Test three c Flashcards
Risk factors for AA
age
male
tobacco
high cholesterol
obesity
htn
CAD
lower extremity artery disease
fam history
Causes of AA
degenerative
congenital
mechanical
inflammatory
Infectious
True vs False aneurysms
True
-at least one vessel layer is in tact
-fusiform = circular; saccular = pouch-like
False/pseudo
-bleeding into surrounding structures
-usually from trauma, infection, bypass graft surgeries
Manifestaton of thoracic, abdominal, and arch aneurysms
Thoracic= usually asymptomatic, but might have deep chest pain
Abdominal = back pain, epigastric stuff, bowel issues, claudication, mass, bruits, blue toe syndrome
Arch =
- coronary artery issues = angina and TIA
-laryngeal nerve issues = cough, dyspnea, hoarse, dysphagia
-venous return issues = JVD, edema
Complication of aneurysms
rupture with severe pain and maybe ecchymosis
-patient can die if rupture happens into thoracic or abdominal cavity
hypovolemic shock
Aortic dissection: type A vs Type B
A = ascending aorta and arch
B = descending aorta
Predisposing factors for Aortic dissection
male
age
vascular disease
trauma
tobacco
coke/meth
fam history
pregnancy
htn
marfan
Etiology of aortic dissection
degenerated elastic fibers in arterial wall
tear in inner layer of aorta
blood goes thru tear –> rupture is fatal
Manifestation of Aortic dissection
-Worst pain ever, tearing, ripping, stabbing
- Type A = LOC change, weak carotid/temporal pulse, dizziness/syncope
Old ppl have vague symptoms like hypotension
Complications of aortic dissection
Cardiac tamponade (into pericardial sac)
Hemorrage into body cavities
Spinal cord ischemia
renal ischemia
mesenteric ischemia
rupture leading to death
How often should aneurysms be monitored
every 6-12 months
2-3 yrs for smaller ones
Surgeries for aneurysms
Endovascular Aneurysm Repair –> uses femoral artery
post surgical complications for aorta stuff
Intraabdominal htn w/ associated abdominal compartment syndrome
Endoleak –> from inadequate seal in graft
Ischemia below graft site
Aneurysm growth above or below graft
Aneurysm rupture
Aortic dissection and bleeding
Renal artery occlusion
Preop aneurysm surgery
Monitor for rupture, intraabdominal htn, compartment syndrome –> signs are diaphoresis, pallor, weakness, tachycardia, hypotension, pain, LOC change, pulsating ab mass
Get baseline data
NPO, antibiotics, BBs, bowel prep, skin cleaned
Virchow’s triad
venous stasis
damage of endothelium (direct or indirect)
hypercoagulability
Pathophysiology of VTE
thrombus forms and gets bigger and forms a tail that occludes vein
if only partial blockage, is covered by endothelial cells
If doesn’t detach, undergoes lysis or becomes adherent within 5-7 days
May become PE
weird venous stasis risks
old age
afib
stroke
weird endothelial damage risks
hypertonic IV drugs
IV drug abuse
indwelling catheters
weird hypercoagulability risks
high altitudes
HRT
Pregnancy and post partum
anemia
protein C and S deficiency
tobacco
Superficial vein thrombosis manifestation
cordlike vein
surrounding area is itchy, tender, red, and warm
mild temp elevation
leukocytosis
edema of extremeties
lower extremity venous thromboembolism
unilateral leg edema, pain, tenderness, dilated superficial veins
paresthesia
systemic temp over 100.4
if IVC i involved, both legs could be edema and blue
if SVC is involved - similar stuff in arms and face
Pulmonary embolism manifestation
dyspnea
hypoxia
tachypnea, cough, chest pain, hemoptysis, crackles, wheezing, fever, tachycardia, syncope
Big ones = mental changes, hypotension, impending doom
Diagnostic studies for TE
ACT, aPTT, INR, bleeding time, platelet count
D-dimer –> elevation suggests VTE
venous compression ultrasound –> bad if veins don’t collapse with pressure
Duplex ultrasound: determines location and extent of thrombus
CT venography (contrast)
MR venography
preventing VTE (positioning)
reposition every 2 hrs
flex/extend feet, knees, and hips every 2 hrs while awake
sit in chair for meals and walk around 4-6 times a day
wear compression stockings
Intermittent pneumatic compression devices`
