aneurysm Flashcards
What is an aneurysm?
sac or dilation formed at a weak point in the wall of the artery
saccular and fusiform most common
what is the most common degenerative aneurysm?
Abdominal aortic aneurysm
Who is most at risk for AAA?
White male smokers over 50 with hypertension
where do most AAA’s occur
below the renal arteries (infrarenal aneurysm)
what’s a common assessment finding of someone with a suspected AAA?
abdominal bruit, palpable mass (don’t perform deep palpation)
at what size can you repair the AAA?
at least 5.5 cm wide
how often should you monitor the size of an AAA
every 6 months
how do you prevent rupture of an aneurysm
maintain normal blood pressure
how do you repair an AAA
Open surgical repair of the vessel with a bypass graft, endovascualar grafting, transluminal placement and attachment of a sutureless aortic graft
What is the most common cause for a thoracic aortic aneurysm
atherosclerosis
What is the most common symptoms of a thoracic aortic aneurysm?
Pain, dyspnea, dysphagia, hoarseness
What is the assessment finding of someone with a TAA?
unequal pupils
How is a TAA diagnosed?
Chest x ray, CT angiogram, TEE
How do you medically treat a non ruptured thoracic aneurysm?
Blood pressure control (beta blocker, hydralazine) maintained at 90-120
Nipride → emergency IV
How do you surgically treat a non ruptured thoracic aneurysm?
Percutaneous
Open
What is the post op care of someone with a non ruptured thoracic aneurysm?
Maintain cerebrospinal fluid pressure less than 10 mmHg
Keep arterial pressure greater than 90 mmHg
What are the signs of an impending rupture?
Severe back or abdominal pain
What are the signs of a rupture taking place?
Constant and intense pain, falling blood pressure, decreasing hematocrit
How would the size, length, and location of a AAA be determined?
Duplex ultrasonography or CT-angiogram
When is the rupture of a AAA likely?
Coexisting hypertension (diastolic above 100 mmHg) or aneurysm >6 cm
What is the most common site for a dissecting aneurysm?
Thoracic → separation of the wall of the vessel
What is the most common cause of AAA?
Atherosclerosis
