Adson Maneuver and ACA Evaluation Quiz
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Questions and Answers

What does the Adson maneuver primarily evaluate?

  • Cervical radiculopathy
  • Carpal tunnel syndrome
  • Rotator cuff injury
  • Thoracic outlet syndrome (correct)

In the context of the Adson maneuver, what might a positive result indicate?

  • Improved range of motion in the arm
  • Increased radial artery pulse
  • Loss of radial artery pulse (correct)
  • Pain in the shoulder region

Which factor could contribute to the loss of the radial artery pulse during the Adson maneuver?

  • Increased hydrostatic pressure (correct)
  • Increased blood flow to the arm
  • Decreased vascular resistance
  • Nerve compression in the wrist

What is a typical physical reaction that may occur during the Adson maneuver?

<p>Localized numbness (A)</p> Signup and view all the answers

Which patient position is commonly used for performing the Adson maneuver?

<p>Seated with the affected arm extended (B)</p> Signup and view all the answers

What is the correct angulation technique for evaluating the ACA with a 65 mm depth using the temporal window?

<p>Anterior angulation with 65 mm depth (C)</p> Signup and view all the answers

When using the temporal window to evaluate the ACA, what depth should the probe be placed for optimal results?

<p>65 mm depth (C)</p> Signup and view all the answers

Which angulation technique is NOT appropriate for evaluating the ACA via the temporal window?

<p>Lateral angulation (D)</p> Signup and view all the answers

What is the relationship between probe placement and depth in evaluating the ACA through the temporal window?

<p>Correct placement and depth ensure accurate evaluation (B)</p> Signup and view all the answers

What would be an inappropriate depth setting while evaluating the ACA?

<p>45 mm depth (B), 70 mm depth (D)</p> Signup and view all the answers

At which angulation should the probe be positioned when using the 65 mm depth technique for ACA evaluation?

<p>Anterior angulation (D)</p> Signup and view all the answers

If the probe is placed at a depth of 50 mm during ACA evaluation, what is likely to happen?

<p>The evaluation may miss crucial data (B)</p> Signup and view all the answers

Which statement best describes the importance of angulation in ACA evaluation?

<p>Proper angulation and depth are equally critical (B)</p> Signup and view all the answers

What is the flow direction of the MCA?

<p>Toward the transducer (C)</p> Signup and view all the answers

Which structure is identified medial and anterior to the MCA?

<p>ACA (B)</p> Signup and view all the answers

Which landmark is used to identify the PCA?

<p>Cerebral peduncles (B)</p> Signup and view all the answers

What is the flow direction of P2?

<p>Away from the transducer (C)</p> Signup and view all the answers

Where is the terminal ICA located in relation to the MCA/ACA level?

<p>Slightly inferior (D)</p> Signup and view all the answers

Which probe placement is recommended for evaluating the MCA?

<p>Cranium in the temporal area, superior to the zygomatic arch (D)</p> Signup and view all the answers

When assessing the P1 segment, how should the probe be angled?

<p>Posteriorly (D)</p> Signup and view all the answers

What anatomical structure serves as a landmark for locating the ICA?

<p>Foramen lacerum (D)</p> Signup and view all the answers

What happens to flow direction in the terminal ICA?

<p>It varies due to the course of the terminal ICA (A)</p> Signup and view all the answers

What position should the patient be in for the examination?

<p>Supine with head supported (D)</p> Signup and view all the answers

What is the primary function of transcutaneous oximetry?

<p>To evaluate oxygen supply and consumption in tissues (D)</p> Signup and view all the answers

Which technique is NOT associated with evaluating wound healing?

<p>Sclerotherapy (D)</p> Signup and view all the answers

What additional capability does transcutaneous oximetry provide beyond assessing oxygen levels?

<p>It can identify sites for amputation (D)</p> Signup and view all the answers

Photoplethysmography is used in conjunction with transcutaneous oximetry to assess which aspect?

<p>Oxygen supply and consumption (D)</p> Signup and view all the answers

Which of the following best describes transcutaneous oximetry?

<p>A technique to measure oxygen levels in skin tissues (A)</p> Signup and view all the answers

What position involves keeping the arm at a 90-degree angle to the body?

<p>Arm at 90-degree angle to body (C)</p> Signup and view all the answers

Which maneuver is specifically designed to assess for Thoracic Outlet Syndrome (TOS)?

<p>Adson's maneuver (B)</p> Signup and view all the answers

In which position is the arm kept resting on the lap to assess TOS?

<p>Resting neutral position (D)</p> Signup and view all the answers

What is the posture used to assess TOS known as?

<p>Exaggerated military posture (A)</p> Signup and view all the answers

Which position requires arm movement and head movement to assess TOS?

<p>Neutral position with head left/head right (C)</p> Signup and view all the answers

Which of the following is NOT a TOS maneuver mentioned?

<p>Pivot point maneuver (C)</p> Signup and view all the answers

For assessing TOS, how is the arm positioned at 180 degrees relative to the body?

<p>Straight above the head (D)</p> Signup and view all the answers

Which TOS maneuver involves the head turning to the left or right?

<p>Neutral position with head left/head right (B)</p> Signup and view all the answers

What should be done next if an abnormal transcutaneous oximetry reading is obtained?

<p>Move the sensor proximally (D)</p> Signup and view all the answers

What does TCPO2 assess in patients?

<p>Tissue viability (C)</p> Signup and view all the answers

In the context of transcutaneous oximetry, a normal reading indicates what?

<p>Normal healing capabilities in the tissue (C)</p> Signup and view all the answers

Why would the sensor be moved proximally in the event of an abnormal reading?

<p>To find an area with normal healing capabilities (D)</p> Signup and view all the answers

If continued abnormal readings are obtained during TCPO2, what should be recorded?

