Arterial Review
The SMA arises approximately 1 cm below the origin of the...
Celiac Trunk
The vessels of patients with ___ may be incompressible because of arterial wall calcification, a condition that leads to falsely elevated pressures
Diabetes
The vein most commonly used in the lower extremity as a reversed vein bypass graft is the...
Great Saphenous Vein
The point at which aliasing occurs is known as...
Nyquist Limit
The largest branch of the celiac trunk is the...
Splenic Artery
What does the Reynolds number describe?
The point at which flow becomes turbulent
In a normal study, what should the ankle systolic pressure be?
The same as or greater than the highest brachial blood pressure
Following cessation of exercise in an individual with normal vascular function, how long does it take for lower extremity blood flow to return to resting values?
1-5 Minutes
The cuff for obtaining pressures in the fingers should be what size? A. 0.5-1 cm B. 3 cm C. 5 cm D. 2-2.5 cm
2-2.5 cm
The most common anatomic variant of the aortic arch is a common origin of the innominate and left CCA, which occurs in ___% of people
22%
The presence of multiple renal arteries is the most common variant of the renal arteries, occurring in up to ___% of individuals
30%
The most common anatomic variant of the aortic arch is... A. An origin of the left vertebral from the aortic arch B. An origin of the right subclavian from the aortic arch C. A common origin of the innominate and left common carotid arteries D. An origin of the right common carotid from the aortic arch
A common origin of the innominate and left common carotid arteries
A 57 year old male presented to the vascular lab for lower extremity arterial testing. Exercise testing was stopped due to symptoms of claudication. Post exercise ankle pressures measured slightly above resting ankle pressures. What is suspected in this patient? A. Occlusion or stenosis at a single level B. A nonvascular cause of leg pain C. Multilevel arterial disease D. Isolated iliac artery occlusion
A nonvascular cause of leg pain
Which of these statements about bruits is not true? A. A bruit is a low frequency sound heard on auscultation B. A prominent bruit will be heard over an arterial occlusion C. The absence of a bruit cannot rule out disease D. A bruit persisting through diastole is usually associated with severe stenosis
A prominent bruit will be heard over an arterial occlusion
The measurement that helps in differentiating between inflow and outflow disease by determining the time between the onset of systole and the initial systolic peak is the...
Acceleration Time
This represents the time period between the onset of systole and the point of maximum peak velocity
Acceleration Time
What is the term for the outermost layer of the arterial wall?
Adventitia (Externa)
Which of the following may be a source of emboli? A. Ulcerated atherosclerotic plaque B. Mural thrombus with an aneurysm C. Cardiac dysrhythmias D. All of the above
All of the above
Which component of the reflected signals does power Doppler encode?
Amplitude
What is the most common form of nonsurgical intervention for focal atherosclerotic disease in the lower extremity?
Angioplasty
The dorsalis pedis artery is a continuation of which artery?
Anterior Tibial Artery
Which bypass graft would most likely be seen in a patient with bilateral common iliac artery obstruction?
Aortobifemoral
The ___ arteries arise at right angles from the interlobar arteries and course on top of the renal pyramids
Arcuate
What is the name of the tiny intrarenal branches that arise at right angles from the interlobar arteries and course above the renal pyramids?
Arcuate Arteries
What does a volume plethysmographic waveform with a normal amplitude, a rounded peak, and an absent dicrotic notch most likely indicate? A. Normal arterial inflow B. Arterial disease proximal to the level of tracing C. Arterial disease distal to the level of tracing D. Arterial occlusion at the level of the tracing
Arterial disease proximal to the level of tracing
What is indicated by the presence of a bruit? A. Arterial occlusion directly beneath the point of auscultation B. The absence of arterial disease C. Arterial stenosis proximal to the point of auscultation D. Venous thrombosis
Arterial stenosis proximal to the point of auscultation
A technique whereby atherosclerotic plaque is mechanically removed by cutting or pulverizing it and then extracted by suction or downstream embolization is termed...
Atherectomy
After it crosses the lateral margin of the first rib the subclavian artery becomes known as the...
