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Aneurysm Flashcards

1
Q

An aneurysm is a (localized or generalized?) ______ of an artery caused by _____ of the wall, forming a _____ along the course of the artery or a cavity communicating with an artery.

A

Localized

dilatation

stretching; swelling

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2
Q

CLASSIFICATION

• Based on the _________
• Based on the _______

A

composition of wall

shape

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3
Q

Aneurysm
• Based on the composition of wall

————
___________

A

True aneurysm
False aneurysm

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4
Q

Aneurysm
Based on the composition of wall

• True aneurysm: a true aneurysm is that in which _________ or the attenuated wall of the ______

A

the sac is formed by the walls of vessel

heart

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5
Q

Aneurysm
Based on the composition of wall

• False aneurysm is one in which _____________ e.g ______________.

A

the sac is formed by the surrounding structure

extra vascular haematoma

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6
Q

atherosclerotic aneurysm

True or fake?

A

True

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7
Q

syphilitic aneurysm
True or false

A

True

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8
Q

congenital aneurysm

True or false?

A

True

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9
Q

ventricular aneurysm

True or false?

A

True

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10
Q

pusatile haematoma

True or false aneurysm

A

False

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11
Q

Aneurysm
Based on the shape

_____ aneurysm
______aneurysm
________ aneurysm
______ with a continuous ________ e.g, _____ aneurysm.
______________ aneurysm

A

Sacular

Fusiform

Cricoid’s or racemose

Cylindrical; parallel dilatation; dissecting

Serpentine or varicose

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12
Q

Aneurysm
Based on the shape

Sacular aneurysm represents a __-like dilatation, which bulges from _______ and may be connected to it by _______

Cricoid’s or racemose aneurysm is a ________ swelling consisting of ___________

A

sac

one side of the artery

a small aperture.

pulsatile; tortuous and dilated arteries and veins

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13
Q

Aneurysm
Based on the shape

Fusiform aneurysm is ( symmetrical or asymmetrical ?) stretching of the circumference.

Serpentine or varicose aneurysm which has ____________

A

symmetrical

tortuous dilatation of vessel

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14
Q

The circumference and the length of fusiform aneurysm are constant .

T/F

A

F

variable

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15
Q

Atheromatous aneurysm

•The aneurysm are more common in (male or female?) after the age of ____ years.

•They are ____ or ______ in shape.

•They are ___cms in greatest diameter and of variable length-most commonly occur in ______,_______, ______ artery, ____ artery and _____ artery.

A

Male; 50

fusiform or saccular

15

abdominal aorta, arch of aorta

common iliac ; renal; mesenteric

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16
Q

The most common cause of aneurysm is _________.

A

atherosclerosis

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17
Q

Atheromatous aneurysm

• Pathogenesis: the aneurysm forms as a results of weakening and thinning of ____ underlying ___________.

• Microscopically: wall of aneurysm consist of ______ layers of aorta. There is _____ with marked ____ infiltration, and ____ debris, later on ___________ infiltration , macrophages, _____ cells and fibrosis.

A

media; atheromatous ulcer

all the

atheroma; leukocytic; fatty

perianeurysmal lymphocytic ; giant

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18
Q

Atheromatous aneurysm
• Effects

• 1. Rupture: the aneurysm may rupture while still small, into _____ cavity with _________ or ________ causing (acute or chronic?) surgical abdominal emergency. It gives rise to __________

A

peritoneal

retroperitoneal or intraperitoneal haemorrhage

Acute; potentially fatal haemorrhage.

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19
Q

Atheromatous aneurysm
• Effects

• 2. Arterial occlusion: Aneurysmal sac is filled with the ______ causing ______ of leg either by occluding the iliac arteries. Obstruction of mesenteric, renal or vertebral arteries (supplying the spinal cord) occurs by _________ from atheroma.

A

thrombus; ischaemia

mural thrombus

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20
Q

Atheromatous aneurysm
• Effects

• 3. Abdominal aorta aneurysm causes compression of ________ or _____.

Impingement of _______ on adjacent structures such as, into _____ cavity. It presents as _________ that simulates ______

A

ureter or erosion; vertebrae

peritoneal; pulsatile abdominal mass

a tumour

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21
Q

Syphilitic aneurysm

Aka

________

A

Leutic aneurysm

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22
Q

Syphilitic (leutic) aneurysm

Syphilitic aortitis is common above the age of ____ years.

•Pathogenesis: it is due to focal loss of _____ tissue, and muscles of ____ resulting in weakening of the wall.

