Aorta Physiology and Pathology Flashcards Preview

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Flashcards in Aorta Physiology and Pathology Deck (142):
1

1st branch seen off aorta in u/s

Celiac Axis

2

What vessels originates from CA

Splenic A, L Gastric A, Common Hepatic A

3

Name artery that comes off CA that isnt seen in u/s

L Gastric A

4

Name artery that come off the CA that is very tortuous

Splenic

5

What vessel runs along the posterior border of the pancreas

Splenic Vein

6

What are the 2 branches of the common hepatic artery

Superior: Gda
Posterior: Proper hepatic artery

7

Another name for adrenals

suprarenals

8

What organs do the gonadal arteries feed

Male: Testicles
Female: Ovaries

9

Vessel between Aorta and SMA and accompanying syndrome

Left Renal Vein (Nutcracker)

10

Renal arteries are seen best in which scan plane

transverse

11

What is the only vessel that runs posterior to the IVC

RRA

12

Relationship of SMA to Celiac

Inferior

13

2 main structures fed by SMA and IMA

colon and pancreas

14

What is most inferior artery off the aorta

Median sacral artery

15

Aorta courses sagitally

Superior to inferior

16

Aorta runs from

posterior to medial

17

Aorta is on left or right of spine

left

18

Aorta originates in

Left ventricle of the heart at the outflow tract

19

what structure does the aorta pass through to begin being abdominal

Diaphragm

20

Can the thoracic aorta be seen in ultrasound

No

21

Shape of aorta

candy cane

22

Aorta passes anteriorly or posteriorly to the diaphragm

posterior

23

The Celiac branches_______to the Aorta

anteriorly

24

Other names for Celiac axix

Celiac trunk / Celiac artery

25

Feeds left lesser curvature of stomach

LGA

26

Feeds the left greater curvature of the stomach

Splenic artery

27

Feeds the right greater curvature of the stomach

GDA

28

Splenic artery feeds

Spleen, pancreas, greater left of stomach

29

Common Hepatic Artery branches into

Gastroduodenal artery, Proper hepatic artery

30

GDA feeds

Greater right, pancreas and duodenal areas

31

Proper hepatic Artery branches into

left middle and right hepatic arteries

32

Right hepatic artery branches into the

cystic artery

33

Cystic artery feeds the

Gallbladder

34

SMA feeds the

Small Intestines, Ascending Colon, part of Transcending Colon

35

Renal arteries are____________to the SMA

inferior

36

Which renal artery is longer

RRA

37

Gonadal Arteries feed

testicles and ovaries

38

Gonadal start______to the respective organs

anteriorly, they course inferiorly

39

IMA feeds

part of transcending colon, descending colon and rectum

40

Median Sacral Artery feeds

Sacrum

41

Aortic Size

3 cm at largest

42

Aortic courses

Inferior to shallow, decreasing in size

43

Best method to decrease observer variation

Measure A to P

44

3 layers of the vessel

tunica intima
tunica media
tunica adventitia

45

Layer that is thick in arteries

Media

46

Why is media thicker

greater elastisity

47

Primary function of aorta

Bring oxygenated blood to organs to ensure oxygenation and metabolism

48

Systole creates

blood to quickly to be sent in aorta causing expansion

49

Diastole and Aortic Valve closure ensures

wall recoil and the release of stored energy: maintains BP

50

Aorta displays

anechoic with echogenic walls (tubular)

51

Vessels that display pulsivity

Large Vessels

52

What portion is hard to visualize fully across the screen sagitally

Proximal due to curviture

53

Distal portion is

more linear

54

Celiac axis makes what sign with which two arteries

Seagull Splenic A and CHA

55

SMA visualized better in which plane

TRV due to parapancreatic fat surrounding it

56

Renal arteries visualized best in which plane

TRV small curvature branching from Aorta

57

IMA visualized best

not visualized unless pathology

58

Bifurcation best visualized in

TRV level with umbillicus

59

Reason for exam

Look for aneurysms and stenosis

60

What is seagull sign

CHA and SA in trv that represent the wings of a seagull

61

What is the echogenic material around SMA in TRV

parapancreatic fat

62

Which renal artery is longer

right

63

Primary reason to have Aorta Ultrasound

ID aneurysms, ID stenosis

64

Branches affected by

Atheroma
Aneurysm
Connective Tissue Disorders: Cystic medial necrosis, Marfans
Rupture
Thrombus
Infection
Displacement

65

Atheroma is

solf lipid (plaque) in intima

66

Atheroma is more prevalent in

old males more likely

67

Atheroma is chronic or acute

Chronic, takes years to accumulate

68

Atherosclerosis is

disease in which fatty deposits collect in vessel walls and narrow and impair blood flow

69

Arteriosclerosis is

disease of hardening of the arteries which may lead to coronary arteries hardening causing a myocardial infarction

70

Most common cause of arteriosclerosis

Atherosclerosis

71

Other cause of arteriosclerosis

cigarette smoking
diabetes
htn
increased cholesterol (Athero)

72

Arteriosclerosis: what side of the vessel is most likely affected

posterior

73

Arterio can also affect which vessels

All branches of Aorta and Iliacs

74

What is an aneurysm

Swelling or dilation of a blood vessel, increase in diameter of 50% in a short amount of time

75

3 kinds of aneurysm

True
False (Pseudo)
Dissecting

76

How much more likely are men to have AAA than women

4x

77

3 Symptoms of AAA

abdominal pain (constant/come and go)
back pain-radiates to groin or butt
heartbeat feeling in abdomen

