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NYCC Physiopathology > Aneurysms > Flashcards

Aneurysms Flashcards

1
Q

what is a localized dilation of a blood vessel or chamber of the heart?

A

aneurysm or dissection

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2
Q

what are the most common sites of aneurysms in order from greatest to least common?

A
  1. aorta
  2. iliac
  3. splenic
  4. renal
  5. vertebral
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3
Q

what are the two categories of aneurysms?

A

true and false

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4
Q

what is a true aneurysm?

A

where the aneurysm is bounded by arterial wall components (all 3 layers dilate)

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5
Q

what is a false aneurysm?

A

where a breach in the wall leads to a vascular hematoma (through internal layers -> bleed into tunica media/adventitia)

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6
Q

what is the most common etiology of TRUE aneurysms?

A

atherosclerotic

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7
Q

what are 4 common etiologies of true aneurysms

A

atherosclerotic (MC)
syphilitic (Treponema pallidum)
congenital
left ventricular (dilative cardiomyopathy)

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8
Q

where do syphilitic aneurysms tend to localize?

A

around ascending aorta

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9
Q

what is the most common cause of FALSE aneurysms?

A

post myocardial infarctive

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10
Q

what are the 3 causes of FALSE aneurysms?

A
  • (MC) post myocardial infarctive
  • junctional leak at vascular graft
  • genetic
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11
Q

what does junctional leak at a vascular graft mean?

A

tearing of stitches or bleeding within new vessel during or after cardiac bypass surgery

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12
Q

what are the 2 genetic collagen vascular disease that can lead to genetic FALSE aneurysms?

A

Marfan’s syndrome
Ehler’s Danlos syndrome

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13
Q

what is Marfan’s syndrome?

A

it is a defect in fibrillin in which causes a person to be long, tall, and thin

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14
Q

what is Ehler’s Danlos syndrome?

A

very compliant collagen = very stretchy/flexible people

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15
Q

what kind of aneurysm is very small spherical dilations (blueberry size)?

A

Berry aneurysm
(Rarely greater than 1-1.5 cm)

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16
Q

where do berry aneurysms most frequently occur at?

A

at the brain base (circle of Willis)

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17
Q

is a berry aneurysm TRUE OR FALSE?

A

TRUE

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18
Q

what kind of aneurysm is large spherical dilations (5-10 cm)?

A

saccular
(same as berry but bigger)

19
Q

are saccular aneurysms true or false?

A

TRUE

20
Q

what kind of aneurysm is gradual and progressive dilation of a blood vessel producing a spindle shaped expansion?

A

fusiform

21
Q

T/F: fusiform aneurysms may be eccentric (dilation may occur unilaterally)

A

T

22
Q

are fusiform aneurysms true or false?

A

TRUE

23
Q

what kind of aneurysm refers to escape of blood into the tunica media?

A

dissecting aneurysm

24
Q

what is the presentation of the lumen of a dissecting aneurysm?

A

double barrel presentation

25
Q

T/F: you need dilation of the blood vessels for a dissecting aneurysm to occur

A

F

26
Q

what are the 2 different types of dissecting aneurysms and how are they different?

A

Type A- includes the ascending aorta
Type B- does not include the ascending aorta

27
Q

is a dissecting aneurysm TRUE or FALSE?

A

false

28
Q

what kind of aneurysm is caused by traumatic injury to muscle layer producing a focal dilation?

A

pseudoaneurysm (traumatic aneurysm)

29
Q

you can classify an aneurysm by which two ways?

A

etiology or location

30
Q

name 5 classifications of aneurysms based on etiology or location

A
  • atherosclerosis
  • infection
  • syphilis
  • arteritis (kawasaki disease)
  • miscellaneous
31
Q

what is the most common area for a atherosclerotic aneurysm?

A

in the abdominal aorta

32
Q

atherosclerotic aneurysms are most common in what population?

A

males around 60-80 years old

33
Q

when is an atherosclerotic aneurysm usually diagnosed?

A

when it is greater than 50% dilation of normal diameter of vessel has occurred

34
Q

what 2 things are atherosclerotic aneurysms usually associated with?

A

hypertension (40%) and heart disease (30%)

35
Q

where does pain manifest when you have an atherosclerotic aneurysm?

A

intermittent back and abdominal pain

36
Q

what are some other symptoms of atherosclerotic aneurysms?

A

claudication and lower limb ischemia

37
Q

what is the difference between neurogenic and vascular claudication?

A
  • neurogenic claudication: limb doesn’t work well all the time
  • vascular claudication: can walk a bit, then it is hard
38
Q

how are atherosclerotic aneurysms commonly found?

A

accidental discovery is extremely common when plain film, MRI, CT is taken for back pain evaluation

39
Q

aneurysms less than 5cm have __________ chance of rupture

A

5%

40
Q

aneurysms greater than 6cm have _____ chance of rupture

A

15%

41
Q

aneurysms greater than 7 cm have _____ chance of rupture

A

75%

42
Q

T/F: treatment must take into account the risk/benefit of surgical intervention

A

T

43
Q

what does treatment for atherosclerotic aneurysms consist of?

A

removal of dilation and replacement with graft

NYCC Physiopathology (28 decks)

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