A

40

elastic; media

23
Q

________ aneurysms are most common in the ascending aorta and arch of aorta because it is most frequently affected by _________

A

Syphilitic

syphilitic mesoaortitis.

24
Q

Syphilitic (leutic) aneurysm

PATHOLOGY
•Gross: The aneurysm may be ______ or ______ in shape .

Usually ___cm in diameter with _________ giving rise to _____ scars.

Intima of the involved segment is ______ color,______ , and ________- the appearance that has been likened to the ______

A

fusiform or saccular

3-5; aneurysmal bulging ; stellate

pearly white, irregular and wrinkled

bark of tree.

25
Q

Syphilitic (leutic) aneurysm

• PATHOLOGY

• Microscopically: Earliest change is _______. There is perivascular cuffing by _______, plasma cells and destruction of the elastic and muscle fibres of _____.

• As aneurysm from elastic tissues and muscles of the artery wall soon degenerates and sac comes to be composed of —————-.

A

mesoaortitis

lymphocytes; media

fibrous tissue

26
Q

Syphilitic aneurysm

Cardiac dysfunction: if dilatation of root of aorta occurs it results, in _________.

Owing to aortic insufficiency the ______ wall can undergo massive volume overload _______. Sometimes ____ grams referred to as ________.

A

aortic valve incompetence

left ventricular ; hypertrophy; 1000

cow’s heart

27
Q

Syphilitic aneurysm

• Thrombosis: laminated thrombus forms on ______ and clot incorporated with the wall of the sac. Blood may __________ and ___________ into __________

A

roughened surface

infiltrate in the wall of the aneurysm

ooze for some distance into the tissue around.

28
Q

Syphilitic aneurysm

• Pressure effect: the _____ effect symptoms are due to pressure on surrounding structure (eg ________ compression syndrome).

A

subjective

superior mediastinal

29
Q

Syphilitic aneurysm

Pain is due to
• - ______ of the wall
• - erosion of _______ and ______ .
• - irritation of _________.
• .Great veins may be _____ and undergo _______
• .______ of head and neck veins causes ______ of collateral veins.

A

stretching

bodies of vertebrae and incorporation into the wall of the sac

intercostals nerve roots

displaced; thrombosis

Congestion; engorgement

30
Q

Syphilitic aneurysm

Pain is due to

• .Pressure on major bronchus causes ________ and ———-.

• .Compression and stretching of left recurrent laryngeal nerve cause ________ and _________.

• Sympathetic symptoms are _____,_____,_______

• ._________ offer greater resistance to absorption and persist longer.

A

chronice cough and suppurating bronchopneumonia

paraslysis of the left vocal cord and hoarsensess of voice

dilatation of pupil, retraction of upper eyelid and exophthalamos

Intervertebral discs

31
Q

Syphilitic aneurysm

• Rupture: Rupture of aneurysm results into an _______ or any _____.

it may rupture externally through the chest wall.

A

adjacent body cavity

hollow viscous

32
Q

In syphilitic aneurysm, Embolism is common.

T/F

A

T

33
Q

Dissecting aneurysm
• Also know as _____ dissection or dissecting ______.

•It is common in (men or women?) , most often encountered between ___-___years of age.

•It is a (true or fake?) aneurysm.

A

aortic; haematoma; men

40 -70 ; fake

34
Q

Dissecting aneurysm

• Complications
• Rupture: in some cases the blood reaches the _______ and ruptures into _____ cavity causing death from ________.

It may track along the ____, ______ aorta, _______ arteries; ____ arteries and ____ arteries and rupture may result in fatal haemorrhages into mediastinum, pleura, retroperitoneal tissue and peritoneal cavity.

A

aorta ring; pericardial

cardiac tamponade

arch; abdominal ; mesenteric; iliac; renal

35
Q

Dissecting aneurysm

COMPLICATIONS

• Cardiac disease: obstruction of coronaries results in myocardial infarction. Involvement of aortic valve results in ________

Occasionally second intimal tear is seen in (proximal or distal?) part of the dissection so that the blood ________________________________________________, therefore a ______ aorta is formed.

A

aortic incompetence.

Distal

enters the false lumen through the proximal tear and reenters the true lumen through the distal tear

double barred

36
Q

Dissecting aneurysm

Pathogenesis

There is a ____ in _____ part of wall of aorta through which blood enters and track between inner ___rd and outer __rd of ____ dissecting the wall into ____ and ____.

Initial tear usually occur in the _____ aorta less than ___cm in length usually 10cm of the ______ but may involve whole circumference

A

tear; inner

2⁄3; 1/3; media

inner and outer layer

ascending; 5; aortic valve

37
Q

Dissecting aneurysm
• Etiopathogenesis

• Hypertension is associated with over ___% of cases.

