Vascular Sonography
Terms
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- Name 3 ways CAD increases the risk for stroke
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Plaque Blocks Carotid Artery
Plaque Breaks from Carotid Artery - and blocks Cerebral Artery
Blood Clot blocks Carotid Artery by Plaque -
Who is at risk for CAD and Stroke
(These are the REASONS to do Cerebrovascular Scan)
FLU SHOTS -
1. Family History
2. LDL 7. Triglycerides
3. Diabetes 8. Smoking
4. Sedentary Life Style
5. High BP
6. Obese -
What are the Symptoms of CAD
These are IMPORTANT to note on PT CHART
B. Shats -
Bruit
Symptoms of Stroke
Headache
Amaurosis Fugax
Trouble Swallowing
Sychope - How is CAD diagnosed
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Doppler Ultrasound Imaging
Oculoplethysmography
Magnetic Resonance Angiography
Arteriography and Digital Subtraction Angiography - Doppler Ultrasound Imaging
- Sound waves check blood flow and measure thickness of carotid artery
- Magnetic Resonance Angiography
- Uses powerful magnetic fields to give a detailed picture of the arteries in the brain
- Oculoplethysmography
- Measures the pulsation of the arteries in the back of your eye. It is an indirect check for blockages in the carotid arteries
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Arteriography
Digitital Subtraction Arteriography -
A method for showing contrast filled vessels without any interfering background
X-Ray - How is CAD treated
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Lifestyle changes
Medicines - TPA
Carotid angioplasty-balloon cath.& stent
Carotid endarectomy - removal - What lifestyle changes can be made to treat CAD
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Stop smoking, control BP, cholesterol, diabetes and heart disease
Find out if heart rhythem problems esp. atrial fibrillation
Exercize
Salt - What medications can be used to prevent and lessen chance of stroke?
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Anticoagulants
Aspirin
TPA - What is TPA
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Tissue Plasminogen Activator, a clot-dissolving medicine approved by the FDA.
It must be given within 3 hours of the start of stoke. - What is carotid angioplasty?
- Involves using a balloon catheter to flatten plaque blockages against the artery wall, opening the passage way. A small metal tube-like device called a stent is then placed in the artery to keep it open.
- What is carotid endarterectomy?
- Removes fatty plaque from neck arteries. While the patient is under anesthesia, surgeons make an incision in neck, at the location of the blockage. A tube is inserted above and below the blockage to reroute blood flow. Surgeons can then open up the carotid artery and remove the plaque. Once the artery is stitched closed, the tube is removed. A carotid edarterectomy can be done without rerouting blood flow. The surgeon stops blood flow long enough to peel the blockage away from the artery.
- Where does plaque occur most commonly
- At bifurcation where there is disturbed flow
- Plaque may cause cerebrovascular symptoms:
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1.By restricting blood flow
2.By generating emboli from ulcerative plaque - Name 3 Types of Plaque
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1.Soft Plaque – hard to see low echo
2.Dense Plaque – fibrotic looking
As older becomes bright white
More Echogenic, Calcifications, Anchored
3.Calcified – Bright echoes with shadowing - Surface of Plaque
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Smooth or Irregular
(soft)
1. Pitted
2. Ulcerated - What is a Stroke
- A cardiovascular disease that affects blood vessels supplying blood to the brain. It occurs when a blood vessel bringing O2 and nutrients to the brain bursts or is clogged (I.E. Blood Clot or Other particle)
- What is the diffence between a TIA and CVA
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1.TIA – Transient Ischemic Attack
·No lasting effects or permanent damage
·Symptoms a few minutes to a few hours (Never more than 24 hours)
2.CVA – Cerebrovascular Accident
·Permanent neurological damage
·The episode lasts longer than 24 hours - TIA
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1.TIA – Transient Ischemic Attack
Focal dysfunction due to a temporary occlusion of a cerebral artery.
·No lasting effects or permanent damage
·Symptoms usually a few minutes to a few hours (Never more than 24 hours) - CVA
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2.CVA – Cerebrovascular Accident (Stroke)
·Permanent neurological damage
·The episode lasts longer than 24 hours - RIND – Resolving Ischemic Neurological Deficit
- ·Neurological symptoms that last longer than 24 hours but then resolve completely
- SIE – Stroke In Evolution
- ·Ischemic neurological deficit that actively worsens during a period of observation
- Completed Stroke
- ·Stable neurologic deficit that had a sudden onset, usually is permanent BRAIN DEAD
- Acute Brain Death
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This can be caused by either:
1.(ISCHEMIA)- Lack of blood supply 80%
2.(HEMORRHAGE) - The effect of blood outside of the normal vessels 20% - Hemorrhagic Stroke
- 1)Hemorrhagic Stroke – refers to bleeding that occurs within membranes surrounding the brain and cerebrospinal fluid
- Intracerebral Stroke
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2)Intracerebral Hemorrhage – bleeding into the brain tissue, frequently caused by HTN.
CausesIntracerebral Hemorrhage:
1.Aneurysms 3. Drugs
2.Use of Anticoagulants 4. Trauma