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Abdomen > Aorta > Flashcards

Aorta Flashcards

1
Q

What vessel layer is made of endothelial cells?

A

Tunica intima

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2
Q

What vessel layer is made of epithelial cells?

A

Tunica adventitia / external

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3
Q

What is the thickest vessel wall?

A

Tunica media

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4
Q

When does the aorta coarse more anteriorly than the IVC?

A

At the level of the umbilicus

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5
Q

What are the paired branches of the aorta?

A
  1. Suprarenal arts. - adrenal glands
  2. Renal arts -kidneys
  3. Gonadal arts.
  4. Lumbar arts.
  5. Common iliac arts.
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6
Q

What are the unpaired branches of the aorta?

A
  1. Celiac axis
  2. SMA
  3. IMA
  4. Median sacral art.
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7
Q

Name the aorta branches from superior to inferior

A
  1. Celiac axis (left gastric, splenic, CHA)
  2. SMA
  3. Renal
  4. Gonadal
  5. IMA
  6. CIA
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8
Q

At what level does the aorta bifurcate?

A

L3-4 vertebra / the umbilicus level

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9
Q

What are the common iliac arteries waveform ?

A

High resistant waveform - triphasic

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10
Q

Above the umbilicus, abdominal arteries are ________ to veins.
While below the umbilicus they are______ to veins

A
  1. Posterior
  2. Anterior
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11
Q

Indications to scan the aorta

A
  • Abdominal pain
  • pulsatile mass
  • aneurysm seen on X-ray
  • f/u aneurysm
  • trauma
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12
Q

What can low hematocrit indicate?

A

An active bleed in the body

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13
Q

What probes should you use for scanning aorta?
(Adult and peds)

A

Adult- 2.5MHz to 6.5 MHz
Peds- 4 MHz to 8MHz

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14
Q

Normal measurements of aorta?

A

Prox- 2.0 - 2.6 cm
Mid- 1.6 - 2.4 cm
Distal- 1.1 - 2.0cm
Iliac - 0.6 - 1.4cm

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15
Q

What is the wave form above the renal arteries?
And below?

A

Above - biphasic due to low resistance branches to organs.
Below-triphasic; supplies lower ext. Which causes an increased resistance

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16
Q

What measurement corresponds to a triple A?

A

> 3 cm or an increase in diameter >50% between 2 adjacent segments

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17
Q

What is the most common cause of triple A?

A

Atherosclerotic disease

18
Q

What are the risk factors for triple A?

A
  • male gender
    -Family history
  • smoking
  • chronic HTN
19
Q

What are the types of AAA?

A
  1. Saccular -localized round outputting may have stalk
  2. Fusiform - vessel wall stretches focally MOST COMMON
  3. Berry- tiny out pouching, usually found in the cerebrum and splanchic arteries
  4. Mycotic- infected aneurysm; seen with syphillis
20
Q

Where is the most common location of fusiform aneurysms?

A

Infrarenal

21
Q

When do AAA need surgical intervention?

A

Above the rentals - immediate intervention
Below- diameter >5.5cm

22
Q

If you find a AAA where else should you check?

A

CIA, CFA, and pop

23
Q

A AAA can cause what complications?

A
  • Rupture
    -Blue toe syndrome
  • affects renal circulation and systemic blood pressure if suprarenal or juxtarenal location
  • large AAA can compress IVC causing reduced flow toward the heart and pedal edema
24
Q

A saccular AAA has an increased risk of?

A

Rupture due to increased pressure in the neck

25
Q

What sign is associated wl a AAA?

A

Yin yang

26
Q

Where is the most common splanchnic artery aneurysm located?

A

Splenic artery
( splanchnic = splenic)

27
Q

Who are more at risk for splenic artery aneurysms?

A

Women due to multigravida

28
Q

What is the 2nd most common splanchnic artery aneurysm?

A

Hepatic artery

29
Q

What is a hepatic artery aneurysm associated with?

A

Associated with systemic infection and trauma
Most are extrahepatic location

30
Q

What is the least common splanchnic artery aneurysm

A

SMA

31
Q

What is blue toe syndrome?

A

Emboli material lodges in the digital arteries of the toes leading to cyanosis of the distal tissues

32
Q

What is a dissection?

A

Initial layer tears and allows flow between the intimate and media layers into a blind pocket (false lumen)

33
Q

Where do dissections most commonly occur?

A

In the aortic arch due to the shearing forces of the blood as it rounds the curve of the arch

34
Q

What syndromes are associated with a dissection?

A
  1. Marfan
  2. Ehlers-danlos syndrome
35
Q

Debakey classifications?
(Dissection)

A

Type l - involves ascending and depending aorta
Type Il - involves ascending aorta ;associated with marfan; least common
Type lll- involves the descending aorta (below the organ of the left subclavian artery); lowest mortality rate

36
Q

What is marfans syndrome?

A
  • A genetic disorder that affects connective tissue of the heart, vessels and bones
    -Patients are usually very tall with a thin frame, long extremities and fingers
  • The aortic root and arch are the most commonly affected blood vessel (debakey type Il)
  • Aorta dissection, aneurysm and value insufficiency are common in this syndrome.
37
Q

Significant risk of rupture in aneurysm measurement?

A

> 7cm in diameter

38
Q

What causes pseudo aneurysms?

A

Caused by trauma or invasive procedures

39
Q

What is leriche syndrome?

A
  • Aka aortoiliac occlusive disease
  • due to occlusion of the abd aorta just above the site of its bifurcation
  • causes bilateral symptoms and flow changes of the lower extremities
  • can be related to erectile dysfunction as the internal iliac arteries supply the penis with blood.
40
Q

What is retroperitoneal fibrosis?

A
  • Aka ormond disease
  • idiopathic (usually) overgrowth of fibrous tissue around an atherosclerotic aorta
  • most commonly occurs at the level of the aortic bifurcation and inferiorly in the pelvis
  • can be related to drugs, infection, malignancy or cancer therapy
  • may lead to hydronephrosis (because of ureteral obstruction)
  • may compress IVC causing bilateral pedal edema
  • may compress the gonadal veins causing scrotal swelling.
41
Q

Retroperitoneal sonographic appearance

A
  • Soft tissue mass surrounding great vessels
    -Hypoechoic
  • smooth borders

Abdomen (5 decks)

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