URR 9 Flashcards
(100 cards)
1
Q
2nd most common type of splanchnic artery aneurysm
A
hepatic artery
2
Q
Most hepatic artery aneurysms are in the ____ segment
A
extrahepatic
3
Q
Hepatic artery aneurysms are associated with ____ and ____
A
systemic infection
trauma
4
Q
Least common type of splanchnic artery aneurysms
A
superior mesenteric artery aneurysm
5
Q
SMA aneurysms are associated with:
A
cystic medial necrosis
6
Q
______ through the groin is the standard treatment for infrarenal aortic aneurysms
A
percutaneous stent or graft placement
7
Q
The stents or graft placements placed in aorta to treat infrarenal aneurysms most be monitored by serial ultrasound exams to assess for:
A
endoleak
8
Q
Percuteaneous stent or graft placements in the aorta should be monitored every ___ months in the first year, and every ____ months after the first year
A
3-6
6-12
9
Q
After a stent or graft placement in the aorta, normally the native aortic sac will ____ in size over time
A
decrease
10
Q
If an endoleak is present, the native sac will ____ in size between exams
A
increase
11
Q
The native aortic sac should be measured in the ____ plane
A
transverse
12
Q
Hallmark sign of endoloeak
A
aortic sac expands more than 0.6 cm between exams
13
Q
Four types of endoleaks
A
Type I, II, III, IV
14
Q
Type I endoleak
A
leak at graft attachment site
15
Q
Type II endoleak
A
retrograde flow into the native sac from the lumbar artery or IMA
16
Q
Type III endoleak
A
defect in the graft
17
Q
Type IV endoleak
A
graft material too porous and allowing blood through the fabric mesh
18
Q
embolic material lodges in the digital arteries of the toes leading to cyanosis of the distal tissues
A
blue toe syndrome
19
Q
causes of blue toe syndrome
A
thrombus in AAA
arteritis
ulcerated atherosclerotic lesions
some angiography procedures
20
Q
Intimal layer tears and allows flow between the intima and media layers into a blind pocket (false lumen)
A
dissection
21
Q
Remaining lumen (true lumen) is decreased in size due to the flap with blood flow beneath it
A
dissection
22
Q
Dissection causes:
A
weakened vessel wall
risk of vessel rupture
23
Q
____ can occur in the false lumen which can cause a significant stenosis/occlusion in the vessel and ischemia distal to the dissection
A
thrombosis
24
Q
Dissection most commonly occurs in the ____ due to the shearing forces of the blood as it rounds curve
A
aortic arch
25
Dissection is associated with:
connective tissue disorders
Marfan syndrome
Ehlers-Danlos syndrome
26
If a dissection is visualized, surgical intervention is required immediately due to:
risk of rupture
27
Dissection uses the ____ classification
Debakey
28
Type I dissection
involves ascending and descending aorta
29
Type II dissection
involves ascending aorta
30
Type II dissection is associated with:
Marfan syndrome
31
least common type of dissection
Type II
32
involves the descending aorta below the origin of the left subclavian artery
Type III
33
Type ___ dissection has the lowest mortality rate
III
34
genetic disorder that affects connective tissue of the heart, vessels, and bones
Marfan syndrome
35
What do patients with Marfan syndrome typically look like?
very tall with a thin fame, long extremities and fingers
36
Who is believed to have Marfan syndrome?
Abraham Lincoln
37
In Marfan syndrome, the ____ and ____ are the most commonly affected blood vessel (Debakey type II dissection)
aortic root and arch
38
_____, _____, and ____ are common associated with Marfan syndrome
aortic dissection
aneurysm
valve insufficiency
39
_____ and _____ are common with Marfan syndrome
Mitral valve prolapse
valve insufficiency
40
Linear echogenicity seen in the lumen of the vessel, separating it into two channels; one channel is a blind ended pocket
aortic dissection
41
With an aortic dissection, color flow demonstrates two lumens, both with:
turbulence
42
In an aortic dissection, ____ flow is seen in the false lumen
bidirectional
43
Type ___ dissection is the most common
I
44
An aortic dissection is a critical finding because:
risk of rupture
45
There is a significant risk of rupture in aneurysms >___cm in diameter
7
46
Aortic rupture clinical symptoms
back pain
hypotension
47
occurs due to sudden significant blood loss
hypovolemic shock
48
Hypovolemic shock can lead to ____ and can be fatal
organ failure
49
An aortic rupture is a critical finding because:
large amounts of blood loss
50
Sonographic appearance of aortic rupture
irregular hypoechoic areas near an aortic aneurysm; hematomas can displace surrounding structures
51
Pseudoaneurysms are caused by ____ or ____
trauma
invasive procedures
52
blood escapes through all 3 layers of the artery into surrounding tissues and is encapsulated within the tissues
pseudoaneurysm
53
A pseudoaneurysm forms:
round sac of blood
54
The connection of a pseudoaneurysm to an artery is made through:
a neck or stalk
55
Treatment of a pseudoaneurysm is by ____ or ____
compression of stalk
thrombin injection
56
clotting agent injected into a pseudoaneurysm to close the opening and clot the blood that has escaped; usually reserved for larger pseudoaneurysms with larger stalks
thrombin
57
Sonographic appearance of pseudoaneurysm
rounded, anechoic structure adjacent to main artery
58
Color Doppler demonstates a connection between the artery and the structure of a pseudoaneurysm as well as ____ flow and the ____ within the body.
