Detailed Outline (RVS)

  1. Anatomy and Physiology
    Anatomic location and physiology of:
    1. Arterial
      1. Aorta
        1. ascending
        2. descending
        3. branches
      2. Lower extremity arteries
      3. Upper extremity arteries
      4. Abdominal vasculature
      5. Cerebral extracranial arteries
    2. Venous
      1. Abdominal venous system
        (vena cava, portal, mesenteric and renal veins)
      2. Lower extremity veins (deep, superficial and perforators)
      3. Upper extremity veins (deep and superficial)
  2. Patient Assessment
    1. Obtaining patient history
      1. Chronic arterial occlusive disease
      2. Acute arterial occlusive disease
      3. Cold sensitivity
      4. Hypertension
      5. Ischemia
      6. Stroke
      7. Diabetes
      8. Hyperlipidemia
      9. Transient symptoms
      10. Previous surgery
      11. Previous or related Non-invasive testing
      12. Chronic venous insufficiency
      13. Acute vein thrombosis
      14. Related medication
      15. Cardiac history and surgery
    2. Obtaining Risk Factors
      1. Age
      2. Smoking
      3. Trauma
      4. Previous DVT
      5. Bed-rest patient
      6. Carcinoma
      7. Diabetes
      8. Hypertension
      9. Hyperlipidemia
      10. Recent surgery
      11. Pregnancy
      12. Birth control pills
      13. Varicose veins
      14. Obesity
      15. Cardiac disease
    3. Indications for Arterial and Venous Non-invasive Procedures
    4. Signs and Symptoms
    5. Physical Examination
      1. Skin changes
      2. Palpating for pulses and aneurysms
      3. Lymphedema
      4. Venous ulcerations
      5. Auscultation for bruits
      6. Pulses
  3. Disease States
    1. Venous Disease
      1. Pathology
        1. peripheral venous diseases
        2. central venous diseases
      2. Preliminary information
        1. acute deep vein thrombosis
        2. chronic venous insufficiency
      3. Interpretation of venous disease with non-invasive testing
        1. Diagnostic indications/values
        2. Diagnostic criteria
        3. Limitations of interpretation
      4. Discerning pathology and artifact
      5. Valvular disease
      6. Thrombosis
        1. Location
        2. Characteristics
      7. Ambulatory hypertension
      8. AV fistula
    2. Arterial Disease
      1. Pathology of peripheral vascular disease
      2. Pathology of central arterial disease
      3. Preliminary information
        1. Acute arterial disease
        2. Chronic arterial disease
      4. Interpretation of arterial disease with non-invasive testing
        1. Diagnostic indications/values
        2. Diagnostic criteria
        3. Limitations of interpretation
      5. Discerning pathology and artifact
      6. Atherosclerosis
      7. Hematomas
      8. Embolism
      9. Entrapment syndromes
      10. Atriovenous fistulas
        1. Thoracic outlet syndrome
      11. Raynaud’s syndrome
      12. Arteritis
    3. Cerebrovascular Disease
      1. Pathology of the cerebrovascular system
      2. Interpretation of cerebrovascular disease with non-invasive testing
        1. Diagnostic indications/values
        2. Diagnostic criteria
        3. Limitations of interpretation
      3. Discerning pathology and artifact
      4. Atherosclerosis
      5. Hemorrhage
      6. Morphology
      7. Ulceration
      8. Masses and aneurysms
      9. Stenosis
      10. Embolism
      11. Subclavian steal
        1. Stroke
  4. Evaluation of Blood Flow
    1. Venous
      1. Normals – Venous Flow
        1. Hemodynamics
          1. Peripheral
          2. Central
        2. Portal vein flow
      2. Flow Patterns in Venous Disease
        1. Acute
        2. Chronic
      3. Interpretation of abnormal flow patterns
      4. Collateral circulation
      5. Non-invasive Venous Testing
        1. Continuous wave Doppler
        2. Duplex imaging
          1. 13-mode
          2. Doppler
          3. Color
      6. Patient positioning
      7. Transducer positioning
    2. Arterial
      1. Normals – Arterial Flow
        1. Hemodynamics
          1. Central
          2. Peripheral
          3. Abdominal
        2. Waveforms
          1. Spectral
          2. Analog
        3. Flow Patterns
          1. Normal
          2. Abnormal
        4. Pressures
          1. Lower extremities
          2. Upper extremities
        5. Non-invasive Arterial Testing
          1. Continuous wave Doppler
          2. Duplex imaging
            1. 13-mode
            2. Doppler
            3. Color
        6. Patient positioning
        7. Transducer positioning
        8. Criteria for diagnosis of hemodynamically significant disease
    3. Cerebrovascular Disease
      1. Normal hemodynamics
      2. Abnormal flow
      3. Waveform analysis
      4. Systolic and diastolic velocities
      5. Criteria for diagnosis
      6. Non-invasive Cerebrovascular Testing
        1. Duplex imaging
          1. Bmode
          2. Doppler
          3. Color
      7. Patient positioning
      8. Transducer positioning
  5. Advanced Techniques
    1. Transcranial Doppler
      1. Techniques
      2. Indications
      3. Flow velocities in the intracranial arteries
        1. Normal
        2. Abnormal
        3. Direction of flow
  6. Vascular Surgery/Intervention
    1. Carotid Endarectomy
      1. Intraoperative survey
      2. Postoperative survey
    2. Bypass Grafts
      1. Types
      2. Flow patterns
        1. Normal
        2. Abnormal
      3. Preoperative assessment
    3. Percutaneous Intervention
      1. Angioplasty
      2. Stents
    4. Venography
      1. Methods
      2. Interpretation
    5. Arteriography
      1. Methods
      2. Interpretation
  7. Physics and Instrumentation
    1. Transducers
      1. Characteristics
      2. Piezoelectric effect
      3. Beam focusing
      4. Near field
      5. Farfield
      6. Mechanical transducers
      7. Phased array transducers
      8. Lateral resolution
      9. Axial resolution
      10. Elements
      11. Beam steering
    2. Sound Propagation
      1. Speed of sound now
        1. Tissue
        2. Air
        3. Blood
      2. Reflection
      3. Refraction
      4. Absorption
      5. Attenuation
      6. Impedance
      7. Scattering
      8. Interfaces
    3. Definitions
      1. Frequency
      2. Wavelength
      3. A-mode
      4. B-mode
      5. M-mode
      6. Bandwidth
      7. Hertz
      8. Power
      9. Range
      10. Velocity
    4. Laws
      1. Ohm’s law
      2. Poiseuille’s law
      3. Bernoulli’s
    5. Doppler Instrumentation
      1. Pulsed wave
      2. Continuous wave
      3. Signal processing
        1. Integral time analysis
        2. Decibel gain
        3. Digital signal
        4. Dynamic range
        5. Fast Fourier transformation
        6. Post scan processing
        7. Scan converters
        8. Time gain compensation
        9. Zero crossing detector
    6. Hemodynamics
      1. Venous resistance
      2. Arterial pressure
      3. Turbulent flow disturbance
      4. Velocity acceleration
      5. Diameter reduction
      6. Aliasing
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