78

What are the 6 finding in ultrasound that point to AAA

1. increased Aorta diameter >3cm
2. focal dilation
3. lack or normal taper
4. presences of thrombus
5. dissection
6. rupture

79

Annual growth of AAA

.25 cm

80

How often will you need checkup if diagnoses with AAA

1-2 years

81

Survival rate for one year if over 6 cm

50%

82

Risk of rupture if over 7cm

75%

83

Mortality rate if operated on before rupter

5%

84

Mortality rate if operated after rupture

50%

85

What does the sonographer need to analyze with a AAA

1. Maximum true dimentions
2. Shape
3. Location and vessel involvement
4. Wall thickening (soft or hard)
5. Presence of patent
6.Examine kidney involvement

86

What are the 3 types of aneurysm

Berry- brain
Saccular
Fusiform

87

How do we determine if an aneurysm is true

Involves all three layers of the vessel

88

How are pseudo AAA formed

A hole in the vessel scabs and blood fills the gap (angiogram)

89

Size of Berry aneurysm

1-1.5 cm

90

What does berry aneurysm look like

bubble rising from the vessel wall, or berries hanging (mostly in cerebral)

91

Size of saccular

5-10 cm

92

physical attribute of saccular

connected by a NECK to the vessel luman

93

What can saccular be filled with

Thrombus

94

What is the most common type of aneurysm

Fusiform

95

How is the fuciform shaped

Gradual uniform dilation or spindle shaped dilation

96

Is fuciform always evenly distributed

No may be eccentric, one side may be more affected

97

Where do aneurysms most often occure

Distal Aorta

98

What is ectatic aorta

The entire aorta is enlarged without a bulge

99

What is ectatic aorta related to

related to age and htn

100

Is ectatic aorta fatal

not likely

101

How often must one follow up for ectatic aorta

6-12 months

102

How do you treat AAA

SURGERY

103

How do you treat ectatic aorta

not always surgery

104

Treatment for ruptured AAA

SURGERY

105

Mortality rate for rupture

50%

106

What is the most catastrophic of all AAA complications

Rupture

107

Are you likely to be diagnosised with AAA before rupture

NO

108

Symptoms of rupture

Sudden abdominal pain radiating to back
paleness
dry mouth, thirst
nausea, vomitting
signs of shock (rapid heart rt, sweating, fainting, dizzines, weakness)

109

Choice modality for rupture

CT, but cant have pt unaccessable for that period of time so US

110

Most common site of rupture

Later wall INFRA RENALS

111

Biggest risk factor of rupture

SIZE

112

What is pseudo filled with

fills and then empties with blood

113

What to look for with pseudo

communicating stock

114

In pseudo what holds blood in

the outer layers of vessel or surrounding tissue

115

Cause of pseudo

1. myocartic infarction
2. surgery
3.trauma
4. angiogram interventional proceedures

116

Intervention of pseudo

1. compression
2. thombin injection
3. surgery

117

Most likely intervention

THROMBIN (immediate clot), compression is uncomfortable for the pt

118

What is Dissecting Aneurysm

Seriour where inner layer has tear and blood is trapped inbetween the layers of the aorta

119

What does dissecting aneurysm look like

looks like a second lumen (aorta) beside the first

120

Outcome if outer layers burst

Usually death

121

Why do dissecting aneurysms happen

deterioration of the arterial wall, most commonly associated with HIGH BLOOD PRESSURE

122

How often is high bp present in dissection

2/3

123

Other causes of dissection

1. Hereditary connective tissue disorders- Marfans and Ehlers-Danlos
2. Birth defects
3. Trauma
4.Pregnancy
5. Thoracic dissection coming down to abdominal

124

What is Marfans syndrome

connective tissue with long limbs and fingers

125

Risk factors for Dissection

Male
African Americans
40-70
HTN
Known aneurysm

126

Symptoms of Dissection rupture

Sudden excrusciating chest and back pain

127

Modality for diagnosing Dissection

CT
MRA
TEE

128

How long before death hits dissection rupture

hours

129

Mortality rate of dissection without intervention

75% in the first 2 weeks

130

What ligament cuts off the celiac axis when engorged

Median arcuate ligament

131

Whats another name for the condition where the CA is crimped by the median arcuate ligament

Celiac Axis Compression Syndrome

132

Purpose of the median arcuate ligament

connect left and right crura of diaphragm

133

Symptoms of Celiac Axis Compression syndrome

1. Weight loss
2. Chronic abdominal pain
3. Bruit in epigastric region

134

What is the flexible material used to repair weaked AAA walls

GRAFTS

135

What are the 4 types of grafts

1. Aorta End to End
2. Aortoiliac
3. Aortobifermoral
4. Fem-Fem

136

What is opening of the graft called

Anastomoses

137

What will you asses with patient who has a graft

1. Ask when it was placed
2. Assess Anastomoses
3. Check stenosis and aneurysm with doppler
4. ID and measure fluid collection
5. Check for distal blood flow

138

Abnormal communication between and artery and a vein

Arteriovenous fistula (congenital-aquired)

139

Symptoms of congenital AV fistula

birth defect
not common
usually lower extremities

140

Causes of aquired AV fistula

usually caused during trauma or surgery
inflamation
neoplasm

141

Symptioms of aquired AV fistula

1. Lower back and abd pain
2. Pulsatile mass with bruit
3. Massive swelling
4. Cardiac decompensation

142

When is AV fistula good

Dialysis