CH 8 & 9 UNCOMMON PATHOLOGY OF THE CAROTID ARTERY QUESTIONS AND ANSWERS 2024
Tortuosity and Kinking - Correct Ans->- length of the vessel exceeds the
... [Show More] fixed distance from the
bifurcation to the skull, it's forced to curve and wind to make space.
- vary from small curves to very sharp angulations
- may be 16% of patients
- can be bilateral
Sign and symptoms: - Correct Ans->• asymptomatic
• TIA like symptoms specially with head turning
• Pulsatile mass, particularly w/ CCA tortuosity
US evaluation of torturous vessel - Correct Ans->increased velocities distal to curves and kinks
- Sampling is from the straight portion
How do scan tortuous vessels? - Correct Ans->The angel cursor must be adjusted frequently to
compensate for the changing vessel direction, AKA get spectral at straightest portion
- Prox to curve and distal to curve"
Dissections/Intimal Flaps - Correct Ans->• Separation of the layers of an artery due to intimal tear,
typically intima from media
• Intimal flap by flutter in the arterial lumen
• May lead to pseudoaneurysm formation
• Results in creation of false vessel lumen
Different types of dissection/intimal flaps - Correct Ans->1. blind end: not a full tear where blood comes
back out
2. secondary: connect to true lumen through tear & blood exits and exits both ends.
causes of dissection/intimal flaps - Correct Ans->• Trauma
• Hypertension
• Following carotid endarterectomy
• May be associated with other diseases(FMD, Marfan syndrome, Ehler-Danlos syndrome)
• Extension into the CCA from an aortic dissection
Sign and symptoms of dissection/intimal flaps - Correct Ans->• Asymptomatic• Unilateral head, face, or
neck pain (usually associated with ICA dissection)
• Hemispheric stroke or TIA symptoms
• Dissection should be suspected in young patients who present with stroke symptoms.
where to place cursor when doing doppler for Tortuous vessels? - Correct Ans->SETTING THE MIDDLE OF
THE ANGLE CORRECT CURSOR PARALLEL TOTHE VESSEL WALL, whether it be straight or tortuous
False Lumen flow patterns when there is a dissection - Correct Ans->- High resistance flow pattern
- Blood flow into and out of the false lumen in a to-and-fro pattern
- No flow as thrombus may form
- Reversed flow direction
Where dissections most commonly occur? - Correct Ans->Most dissections occur in the thoracic aorta
Dissections - who is most commonly affected and what would their symptoms be? - Correct Ans-
>DISSECTION SHOULD BE SUSPECTED WHEN YOUNG PEOPLE BETWEEN 35 & 50 PRESENT WITH STROKE
SYMPTOMS, WITH NO RISK FACTORS FOR ATHEROSCLEROSIS, PARTICULARLY IF THERE IS A HISTORY OF
TRAUMA [Show Less]