week 3: diseases of arteries Flashcards
(59 cards)
an ____ is a localized dilation or outpouching of a vessel wall or cardiac chamber
aneurysm
_____ aneurysm involves all 3 layers of arterial wall and are described as a weakening of the vessel wall (fusiform or circumferential)
true aneurysm
outpouches on both sides
____ aneurysm is an extravascular hematoma that communicated with the intravascular space
false aneurysm
break in vessel wall (usually by trauma)
the 2 conditions that are found in more than half of all individuals with aneurysms
arteriosclerosis and htn
(htn - shear forces that remodel/weaken vessel walls
atherosclerosis - plaque formation erodes the vessel wall)
where do aneurysms most commonly occur?
thoracic or abdominal aorta
____ _____ is a devastating complication that can involve any part of the aorta and can disrupt flow through arterial branches, thus creating surgical emergency
aortic dissection
symptoms of aortic dissection :
sudden severe sharp pain in chest of upper back, described as a tearing, stabbing or ripping feeling, SOB, fainting, dizziness, low blood pressure, high suspicion when there’s 20mmHg pressure difference bw the arms
____ occurs when there’s a tear in the intima and blood enters the wall of the artery
(occurs from trauma or ischemia from plaque weakening the intima, chronic htn and inflammation contribute to degradation of vessel wall)
(aortic) dissection
____ ___ ____ occurs when intraventricular tension stretches the noncontracting infarcted muscle
usually after a heart attack !!
ventricular wall aneurysm
with time the aneurysm becomes fibrotic but continues to bulge with each systole, acting as a reservoir for some of the stroke volume
__ ___ is an outpouching of a weakened arterial wall
occurs in 2-4% of population
it is usually silent over a lifetime, but can be complicated by subarachnoid hemorrhage
intracranial aneurysm
goals of medical treatment on aneurysms are:
maintain low blood volume and low blood pressure to decrease mechanical forces thought to contribute to vessel wall dilation
for aortic aneurysms: smoking cessation, reducing blood pressure/volume and beta blockers. surgery is done when the anuerysm reaches 5cm in diameter
(If aneurysms are dilating rapidly, surgery indicated. Surgical repair is done when aortic aneurysms reach 5cm in diameter )
varicose veins are caused by:
trauma to the saphenous
Clinical manifestations of aneurysms in heart:
Dysrhythmias, heart failure, embolism of clots to the brain or other vital organs
Clinical manifestations of aortic aneurysms:
Often asymptomatic until they rupture, when they become painful. Sxs of dysphagia, dyspnea caused by pressure of a thoracic aneurysm on surrounding organs
Clinical manifestations of abdominal aneurysms:
Impair flow to an extremity and cause sxs of ischemia
___ ____ are a common condition, affecting women nearly twice as often as men
Varicose veins
__ ___ is a superficial vein in which blood has pooled, typically involving the saphenous veins of the legs and are distended, tortuous, and palpable
Varicose veins
2 causes of varicose veins
- Traumas to the saphenous veins that damages one or more valves
- Gradual venous distention caused by the action of gravity on blood in legs
(Gravity and valves)
Valve damage causing varicose veins
Pressure in the vein builds and damages the valves
From standing long periods, wearing constricting garments, crossing legs
Damaged valves can’t maintain normal venous pressure, which causes hydrostatic pressure in the vein to increase — distending the vein and it becomes tortuous and edema develops in extremity
Virtually everyone who is hospitalized is at risk for ___
deep vein thrombosis (DVT)
Especially after hip surgery
S/sxs of ___ entail:
Potentially no s/sxs
Throbbing or cramping in 1 leg, usually the calf, swelling in 1 leg
Warm/red/darkened skin around painful area
Swollen veins that are hard or sore to the touch
calf cramping
DVT
Diagnoses of a DVT
- D dimer = blood test that measures the presence of thrombosis
if positive, diagnosis must be confirmed with ultrasound - Ultrasound
What is a thrombus?
A blood clot that remains attached to a vessel wall
What is d-dimer?
A protein fragment made when a blood clot dissolves in your body
Only detectable when body is forming or breaking down significant blood clots
D-dimer detectable in patients w DVT as it is a marker of endogenous fibrinolysis
