Aneurysm and Dissection Flashcards Preview

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Flashcards in Aneurysm and Dissection Deck (25):
1

Types of aneurysms

True: involves all 3 layers of the vessel wall; saccular or fusiform

False: breaking of the blood wall and formation of a hematoma

Dissection: tear of the intimal layer

2

Aneurysm pathogenesis

Inadequate or abnormal collagen syntheses; Marfans (cystic medial necrosis), Ehlers-Danlos

Excessive collagen degradation - excess MMPs, low TIMPs; smokers

3

Aneurysm vessel wall pathogenesis

Intimal thickening - due to atherosclerosis; causes ischemia of inner media

Systemic HTN - narrows vasa vasorum; ischemia of outer media layer

4

Common causes of aneurysms

Common:
-atherosclerosis - abdominal aortic aneurysm
-HTN - ascending aortic aneurysm

5

Uncommon causes of aneurysms

Congenital:
-collagen defects
-Berry aneurysm

Infections - myoctic aneurysm; syphilis

Trauma - AV fistula aneurysm

Vasculitis

6

Most common aortic aneurysm

Abdominal aortic aneurysm - infrarenal aorta

7

Abdominal aortic aneurysm; pathogenesis and etiology

More common in men and smokers

Most common cause - atherosclerosis

8

AAA; complications

-Rupture

-Vascular obstruction = of nearby vessels

-Embolism

-Ureter impingement

9

AAA; management

Surgical repair when it is >5cm; open repair or stent-graft

10

Thoracic aortic aneurysms; causes

-HTN
-Marfan's
-Syphilis

11

Thoracic aortic aneurysms; features

-Tracheal compression

-Esophageal compression

-Recurrent laryngeal nerve compression

-Aortic insufficiency

-Aortic rupture

12

Aortic dissection; blood location

Between and along laminar planes of media

13

Aortic dissection; Age and pathogenesis

-HTN = older age
-CT disorders = younger age

14

Aortic dissection; most common location

Ascending aorta

15

Rare cause of aortic dissection

Pregnancy

16

Aortic dissection; rupture

-Usually ruptures outward

-Double-barreled lumen = inward rupture

17

Cystic medial degeneration is seen in who?

Marfan's

18

Cystic medial degeneration causes what?

-Dissection
-Aneurysm

19

Cystic medial degeneration histology

Blue mucinous ground substance that disrupts elastic fibers

20

Aortic dissection; complications

Hemopericardium

21

Vasculitis and pathogenesis

Immune-mediated

Infection - syphilis, aspergillus (lung)

Unknown - giant cell, takayasu, polyarteritis nodosa

22

Most common form of systemic vasculitis in adults

Giant cell arteritis

23

Gross morphology of giant cell arteritis

Nodular thickenings of artery

24

Polyarteritis Nodosa; effected organs/arteries

Renal and visceral

Lungs are spared

25

Polyarteritis nodosa; special feature

All stages co-exist; lesions are not at the same stage