Intro to Vas and Car

What can a delayed arterial upstroke and an increased Time To Peak (TTP) signify in a spectral Doppler waveform?

a stenosis proximal to the sample volume

Which wave vibrational frequency (in cycles per second) is generally used to describe "ultrasound" waves?

>20,000

T/F: Changing the angle of the color box Will Not have any effect on the appearance of the color flow image.

False

What may happen to a spectral Doppler waveform if the gain is set too low?

a waveform may not be displayed

According to your textbook, the sample volume width in a normal artery should not exceed what fraction of the vessel's diameter?

2/3

What is one of the major disadvantages of CW Doppler?

lack of depth discrimination

In a pulsed Doppler system, which term refers to the number of pulses transmitted per second?

pulse repetition frequency (PRF)

Why is a vessel angle of 0 degrees most favorable?

it allows more accurate velocity calculations

Where should the sample volume be placed during the spectral Doppler examination of a normal artery?

in the center of the vessel

What spectral Doppler waveform characteristics are present when the sample volume is located within a high-grade arterial stenosis?

all are correct

What is the range for the angle of insonation for vascular scanning?

45-60 degrees

What causes this "notch" (indicated with the yellow arrow) in the envelope of this spectral Doppler waveform of a normal artery?

aortic valve closure

What may happen to a spectral Doppler waveform if the sample volume is set too wide during the examination of a normal artery?

slower blood flow velocities near the vessel walls may be displayed

Which of the following statements is Most Correct in describing the color flow appearance of variations in blood flow velocity?

all are correct

What is the purpose of angling (steering) the color box during color flow imaging?

creates a better Doppler angle

What is one of the major advantages of continuous wave (CW) Doppler?

resistance to aliasing at higher flow velocities

What happens to the imaging capability of an ultrasound system if too many focal zones are utilized during cardiovascular examinations?

decreased frame rate

What may happen to a color flow image if the PRF (Velocity Scale) is set too low?

aliasing

What type of spectral Doppler waveform is usually seen in a normal peripheral artery?

triphasic

What happens to the Pulse Repetition Frequency (PRF) as the sample volume depth increases with a pulsed Doppler system?

decreases

Which term describes sound waves whose frequency is below 20 Hz?

infrasound

What is the first step to take in order to eliminate aliasing in a spectral Doppler waveform?

increase the PRF (velocity scale) settings

What may happen to a spectral Doppler waveform if the gain is set too high?

a false indication of spectral broadening

Why is the sample volume placed in the middle of a normal artery during a spectral Doppler examination?

this is where the fastest blood flow velocities are located

What is a major advantage of using the Resistive Index (RI) or Pulsatility index (PI) to evaluate arterial blood flow?

the Doppler angle is ignored

The term for the junction that connects cardiac muscle fibers is

Intercalated disks

True or False: Cardiac tamponade is considered a life-threatening condition.

True

True or False: The heart receives oxygenated blood during systole.

False

Which of the following is the origin of the first heart sound ("lubb")?

ventricular contraction when AV valves are closing

The layers of the heart from inner to outer are:

Endocardium, myocardium, epicardium, pericardium

Which term refers to the basic protein units responsible for contraction of the cardiac muscle?

Sarcomeres

True or False: The right heart functions as the systemic pump and under high pressure.

False

Which two coronary arteries are the first to branch off of the aorta?

right and left coronary arteries

Which of the following determines coronary artery dominance?

artery giving rise to posterior descending artery

The atrioventricular valves differ from the semilunar valves in all but the following?

Keep blood flowing forward

According to your textbook, where do most carotid artery stenoses occur?

CCA bifurcation

This is a longitudinal color flow image from an earlier version of your textbook of the carotid bifurcation In the associated line drawing, #40 is the CCA and # 40b is the ECA. #3 is an area of plaque in the ICA. What is #6 pointing to?

aliasing due to flow acceleration past the plaque

If your transducer is in the proper longitudinal orientation on a normal Common Carotid Artery (CCA) during color Doppler imaging, which way should the blood be flowing when you are looking at the image monitor?

from the right to the left side of the image monitor

A normal vertebral artery exhibits what kind of flow pattern when examined with spectral Doppler?

biphasic

Which arteries normally bring blood into the Circle of Willis (COW)?

internal carotids and vertebrals

T/F: Atherosclerotic plaque deposits in the Internal Carotid Artery (ICA) always produce heavy acoustic shadows due to internal calcifications.

