274 Aorta

Question 1

What is the diameter of the aorta

Answer 1

diameter is
~3 cm at the origin and in the ascending portion,
2.5 cm in the descending portion in the thorax, and
1.8–2 cm in the abdomen

Question 2

Parts of the aorta affected congenitally?

Answer 2

Congenital anomalies of the aorta usually involve the aortic arch and its branches

Question 3

an anatomic remnant of a right aortic arch

Answer 3

Kommerell’s diverticulum

Question 4

Where does coarctation of the aorta typically occurs

Answer 4

Coarctation of the aorta typically occurs near the insertion of the ligamentum arteriosum, adjacent to the left subclavian artery

Question 5

PE findings that raise the suspicion of aortic coarctation

Answer 5

A pulse delay or pressure differential between the upper and lower extremities should raise suspicion of aortic coarctation

Question 6

True or false. Hypertension develops in the arteries proximal to the coarctation.

Answer 6

True

Question 7

Differentiate true aneurysm vs pseudo aneurysm

Answer 7

true aneurysm: involves all three layers of the vessel wall pseudoaneurysm: in which the intimal and medial layers are disrupted and the dilated segment of the aorta is lined by adventitia only and, at times, by perivascular clot.

Question 8

Affects the entire circumference of a segment of the vessel, resulting in a diffusely dilated artery

Answer 8

Fusiform aneurysm

Question 9

involves only a portion of the circumference, resulting in an outpouching of the vessel wall

Answer 9

Saccular aneurysm

Question 10

factors associated with degenerative aortic aneurysms

Answer 10

aging, cigarette smoking, hypercholes-terolemia, hypertension, and male sex

Question 11

The most common pathologic condition associated with degenerative aortic aneurysms

Answer 11

atherosclerosis

Question 12

histopathologic term used to describe the degeneration of collagen and elastic fibers in the tunica media of the aorta as well as the loss of medial cells that are replaced by multiple clefts of mucoid material, such as proteoglycans

Answer 12

Medial degeneration

Question 13

infectious causes of aortic aneurysms

Answer 13

include syphilis, tuberculosis, and other bacterial infections

Question 14

Approximately 90% of syphilitic aneurysms are located where

Answer 14

ascending aorta or aortic arch

Question 15

rare condition that develops as a result of staphylococcal, streptococcal, Salmonella, or other bacterial or fungal infections of the aorta, usually at an atherosclerotic plaque

Answer 15

Mycotic aneurysm

Question 16

Vasculitides associated with aortic aneurysms of the aortic arch and descending thoracic aorta

Answer 16

Takayasu’s arteritis and giant cell arteritis

Question 17

most common pathology associated with ascending aortic aneurysms

Answer 17

Medial degeneration

Question 18

condition most frequently associated with aneurysms of the descending thoracic aorta

Answer 18

atherosclerosis

Question 19

average growth rate of thoracic aneurysms

Answer 19

0.1–0.2 cm per year

Question 20

Rupture rate for thoracic aortic aneurysms <4.0 cm in diameter

Answer 20

2–3%

Question 21

Rupture rate for aneurysm >6 cm in diameter

Answer 21

7%

Question 22

True or false. Aneurysmal dilation of the ascending aorta may cause congestive heart failure as a consequence of aortic regurgitation, and compression of the superior vena cava

Answer 22

True

Question 23

Chest x-ray finding suggestive of thoracic aortic aneurysm

Answer 23

include widening of the mediastinal shadow and displacement or compression of the trachea or left main stem bronchus.

Question 24

What is the monitoring for patients with small aortic aneurysm not requiring sugery

Answer 24

contrast-enhanced CT or MRI should be performed at least every 6–12 months to monitor expansion.

Question 25

recommended for patients with thoracic aortic aneurysms

Answer 25

Beta blockers

ARBs