Flashcards in Vascular Pathology Test 1 Deck (60):
what do you most likely have if you see the SMA arising stright up instead of parallel?
What is a true aneurysm?
involves all three layers of the aorta
What percent of abd Ao aneurysm are infrarenal?
below the renal arteries
this has to be documented
what is a murual aneurysm?
common with larger aneurysm
hangs around the edges of the vessel
What kind of aneurysm results from an infection?
What is present in a Mural thrombus?
Atherosclerosis with tortuosity, folding.
When is surgery considered for an Abd Ao aneurysm?
When an aneurysm in > 5CM
What kind of aneurysm is the result of trauma?
What does an aneurysm do to the vessel?
consistent dilation of the vessel
What is aortic ectasia?
characterized by aortic root dilatation
dilatation associated with HTN and aging, resulting in aortic regurgitation
not an aneurysm
What does AAA stand for?
Abdominal Aortic Aneurysm
What is the size of the Ao to be considered an aneurysm?
increase in diameter of greater than 1.5 times normal
(Normal is < 3cm and tapers)
How is an AA found?
often made by physical exam by palpating a pulsatile mass
Abd bruit (tumultuous sounds through stethoscope)
Where is an AAA most commonly found?
What affects the likelihood of AAA?
Where do you measure an AAA
At the largest diameter AP but not long
What is present when thrombus is found?
What are risk factors for AAA?
age over 60
these all weaken the arterial wall
What is the most common reason for the thrombus resulting in AAA?
atherosclerosis _ most common cause - lipid deposits, plaque
syphilis (bacterial sexually transmitted infection)
What are some factors for AAA?
cystic medial Necrosis _ marfan
volume overload - severe reguritation
What is Marfan's Syndrome?
Autosomal Dominant Connective Tissue Disorder
may be diagnosed at birth or not recognized until late in life
will be monitored because it could rupture
What is the one main reason for AAA?
What are some causes of AAA?
inflammation of media and adventitia (ex: rheumatic fever, polychondritis, ankylosing spondylitis)
increased pressure (ex: systemic hypertension, aortic valve stenosis)
abnormal volume load (reguritation)
What are clinical symptoms of AAA?
symptoms results from rupture or vessel expansion that affects other organs
palpable abd mass
back or abd pain
drop in hematocrit (rupture)
What is a hematocrit drop indicate??
something is bleeding somewhere
When is an AAA considered high risk?
greater than 6 cm
When do you follow an AA every 6 months?
When is surgical intervention for AA considered?
What affects the growth rate of an AA?
blood pressure lowering medication (beta blocker)
Do you also measure the lumen when measuring an AA?
Get AP measurement of entire vessel and then just the lumen
What happens to the tensile strength of the aortic wall when a true aneurysm develops?
the tensile strength decreases
What are the different shapes of AAA?
SAccular - sudden
fusiform - most common, infrarenal, gradual enlargement
what is a psuedoaneurysm?
What is a pulsatile hematoma?
leakage of blood into the soft tissue abutting the punctures artery
What can cause a psuedoaneurysm?
Cardiac cath or angiography
so pseudoaneurysm would be found in the groin where the cath is startedmost common complications: hemmorrhage, torsion
knicked vessel causes this...dr mistake
on US what do you see on the blood flow picture?
a little neck attached to the vessel
How do you fix a pseudoaneurysm?
What is the compression technique for fixing a pseudoaneurysm?
You compress the bubble of the psuedoaneurysm with the transducer in hope of popping the bubble.
not very successful
What is a thrombin injection for psuedoanurysm?
a needle is inserted in to the psuedoaneurysm with clotting medicine. the bubble clots and closes off.
What is an Ao dissection?
it's a line found in the vessel on the ultrasound
a tear in the wall of the Ao - creates a dissection flap
What are the symptoms of a Aortic Dissection?
intense chest pain
What is the deBakey model?
a model that describes the different types of Ao dissections
closer to the heart is more dangerous
What are the symptoms of a ruptured AAA?
greater than 6cm
What are the clinical symptoms of AAA rupture?
intense back pain
decrease in hematocrit
What test would be done if AAA rupture?
CT is the method of choice esp in a surgical emergency
What is AAA stent graft repair?
put into a patient with AAA to repair it
a hollow tube inserted into the vessel
make sure the flow is in the tube and the tube is intact
will see the tube on US
What is a pseudo pulsatile abd. mass?
something palpated but not an AAA
fibroid uterus (so large felt in abd)
horseshoe kidneys (connected across Ao)
para-aortic nodes (lymphnodes)
What is an arteriovenous fistula?
acquired secondary to trauma
communication between and artery and a vein
What is a clinical sign of an Arteriovenous fistula?
Massive swelling of lower extremities
What are the IVC tumors?
Renal cell carcinoma
What is IVC thrombosis
pulmonary emboli from lower extremities
fixed with filter
What are the symptoms of a renal vein obstruction?
What is renal vein thrombosis related to?
thrombosis in the IVC
What causes renal artery stenosis?
What are some IVC abnormalities?
Infrahelpatic interruption of the IVC
What kind of IVC abnormality do you have if your hepatic veins empty directly into the right atrium?
Infrahepatic interruption of the IVC
When might you find a renal vein obstruction in infants and adults?
Seen in dehydrated infants
adults with kidney abnormalities
Can you see thrombi in the renal vein?
What are some symptoms of renal vein thrombosis?