Axillary Artery
The axillary artery becomes the ___ artery
Brachial Artery
A vibratory reaction in the tissue distal to a stenosis
Bruit
This is also known as thromboangitis obliterans, occurs in men younger than 40 years of age, and is strongly associated with heavy cigarette smoking
Buerger's Disease
Which disease involves the thrombosis of the small or medium-sized arteries of the extremities and occurs predominantly in male smokers? A. Allen's disease B. Buerger's disease C. Raynaud's disease D. Thoracic outlet disease
Buerger's Disease
The ___ is the first major branch of the abdominal aorta
Celiac Trunk
The common hepatic, splenic, and left gastric arteries are branches arising from which abdominal artery?
Celiac Trunk
What symptom involves cramping muscle pain that is induced by exercise and relieved by rest?
Claudication
At the inguinal ligament, the external iliac artery becomes what peripheral artery?
Common Femoral Artery
A patient with a history of tibial artery surgical repair now presents with foot drop, muscle necrosis, and sever pain. What diagnosis is suspected? A. Compartment syndrome B. Pseudoaneurysm C. Raynaud's syndrome D. Arteriovenous fistula
Compartment Syndrome
Following repair of injuries to the anterior tibial artery after a motor vehicle accident, your patient complains of weakness in the calf muscle, paresthesia, and pain on passive stretching of the calf muscle. What condition does this suggest? A. Cystic adventitial disease B. Compartment syndrome C. Paget-Schroetter syndrome D. Acute arterial occlusion
Compartment Syndrome
One of the chief limitations of CW Doppler is... A. Polarity of the reflected signal frequency shift cannot be determined; direction of blood flow cannot be defined B. The two transducer system is inherently more expensive C. Depth information is not possible; precise location of flow pattern cannot be determined D. The sample volume is too small to interrogate deeper vessels
Depth information is not possible; precise location of flow pattern cannot be determined
A disease in which segmental pressure studies may show falsely elevated Doppler pressures due to arterial wall calcification is... A. Diabetes mellitus B. Takayasu's arteritis C. Raynaud's syndrome D. Marfan syndrome
Diabetes Mellitus
In measurements of segmental pressures, gradients of 20-30mmHg between corresponding segments of the legs indicate... A. Disease below the level in the leg with higher pressure B. Disease above the level in the leg with higher pressure C. Disease at or above the level in the left with lower pressure D. No significant disease
Disease at or above the level in the leg with lower pressure
Hemorrhage within the layers of the arterial wall is known as...
Dissection
What is the best method for evaluation of a suspected popliteal aneurysm A. Pulse volume recording B. Duplex ultrasound C. Segmental pressures D. CW Doppler
Duplex Ultrasound
Which of the following correctly describes an advantage of PW Doppler over CW Doppler? A. PW Doppler is more accurate in measuring high velocities B. PW Doppler does not exhibit aliasing C. Echoes can be received from a specific depth with PW Doppler D. PW Doppler is more accurate in measuring low velocities
Echoes can be received from a more specific depth with PW Doppler
What is the most serious risk from femoropopliteal aneurysms?
Embolization
Which of the following is a cause of blue toe syndrome? A. Venous thrombosis of the pedal veins B. Hyperemic flow from arteriovenous fistulas C. Congenital absence of the dorsaslis pedis artery D. Embolization from proximal arteries
Embolization from the proximal arteries
This can be solid, liquid, or gaseous and is carried along in the bloodstream; most commonly arises from ulcerative atherosclerotic plaque, mural thrombus in an aneurysm, or the heart
Embolus
What is the term for a fragment of atherosclerotic debris that courses distal through the vasculature until it lodges in a small vessel?
Embolus
Which procedure consists of the surgical removal of the atherosclerotic plaque from an artery? A. Atherectomy B. Angioplasty C. Thrombectomy D. Endarterectomy
Endarterectomy
Which of the vessel courses along the medial aspect of the psoas muscle?
External Iliac Artery
What does a high pitched signal heard on audible Doppler analysis always indicate?
High Frequency Shifts
Using the four cuff technique for segmental pressures, what is the relationship of normal high thigh pressures and brachial pressure? A. High thigh pressures are not compared to brachial pressure B. They are equal C. High thigh pressures are at least 30 mmHg less than brachial pressure D. High thigh pressures are at least 30 mmHg greater than brachial pressure
High thigh presures are at least 30 mmHg greater than brachial pressure
Following exercise, what is a normal response for ankle pressures in comparison with resting values?
