Aortic and Peripheral Arterial DIsease Flashcards Preview

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Flashcards in Aortic and Peripheral Arterial DIsease Deck (31):
1

Define aneurysm

abnormal local dilatation of an artery, vein, or heart

2

True aneurysm

outpouching of all three layers (intima, media, adventitia)

3

False aneurysm

contained ruptures of the intima, media, and sometimes adventitia. Its contained by the tunica adventitia or perivascular thrombus.

4

Aortic aneurysm more commonin who>

Old, white, males...most common in the abdomen (75%)

5

Arteries undergo continuous remodelling throughout life mediated by what?

Matrix metalloproteinases

6

C-reactive protein and IL-6 are markers of ?

Inflammation

7

Whats going on in Marfans syndrome or Ehlers Danlos?

Fibrillin or collagen defects weaken the tunica media.

8

Aneurysm symptoms

usually asymptomatic, may cause back pain if leaky

9

Risk of rupture stats

<4cm....0.3%
4-4.9cm...1.5%
5-5.9cm.....6.5%

10

Major factor in the rate of growth

Hypertension

11

Some complications of an aortic aneurysm

mural thrombus formation, embolism of atheroma or thrombus, obstruction of aortic branches, aortoenteric fistulas
Rupture is obviously the most problematic.

12

Aortic aneurysms are familial

true

13

Catastrophic tear of the tunica intima allowing blod into the tunica media where it tunnels a second lumen

aortic dissection

14

Type A aortic dissection

ascending aorta or arch

15

Type B

descending alone

16

Which is more common

Type A

17

Aortic dissections associated with who?

late middle age black males
May also occur in younger patients with Marfan's syndrome

18

Dissections are associated with what state

Hypertensive stae

19

Pathogenesis of a dissection

Intimal tear...can be caused by surgery
MVAs can cause an intimal tear at the ligamentum arteriosum

20

Severe pain where for type A dissection

ANterior chest

21

Pain where for TYpe B

Between the scapulae

22

Peripheral arterial disease usually refers to what?

Chronic atherosclerotic occlusive disease of the large and medium arteries. Primarily seen in the legs. COmmon in the elderly

23

Claudication

pain brought on by exercise and relieved by rest

24

How do you evaluate for Peripheral arterial disease

measure blood pressure in the arm and lower leg, ratio less than 0.9 they've got it.

25

treatment of peripheral arterial disease

walking (increases collateral vasculature)

26

Acute arterial occlusion

uncommon, generally due to thromboembolism

27

Beurger disease

Thrmboangiitis obliterans...chronic thrmbosing inflammatory disease of small and medium arteries and veins of arms and legs

28

Beurger disease associated with what?

smoking

29

Acute and chronic phase. Describe them

Acute involves transmural acute inflammation with granulomas and giant cells, but without necrosis. Thromboses have microabcesses in the thrombus.
Chronic involves nonspecific organization and recenalization of the thrombus with neovascularization and fibrosis.

30

Signs and symptoms of bruegers disease

instep claudication, cold feet,

31

Pathogenesis of an aneurysm

Usually an interplay between atherosclerosis and genetic predisposition to degeneration of the tunica media