False

What’s A

Middle Cerebral Artery

What’s B

Basilar Artery

What’s C

Anterior Communicating Artery

What’s D

Posterior Cerebral Artery

How may blood get to the Internal Carotid Artery (ICA) if the ipsilateral Common Carotid Artery (CCA) is occluded proximal to the carotid bifurcation?

flow reversal in the ECA

The Parasympathetic Nervous system controls:

rest and digest response

The Sympathetic Nervous system controls:

fight and flight response

Another name given to the sympathetic response is:

autonomic response

Which of these is the largest vein that drains the heart muscle?

coronary sinus

What is the definition of angina pectoris?

symptoms such as chest discomfort of sudden onset

Which of the following is a possible cause of inadequate oxygen supply to the myocardium?

anemia

Specialized nerve tissue that detect changes in blood pressure are known as:

baroreceptors

Muscarinic receptors in cardiac muscle act in which manner?

slows the natural pacing rate of the heart

Which of the following is referred to as chronotropy?

change in heart rate

True or False:

Myocardial ischemia, if not reversed, can lead to myocardial infarction, which is death of the myocardial tissue affected by ischemia.

True

Alpha1 & 2, Beta 1 & 2, and dopamine receptor sites are receptors in which autonomic nervous system?

sympathetic nervous system

Given a situation in which a patient has been determined to have suffered a temporary or permanent blockage of a coronary artery, the diagnosis could include which of these terms?

acute coronary syndrome

What is the function of afferent lymphatic vessels?

carry unfiltered lymph into the lymph nod

What type of gland is the thyroid?

endocrine

What type of vascularity is associated with a lymph rode that exhibits an "arborizing" blood vessel pattern?

hypervascular

T/F: Sonography alone is not very sensitive in differentiating a malignant thyroid nodule from a benign mass

True

What is a goiter?

enlarged thyroid

When interrogated with spectral Doppler, what is the maximum velocity (cm/sec) of blood flow in a normal thyroid artery?

25

As it used in the textbook to describe the diffuse hypervascularity of Grave's Disease, what does pathognomonic mean?

distinct characteristic of a disease

What is the echogenicity of a lymph node with malignant lymphoma?

markedly low

According to the lecture, about how many lymph nodes are in the cervical region of the neck?

300

What is the normal range of right atrial pressure?

2--6 mm Hg

What two factors determine cardiac output?

stroke volume, heart rate

What term refers to the force exerted on the walls of the ventricles at the end of diastole?

preload

What is the "atrial kick"?

contraction of atria from SA node impulse

Scenario:

If a patient's stroke volume decreases, what must occur with the heart rate to maintain a constant cardiac output?

increase

During which part of the cardiac cycle does blood return to the heart?

atrial diastole

What term refers to the pressure or resistance against which the ventricles must pump to eject blood?

afterload

True or False:

The stroke volume and ejection fraction are expressed the same way and mean the same thing.

False

Blood pressure is defined as_____

force exerted by circulating blood on walls of arteries

T/F: The cardiac output of the right ventricle is normally equal to that of the left ventricle on a minute-to-minute basis.

True

Epinephrine and norepinephrine are two hormones that are secreted by the adrenal medulla and may cause what to happen?

increase the force of the heart's contractions

What makes pacemaker cells unique compared to other cells?

capable of generating an electrical impulse without nerve stimulation

Where does the 5 phases of the "fast response action potential" occur?

atrial & ventricular myocardial cells, Purkinje fibers

What alternate name do myocardial cells have?

mechanical cells

What are electrolytes, such as sodium, potassium, and calcium which carry a positive charge, known as?

Ions

What occurs in cells during depolarization?

inside of cell becomes positive

What state of a cell exists when at rest and the inside of the cell is more negative than the outside?

polarized

What term is defined as the ability of cardiac muscle to respond to external stimulus?

excitability

What do electrical charges of opposite polarity possess when they are separated?

potential energy

True or False:

Depolarization is the same thing as contraction.

False

Which of the following is true of the portal venous flow as measured by Doppler sonography?

the peak velocity increases postprandial

Which of the following is true of the portal venous flow as measured by Doppler sonography?

the peak velocity increases postprandial

"TIPSS" is an acronym for which of the following medical procedures?

a shunt between the IVC and the portal system

T/F: There can never be more than three (3) hepatic veins.

False

What vessel normally crosses posterior to the IVC?

right renal artery

Which of the following leads to pathologic flow reversal in the IVC during systole?

Tricuspid valve insufficiency

Which of the following refers to an occlusion of the distal abdominal aorta that involves the iliac bifurcation?

Leriche syndrome

Portal hypertension may NOT result from which of the following?

anemia

Flow velocities in the aorta are approximately_______cm/second slower than in peripheral arteries because of the large aortic caliber.

50 cm/second

What is the normal range of diameters for the abdominal aorta?

20-25 mm

Hepatic vein thrombosis is known as which of the following?

Budd-Chiari syndrome

Where, in the heart's conduction system, is the speed of impulse conduction the fastest?

His-Purkinjesystem

Any beat that originates from a source other than the SA node is called a(n) _ beat.

ectopic