<p>The location of the abnormal reading (C)</p> Signup and view all the answers

What may indicate that an amputation is required in a particular area?

<p>Abnormal readings indicating poor tissue viability (A)</p> Signup and view all the answers

Which of the following actions is NOT appropriate if abnormal readings continue during TCPO2?

<p>End the exam without recording further information (B)</p> Signup and view all the answers

The process of performing TCPO2 primarily relates to what medical decision?

<p>Determining the necessary level of amputation (A)</p> Signup and view all the answers

Which factor is least likely to represent an abnormal transcutaneous oximetry reading?

<p>Normal oxygen levels in untested areas (B)</p> Signup and view all the answers

What does turning up the oxygen level initially indicate regarding TCPO2 readings?

<p>It is a corrective measure for abnormal readings (D)</p> Signup and view all the answers

What is the primary goal of assessing tissue viability through TCPO2?

<p>To prepare for possible surgical interventions (C)</p> Signup and view all the answers

In a situation where the sensor must be moved, what is most important to monitor?

<p>Changes in oxygen levels with each location (C)</p> Signup and view all the answers

Which part of the patient’s anatomy does TCPO2 focus on assessing?

<p>Extremities that may require amputation (A)</p> Signup and view all the answers

If proximate readings are obtained, what should be done regarding TCPO2 protocol?

<p>Keep moving proximally until a normal reading is obtained (D)</p> Signup and view all the answers

What is the main importance of recording the location of abnormal readings?

<p>To enhance documentation and potential follow-up (B)</p> Signup and view all the answers

What is the most accurate Doppler predictor of ICA stenosis?

<p>End diastolic velocity (D)</p> Signup and view all the answers

Which Doppler measure is NOT typically regarded as a primary predictor of ICA stenosis?

<p>The diastolic ratio (D)</p> Signup and view all the answers

Which alternative parameter could be misleading when assessing ICA stenosis?

<p>Peak diastolic velocity to systolic velocity ratio (C)</p> Signup and view all the answers

Which method is used to assess ICA stenosis but may not provide as accurate predictions as end diastolic velocity?

<p>The systolic ratio (ICAs/CCAs) (C)</p> Signup and view all the answers

In evaluating ICA stenosis, what aspect should NOT be emphasized over the end diastolic velocity?

<p>The abnormal peak systolic velocity (D)</p> Signup and view all the answers

What is the average depth setting for the Basilar artery when evaluating with a transducer?

<p>8 - 120 mm (D)</p> Signup and view all the answers

What is the direction of flow for the PCA segment PI?

<p>Away from the transducer (B)</p> Signup and view all the answers

At what angulation should the probe be set to evaluate the Basilar artery based on the given information?

<p>Midline (C)</p> Signup and view all the answers

What is the time averaged maximum velocity for the Basilar artery when assessed at the indicated depth?

<p>34 cms ± 10 cm/s (D)</p> Signup and view all the answers

Which of the following arrow direction indicators is correct for the flow in segment P2 of the PCA?

<p>Toward the transducer (B)</p> Signup and view all the answers

Considering the evaluation of the Vertebral artery, what is the average depth setting recommended?

<p>60 - 90 mm (D)</p> Signup and view all the answers

What is the typical angulation required for evaluating the Vertebral artery?

<p>Lateral (B)</p> Signup and view all the answers

What adjustment might be necessary if abnormal readings are detected during Transcranial Doppler ultrasound of the Basilar artery?

<p>Change the angulation of the probe (D)</p> Signup and view all the answers

What is the primary position used in the resting neutral position when assessing TOS?

<p>Arm resting on the lap (C)</p> Signup and view all the answers

Which position involves the arm being extended at a 90-degree angle to the body?

<p>Arm at 90-degree angle to body (B)</p> Signup and view all the answers

Which maneuver is specifically associated with testing for Thoracic Outlet Syndrome (TOS)?

<p>Adson's maneuver (B)</p> Signup and view all the answers

How is the arm positioned during the exaggerated military posture maneuver to assess TOS?

<p>Arms positioned back at 180 degrees (A)</p> Signup and view all the answers

What is the aim of maneuvering the head left or right during a TOS assessment?

<p>To assess for vascular obstruction (C)</p> Signup and view all the answers

What is the starting point for marking the lower extremity veins?

<p>The groin at the saphenofemoral junction (A)</p> Signup and view all the answers

In the context of assessing TOS, which of the following positions would NOT be suitable?

<p>Arm lowered below the body (A)</p> Signup and view all the answers

Which veins must be marked for an in situ graft or AV fistula in the lower extremity?

<p>All cutaneous tributaries and perforating veins (B)</p> Signup and view all the answers

At what dimension does the diagnosis of AAA become significant?

<p>3.0 cm (D)</p> Signup and view all the answers

What does the 180-degree arm position during a TOS assessment signify?

<p>Fully extended arm positioning (D)</p> Signup and view all the answers

Which TOS maneuver would involve the head movement to assess symptoms related to cervical compression?

<p>Head left/right maneuver (A)</p> Signup and view all the answers

What is the first step in evaluating the upper extremity for veins?

<p>Begin at the axilla or shoulder (A)</p> Signup and view all the answers

What should be done with perforating veins during venous marking for an AV fistula?

<p>They must be marked if the vein will be used (B)</p> Signup and view all the answers

What is the correct marking technique for the basilic or cephalic vein?

<p>Follow the same marking techniques and documentation as for the GSV (B)</p> Signup and view all the answers

How does astenial flow move in relation to an AV fistula graft?

<p>From the graft through the perforator into the deep venous system (A)</p> Signup and view all the answers

What is indicated if the aorta's AP width dimension measures 2.5 cm?

<p>Normal condition with no concerns (B)</p> Signup and view all the answers

Why is it important to mark all tributaries during the marking process?