Increase
The ___ feeds the left third of the transverse colon, the sigmoid colon, and part of the rectum
Inferior Mesenteric Artery
The left colic artery, sigmoid branches, and the superior rectal artery are major branches of the...
Inferior Mesenteric Artery
Segmental renal arteries give rise to the ___ arteries, which course alongside the renal pyramids
Interlobar
Within the renal cortex, the arcuate arteries give rise to the radially oriented ___ arteries
Interlobular
What is another name for the hypogastric artery?
Internal Iliac Artery
Which of the following is a late complication of extremity bypass grafts? A. Intimal hyperplasia B. Pseudoaneurysm C. Arteriovenous fistula D. Hematoma
Intimal Hyperplasia
Your patient has undergone a femoral to anterior tibial bypass graft. During routine postoperative surveillance of the graft, you detect retrograde flow in the native anterior tibial artery just proximal to the distal anastomosis. What is the most likely explanation for this finding? A. It is consistent with severe obstruction in the native outflow artery B. It is evident because blood moves from a higher pressure energy in the bypass graft to the lower pressure energy of the diseased native vessel C. It represents a steal phenomenon that may result in graft failure D. It is a normal finding because blood moves from the lower pressure of the bypass to the higher pressure of the diseased native vessel
It is evident because blood moves from a higher pressure energy in the bypass graft to the lower pressure energy of the diseased native vessel
Which of these statements about primary Raynaud's phenomenon is correct? A. It results from ischemia caused by distal arterial spasm B. It relates to vasodilation of a healthy vessel C. It can be the first manifestation of thromboangiitis obliterans D. It is often evident after an acute arterial occlusion
It results from ischemia caused by distal arterial spasm
Individuals with ectopic or horseshoe kidneys commonly have this anatomic variant of the renal arteries
Multiple Renal Arteries
What is the most common variant of the renal arteries? A. Retroaortic renal artery B. Multiple renal arteries C. Anterocaval course of the right renal artery D. Congenical absence of one main renal artery
Multiple Renal Arteries
An aneurysm resulting from infection is known as...
Mycotic
Which term describes a pale skin color due to insufficient blood flow?
Pallor
A type of plethysmography that detects cutaneous blood flow by sending infrared light into the tissue is termed... A. Photoplethysmography B. Air plethysmography C. Volume plethysmography D. Impedance plethysmography
Photoplethysmography
___ detects cutaneous blood flow by sending infrared light into the tissue with a light emitting diode
Photoplethysmography
The best way for a vascular technologist to palpate a pulse is to...
Place their fingertips over the pulse site
Which syndrome results in the medial displacement of the vessel due to compression by fibrous bands or the medial head of the gastrocnemius muscle? A. Thoracic outlet syndrome B. Compartment syndrome C. Adductor canal compression syndrome D. Popliteal entrapment syndrome
Popliteal Entrapment Syndrome
A pulse palpated in the groove behind the medial malleolus of the ankle corresponds to which artery?
Posterior Tibial Artery
What complication that may follow femoral artery catheterization involves a characteristic to-and-fro Doppler waveform seen within a tract leading to a perivascular hematoma?
Pseudoaneurysm
This is calculated by dividing the peak to peak frequency by the mean frequency
Pulsatility Index
What quantitative index is calculated by dividing the peak to peak frequency difference by the mean frequency?
Pulsatility Index
In which syndrome does recurrent digital vasospasm occur in response to cold exposure or emotional stress? A. Buerger's Syndrome B. Raynaud's Syndrome C. Takayasu's Syndrome D. Thoracic Outlet Syndrom
Raynaud's Syndrome
What severe symptom of decreased blood perfusion is aggravated by elevation, is relieved by dependency, and often occurs when the patient goes to bed at night?
Rest Pain
With which type of bypass graft will there be a size discrepancy between the graft and the native artery at both the proximal and distal anastomotic sites?