turbulent
Yin yang sign
59
In a pseudoaneurysm, doppler evaluation will demonstrate ___ resistance to-and-fro flow in the stalk and ____ resistance to-and-fro flow in the body.
high
lower
60
_____ to the pseudoaneurysm is helpful for needle selection with thrombin injection
measuring the depth
61
Compression treatment for a pseudoaneurysm is performed in ___ 1 minutes intervals; color Doppler after each compression interval
10
62
Color Doppler demonstrates the ____ sign in the body of the pseudoaneurysm
yin yang
63
Aortic stenosis is most commonly caused by:
atherosclerotic changes
64
Aortic stenosis can also be related to AAA ___ or ____
thrombosis
arteritis
65
Resistance will increase ____ to aortic stenosis
proximal
66
Aortic stenosis caused ____ velocity at site of stenosis
increase
67
Distal to aortic stenosis, the flow will be dampened with _____ waveforms possible
tardus parvus
68
If the stenosis is superior to the renal artery origins, renal ischemia will activate the renin-angiotensin system causing:
systemic HTN
69
also known as aortoiliac occlusive disease
Leriche syndrome
70
Syndrome due to occlusion of the abdominal aorta just above site of bifurcation
Leriche syndrome
71
Symptoms of Leriche syndrome
fatigue of both lower limbs
intermittent bilateral claudication with ischemic pain
absent or diminished femoral pulses
pallor or coldness of both lower extremities
72
In Leriche syndrome, Doppler waveforms will demonstrate ___ resistance, ____ flow changes throughout both legs
low
post-stenotic
73
Leriche syndrome can be related to _____ as the internal iliac arteries supply penis with blood
erectile dysfunction
74
also known as Ormond disease
Retroperitoneal fibrosis
75
Retroperitoneal fibrosis most commonly occurs at level of:
aortic bifurcation and inferiorly in pelvis
76
Idiopathic overgrowth of fibrous tissue around an atherosclerotic aorta
retroperitoneal fibrosis
77
Retroperitoneal fibrosis can be related to ____, ___, ____, or ____
drugs
infection
malignancy
cancer therapy
78
Retroperitoneal fibrosis may lead to ______ leading to hydronephrosis
ureteral obstruction
79
Retroperitoneal fibrosis may compress the IVC causing bilateral ____
pedal edema
80
Retroperitoneal fibrosis may compress the gonadal veins causing:
scrotal swelling
81
Sonographic appearance of retroperitoneal fibrosis
soft tissue mass surrounding great vessels, hypoechoic with smooth borders
82
most common type of AAA
fusiform
83
Most common location of AAA
infrarenal segment
84
Aortic dissection most commonly affects the:
ascending aorta and arch
85
Aortic stenosis is most commonly caused by:
atherosclerosis
86
Retroperitoneal fibrosis commonly occurs:
at aortic bifurcation and below
87
Most common location of a splanchnic artery aneurysm
splenic artery
88
The iliac arteries originate:
a. at level of kidneys
b. at level of symphysis pubis
c. at level of umbilicus
d. at level of inguinal ligament
c
89
How can you demonstrate a longitudinal view of the aorta and IVC?
a. use a coronal view with decubitus patient positioning
b. use a transverse view with decubitus patient positioning
c. use a transverse view with supine patient positioning
d. use a longitudinal view with supine patient positioning
a
90
The AP dimensions of the aorta:
a. are most accurately measured in the transverse plane
b. are most accurately measured with color Doppler activated
c. are most accurately measured with the sound beam parallel to the aorta
d. are most accurately measured with a longitudinal plane
d
91
What changes occur in the normal aortic flow as it moves from the diaphragm to the legs?
a. the resistance to flow increases as you move toward the extremities
b. the resistance to flow decreases as you move toward the extremities
c. the flow pattern changes from triphasic to biphasic
d. the flow pattern demonstrates more antegrade diastolic flow as you move toward the extremities
a
92
An abdominal aortic aneurysm is diagnosed when the diameter exceeds:
a. 4cm
b. 3 cm
c. 2.5 cm
d. 3.5 cm
b
93
What is the most common complication of an aortic aneurysm?
a. rupture
b. dissection
c. systemic HTN
d. ischemia of the legs
a
94
The yin-yang sign on Color Doppler evaluation is related to what aortic abnormality?
a. dissection
b. coarctation
c. aneurysm
d. bovine arch
c
95
Anemia and low hematocrit levels can be an indicator for:
a. slow leak of an AAA
b. dissection
c. Leriche Syndrome
d. Ormond disease
a
96
Identifying which two structures guarantees a complete evaluation of the abdominal aorta?
a. coronary arteries and iliac arteries
b. celiac axis and iliac arteries
c. superior and inferior mesenteric arteries
d. hepatic and splenic arteries
b
97
What is a hallmark sonographic sign of an endoleak in an aortic graft?
a. increase in aortic sac size
b. changes in echogenicity of graft
c. increase in aortic lumen size
d. abdomen pain while scanning
a
98
What are two connective tissue disorders that have an increased risk of aortic dissection?
a. leriche syndrome and Beurger disease
b. Paget-schroetter syndrome and Arteritis
c. Marfan and Ehlers- Danlos syndrome
d. all the above
c
99
A dissection involved blood flowing between:
a. the externa and vasa vasorum
b. the media and externa layers
c. the intima and media layers
d. the externa and muscle tissues
c
100
The yin-yang sign indicates:
a. blue toe syndrome
b. aortic dissection
c. Leriche syndrome
d. Pseudoaneurysm
d
