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Cardiovascular Module > Aneurysm & Varicosities > Flashcards

Aneurysm & Varicosities Flashcards

1
Q

Aneurysm

A

Localized
Permanent
Abnormal dilation of blood vessel

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2
Q

Two forms of aneurysm

A

True

False

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3
Q

True aneurysm

A

Complete but thinned vascular wall

Blood remains within confine le of vascular tree

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4
Q

False aneurysm ( pseudoaneurysm / pulsating hematoma)

A

Blood filled extra vascular space with fibrous wall

Communicate with intravascular space because of hematoma after vascular rupture

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5
Q

Aneurysm classification based on morphology

A

Saccular aneurysm

fusiformaneurysm

Cylindroid aneurysm

Berry aneurysm

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6
Q

Saccular aneurysm

A

Only part of the vessel wall
Spherical outpouching of the wall
orifice maybe small compared to diameter of aneurysm
variation in size but quite quite large
often completely or partially filled with thrombus because of blood stasis

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7
Q

Fusiform aneurysm

A

Complete circumference of the vessel involved

not always symmetrical around the long axis of the artery
Variation in diameter and length but quite large

Maximum diameter in the middle and small size of the proximities

Variable mural thrombus

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8
Q

Cylindroid aneurysm

A

Variant of fusiform aneurysm

No gradual dilatation as in fusiform aneurysm

Abrupt cylindrical dilatation to maximum diameter

Variable symmetry and mural thrombosis

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9
Q

Berry aneurysm

A

Miniature saccular aneurysm

Rarely exceeds 15mm diameter

Most frequently seen in circle of Willis

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10
Q

Etiologic classification of aneurysm

A 
Atherosclerotic
Luetic or syphilitic 
mycotic 
congenital 
vasculitic 
capillary microaneurysms (Charcott Bouchard) 
 cardiac 
traumatic 
racemose or cirsoide
 arterio-venous
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11
Q

Atherosclerotic aneurysm

A

Weakening of the vessel wall due to atherosclerosis with loss of elastic tissue and replacement by fibrous tissue ( due to action of macrophages enzymes on elastic fibers after ischemia)

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12
Q

Main vessel affected by atherosclerotic aneurysm

A

Abdominal Aorta ( Below renal arteries and above bifurcation)

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13
Q

Incidence of atherosclerotic aneurysm

A

Usually after 60 years
Most common in males
50% of patients are hypertensive

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14
Q

Main type of morphology of atherosclerotic aneurysm

A

Fusiform

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15
Q

Effects of atherosclerotic aneurysm

A

Emboli of mural thrombi to legs vessels

Occlusion of renal, superior/inferior mesenteric arteries due to compression of aneurysm or blockade by thrombi => ischemia

Massive or fatal hemorrhage if rupture of aneurysm

Can stimulate intra abdominal tumor

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16
Q

Luetic or syphilitic aneurysm

A

Secondary to syphilitic mesaortitis from inflammation and proliferated endarteritis

Ischaemic damage due to fibrosis and loss of elasticity

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17
Q

Main vessel affected by syphilitic aneurysm

A

Thoracic aorta (diffuse dilatation of ascending and loop of aorta )

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18
Q

Main morphology of syphilitic aneurysm

A

Fusiform aneurysm and saccular aneurysm

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19
Q

Effects of syphilitic aneurysm

A

Aortic Incompetence through aortic valve dilatation

Lead to left ventricular hypertrophy and failure

syndrome of superior mediastinal compression due to pressure on surrounding structures

Thrombosis of great veins and displacement

congestion of head and neck

dysphagia if esophagus involved

chronic cough and suppurative bronchopneumonia if there’s pressure on a major Bronchus

Paralysis of left vocal cord due to left recurrent laryngeal nerve occlusion by transverse aorta loop

