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Abdominal Scanning > Aorta Physiology and Pathology > Flashcards

Aorta Physiology and Pathology Flashcards

1
Q

1st branch seen off aorta in u/s

A

Celiac Axis

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2
Q

What vessels originates from CA

A

Splenic A, L Gastric A, Common Hepatic A

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3
Q

Name artery that comes off CA that isnt seen in u/s

A

L Gastric A

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4
Q

Name artery that come off the CA that is very tortuous

A

Splenic

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5
Q

What vessel runs along the posterior border of the pancreas

A

Splenic Vein

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6
Q

What are the 2 branches of the common hepatic artery

A

Superior: Gda
Posterior: Proper hepatic artery

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7
Q

Another name for adrenals

A

suprarenals

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8
Q

What organs do the gonadal arteries feed

A

Male: Testicles
Female: Ovaries

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9
Q

Vessel between Aorta and SMA and accompanying syndrome

A

Left Renal Vein (Nutcracker)

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10
Q

Renal arteries are seen best in which scan plane

A

transverse

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11
Q

What is the only vessel that runs posterior to the IVC

A

RRA

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12
Q

Relationship of SMA to Celiac

A

Inferior

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13
Q

2 main structures fed by SMA and IMA

A

colon and pancreas

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14
Q

What is most inferior artery off the aorta

A

Median sacral artery

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15
Q

Aorta courses sagitally

A

Superior to inferior

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16
Q

Aorta runs from

A

posterior to medial

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17
Q

Aorta is on left or right of spine

A

left

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18
Q

Aorta originates in

A

Left ventricle of the heart at the outflow tract

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19
Q

what structure does the aorta pass through to begin being abdominal

A

Diaphragm

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20
Q

Can the thoracic aorta be seen in ultrasound

A

No

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21
Q

Shape of aorta

A

candy cane

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22
Q

Aorta passes anteriorly or posteriorly to the diaphragm

A

posterior

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23
Q

The Celiac branches_______to the Aorta

A

anteriorly

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24
Q

Other names for Celiac axix

A

Celiac trunk / Celiac artery

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25
Q

Feeds left lesser curvature of stomach

A

LGA

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26
Q

Feeds the left greater curvature of the stomach

A

Splenic artery

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27
Q

Feeds the right greater curvature of the stomach

A

GDA

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28
Q

Splenic artery feeds

A

Spleen, pancreas, greater left of stomach

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29
Q

Common Hepatic Artery branches into

A

Gastroduodenal artery, Proper hepatic artery

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30
Q

GDA feeds

A

Greater right, pancreas and duodenal areas

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31
Q

Proper hepatic Artery branches into

A

left middle and right hepatic arteries

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32
Q

Right hepatic artery branches into the

A

cystic artery

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33
Q

Cystic artery feeds the

A

Gallbladder

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34
Q

SMA feeds the

A

Small Intestines, Ascending Colon, part of Transcending Colon

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35
Q

Renal arteries are____________to the SMA

A

inferior

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36
Q

Which renal artery is longer

A

RRA

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37
Q

Gonadal Arteries feed

A

testicles and ovaries

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38
Q

Gonadal start______to the respective organs

A

anteriorly, they course inferiorly

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39
Q

IMA feeds

A

part of transcending colon, descending colon and rectum

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40
Q

Median Sacral Artery feeds

A

Sacrum

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41
Q

Aortic Size

A

3 cm at largest

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42
Q

Aortic courses

A

Inferior to shallow, decreasing in size

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43
Q

Best method to decrease observer variation

A

Measure A to P

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44
Q

3 layers of the vessel

A

tunica intima
tunica media
tunica adventitia

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45
Q

Layer that is thick in arteries

A

Media

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46
Q

Why is media thicker

A

greater elastisity

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47
Q

Primary function of aorta

A

Bring oxygenated blood to organs to ensure oxygenation and metabolism

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48
Q

Systole creates

A

blood to quickly to be sent in aorta causing expansion

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49
Q

Diastole and Aortic Valve closure ensures

A

wall recoil and the release of stored energy: maintains BP

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50
Q

Aorta displays

A

anechoic with echogenic walls (tubular)