<p>They can cause complications if left unmarked (B)</p> Signup and view all the answers

What is indicated by the term 'end diastolic velocity'?

<p>Velocity of blood flow at the end of the diastolic phase (A)</p> Signup and view all the answers

Which option describes the primary use of sclerotherapy?

<p>To manage superficial varicosities (C)</p> Signup and view all the answers

What does the diastolic ratio (ICAd/CCAd) indicate?

<p>Assessment of the hemodynamic significance of stenosis (C)</p> Signup and view all the answers

Which of the following is NOT a focus of Doppler evaluations regarding ICA stenosis?

<p>Mean arterial pressure assessment (C)</p> Signup and view all the answers

In the context of vascular studies, what does the peak systolic velocity represent?

<p>The fastest blood flow observed during systole (D)</p> Signup and view all the answers

What is a key factor in evaluating ICA stenosis using Doppler techniques?

<p>The velocity patterns of blood flow (C)</p> Signup and view all the answers

Which complication is most likely associated with sclerotherapy?

<p>Development of deep vein thrombosis (B)</p> Signup and view all the answers

How is end diastolic velocity relevant in the assessment of ICA stenosis?

<p>It provides insights into the flow resistance caused by stenosis. (A)</p> Signup and view all the answers

What feature best describes the anatomical landmark for abdominal structures in ultrasound imaging?

<p>Anechoic, hollow tube located anterior to the spine (D)</p> Signup and view all the answers

What type of view can a transverse ultrasound provide?

<p>Images of both great vessels but not a longitudinal view (D)</p> Signup and view all the answers

What characteristic is indicated by the term 'longitudinal' in ultrasound imaging of the aorta?

<p>An anechoic representation of the aorta (B)</p> Signup and view all the answers

Which statement is true regarding the imaging of great vessels in ultrasound?

<p>Transverse views can show both vessels but lack longitudinal perspective (D)</p> Signup and view all the answers

What important information is provided by the transverse view in ultrasound imaging?

<p>It demonstrates both great vessels in a single image (A)</p> Signup and view all the answers

In ultrasound imaging, what is usually depicted as an anechoic structure?

<p>Blood vessels and the aorta (A)</p> Signup and view all the answers

Why is the transverse view considered limited in some respects?

<p>It provides only partial data regarding vessel dimensions (D)</p> Signup and view all the answers

What imaging perspective captures a vessel's diameter more effectively?

<p>A longitudinal view showing the length and diameter (A)</p> Signup and view all the answers

What essential detail is generally sacrificed when using a transverse view for showing vessels?

<p>Detailed flow dynamics within the vessel (A)</p> Signup and view all the answers

What aspect of ultrasound imaging is primarily limited when focusing on both great vessels in transverse view?

<p>Longitudinal visualization of anatomical structures (C)</p> Signup and view all the answers

What is the patient position recommended for using the transtemporal window during evaluation?

<p>Supine with head supported (A)</p> Signup and view all the answers

Which structure serves as a landmark for the middle cerebral artery (MCA) during evaluation?

<p>Sphenoid bone (B)</p> Signup and view all the answers

What is the specific angle of probe placement suggested for optimal flow visualization of the MCA?

<p>Slight anterior angulation (C)</p> Signup and view all the answers

At what depth should the probe be placed to evaluate the anterior cerebral artery (ACA)?

<p>65 mm (D)</p> Signup and view all the answers

Which arteries can be evaluated if stenosis and collateral flow are present?

<p>Communicating arteries (C)</p> Signup and view all the answers

What does midline probe placement with slight anterior angulation demonstrate?

<p>Flow of middle cerebral artery (D)</p> Signup and view all the answers

What is crucial for probe placement in the temporal area during evaluation?

<p>Notch should be towards the patient's nose (B)</p> Signup and view all the answers

What is the purpose of using a 65 mm depth setting for angulation during evaluation?

<p>To visualize deeper brain structures (A)</p> Signup and view all the answers

How should the probe be angled to assess the P1 segment?

<p>Inferior to the MCA (A)</p> Signup and view all the answers

Where is the terminal ICA identified in relation to the MCA/ACA level?

<p>Slightly inferior (B)</p> Signup and view all the answers

When assessing the PCA, which segment demonstrates flow away from the transducer?

<p>P2 (A)</p> Signup and view all the answers

In which position should the patient be for the examination using the temporal window?

<p>Supine (A)</p> Signup and view all the answers

What adjustment should be made when assessing the MCA flow direction?

<p>Angle anterior and adjust depth (B)</p> Signup and view all the answers

What factors can be evaluated in relation to collateral flow during the assessment?

<p>Stenosis and collateral flow (C)</p> Signup and view all the answers

What color is used to represent flow moving toward the Doppler probe?

<p>Red (D)</p> Signup and view all the answers

Which Doppler sample size is recommended for optimal evaluation?

<p>5-10 mm (C)</p> Signup and view all the answers

In color Doppler imaging, what does a blue appearance signify?

<p>Flow away from the probe (C)</p> Signup and view all the answers

What is the purpose of adjusting frame rates in Doppler visualization?

<p>To improve 2D and color Doppler visualization (A)</p> Signup and view all the answers

Which imaging plane is appropriate for producing a longitudinal image of the IVC and aorta?

<p>Coronal (A)</p> Signup and view all the answers

When positioning a patient in a decubitus position, what is the aim regarding image capture?

<p>To capture both IVC and aorta in the same image (B)</p> Signup and view all the answers

What technique is essential for detecting collateral flow in vascular imaging?

<p>Evaluating flow direction and velocity (D)</p> Signup and view all the answers

Which of the following best describes how the Doppler sample is utilized?

<p>It analyzes flow dynamics in blood vessels. (C)</p> Signup and view all the answers

What type of imaging view does a coronal plane provide?

