Training activity information
Details
Identify, analyse and interpret the anatomy and haemodynamics of normal extracranial carotid, vertebral and subclavian arteries in a range of patients using:
- Spectral Doppler
- Colour
- B mode
Type
Developmental training activity (DTA)
Evidence requirements
Evidence the activity has been undertaken by the trainee​.
Reflection on the activity at one or more time points after the event including learning from the activity and/or areas of the trainees practice for development.
An action plan to implement learning and/or to address skills or knowledge gaps identified.
Considerations
- Troubleshooting
- Physiology, histology and pathology of the carotid, vertebral and subclavian arteries on ultrasound
- Impact of disease on Doppler spectrum, colour spectral and B mode
- Artifact causes and corrections
- Limitations and pitfalls
- Consequences of misdiagnosis
Reflective practice guidance
The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.
Before action
- What are the expected normal anatomical features and haemodynamic characteristics (spectral Doppler waveforms, colour flow patterns) of the extracranial carotid, vertebral, and subclavian arteries?
- What criteria will you use to differentiate normal from potentially abnormal findings in B-mode, colour Doppler, and spectral Doppler assessments?
- What preparation will you do to review normal vascular anatomy and haemodynamics prior to undertaking this activity?
- How will you ensure you are prepared for the range of patient presentations and potential variations in normal anatomy and haemodynamics?
In action
- As you visualise each artery (carotid, vertebral, subclavian) in B-mode, what anatomical features are you noting to confirm its identity and normality?
- How do the colour Doppler flow patterns correlate with the expected direction of blood flow in each vessel? Is there any vessel, or region of a vessel, where the colour flow patterns differ?
- What are the characteristics of the spectral Doppler waveforms you are obtaining? Do they appear normal for each specific artery?
- Are you encountering any normal variations in anatomy or haemodynamics between different patients?, What are these?
- What aspects of the analysis and interpretation require more conscious effort, and what aspects feel more automatic based on your understanding?
On action
- Describe the ultrasound appearances (B-mode, Colour Dopplerand spectral Doppler)you observed for the normal extracranial carotid, vertebral, and subclavian arteries.
- Were there any differences in these findings across the ‘range of patients’?
- What haemodynamic characteristics did you note?
- How effectively were you able to use Spectral Doppler, Colour Doppler, and B-mode to identify and analyse the normal anatomy and haemodynamics?
- How confident were you in interpreting the waveforms and colour flow patterns?
- Were there any specific arteries or haemodynamic parameters that you found easier or more difficult to interpret?
- What aspects of haemodynamics will you revise further following this DTA?
- Are there any specific Doppler techniques you want to practice more?
- How will you apply this knowledge when encountering variations in patient presentations?
Beyond action
- Consider your initial attempts at interpreting the haemodynamics in these vessels. How has your understanding of blood flow and spectral Doppler waveforms evolved since?
- Can you recall specific cases since completing this DTA where your ability to analyse and interpret normal haemodynamics helped you to identify or rule out pathology?
- What have you done to focus on developing and applying your knowledge of haemodynamics in these vessels? How has your knowledge enabled your scanning interpretation and performance to improve?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 6 |
Outcome
Analyse and interpret ultrasound images with reference to haemodynamics whilst performing a range of scans. |