• Weakening of the vessel wall of aorta is due to ______ necrosis or ______ degeneration.

There are degenerative and cystic changes in ______ , elastic and muscles being replaced by ______________ material. There are small areas of necrosis with _____.

A

90; cystic medial

Erdheim’s media

media; metachromatic mucoid

softening

38
Q

Dissecting aneurysm
Etiopathogenesis

• Similar morphological changes seen in Edheim’s media are also seen in the media in _____ Syndrome .

it is a _______ disorder inherited as autosomal ______, characterized by inadequate ____ formation of aorta, ______ and ______ disturbances.

Disturbance of vision results from ______ of the lens

A

Marfan’s ; connective tissue

dominant; elastic fiber

cardiovascular and ocular

subluxation

39
Q

Dissecting aneurysm
• Etiopathogenesis

• Iatrogenic trauma as a complication of _______ during _________ or __________ bypass can cause weakening of vessel wall.

A

canalization

diagnostic catheterization

cardio-pulmonary

40
Q

Infective mycotic aneurysm

It may occur at the ________ by direct _____ of micro-organism from _____ in acute bacterial endocarditic particularly _________.

The organism settle on the ____ layer, an ________ forms, invasion and weakening of the wall follow and (acute or chronic ?) aneurysm is produced which may rupture.

A

beginning of the aorta

extension; vegetations

staphylococcus aureus

infective thrombus

Acute

41
Q

Infective mycotic aneurysm

In small arteries , infected emboli in the lumen of the artery may give rise to acute inflammatory softening with rupture and cerebral haemorrhage.

T/F

A

T

42
Q

A mycotic aneurysm is sometimes seen in the wall of ________ ———- cavity which may cause fatal haemorrhage

A

tuberculous pulmonary

43
Q

Congenital aneurysm
a. _____ or _______ aneurysm
b. _______ or _______ aneurysm

A

Cerebral or berry

Circoid or Racemose

44
Q

Congenital aneurysm
a. Cerebral or berry aneurysm
• berry aneurysm are (small or large?)
•_____ shaped lesion like a blue berry
• normally ___cm in diameter, which bulges out from __________

•They are important only in the _____ artery.

A

Small ; spheroid

1 ; one side of an artery.

cerebral

45
Q

Congenital aneurysm
a. Cerebral or berry aneurysm

•LESION: over 80%berry aneurysm of the cerebral arteries occur in ______

•_____% of patient with berry aneurysm have congenital weakness of the arterial wall.

•Over ___% of patients are hypertensive.

A

Circle of Willis.

1 to 2

50

46
Q

Congenital aneurysm
a. Cerebral or berry aneurysm

• Complications
• Rupture: causes ______
• Space occupying lesion: A berry aneurysm up to __ cm across and acts as a space-occupying lesion.

A

subarachnoid haemorrhages

10

47
Q

Berry aneurysm occurs in ____% of people.

A

5

48
Q

Berry aneurysm are often found in people less than 30 years old.

T/F

A

F

rarely

49
Q

Often, a berry aneurysm becomes filled with thrombus.

T/F

A

F

occasionally

50
Q

Congenital aneurysm

Circoid or Racemose aneurysm

Are (Local or systemic ?) malformations of the blood vessels often with _________________________ occur in many part of the body, known as _____ aneurysm or circoid aneurysm from the greek for a ________

Commonest site is ____ and is congenital in origin. It may also occur as a result of ______

A

Local

abnormal connection between arteries and veins

arteriovenous; varicosity of vein.

scalp; brain injury.

51
Q

Micro aneurysm
• multiple microaneurysm occur on the smalll arterial twigs in _____ subjects above the age of ____ years. They are multiple, ___ in diameter.

A

hypertenive

50

2mm

52
Q

Traumatic aneurysm

• rupture of aorta may results from damage of its wall from outside, as by the _____ of an impacted fish-bone or other sharp foreign body in the esophagus, also from very severe injury such as ____ of the chest. Injury to arterial wall occur in ___ injury or ____ wound.

Carcinoma of bronchus or esophagus may invade the ______ and cause fatal haemorrhage.

A

perforation

crushing

stab; bullet

aortic wall

53
Q

Sizes of aneurysms

Berry-___cm
Leutic- ______ cm
Micro- ______
Atheromas-_____

A

1

3-5

2mm

15cm

54
Q

Dissecting aneurysm is - usually ____cm in length but less than ____cm in diameter

A

5

10

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