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51
Q

Vessels that display pulsivity

A

Large Vessels

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52
Q

What portion is hard to visualize fully across the screen sagitally

A

Proximal due to curviture

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53
Q

Distal portion is

A

more linear

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54
Q

Celiac axis makes what sign with which two arteries

A

Seagull Splenic A and CHA

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55
Q

SMA visualized better in which plane

A

TRV due to parapancreatic fat surrounding it

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56
Q

Renal arteries visualized best in which plane

A

TRV small curvature branching from Aorta

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57
Q

IMA visualized best

A

not visualized unless pathology

58
Q

Bifurcation best visualized in

A

TRV level with umbillicus

59
Q

Reason for exam

A

Look for aneurysms and stenosis

60
Q

What is seagull sign

A

CHA and SA in trv that represent the wings of a seagull

61
Q

What is the echogenic material around SMA in TRV

A

parapancreatic fat

62
Q

Which renal artery is longer

A

right

63
Q

Primary reason to have Aorta Ultrasound

A

ID aneurysms, ID stenosis

64
Q

Branches affected by

A 
Atheroma
Aneurysm
Connective Tissue Disorders: Cystic medial necrosis, Marfans
Rupture 
Thrombus
Infection
Displacement
65
Q

Atheroma is

A

solf lipid (plaque) in intima

66
Q

Atheroma is more prevalent in

A

old males more likely

67
Q

Atheroma is chronic or acute

A

Chronic, takes years to accumulate

68
Q

Atherosclerosis is

A

disease in which fatty deposits collect in vessel walls and narrow and impair blood flow

69
Q

Arteriosclerosis is

A

disease of hardening of the arteries which may lead to coronary arteries hardening causing a myocardial infarction

70
Q

Most common cause of arteriosclerosis

A

Atherosclerosis

71
Q

Other cause of arteriosclerosis

A

cigarette smoking
diabetes
htn
increased cholesterol (Athero)

72
Q

Arteriosclerosis: what side of the vessel is most likely affected

A

posterior

73
Q

Arterio can also affect which vessels

A

All branches of Aorta and Iliacs

74
Q

What is an aneurysm

A

Swelling or dilation of a blood vessel, increase in diameter of 50% in a short amount of time

75
Q

3 kinds of aneurysm

A

True
False (Pseudo)
Dissecting

76
Q

How much more likely are men to have AAA than women

A

4x

77
Q

3 Symptoms of AAA

A 
abdominal pain (constant/come and go)
back pain-radiates to groin or butt
heartbeat feeling in abdomen
78
Q

What are the 6 finding in ultrasound that point to AAA

A
  1. increased Aorta diameter >3cm
  2. focal dilation
  3. lack or normal taper
  4. presences of thrombus
  5. dissection
  6. rupture
79
Q

Annual growth of AAA

A

.25 cm

80
Q

How often will you need checkup if diagnoses with AAA

A

1-2 years

81
Q

Survival rate for one year if over 6 cm

A

50%

82
Q

Risk of rupture if over 7cm

A

75%

83
Q

Mortality rate if operated on before rupter

A

5%

84
Q

Mortality rate if operated after rupture

A

50%

85
Q

What does the sonographer need to analyze with a AAA

A
  1. Maximum true dimentions
  2. Shape
  3. Location and vessel involvement
  4. Wall thickening (soft or hard)
  5. Presence of patent
  6. Examine kidney involvement
86
Q

What are the 3 types of aneurysm

A

Berry- brain
Saccular
Fusiform

87
Q

How do we determine if an aneurysm is true

A

Involves all three layers of the vessel

88
Q

How are pseudo AAA formed

A

A hole in the vessel scabs and blood fills the gap (angiogram)

89
Q

Size of Berry aneurysm

A

1-1.5 cm

90
Q

What does berry aneurysm look like

A

bubble rising from the vessel wall, or berries hanging (mostly in cerebral)

