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Abdomen Review > Abdominal Vasculature - Part 5 > Flashcards

Abdominal Vasculature - Part 5 Flashcards

1
Q

Dissection aneurysm

A

Is an aneurysm in which the wall of an artery rips (dissects) longitudinally
- rupture of the intima of the aorta which separates from the media with a column of blood between the two layers

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2
Q

Why does dissection aneurysms occur?

A

Because of the bleeding into the weakened wall splits the wall

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3
Q

What do dissecting aneurysms tend to affect?

A

The thoracic aorta

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4
Q

When are dissecting aneurysms particularly dangerous?

A

In Marfan syndrome

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5
Q

What are causes of dissection aneurysms? (4)

A
  1. Hypertension
  2. Marfan syndrome
  3. Pregnancy
  4. Chest trauma
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6
Q

What is a dissection aneurysm a result of? (2)

A
  1. Congenital defect
  2. Iatrogenic event
    - man made nick in a vessel
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7
Q

How do you measure an aneurysm?

A

From the outer wall to the other outer wall

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8
Q

What does a dissection aneurysm look like on US? (2)

A
  1. Identification of an intimal flap in the arctic lumen

2. Arterial pulsations

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9
Q

What is demonstrated in the dissection aneurysm between the membranes during diastole?

A

Opposite flow direction

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10
Q

What is the sonographic findings of a rupture?

A

Is a hematoma in soft tissue adjacent to the dissected area

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11
Q

What is the average measurement of the aorta at the level of the suprarenal?

A

2.5cm

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12
Q

What is the average measurement of the aorta at the level of the renal?

A

2cm

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13
Q

What is the average measurement of the aorta at the level of the infrarenal?

A

1.5cm

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14
Q

What is the average measurement of the aorta at the level of the common iliac?

A

1cm

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15
Q

Aneurysm

A

Is a permanent focal dilation of an artery 1.5x its normal diameter involving all three layers of the wall

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16
Q

What are the clinical signs and symptoms of AAA? (3)

A
  1. Pulsatile mass at or above the umbilicus AAA
  2. Usually asymptomatic
  3. Symptoms = back pain
17
Q

What are common causes of AAA? (5)

A
  1. Hypertension
  2. Atherosclerosis
  3. Infection
  4. Trauma
  5. Hereditary or acquired connective tissue disorders
    - eg. Marfan syndrome or Ehlers-Danlos syndrome
18
Q

What layers of the vessel are involved with AAA? (2)

A
  1. Media layer

2. Adventitia layer

19
Q

What happens to the media and adventitial layer when you have a AAA?

A

There is s significant decrease in elastin and collagen in both layers

20
Q

When is an aneurysm considered present?

A

When the infrarenal diameter is 3cm or greater

21
Q

What are 7 risk factors of AAA?

A
  1. Over age 50
  2. More common in males
  3. Grows faster in women and ruptures at a smaller diameter
  4. Smoking
  5. Family history history of peripheral vascular disease
  6. Cardiovascular disease
  7. Hypertension
22
Q

What is common in an AAA?

A

A thrombus

23
Q

What is important to note with an AAA?

A

Its location

- above or below renals

24
Q

What diameter should be reached in order to have surveillance done every 6 months?

A

4-4.5cm

25
Q

What happens when the diameter of the AAA reaches > 4.5cm?

A

The patient should be referred for elective surgical options
- but this is not mandatory

26
Q

When is a repair indicated for an AAA? (2)

A
  1. When the diameter is > 5.5cm

2. Grows 0.6-0.8cm per year

27
Q

AS

A

Aortic stenosis

28
Q

Aortic stenosis

A

Orifice of the aortic valve is significantly reduced due to the failure of the arctic valve leaflets to open fully during systole

29
Q

What is the classic triad of symptoms from the aortic stenosis occur on exertion? (3)

A
  1. Angina
  2. Syncope
  3. Dyspnea
30
Q

Angina

A

A condition marked by severe pain in the chest, caused by inadequate blood supply to the heart

31
Q

Syncope

A

Temporary loss of consciousness caused by a fall in blood pressure

32
Q

Dyspnea

A

Difficulty breathing

33
Q

What are the sonographic findings for a stenosis of the aorta? (3)

A
  1. Assess compete aorta with doppler
    - colour aliasing
    - high systolic velocities in aorta
  2. Must evaluate the iliac vessels
  3. Tardus parvus waveforms in the iliac

Abdomen Review (12 decks)

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