Aneurysm Flashcards by Iseoluwa Ojo

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.

Localized

dilatation

stretching; swelling

How well did you know this?

Not at all

Perfectly

CLASSIFICATION

• Based on the _________
• Based on the _______

composition of wall

shape

How well did you know this?

Not at all

Perfectly

Aneurysm
• Based on the composition of wall

————
___________

True aneurysm
False aneurysm

How well did you know this?

Not at all

Perfectly

Aneurysm
Based on the composition of wall

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

the sac is formed by the walls of vessel

heart

How well did you know this?

Not at all

Perfectly

Aneurysm
Based on the composition of wall

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

the sac is formed by the surrounding structure

extra vascular haematoma

How well did you know this?

Not at all

Perfectly

atherosclerotic aneurysm

True or fake?

True

How well did you know this?

Not at all

Perfectly

syphilitic aneurysm
True or false

True

How well did you know this?

Not at all

Perfectly

congenital aneurysm

True or false?

True

How well did you know this?

Not at all

Perfectly

ventricular aneurysm

True or false?

True

How well did you know this?

Not at all

Perfectly

pusatile haematoma

True or false aneurysm

False

How well did you know this?

Not at all

Perfectly

Aneurysm
Based on the shape

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

Sacular

Fusiform

Cricoid’s or racemose

Cylindrical; parallel dilatation; dissecting

Serpentine or varicose

How well did you know this?

Not at all

Perfectly

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 ___________

sac

one side of the artery

a small aperture.

pulsatile; tortuous and dilated arteries and veins

How well did you know this?

Not at all

Perfectly

Aneurysm
Based on the shape

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

Serpentine or varicose aneurysm which has ____________

symmetrical

tortuous dilatation of vessel

How well did you know this?

Not at all

Perfectly

The circumference and the length of fusiform aneurysm are constant .

T/F

variable

How well did you know this?

Not at all

Perfectly

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.

Male; 50

fusiform or saccular

abdominal aorta, arch of aorta

common iliac ; renal; mesenteric

How well did you know this?

Not at all

Perfectly

The most common cause of aneurysm is _________.

atherosclerosis

How well did you know this?

Not at all

Perfectly

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.

media; atheromatous ulcer

all the

atheroma; leukocytic; fatty

perianeurysmal lymphocytic ; giant

How well did you know this?

Not at all

Perfectly

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 __________

peritoneal

retroperitoneal or intraperitoneal haemorrhage

Acute; potentially fatal haemorrhage.

How well did you know this?

Not at all

Perfectly

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.

thrombus; ischaemia

mural thrombus

How well did you know this?

Not at all

Perfectly

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 ______

ureter or erosion; vertebrae

peritoneal; pulsatile abdominal mass

a tumour

How well did you know this?

Not at all

Perfectly

Syphilitic aneurysm

Aka

________

Leutic aneurysm

How well did you know this?

Not at all

Perfectly

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.

elastic; media

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

Syphilitic

syphilitic mesoaortitis.

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 ______

fusiform or saccular

3-5; aneurysmal bulging ; stellate

pearly white, irregular and wrinkled

bark of tree.

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 —————-.

mesoaortitis lymphocytes; media fibrous tissue

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 ________.

aortic valve incompetence left ventricular ; hypertrophy; 1000 cow’s heart

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

roughened surface infiltrate in the wall of the aneurysm ooze for some distance into the tissue around.

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

subjective superior mediastinal

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.

stretching bodies of vertebrae and incorporation into the wall of the sac intercostals nerve roots displaced; thrombosis Congestion; engorgement

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.

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

Syphilitic aneurysm • Rupture: Rupture of aneurysm results into an _______ or any _____. it may rupture externally through the chest wall.

adjacent body cavity hollow viscous

In syphilitic aneurysm, Embolism is common. T/F

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.

aortic; haematoma; men 40 -70 ; fake

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.

aorta ring; pericardial cardiac tamponade arch; abdominal ; mesenteric; iliac; renal

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.

aortic incompetence. Distal enters the false lumen through the proximal tear and reenters the true lumen through the distal tear double barred

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

tear; inner 2⁄3; 1/3; media inner and outer layer ascending; 5; aortic valve

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 _____.

90; cystic medial Erdheim’s media media; metachromatic mucoid softening

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

Marfan’s ; connective tissue dominant; elastic fiber cardiovascular and ocular subluxation

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

canalization diagnostic catheterization cardio-pulmonary

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.

beginning of the aorta extension; vegetations staphylococcus aureus infective thrombus Acute

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

tuberculous pulmonary

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

Cerebral or berry Circoid or Racemose

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.

Small ; spheroid 1 ; one side of an artery. cerebral

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.

Circle of Willis. 1 to 2 50

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.

subarachnoid haemorrhages 10

Berry aneurysm occurs in ____% of people.

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

F rarely

Often, a berry aneurysm becomes filled with thrombus. T/F

F occasionally

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 ______

Local abnormal connection between arteries and veins arteriovenous; varicosity of vein. scalp; brain injury.

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

hypertenive 50 2mm

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.

perforation crushing stab; bullet aortic wall

Sizes of aneurysms Berry-___cm Leutic- ______ cm Micro- ______ Atheromas-_____

1 3-5 2mm 15cm

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

5 10