, Antegrade flow throughtout cardiac cycle, Brisk systolic acceleration, sharp peak, and relatively high diastolic flow component, Usually a lower vel (lower scale-CF, spectral)
Created by: EmilyGriffin
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