Vertebral erosion

Rupture not common but happens in massive fatal hemorrhage

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20
Q

Mycotic aneurysm

A

Weakening of the arterial wall secondary to bacterial or fungal infection

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21
Q

Origin of mycotic aneurysm

A

Septic embolus
Extension of an adjacent suppurative process
Circulating organism

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22
Q

Most common zone of mycotic aneurysm

A

Cerebral arteries which can cause intracerebrak hemorrhage

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23
Q

Congenital aneurysm

A

Small d’acculer aneurysm

Also called berry aneurysm which occur at branching point of circle Willis

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24
Q

People more at risk of congenital aneurysm

A

Young hypertensive

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25
Congenital aneurysm , acquired or not ?
Acquired
26
Complication of congenital aneurysm
Subarachnoid hemorrhage Visual field defect if in circle of Willis Bitemporal hemaniopa Ipsylateral eye
27
Main site of cerebral berry aneurysm
Anterior communicating artery (40%) Middle cerebral artery (34%) Posterior communicating artery (20%)
28
Vasculitic aneurysm
Caused by inflammatory vasculitides | Such as PAN , Kawasaki syndrome
29
Traumatic aneurysm
Due to Injury to wall of artery
30
Racemose aneurysm
Masses of interconnecting small arteries and veins | May be due to a blow of the head or congenital
31
Capillary micro aneurysm
Caused by Hypertension (middle cerebral artery ) and diabetic vascular disease
32
Arteriovenous aneurysm
Dilated vessels due to artrriovenous fistula Special type is carotid cavernous sinus aneurysm
33
Cardiac aneurysm
Complication of IHD Stretching of healed myocardial infarction Laminated thrombus
34
Aortic dissection
Blood forced through transverse intimai tear and create blood filled space in aortic media between middle and outer thirds
35
Common location of dissection aorta
60% in ascending aorta. | 30% in beginning of descending aorta
36
Main cause of aorta abdominal dissection
Trauma
37
Main population affected by aortic dissection
Male 50-70 years Black Individuals with localised congenital abnormality of connective tissue (Marfan syndrome, osteogenesis perfecta, ehlers danos syndrome pseudonoma elastic Kim and cutis laxa)
38
Characteristics of aortic dissection
Cystic medial necrosis Multi focal destruction of elastic and muscular components of media Accumulation of mucous material
39
Conditions affected with aortic dissection
``` 70% hypertension Pregnancy Atherosclerosis Trauma Aortic valvular stenosis Coarctation of aorta Arterial catheterization ```
40
Why is there higher incidence of intimai medial tears in ascending aorta
Due to hemodynamics factors
41
Complications of aortic dissection
Fatal hemopericardium (cardiac tamponnade) due to rupture Infarction due to obstruction of arteries
42
Retrograde dissection
Dissection in root of aorta Can disrupt aortic valve Cause valvular incompetence
43
3 types of aortic dissection
Type I (75% ) - ascending thoracic aorta extending distally to involve descending aorta Type II (5%)- confined to ascending aorta Type III- aorta distal to origin of left subclavian without ascending portion
44
Clinical presentation of aortic dissection
Episodic pain | Compression of regional arteries (create symptoms based of organs )
45
Prognosis of aortic dissection
90% of patients die within 3months if untreated 15% - 20% mortality with treatment
46
Varicose vein
Dilatation and tortuosity of veins | Due to chronic or recurrent increase in pressure of blood within veins because of gravity or obstruction to major veins
47
Types of varicosity
Gravitational | Obstructive
48
Gravitational varicosity
Saphenous system of legs affected
49
Gravitational varicosity people at risk
Women Occupations with prolonged standing Hereditary predisposition-43%
50
Gravitational varicosity cause
Prolonged standing upright causing rise in pressure and distension of long saphenous vein
51
Gravitational varicosity pathogenesis
Rise in pressure and distension of vein Permanently stretched veins Incompetent veins Swollen and tortuous veins
52
Clinical effects of Gravitational varicosity
Nutrition of skin impaired due to stagnation of blood Oedema and hypoxia Eczematous and pigmented skin Indolent varicose ulcer Dilated veins with profuse bleeding Thrombosis which can organise and form phlebolith
53
Varicocele
Gravitational varicosity involving pampiniform plexus of veins which is commoner on the left Than the right Distended vein like bag of worms
54
Haemorrhoids
Varicosities of haemorrhoidal plexus | At ano rectal junction
55
Hemorrhoids common. In
Pregnancy (pressure of Travis uterus on pelvic veins) Chronic constipation Portal hypertension
56
Complications of hemorrhoids
