Vascular FInal

Practice flashcards covering vascular anatomy, pathophysiology, waveform analysis, and clinical diagnostic criteria for carotid and venous ultrasound.

Tunica adventitia (externa)

The outermost layer of an arterial wall.

Tunica media

The middle layer of an arterial wall, composed of thick muscle.

Tunica intima

The innermost layer of an arterial wall.

Venous valves

Bicuspid intimal folds that prevent backflow to keep blood moving toward the heart.

Capillaries

The smallest vessels consisting of a single endothelial layer; the site of $O_2$, nutrient, and waste exchange.

Carotid endarterectomy

Surgical removal of plaque from the inner carotid wall to restore flow and reduce stroke risk.

Steal phenomenon

Blood shunted away from its normal path to a lower-resistance bed due to proximal stenosis or occlusion.

Amaurosis fugax

Transient painless monocular vision loss ("curtain") from retinal ischemia, usually caused by a carotid embolus.

Flow separation

A normal finding in the carotid bulb where flow splits into forward and reversed or recirculating streams.

TIA

Temporary focal neurological dysfunction from ischemia without infarction where symptoms resolve; also known as a "warning stroke."

Tardus parvus waveform

A waveform indicating proximal stenosis, characterized by a delayed systolic upstroke (tardus) and a small, low-amplitude peak (parvus).

Tardus

A term describing a delayed systolic upstroke in a waveform.

Parvus

A term describing a small, low-amplitude peak in a waveform.

Intra-aortic balloon pump (IABP)

A device in the descending thoracic aorta that inflates in diastole and deflates in systole.

Counterpulsation

The inflation and deflation mechanism of an IABP relative to the cardiac cycle.

LVAD

Left ventricular assist device; a pump supporting a failing left ventricle to the aorta, usually providing continuous, low-pulsatility flow.

Spectral broadening

A widened waveform with a filled-in spectral window indicating a range of velocities consistent with turbulent or disturbed flow.

Vessel dissection

An intimal tear letting blood track into the wall, forming a false lumen and an intimal flap.

Intimal flap

A piece of the inner vessel wall created during a dissection that can obstruct flow.

False lumen

The secondary channel formed between layers of a vessel wall during a dissection.

D-Dimer

A fibrin degradation product measured to help evaluate for DVT or PE.

Negative D-Dimer

A laboratory result that helps rule out Deep Vein Thrombosis (DVT) or Pulmonary Embolism (PE).

Arterioles

Primary resistance vessels that regulate blood pressure and distribute flow to capillary beds via vasoconstriction and vasodilation.

Resistance vessels

A functional classification for arterioles due to their role in regulating blood pressure.

Arteries

Vessels characterized by a thick muscular media and high pressure that do not contain valves.

Veins

Vessels with thin walls and valves that are compressible and act as capacitance vessels.

Capacitance

The function of the venous system to hold approximately $2/3$ of total blood volume.

Brachiocephalic artery

The first branch of the aortic arch, also known as the innominate artery.

Innominate artery

Another name for the brachiocephalic artery which forms the right common carotid and right subclavian arteries.

Basilar artery

The vessel formed by the junction of the right and left vertebral arteries.

Vertebral arteries

Arteries that branch from the subclavian arteries and supply the basilar artery.

Iatrogenic injury

Injury caused by medical care, such as a pseudoaneurysm or AV fistula resulting from an arterial puncture.

Pre-steal systolic notch

The "bunny rabbit" waveform seen as the first stage of flow reversal in subclavian steal.

To-and-fro flow

The transitional stage of vertebral flow reversal in subclavian steal characterized by systolic reversal.

Complete retrograde flow

The final stage of vertebral flow reversal in a subclavian steal.

Well's Criteria

A pretest-probability scoring tool used to stratify the risk of DVT as low, moderate, or high.

Virchow's triad

The three factors contributing to thrombosis: venous stasis, endothelial injury, and hypercoagulability.

Venous stasis

One component of Virchow's triad involving slowed blood flow.

Endothelial injury

One component of Virchow's triad involving damage to the vessel lining.

Hypercoagulability

One component of Virchow's triad involving an increased tendency of the blood to clot.

String sign

A thin trickle of flow through a near-occluded Internal Carotid Artery (ICA), indicating it is critically stenosed but patent.

Median cubital vein

The superficial vein that connects the cephalic vein and the basilic vein.

Great saphenous vein

A superficial vein of the lower extremity, also known as the long saphenous vein.

Small saphenous vein

A superficial vein of the lower extremity, also known as the short saphenous vein.

FAST

A stroke recognition acronym standing for Face (drooping), Arms (weakness), Speech (slurred), and Time (call 911).

Bruit

An abnormal sound over a vessel and a clinical indication for carotid ultrasound.

Syncope

A term for dizziness or fainting, which serves as a clinical indication for carotid ultrasound.

Reverse Trendelenburg

An optimal positioning for DVT assessment, tilting the patient approximately $15-30^{\circ}$.

Anticoagulation

A treatment option for DVT using medications such as heparin, LMWH, warfarin, or DOACs.

Spontaneous flow

A normal venous Doppler signal that occurs without external physical maneuvers.

Phasic flow

A normal venous Doppler signal that changes in response to the patient's respiration.

Acute DVT

A clot characterized by a dilated vein, soft anechoic or hypoechoic appearance, and poor attachment to the wall.

Chronic DVT

A clot characterized by an echogenic appearance, wall attachment, and a contracted vein size.

Factor V Leiden

A specific genetic hypercoagulability risk factor for DVT.

Valsalva maneuver

An action that raises intrathoracic pressure to halt venous return, used to test for valvular incompetence at the saphenofemoral junction.