AAA Flashcards
1
Q
AAA
A
Abdominal Aortic Aneurism
2
Q
What physiologically causes AAA
A
Loss of elastin and collagen in arteries. degernerative process. affected by amount of pressure applied to walls
3
Q
Predisposing Factors for AAA
A
- 5x more common in males
- Familial Link
- Genetic - common in Marfans
- Age >50
- Smoking
- CAD
- HTN
- COPD
4
Q
Symptoms of Un-ruptured AAA
A
- Vague abd - belt-like tightening on abd
- back pain - from pressing on spinal nerves
- Related symptoms of AAA pressing on other structures
- Nausea/vomiting - pressing on GI viscera
- Ischemia from embolization resulting from aneurism
5
Q
Symptoms of AAA Rupture
A
-Hypovolemic Shock
-PEA arrest
-if RPB - may have radiating groin pain and swelling
Symptoms Triad:
-Severe Abd pain
-Hypotension
-Pulsatile Mass
6
Q
When to operate?
A
> 5.5cm, measured on CT/US
-or of course if its ruptured
7
Q
Declamping shock
A
- area proximal to area has increased preload to heart, inc HTN, inc afterload, activating PNS to compensate
- area distal to aorta has been ischmic during procedur,e, leading to significant vasodilation from CO2 buildup
- When blood flow through aorta is suddenly returned. preload tanks, afterload drops in to boggy vasodilated systemic circulation, CO dec. acidosis from lactate and CO2. takes a bit to normalize. dec effect by slow unclamping
8
Q
Post op complications
A
- Dysrhythmias
- embolism
- fluid imbalance
- CNS effects from ischemia during clamp
- organ ischemia distal to clamp