91
Q

Size of saccular

A

5-10 cm

92
Q

physical attribute of saccular

A

connected by a NECK to the vessel luman

93
Q

What can saccular be filled with

A

Thrombus

94
Q

What is the most common type of aneurysm

A

Fusiform

95
Q

How is the fuciform shaped

A

Gradual uniform dilation or spindle shaped dilation

96
Q

Is fuciform always evenly distributed

A

No may be eccentric, one side may be more affected

97
Q

Where do aneurysms most often occure

A

Distal Aorta

98
Q

What is ectatic aorta

A

The entire aorta is enlarged without a bulge

99
Q

What is ectatic aorta related to

A

related to age and htn

100
Q

Is ectatic aorta fatal

A

not likely

101
Q

How often must one follow up for ectatic aorta

A

6-12 months

102
Q

How do you treat AAA

A

SURGERY

103
Q

How do you treat ectatic aorta

A

not always surgery

104
Q

Treatment for ruptured AAA

A

SURGERY

105
Q

Mortality rate for rupture

A

50%

106
Q

What is the most catastrophic of all AAA complications

A

Rupture

107
Q

Are you likely to be diagnosised with AAA before rupture

A

NO

108
Q

Symptoms of rupture

A 
Sudden abdominal pain radiating to back
paleness
dry mouth, thirst
nausea, vomitting
signs of shock (rapid heart rt, sweating, fainting, dizzines, weakness)
109
Q

Choice modality for rupture

A

CT, but cant have pt unaccessable for that period of time so US

110
Q

Most common site of rupture

A

Later wall INFRA RENALS

111
Q

Biggest risk factor of rupture

A

SIZE

112
Q

What is pseudo filled with

A

fills and then empties with blood

113
Q

What to look for with pseudo

A

communicating stock

114
Q

In pseudo what holds blood in

A

the outer layers of vessel or surrounding tissue

115
Q

Cause of pseudo

A
  1. myocartic infarction
  2. surgery
  3. trauma
  4. angiogram interventional proceedures
116
Q

Intervention of pseudo

A
  1. compression
  2. thombin injection
  3. surgery
117
Q

Most likely intervention

A

THROMBIN (immediate clot), compression is uncomfortable for the pt

118
Q

What is Dissecting Aneurysm

A

Seriour where inner layer has tear and blood is trapped inbetween the layers of the aorta

119
Q

What does dissecting aneurysm look like

A

looks like a second lumen (aorta) beside the first

120
Q

Outcome if outer layers burst

A

Usually death

121
Q

Why do dissecting aneurysms happen

A

deterioration of the arterial wall, most commonly associated with HIGH BLOOD PRESSURE

122
Q

How often is high bp present in dissection

A

2/3

123
Q

Other causes of dissection

A
  1. Hereditary connective tissue disorders- Marfans and Ehlers-Danlos
  2. Birth defects
  3. Trauma
  4. Pregnancy
  5. Thoracic dissection coming down to abdominal
124
Q

What is Marfans syndrome

A

connective tissue with long limbs and fingers

125
Q

Risk factors for Dissection

A 
Male 
African Americans
40-70
HTN
Known aneurysm
126
Q

Symptoms of Dissection rupture

A

Sudden excrusciating chest and back pain

127
Q

Modality for diagnosing Dissection

A

CT
MRA
TEE

128
Q

How long before death hits dissection rupture

A

hours

129
Q

Mortality rate of dissection without intervention

A

75% in the first 2 weeks

130
Q

What ligament cuts off the celiac axis when engorged

A

Median arcuate ligament

131
Q

Whats another name for the condition where the CA is crimped by the median arcuate ligament

A

Celiac Axis Compression Syndrome

132
Q

Purpose of the median arcuate ligament

A

connect left and right crura of diaphragm

133
Q

Symptoms of Celiac Axis Compression syndrome

A
  1. Weight loss
  2. Chronic abdominal pain
  3. Bruit in epigastric region
134
Q

What is the flexible material used to repair weaked AAA walls

A

GRAFTS

135
Q

What are the 4 types of grafts

A
  1. Aorta End to End
  2. Aortoiliac
  3. Aortobifermoral
  4. Fem-Fem
136
Q

What is opening of the graft called

A

Anastomoses

137
Q

What will you asses with patient who has a graft

A
  1. Ask when it was placed
  2. Assess Anastomoses
  3. Check stenosis and aneurysm with doppler
  4. ID and measure fluid collection
  5. Check for distal blood flow
138
Q

Abnormal communication between and artery and a vein

A

Arteriovenous fistula (congenital-aquired)

139
Q

Symptoms of congenital AV fistula

A

birth defect
not common
usually lower extremities

140
Q

Causes of aquired AV fistula

A

usually caused during trauma or surgery
inflamation
neoplasm

141
Q

Symptioms of aquired AV fistula

A
  1. Lower back and abd pain
  2. Pulsatile mass with bruit
  3. Massive swelling
  4. Cardiac decompensation
142
Q

When is AV fistula good

A

Dialysis

Abdominal Scanning (2 decks)

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