<p>Longitudinal view from anterior to posterior (D)</p> Signup and view all the answers

In which plane is the abdomen evaluated to show the aorta?

<p>Transverse plane (C)</p> Signup and view all the answers

What plane is best for assessing an organ's lateral aspect?

<p>Coronal plane (B)</p> Signup and view all the answers

Which anatomical structure is most likely demonstrated in a mid-sagittal view?

<p>Spine (B)</p> Signup and view all the answers

What is the primary function of imaging in the coronal plane?

<p>Evaluating lateral and medial structures (C)</p> Signup and view all the answers

Which plane is particularly useful for viewing cross-sections of the abdomen?

<p>Transverse plane (C)</p> Signup and view all the answers

When imaging in the mid-sagittal plane, what can be primarily visualized?

<p>Both halves of the body evenly (C)</p> Signup and view all the answers

Which anatomical view would best demonstrate the aorta on the lateral aspect?

<p>Coronal view (B)</p> Signup and view all the answers

Which imaging viewpoint allows for visualization of the aorta in a normal patient?

<p>Coronal and transverse (A)</p> Signup and view all the answers

What color in a Color Doppler study indicates blood flow toward the probe?

<p>Red (D)</p> Signup and view all the answers

What type of blood does the inferior vena cava carry?

<p>Deoxygenated blood (B)</p> Signup and view all the answers

What is the significance of the Doppler velocity range indicated between -38.5 cm/s to +365 cm/s?

<p>It indicates normal flow velocities. (D)</p> Signup and view all the answers

What does the aorta primarily serve as in the circulatory system?

<p>Main artery carrying oxygenated blood (A)</p> Signup and view all the answers

Which imaging modality would best show both coronal and transverse views simultaneously?

<p>Ultrasound (C)</p> Signup and view all the answers

Which of the following statements about the Color Doppler technique is true?

<p>It shows both direction and velocity of blood flow. (A)</p> Signup and view all the answers

What role does the aorta play in the systemic circulation?

<p>Delivering oxygenated blood to the body (C)</p> Signup and view all the answers

What is the primary purpose of performing TCPO2?

<p>To assess tissue viability for amputation decisions (A)</p> Signup and view all the answers

What should you do if you obtain an abnormal transcutaneous oximetry reading?

<p>Move the sensor proximally until a normal reading is obtained (B)</p> Signup and view all the answers

Which action is NOT appropriate if abnormal TCPO2 readings persist?

<p>Terminate the examination without documentation (A)</p> Signup and view all the answers

What might a patient require if the transcutaneous oximetry reading is persistently abnormal?

<p>Assessment for possible amputation (B)</p> Signup and view all the answers

If the sensor is moved and still shows abnormal readings, what is the next step?

<p>Continue moving the sensor proximally until a normal reading is obtained (A)</p> Signup and view all the answers

Which of the following represents a potential consequence if TCPO2 is performed incorrectly?

<p>Incorrect assessment of tissue viability (A), Unreliable results for amputation decisions (C)</p> Signup and view all the answers

What does movement of the sensor distally imply in TCPO2?

<p>Attempting to find an area with normal healing (B)</p> Signup and view all the answers

What would signify a need to move the sensor during a TCPO2 procedure?

<p>Abnormal oximetry reading obtained (D)</p> Signup and view all the answers

What might indicate that a tissue area could require an amputation based on TCPO2 results?

<p>Abnormal readings in that area (D)</p> Signup and view all the answers

If a TCPO2 reading shows a normal level, what does it generally indicate?

<p>The tissue has adequate healing capabilities (A)</p> Signup and view all the answers

What could be a sign of an inadequate blood supply as determined through TCPO2?

<p>Low transcutaneous oxygen readings (A)</p> Signup and view all the answers

What is the rationale behind moving the sensor proximally during TCPO2?

<p>To find an area with better oxygen supply (D)</p> Signup and view all the answers

What key information should be documented if abnormal readings are encountered in TCPO2?

<p>Location of the sensor and the readings obtained (A)</p> Signup and view all the answers

What does TCPO2 assess specifically regarding the tissues?

<p>Oxygen supply and healing capability (D)</p> Signup and view all the answers

Which vessel is interrogated with flow moving toward the transducer?

<p>Basilar (C)</p> Signup and view all the answers

What is the flow direction of the carotid siphon?

<p>Variable with the portion of the siphon (B)</p> Signup and view all the answers

Which vessel is assessed with flow moving away from the transducer?

<p>Basilar artery (A)</p> Signup and view all the answers

Which statement about the vertebral flow direction is accurate?

<p>Fluctuates based on patient position (C)</p> Signup and view all the answers

Considering the flow characteristics, which of the following vessels has a consistent flow towards the brain?

<p>Internal carotid artery (B)</p> Signup and view all the answers

Which predictor is considered the most accurate for assessing ICA stenosis?

<p>End diastolic velocity (C)</p> Signup and view all the answers

What role does the end diastolic velocity play in Doppler ultrasound assessments?

<p>It predicts severity of stenosis (B)</p> Signup and view all the answers

Which statement best describes the relationship between Doppler measurements and ICA stenosis?

<p>Both end diastolic velocity and systolic ratio are important measures (A)</p> Signup and view all the answers

Why is the end diastolic velocity a preferred measure in vascular assessments?

<p>It provides information on blood flow patterns (B)</p> Signup and view all the answers

What might be a limitation of relying solely on the systolic ratio in Doppler assessments of ICA?

<p>It does not account for diastolic flow (D)</p> Signup and view all the answers

What is the typical location of the inferior vena cava in relation to the spine?

<p>Anterior to the spine (D)</p> Signup and view all the answers

In a cross-section view, where is the aorta typically located in relation to the inferior vena cava?

