B P5 C42 Diseases of the Aorta Flashcards
(224 cards)
Begins at the aortic valve and extends to the sinotubular junction. This supports the bases of the aortic valve leaflets.
Aortic root
The right and left coronary arteries arise from the __________________
Sinuses of Valsalva
Begins at the sinotubular junction and rises to join the aortic arch. The proximal portion of the ascending aorta lies within the pericardial cavity, anterior to the pulmonary artery bifurcation
Upper portion of the ascending aorta
Gives rise to the innominate artery, the left common carotid artery, and the left subclavian artery.
Aortic arch
Begins distal to the left subclavian artery.
Descending thoracic aorta
Marks the point at which the aortic arch joins the descending aorta
Ligamentum arteriosum
Marks the site of transition between the relatively mobile ascending aorta and the fixed descending aorta making it vulnerable to deceleration trauma.
Aortic isthmus
Gives rise to the celiac artery and the superior mesenteric artery anteriorly, followed by the posterolateral origins of the left and anterolateral right renal arteries.
Abdominal aorta
This segment of the aorta is called the suprarenal or visceral segment. The infrarenal aorta lies anterior to the lumbar spine, where paired lumbar artery branches arise posteriorly.
The aorta ends by bifurcation into _________________
Common iliac arteries
In the proximal aortic segments, the vasa vasorum supply additional nutrients to the outer third of the thoracic aortic media. The ____________ aorta normally lacks an independent microvascular supply.
Infrarenal
The aortic wall pressure-diameter relationship is nonlinear; a more distensible component is demonstrated at lower pressures and a stiffer component at higher pressures, with the transition from distensible to stiff behavior occurring at pressures higher than _________________
80 mm Hg
Aortic diameter is generally less than __________________ at the root and becomes smaller distally.
< 40 mm
The bifurcation typically occurs at the level of the umbilicus and the _______________
L4 vertebral body.
refers to a pathologic segment of aortic d tation that expands and can eventually rupture or dissect. One criterion for abnormal aortic dilatation is a diameter of at least 50% greater than expected for the same aortic segment or l dilation 50% greater than the adjacent normal aorta
Aortic aneurysm
The more common type, are symmetrically dilated with involvement of the entire aortic circumference
Fusiform
Exhubits focal outpouching. These both are “true” aneurysms with an intact aortic wall involving all layers.
Saccular
Bleeding has occurred through the aortic wall r ing in a contained periaortic hematoma in continuity with the aortic lumen; may result from trauma, infection or contained rupture of an aortic aneurysm, dissection, or penetrating ulcer.
Pseudoaneuyrsm
Defined by an abdominal aorta greater than 3.0 cm in diameter
AAA
The most common form of aortic aneurysms, being present in 2.3% of those 75 to 79 years old.
AAA
Most AAA (>80%) arise in the ______________
Infrarenal aorta
AAAs are approximately five times more prevalent in _____ than in women, and are associated strongly with age, with most occurring in those ______________ and even higher risk in those older than 75 years.
Men
>60 years
AAAs strongly are associated with ______________
Cigarette smoking
Current smokers are seven times more likely to have an AAA than nonsmokers with duration and quantity of smoking increasing risk. Smoking also increases AAA growth rate. Other risk factors include emphysema, hypertension, and hyperlipidemia.
A family history is a potent risk factor for AAA being present in about 20%
Matrix-degrading enzymes released by inflammatory cells lead to ___________________ and play a role in dilation and rupture.
Medial degeneration
AAA formation associates with chronic aortic wall inflammation, increased local expression of proteinases, and degradation of structural connective tissue proteins
Enzymes including ____________________ and elastolytic cathepsins degrade arterial matrix constituents contributing to aneurysm expansion and rupture.
Matrix metalloproteinases (MMPs)