Bleed - iron deficiency anemia Rupture into perianal subcutaneous Thrombosis Prolapse through anal sphincter
57
Obstructive varicosity
Chronic obstruction to portal venous blood mostly due to cirrhosis causing varicose
58
Most important site of obstructive varicosity
Lower esophagus and gastric mucosa Inferior vena cava
59
Parhogenesis of obstructive varicosity
Early stage : Muscular hypertrophy Intimai fibro elastic thickening occurs Later stage : Thickened muscular wall replaced by fibrous tissue Atrophy of valves, smooth muscle , elastic tissue Thinning and pouch like dilatation Venous wall mainly with fibrous tissue Spotty calcifications
60
Traumatic aneurysm
Due to Injury to wall of artery
61
Racemose aneurysm
Masses of interconnecting small arteries and veins | May be due to a blow of the head or congenital
62
Capillary micro aneurysm
Caused by Hypertension (middle cerebral artery ) and diabetic vascular disease
63
Arteriovenous aneurysm
Dilated vessels due to artrriovenous fistula Special type is carotid cavernous sinus aneurysm
64
Cardiac aneurysm
Complication of IHD Stretching of healed myocardial infarction Laminated thrombus
65
Aortic dissection
Blood forced through transverse intimai tear and create blood filled space in aortic media between middle and outer thirds
66
Common location of dissection aorta
60% in ascending aorta. | 30% in beginning of descending aorta
67
Main cause of aorta abdominal dissection
Trauma
68
Main population affected by aortic dissection
Male 50-70 years Black Individuals with localised congenital abnormality of connective tissue (Marfan syndrome, osteogenesis perfecta, ehlers danos syndrome pseudonoma elastic Kim and cutis laxa)
69
Characteristics of aortic dissection
Cystic medial necrosis Multi focal destruction of elastic and muscular components of media Accumulation of mucous material
70
Conditions affected with aortic dissection
``` 70% hypertension Pregnancy Atherosclerosis Trauma Aortic valvular stenosis Coarctation of aorta Arterial catheterization ```
71
Why is there higher incidence of intimai medial tears in ascending aorta
Due to hemodynamics factors
72
Complications of aortic dissection
Fatal hemopericardium (cardiac tamponnade) due to rupture Infarction due to obstruction of arteries
73
Retrograde dissection
Dissection in root of aorta Can disrupt aortic valve Cause valvular incompetence
74
3 types of aortic dissection
Type I (75% ) - ascending thoracic aorta extending distally to involve descending aorta Type II (5%)- confined to ascending aorta Type III- aorta distal to origin of left subclavian without ascending portion
75
Clinical presentation of aortic dissection
Episodic pain | Compression of regional arteries (create symptoms based of organs )
76
Prognosis of aortic dissection
90% of patients die within 3months if untreated 15% - 20% mortality with treatment
77
Varicose vein
Dilatation and tortuosity of veins | Due to chronic or recurrent increase in pressure of blood within veins because of gravity or obstruction to major veins
78
Types of varicosity
Gravitational | Obstructive
79
Gravitational varicosity
Saphenous system of legs affected
80
Gravitational varicosity people at risk
Women Occupations with prolonged standing Hereditary predisposition-43%
81
Gravitational varicosity cause
Prolonged standing upright causing rise in pressure and distension of long saphenous vein
82
Gravitational varicosity pathogenesis
Rise in pressure and distension of vein Permanently stretched veins Incompetent veins Swollen and tortuous veins
83
Clinical effects of Gravitational varicosity
Nutrition of skin impaired due to stagnation of blood Oedema and hypoxia Eczematous and pigmented skin Indolent varicose ulcer Dilated veins with profuse bleeding Thrombosis which can organise and form phlebolith
84
Varicocele
Gravitational varicosity involving pampiniform plexus of veins which is commoner on the left Than the right Distended vein like bag of worms
85
Haemorrhoids
Varicosities of haemorrhoidal plexus | At ano rectal junction
86
Hemorrhoids common. In
Pregnancy (pressure of Travis uterus on pelvic veins) Chronic constipation Portal hypertension
87
Complications of hemorrhoids
Bleed - iron deficiency anemia Rupture into perianal subcutaneous Thrombosis Prolapse through anal sphincter
88
Obstructive varicosity
Chronic obstruction to portal venous blood mostly due to cirrhosis causing varicose
89
Most important site of obstructive varicosity
Lower esophagus and gastric mucosa Inferior vena cava
90
Parhogenesis of obstructive varicosity
Early stage : Muscular hypertrophy Intimai fibro elastic thickening occurs Later stage : Thickened muscular wall replaced by fibrous tissue Atrophy of valves, smooth muscle , elastic tissue Thinning and pouch like dilatation Venous wall mainly with fibrous tissue Spotty calcifications

Cardiovascular Module (21 decks)

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