<p>Left and anterior (D)</p> Signup and view all the answers

What is the preferred diameter of the vein when evaluating the GSV for use as a bypass graft?

<blockquote> <p>10 mm (D)</p> </blockquote> Signup and view all the answers

Which of the following statements about the aorta is true during imaging?

<p>It is located left and slightly anterior to the inferior vena cava. (C)</p> Signup and view all the answers

When evaluating a graft, which size of the vein is generally considered insufficient?

<p>&lt;3 mm (A)</p> Signup and view all the answers

What characteristic differentiates the inferior vena cava from the aorta when viewed in cross-section?

<p>IVC has a round shape and is anterior to the spine. (C)</p> Signup and view all the answers

Why is it important to evaluate the GSV diameter when considering it for a bypass graft?

<p>To confirm it meets the minimum size requirement. (B)</p> Signup and view all the answers

If the diameter of the GSV is found to be 8 mm, what conclusion can be drawn regarding its suitability for a bypass graft?

<p>It is too small and not suitable. (D)</p> Signup and view all the answers

What aspect of the body is primarily observed in a coronal view during medical imaging?

<p>Aorta's spatial structure (A)</p> Signup and view all the answers

In imaging techniques, what does the mid-saggital plane specifically refer to?

<p>A vertical section that divides the body into left and right halves (A)</p> Signup and view all the answers

What type of view is demonstrated when examining the abdomen on the lateral aspect?

<p>Transverse view (D)</p> Signup and view all the answers

Which imaging technique best illustrates the alignment of the aorta from a lateral perspective?

<p>Coronal imaging (D)</p> Signup and view all the answers

When taking a longitudinal view, which anatomical feature is primarily highlighted?

<p>The descending aorta (A)</p> Signup and view all the answers

Which plane is crucial for obtaining a clear coronal view during imaging?

<p>Frontal plane (D)</p> Signup and view all the answers

What structure is primarily assessed when applying a transverse view in abdominal imaging?

<p>The aorta (C)</p> Signup and view all the answers

Which term is synonymous with the lateral aspect in imaging contexts?

<p>Transverse aspect (D)</p> Signup and view all the answers

What should the temperature of the exam room be set to in order to limit vasoconstriction?

<p>Warm to limit vasoconstriction (D)</p> Signup and view all the answers

Which tool should be used to cover the transducer during the examination?

<p>A nonsterile probe cover (A)</p> Signup and view all the answers

How should the transducer be positioned against the skin for optimal imaging?

<p>Perpendicular with light pressure (D)</p> Signup and view all the answers

What type of ink should be used for marking the skin during the procedure?

<p>Permanent marker or carbot fuchsin (B)</p> Signup and view all the answers

Where should the marking for vein diameter be recorded?

<p>On the patient's body at the measurement site (B)</p> Signup and view all the answers

What should be the starting point for examining lower extremity veins?

<p>At the saphenofemoral junction in the groin (A)</p> Signup and view all the answers

What is the recommended distance to move the transducer while marking veins?

<p>Every 2-3 cm for adequate spacing (A)</p> Signup and view all the answers

Which appearance should veins have in transverse view during an examination?

<p>Circular and filling the screen from right to left (C)</p> Signup and view all the answers

What is the minimum vein diameter preferred for grafting according to the given information?

<blockquote> <p>3 mm (A)</p> </blockquote> Signup and view all the answers

Which vein is NOT commonly mapped for harvesting?

<p>Radial veins (C)</p> Signup and view all the answers

What characteristic of a vein indicates its suitability for use as a graft?

<p>Flexible walls for expansion (A)</p> Signup and view all the answers

What should patients avoid using before a procedure involving vein mapping?

<p>Body lotions (B)</p> Signup and view all the answers

In what position should the leg be placed for the harvesting of the GSV?

<p>Reverse Trendelenburg (D)</p> Signup and view all the answers

Which condition would disqualify a vein for use in grafting?

<p>Chronic occlusion (B)</p> Signup and view all the answers

What is a recommended positioning for arms during the vein mapping process?

<p>Arms extended at the side, lower than the heart (D)</p> Signup and view all the answers

Which of the following is a common requirement for vein mapping?

<p>Tourniquet application for small veins (D)</p> Signup and view all the answers

Flashcards

ACA through Temporal Window Angulation

The correct positioning of the ultrasound probe to visualize the Anterior Cerebral Artery (ACA) through the temporal bone window.

Depth for ACA Visualization

The optimal depth setting for visualizing the ACA through the temporal window.

Probe Angulation for ACA

The direction the ultrasound probe should be angled to properly visualize the ACA through the temporal window.

Midline Placement

The ultrasound probe is placed in the middle of the temporal window, aiming slightly towards the front of the head. This is also known as the mid-line placement.

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Depth Setting for ACA Visualization

The depth setting used when visualizing the ACA through the temporal window.

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Probe Placement

The position of the ultrasound probe relative to the patient's anatomy, specifically in this case, the temporal window.

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ACA Visualization Technique

The technique used to visualize the Anterior Cerebral Artery (ACA) through the temporal window.

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Temporal Window Technique

A common method used to view the ACA through the temporal window.

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What is the MCA?

The middle cerebral artery (MCA) is a major artery that supplies blood to the lateral surface of the brain, including the temporal and parietal lobes. It is one of the three major branches of the internal carotid artery.

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What is the ACA?

The anterior cerebral artery (ACA) is an artery that supplies blood to the medial surface of the brain, including the frontal and parietal lobes. It is one of the three major branches of the internal carotid artery. Normally, it travels superior and anterior to the MCA.

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What is the flow direction in the ACA?

The flow direction in the ACA is away from the transducer.

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What is the PCA?

The posterior cerebral artery (PCA) is an artery that supplies blood to the posterior part of the brain, including the occipital lobe. It is one of the three major branches of the basilar artery.