Reversed Vein Graft
The main renal artery divides at the hilum of the kidney into ___ renal arteries
Segmental
You are performing a photoplethysmography on a patient with chronic ankle and calf edema. The PPG sensor is placed slightly proximal to the medial malleolus, and the patient dorsiflexes five times then relaxes, resulting in this tracing. What does it suggest? A. Within normal limits B. Not venous but arterial insufficiency C. Significant valvular incompetence D. Acute DVT
Significant Valvular Incompetence
Which method of Doppler display exhibits a gray scale trace representing the entire range of reflected frequency shifts from the location of the sample volume? A. Spectral analysis B. Analog waveform C. Power Doppler D. Color flow
Spectral Analysis
During performance of a postoperative study for a reversed saphenous bypass graft, which of the following potential complications should you consider? A. Stenosis at the proximal anastomosis B. Arteriovenous fistula C. Increased flow secondary to retained valve cap D. Pseudoaneurysm at mid graft level
Stenosis at the proximal anastomosis
The ___ artery continues as the axillary artery after if passes the lateral margin of the first rib
Subclavian Artery
Which vessel normally exhibits a triphasic waveform? A. Common carotid artery B. Subclavian artery C. Vertebral artery D. Internal carotid artery
Subclavian Artery
Photoplethysmography was performed on your patient. Venous refilling time was 10 seconds without a tourniquet applied and 25 seconds with a tourniquet applied to the lower thigh. What is the diagnosis? A. Deep valvular insufficiency B. Superficial venous thrombosis C. Deep venous thrombosis D. Superficial valvular insufficiency
Superficial Valvular Insufficiency
The ___ is the second major branch of the abdominal aorta
Superior Mesenteric Artery
The inferior pancreaticoduodenal artery, jejunal and ileal branches, ileocolic artery, right colic artery, and middle colic artery are major branches of the...
Superior Mesenteric Artery
The renal arteries arise from the abdominal aorta approximately 1cm distal to the...
Superior Mesenteric Artery
What artery supplies the small intestine, right colon, and transverse colon?
Superior Mesenteric Artery
How should the patient be positioned to obtain digital pressures of the toes?
Supine
What should the patient's position be when you are taking ankle pressures?
Supine
This is a chronic inflammatory process that primarily affects the aorta and its major branches and occurs primarily in females; due to homogeneous segmental wall thickening, the "macaroni" sign is an indicator
Takayasu's Arteritis
Which of these conditions most commonly affects the subclavian, renal, and carotid arteries and the ascending aorta and predominantly affects females? A. Takayasu's arteritis B. Temporal arteritis C. Polyarteritis nodosa D. Kawasaki disease
Takayasu's Arteritis
What is suggested by an acceleration time of less than 133 msec obtained in the femoral artery? A. Proximal iliac artery stenosis B. The absence of significant iliac artery disease C. Distal femoral artery occlusion D. Pseudoaneurysm of the femoral artery
The absence of significant iliac artery disease
The ABI is calculated by dividing the ankle pressure by...
The highest of the two brachial pressures
Which of the following is always true of patients who suffer from intermittent claudication? A. Peripheral blood flow is reduced at rest B. There is pressure drop distal to the obstructed segment after exercise C. Marked peripheral vasoconstriction occurs in response to exercise D. There is always a pressure drop distal to the obstructed segment at rest
There is always a pressure drop distal to the obstructed segment after exercise
What is the primary function of the vasa vasorum?
To provide nourishment to the tunica adventitia
Percentage diameter and area reduction measurements are most accurate when obtained in which imaging plane?
Transverse
In pulse-wave Doppler studies, loss of the spectral window characterizes which type of blood flow? A. Parabolic flow B. Turbulent flow C. Laminar flow D. All of the above
Turbulent Flow
Which of the following is not a risk factor for development of atherosclerotic disease? A. Diabetes mellitus B. Male sex C. Underweight D. Hypertension
Underweight
In the presence of arterial obstructive disease and distal ischemia... A. Vasoconstriction increases and distal resistance increases B. Vasodilatation increases and distal resistance decreases C. Vasoconstriction increases and distal resistance decreases D. Vasodilatation decreases and distal resistance decreases
Vasodilatation increases an distal resistance decreases
On which axis on the spectral display is time displayed?
X-Axis