Abdominal Vasculature - Part 5

Question 1

What are the indications for an abdominal aorta US? (10)

Answer 1

1. Pulsatile abdominal mass
2. Family history of abdominal aortic aneurysm
3. Hypertension
4. Abdominal pain
5. Lower back pain
6. History of arteriosclerosis
7. Severe postprandial pain
8. Pulmonary embolism
9. Liver disease
10. Evaluate mass from previous medical imaging study
    - eg) CT

Question 2

Aneurysm

Answer 2

Weakening of the arterial wall

Question 3

What happens to the vessel walls with an aneurysm?

Answer 3

All layers of the artery are stretched but intact

Question 4

When are aneurysms more rare?

Answer 4

In patients less than 50 years

Question 5

Are aneurysms more common in males or females?

Answer 5

Males

Question 6

What is considered a normal growth rate for an aneurysm?

Answer 6

Growth rate of 2mm/year is average and considered normal up to 5mm/year

Question 7

What size is the aorta when there is an aneurysm?

Answer 7

When is exceeds 3.0cm in diameter

Question 8

What size is the common iliac artery when there is an aneurysm?

Answer 8

When is exceeds 2.0cm in diameter

Question 9

What size is the popliteal artery when there is an aneurysm?

Answer 9

When is exceeds 1.0cm in diameter

Question 10

What is 25% of popliteal aneurysms associated with?

Answer 10

Abdominal aortic

aneurysm

Question 11

Arterial stenosis

Answer 11

Narrowing or constriction of an artery

Question 12

What is an arterial stenosis caused by? (3)

Answer 12

1. Atherosclerosis
2. Arteriosclerosis
3. Fibrointimal hyperplasia

Question 13

Arteriosclerosis

Answer 13

Pathologic thickening, hardening, and loss of elasticity of the arterial walls

Question 14

Atherosclerosis

Answer 14

Disorder characterized by yellowish plaques of lipids and cellular debris in the medial and intimal layers of the arterial walls

Question 15

Pseudoaneurysm

Answer 15

Dilatation of an artery caused by damage to one or more layers of the artery as a result of trauma or aneurysm rupture

Question 16

What is the most common cause and an abdominal aortic aneurysm?

Answer 16

Arteriosclerosis

Question 17

What are other causes of an abdominal aortic aneurysm? (3)

Answer 17

1. Infection
2. Hypertension
3. Family history

Question 18

What are the clinical findings of an abdominal aortic aneurysm? (5)

Answer 18

1. Asymptomatic
2. Pulsatile abdominalmass
3. Back and/or leg pain
4. Abdominal pain
5. Abdominal bruit

Question 19

What is the US appearance of an abdominal aortic aneurysm? (6)

Answer 19

1. Typically fusiform-shaped dilatation of the aorta
2. Saccular dilatation of the aorta may be demonstrated
3. Diameter of 3cm or greater
4. Vessel becomes tortuous 5. Wall calcifications
5. Intramural thrombus

Question 20

What are 3 differential diagnosis of an abdominal aortic aneurysm?

Answer 20

1. Lymphadenopathy 2. Retroperitoneal tumour

3. Dissection

Question 21

What are the causes of a dissecting aneurysm? (5)

Answer 21

1. Extension of a dissecting thoracic aneurysm
2. Hypertension
3. Marfan syndrome
4. Idiopathic
5. Trauma

Question 22

What are the clinical findings of a dissecting aneurysm? (4)

Answer 22

1. Sharp chest or abdominal pain
2. Audible bruit
3. Headache
4. Shock

Question 23

What is the US appearance of a dissecting aneurysm? (3)

Answer 23

1. Thin hyper echoic membrane within the aorta
2. Membrane flaps with arterial pulsations
3. Doppler demonstrates opposite flow direction between the membrane during diastole

Question 24

What are 2 differential diagnosis for dissecting aneurysm?

Answer 24

1. Chronic intraluminal thrombus

2. Postsurgical repair

Question 25

What causes an ectatic aneurysm?

Answer 25

Weakening of the arterial wall

Question 26

What is a clinical find of an ectatic aneurysm?

Answer 26

Asymptomatic

Question 27

What is the US appearance of an ectatic aneurysm? (2)

Answer 27

1. Dilatation of the aorta when compared with a more proximal segment 2. Dilatation measures less than 3cm in diameter

Question 28

What are 2 differential diagnosis of an ectatic aneurysm?

Answer 28

1. Tortuous artery | 2. Technical error

Question 29

What is a cause of mycotic aneurysm?

Answer 29

Bacterial infection

Question 30

What are clinical findings of mycotic aneurysm? (3)

Answer 30

1. Asymptomatic | 2. Abdominal pain 3. Pulsatile abdominal mass

Question 31

What is the US appearance of mycotic aneurysm? (2)

Answer 31

1. Typically saccular-shaped dilatation of the aorta | 2. Asymmetrical wall thickening

Question 32

What are 3 differential diagnosis of mycotic aneurysm?

Answer 32

1. Lymphadenopathy 2. Retroperitoneal tumour | 3. Intramural thrombus

Question 33

What is a cause of a pseudoaneurysm?

Answer 33

Trauma to the arterial wall permits the escape of blood into the surrounding tissues

Question 34

What is the most common complication of an aortic graft?

Answer 34

Pseudoaneurysm

Question 35

What are clinical findings of a pseudoaneurysm? (3)

Answer 35

1. Pulsatile mass 2. Focal pain 3. Bruising

Question 36

What is the US appearance for a pseudoaneurysm? (3)

Answer 36

1. Fluid collection communicating with an artery 2. Doppler will demonstrate turbulent swirling blood flow within the fluid collection 3. To and fro blood flow pattern is demonstrated in the neck of the aneurysm

Question 37

What are 4 differential diagnosis for a pseudoaneurysm?

Answer 37

1. Hematoma 2. Lymphadenopathy 3. Aneurysm 4. Arteriovenous fistula