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What are the flow directions of the P1 and P2 segments of the PCA?

The P1 segment of the PCA demonstrates flow toward the transducer, while the P2 segment demonstrates flow away from the transducer.

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What is the ICA?

The internal carotid artery (ICA) is an artery that supplies blood to the brain. One of the two main arteries that supply the head and neck.

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Where is the terminal ICA located and what's special about its flow direction?

The terminal ICA is located inferior to the MCA/ACA level. Flow direction in the terminal ICA can vary due to its varied course.

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Which bone serves as a landmark for identifying the MCA during transtemporal ultrasound?

The sphenoid bone is a landmark used to identify the MCA during a transtemporal window ultrasound.

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Which landmark is used to identify the terminal ICA during transtemporal ultrasound?

The foramen lacerum is a landmark used to identify the terminal ICA during transtemporal window ultrasound.

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What are the cerebral peduncles used for during transtemporal ultrasound?

The cerebral peduncles are a pair of structures in the brainstem used as landmarks for identifying the PCA during transtemporal window ultrasound.

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Adson's Maneuver

The Adson's maneuver is a medical test used to evaluate the presence of thoracic outlet syndrome, a condition that affects the nerves and blood vessels in the space between the collarbone and the first rib.

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How is the Adson's Maneuver done?

This test involves the patient rotating their head towards the affected side and extending their arm while taking their pulse.

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What does a Positive Adson's Maneuver mean?

The Adson's maneuver, if positive, can result in the loss of the radial artery pulse due to compression or pressure on the nerves and blood vessels in the thoracic outlet.

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Thoracic Outlet Syndrome

Thoracic outlet syndrome is a condition that occurs when the nerves or blood vessels in the space between the collarbone and the first rib are compressed.

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Why is the Adson's Maneuver important?

The Adson's maneuver is used to detect this condition and help determine if the patient is suffering from it.

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Transcutaneous Oximetry

A non-invasive technique that measures oxygen levels in tissue surrounding a wound, helping to assess the wound's healing potential and identify suitable sites for amputation.

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Photoplethysmography (PPG) in TCO

A technique used in transcutaneous oximetry that measures changes in blood volume in the tissue under the skin's surface, providing information about oxygen flow and tissue health.

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TCO for Wound Healing

One of the applications of transcutaneous oximetry is to assess wound healing by measuring the oxygen levels in the tissue surrounding the wound.

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TCO for Amputation Assessment

Another application of transcutaneous oximetry is to evaluate the suitability of a limb for amputation, by measuring the tissue oxygen levels below the potential amputation site.

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What is Transcutaneous Oximetry (TCO)?

Transcutaneous Oximetry measures oxygen supply and consumption in tissues using a probe placed on the skin's surface. It is a valuable tool for assessing wound healing potential and amputation suitability.

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What is Thoracic Outlet Syndrome (TOS)?

A condition where blood vessels or nerves in the space between the collarbone and the first rib are compressed, leading to arm pain, numbness, and weakness.

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What is Adson's Maneuver?

A common maneuver used to assess for Thoracic Outlet Syndrome. It's performed by having the patient turn their head towards the affected side and extend their arm while taking a deep breath.

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What is the Exaggerated Military Posture Maneuver?

A maneuver to assess for TOS involving a position similar to a military stance with the shoulders pulled back and down, further compressing the space where blood vessels and nerves run.

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What is the 90-degree Arm Position Maneuver?

A maneuver used to assess for TOS where the patient's arm is held at a 90-degree angle to their body.

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What is the 180-degree Arm Position Maneuver?

This maneuver assesses for TOS by extending the patient's arm out straight, creating compression in the space where blood vessels and nerves run.

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What is the Neutral Head Rotation Maneuver?

A maneuver that assesses for TOS by asking the patient to rotate their head to the left and right while holding a neutral arm position.

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What is the Resting Neutral Position Maneuver?

A maneuver to assess for TOS where the patient's arm is resting on their lap with their body in a neutral position.

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How might TOS affect the radial artery pulse?

In TOS, the pulse in the radial artery may be diminished or absent due to compression of the artery.

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Transcutaneous Oximetry (TCPO2)

A device used to measure the oxygen levels in the tissues.

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Transcutaneous Oximetry Procedure

The process of assessing the oxygen levels in the tissues.

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TCPO2 Reading

The reading obtained from a TCPO2 device.

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Abnormal TCPO2 Reading

A reading that is outside of the normal range.

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Moving the Sensor Proximally

Moving the TCPO2 sensor towards the heart, closer to the body's core.

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Moving the Sensor Distally

Moving the TCPO2 sensor away from the heart, towards the extremities.

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Necessary Level of Amputation

The level at which a limb needs to be amputated to ensure proper healing.

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Area of Tissue with Normal Healing Capabilities

An area of tissue able to heal properly.

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Purpose of TCPO2 Procedure

The process of assessing the viability of tissues and determining amputation levels.

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Ending the Exam in TCPO2

The decision to stop the TCPO2 procedure and relocate the sensor.

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Relocating the Sensor Proximally

The process of repositioning the TCPO2 sensor to obtain a normal reading.

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Oxygen Level Entering the Patient's Mask

The level of oxygen supplied to the patient through a mask or other devices.

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Obtaining a Normal TCPO2 Reading

Obtaining a normal TCPO2 reading in a specific location.

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Recording the Location

Recording the location of a TCPO2 reading.

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Interpreting Abnormal TCPO2 Readings

The correct way to interpret an abnormal TCPO2 reading.

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Transverse View

A type of ultrasound view that shows structures like the aorta and IVC side-by-side in a cross-sectional plane.

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Longitudinal View

A type of ultrasound view that shows structures like the aorta and IVC along their length.

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Aorta

An anechoic, hollow tube that appears anterior to the spine on an ultrasound image. It's considered a good landmark for identifying abdominal structures.

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IVC

A large vein that carries deoxygenated blood from the lower body back to the heart.

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Transtemporal Ultrasound

An ultrasound technique used to visualize the structures in the brain through the temporal bone.

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Middle Cerebral Artery (MCA)

A major artery that supplies blood to the lateral surface of the brain, including the temporal and parietal lobes.

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Anterior Cerebral Artery (ACA)

A major artery that supplies blood to the medial surface of the brain, including the frontal and parietal lobes.

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Posterior Cerebral Artery (PCA)

A major artery that supplies blood to the posterior part of the brain, including the occipital lobe.

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Internal Carotid Artery (ICA)

The main artery that supplies blood to the brain, located in the neck.

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Terminal ICA

The part of the ICA that is located inferior to the MCA/ACA level. Its flow direction can vary due to its varied course.

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Basilar Artery

The Basilar Artery is a major artery in the brain formed by the merger of the two vertebral arteries. It runs along the brainstem and supplies blood to the back of the brain.

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Flow Direction in PCA Segments

The P1 segment of the PCA demonstrates flow towards the transducer, while the P2 segment demonstrates flow away from the transducer.

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Probe Angulation for Vertebral Artery

The probe is angled laterally (sideways) relative to the patient's body when visualizing the vertebral artery.

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Midline Placement for Basilar Artery

The ultrasound probe is placed in the middle of the patient's neck, aiming slightly towards the front of the head. This is the midline placement.

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Average Depth Setting - Basilar Artery

The Average Depth Setting for visualizing the Basilar Artery is between 8 - 120 mm.

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Flow Direction - Vertebral Artery

The direction of blood flow in the Vertebral Artery is away from the transducer.

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Flow Direction - Basilar Artery

The direction of blood flow in the Basilar Artery is away from the transducer.

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Thoracic Outlet Syndrome (TOS)

A condition where the nerves or blood vessels in the space between the collarbone and the first rib are compressed, leading to arm pain, numbness, and weakness.

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EDV for ICA Stenosis

The end diastolic velocity (EDV) of the internal carotid artery (ICA) is the most accurate predictor of ICA stenosis.

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Systolic Ratio (ICAs/CCAs)

The systolic ratio (ICAs/CCAs) is a measurement used to assess the degree of stenosis in the internal carotid artery (ICA), comparing the velocity of the ICA to the common carotid artery (CCA).

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What is Thoracic Outlet Syndrome?

Thoracic Outlet Syndrome (TOS) is a condition that occurs when the nerves or blood vessels in the space between the collarbone and the first rib are compressed. This compression can cause arm pain, numbness, weakness, and tingling.

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What is the Adson's Maneuver?

The Adson's maneuver is a medical test used to evaluate the presence of TOS by assessing the radial artery pulse. The test involves the patient rotating their head towards the affected side and extending their arm while taking their pulse. A positive Adson's maneuver indicates a decrease or absence of the radial artery pulse, suggesting compression of the artery.

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What happens to the radial artery pulse in a positive TOS test?

A positive TOS test results in the loss or reduction of the radial artery pulse, which is a key indicator of compression in the thoracic outlet, indicating the potential for TOS.

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What is the end diastolic velocity (EDV)?

The end diastolic velocity (EDV) is the speed of blood flow in an artery at the end of the diastolic phase of the cardiac cycle.

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What is the diastolic ratio?

The diastolic ratio is the ratio of the end diastolic velocity (EDV) in the internal carotid artery (ICA) to the EDV in the common carotid artery (CCA).

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What is sclerotherapy?

Sclerotherapy involves injecting saline into superficial varicosities to treat incompetent deep veins.

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What is Peak Systolic Velocity (PSV)?

The peak systolic velocity (PSV) is the highest speed of blood flow in an artery during the systolic phase of the cardiac cycle.

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What did the Doppler Predictor of ICA Stenosis study find?

The Doppler Predictor of ICA Stenosis study found that the diastolic ratio (ICAd/CCAd) is the most accurate predictor of internal carotid artery (ICA) stenosis.

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Longitudinal IVC and Aorta Image

A longitudinal ultrasound image of the Inferior Vena Cava (IVC) and the Aorta can be obtained by placing the patient in the decubitus position and angling the probe accordingly.

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Collateral Flow Assessment Vessels

The vertebral and single basilar vessels are used to assess collateral blood flow in the brain by evaluating the direction and velocity of blood flow in the orbital/ophthalmic and basilar arteries.

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Doppler Sample Size for Collateral Flow

The Doppler sample size typically used for assessing collateral flow in the brain is between 5-10 mm.

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Color Doppler Flow Direction

A color Doppler setting that displays blood flow towards the probe as red and flow away from the probe as blue.

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Midline Placement for ACA Visualization

The ultrasound probe is placed in the middle of the temporal window, aiming slightly towards the front of the head. This is also known as the mid-line placement.

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MCA Flow Direction (Transtemporal Window)

The Middle Cerebral Artery (MCA) is visualized through the temporal window with the probe angled slightly anterior. The flow in the MCA travels towards the transducer.

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ACA Flow Direction (Transtemporal Window)

The Anterior Cerebral Artery (ACA) is located medial and anterior to the MCA. The flow in the ACA travels away from the transducer.

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PCA Flow Direction (Transtemporal Window)

The Posterior Cerebral Artery (PCA) is assessed by angling the probe posterior from the MCA. Its flow direction varies depending on the segment: P1 segment flows towards the transducer, while P2 segment flows away.

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Inferior Vena Cava (IVC)

A large vessel that carries deoxygenated blood from the lower body back to the heart. It is located on the right side of the abdomen, posterior to the aorta.

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ICA Flow Direction (Transtemporal Window)

The Internal Carotid Artery (ICA) is located inferior to the MCA origin. The flow direction in the terminal ICA can vary due to its varied course.

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MCA Landmark (Transtemporal Window)

The sphenoid bone acts as a landmark to identify the MCA during transtemporal ultrasound.

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ICA Landmark (Transtemporal Window)

The foramen lacerum serves as a landmark for identifying the terminal ICA during transtemporal ultrasound.

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PCA Landmark (Transtemporal Window)

The cerebral peduncles are used as landmarks to find the PCA during transtemporal ultrasound.

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Midline Probe Placement (Transtemporal Window)

The probe is placed in the middle of the temporal window, angled slightly anterior. This is the midline placement.

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Transtemporal Ultrasound Technique

Transtemporal ultrasound is a technique to visualize the brain's structures through the temporal bone, with the probe placed above the zygomatic arch and angled towards the nose.

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Collateral Flow Assessment (Transtemporal Window)

Communicating arteries, such as the Circle of Willis, can be visualized if stenosis or collateral flow is present, helping assess the brain's blood supply.

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What is an abnormal TCPO2 reading?

A reading that is outside of the normal range obtained during Transcutaneous Oximetry (TCO).

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What should you do if an abnormal TCPO2 reading is obtained?

An abnormal TCPO2 reading usually indicates insufficient oxygen supply to the tissues. It's important to address this by moving the TCPO2 sensor proximally.

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What does 'moving the sensor proximally' mean in TCPO2?

Moving the TCPO2 sensor towards the heart, closer to the body's core.

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What is 'an area of tissue with normal healing capabilities' during a TCPO2 procedure?

An area of tissue that is able to heal properly, indicating a suitable location for potential amputation.

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What is the 'necessary level of amputation' in TCPO2?

The level at which a limb needs to be amputated to ensure proper healing and function.

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What does 'relocating the sensor proximally' mean in TCPO2?

The process of repositioning the TCPO2 sensor to a different location to obtain a normal reading.

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When do you 'end the exam' in a TCPO2 procedure?

The decision to stop the TCPO2 procedure and move the sensor to a different location to obtain a normal reading.

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Why is 'recording the location' important in TCPO2?

The specific location where a TCPO2 reading is taken.

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What is 'the oxygen level entering the patient's mask' in TCPO2?

The level of oxygen supplied to the patient through a mask or other devices.

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What is Collateral Flow Assessment in Transcranial Doppler?

A technique used to assess the circulation and flow direction of blood in the brain.

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What is the Doppler sample size used for Collateral Flow Assessment?

The size of the Doppler sample volume used during collateral flow assessment. It typically ranges from 5 to 10 mm.

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What is color flow direction used for during Doppler imaging?

A color Doppler setting that displays blood flow towards the probe as red and flow away from the probe as blue. It helps visualize the direction of blood flow.

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What is Midline Placement for Basilar Artery Ultrasound?

The ultrasound probe is placed in the middle of the patient's neck, aiming slightly towards the front of the head.

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Thoracic Outlet

The space between the collarbone and the first rib where blood vessels and nerves can be compressed causing symptoms like arm pain, numbness, and weakness.

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Loss or Reduction of the Radial Artery Pulse

A key indicator of compression in the thoracic outlet, suggesting the potential for TOS.

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End Diastolic Velocity (EDV)

The speed of blood flow in an artery at the end of the diastolic phase of the cardiac cycle.

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Diastolic Ratio

The ratio of the end diastolic velocity (EDV) in the internal carotid artery (ICA) to the EDV in the common carotid artery (CCA).

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Sclerotherapy

Involves injecting saline into superficial varicosities to treat incompetent deep veins.

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What is the flow direction of the basilar artery?

The blood flow direction in the basilar artery is away from the transducer, which is the ultrasound probe you're using. This means the blood is flowing away from the probe, similar to how the blood flows away from your heart when it's traveling to the rest of your body.

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How is the probe angled when visualizing the vertebral artery?

The vertebral artery is angled laterally, meaning the ultrasound probe is tilted sideways relative to the patient's body, to get a good view of the artery.

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What is the flow direction of the vertebral artery?

The vertebral artery is located in the neck and its flow direction is away from the transducer, meaning the blood is flowing away from the ultrasound probe you are using.

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What is the flow direction of the anterior cerebral artery (ACA) in a transtemporal view?

The flow in the anterior cerebral artery (ACA) is away from the transducer, which means the blood is traveling away from the probe you're using. Remember, it's located medial and anterior to the middle cerebral artery (MCA).

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What is the flow direction of the middle cerebral artery (MCA) in a transtemporal view?

The flow in the middle cerebral artery (MCA) is towards the transducer when looking at it through the temporal window. In other words, the blood is moving towards you, the person holding the probe.

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What is EDV?

EDV refers to the blood flow velocity in an artery at the end of the diastolic phase. It is the highest velocity during a heartbeat cycle.

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What is the Depth Setting for ACA Visualization?

The optimal depth setting for visualizing the Anterior Cerebral Artery (ACA) through the temporal window.

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How is the Probe Angled for ACA Visualization?

The direction the ultrasound probe should be angled to properly visualize the ACA through the temporal window.

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How is the Adson's Maneuver Performed?

This maneuver involves the patient rotating their head towards the affected side and extending their arm while taking their pulse.

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What is a Positive Adson's Maneuver?

The Adson's maneuver, if positive, can result in the loss of the radial artery pulse due to compression or pressure on the nerves and blood vessels in the thoracic outlet.

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Description

Test your knowledge on the Adson maneuver and its evaluation techniques for the anterior cerebral artery (ACA). This quiz covers indications, physical reactions, proper positioning, and angulation techniques. Perfect for students in medical and healthcare fields looking to enhance their clinical skills.

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