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Abdomen Section 1 > Aorta reverse > Flashcards

Aorta reverse Flashcards

1
Q

reverse

first system to begin to function in the embryo

A

Cardiocasvular system

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2
Q

reverse

from mesodermal cells

angioblasts during 3rd week

A

Aorta developement

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3
Q

reverse

location in relation to heart

arteries or veins

A

vessel determination

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4
Q

reverse

2 dorsal aortas

extensions of 2 endocardial heart tubes

quickly fuse into singel vessel

A

3rd week development

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5
Q

reverse

many branches to feed embryo

branches become lumbar arteries

A

first single aorta

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6
Q

reverse

develope from intersegmental arteries

A

common iliac artery developement

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7
Q

reverse

branches anteriorly from aorta and extends into the yolksac

celiac artery

SMA

IMA

develope from this

A

vitelline artery

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8
Q

reverse

branches off the anterior aorta

gives rise to the internal iliac arteries

A

umbilical artery

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9
Q

reverse

carries blood from heart

enclosed in sheath containing nerve and vein

3 layers

tunica intima

tunica media

tunicat adventitia

A

Aorta

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10
Q

reverse

inner vessel wall

A

tunica intima

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11
Q

reverse

middle vessel wall

arteries have thicker to allow for great elasticity

A

tunica media

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12
Q

reverse

outer vessel wall

A

tunica adventitia

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13
Q

reverse

root

ascending

descending

abdominal and branches

bifurcation

A

Aorta sections

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14
Q

reverse

arises from left ventricle

A

Aortic root section

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15
Q

reverse

arises short distance from root

forms aortic arch

supplies blood to head and upper extremities

3 branches arise from arch

A

Aorta ascending

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16
Q

reverse

after aortic arch

posterior along back wall of heart

A

Aorta descending

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17
Q

reverse

supplies blood to all soft tissue organs in abdomen

starts after passing through diaphragm

A

Aorta abdominal

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18
Q

reverse

into iliac arteries

A

Aortic bifurcation

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19
Q

reverse

brachiocephalic

commom carotid

subclavian

A

Arteries arising from aortic arch

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20
Q

reverse

endters through aortic hiatus of diaphragm

descends anteriorly and slightly left of vertebral bodies

posterior and left of gastroesophogeal junction

flanked on either side by diaphragmatic crura

A

Anatomy of Abdominal aorta

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21
Q

reverse

Celiac Trunk

SMA

Left & Right Renal A

Left & Right Gonadal A

Root of IMA

Left & Right Common Iliac

A

Aortic branches

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22
Q

reverse

at L4 into iliac arteries

5cm long

run anterior with corresponding veins

A

Aortic bifurcation

common iliac arteries

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23
Q

reverse

internal and external iliac arteries

A

common iliac artery bifurcation

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24
Q

reverse

common hepatic artery

left gastric artery

splenic artery

A

Celiac trunk

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25
Q

reverse

forms proper hepatic artery and GDA

A

common hepatic artery

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26
Q

reverse

supplies stomach and esophagus

A

left gastric artery

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27
Q

reverse

largest branch

forms gastroepiploic artery

supplies stomach and spleen

A

splenic artery

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28
Q

reverse

arises 1cm inferior to celiac trunk

5 main branches that feed small intestines, inferior pancreatic, duodenal, colic, ileocolic and intestinal arteries

each branch has 10-16 branches

A

SMA

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29
Q

reverse

arises at L3 or L$

proceeds left and supplies colon and rectum

3 main branches

A

IMA

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30
Q

reverse

left colic

sigmoid

superior rectal

A

3 branches of the IMA

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31
Q

reverse

pulsatile abd mass

hemodynamic compromise in lower limbs

abd pain

abd bruit

A

indications for aortic ultrasound

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32
Q

reverse

midline, left flank with patient supine

right lat decubitus and along lateral edge of rectus abd muscle to evaluate iliacs

A

acoustic window for aorta

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33
Q

reverse

visualize entire aorta and branches

disections of atheromatous stenoses, aneurysmas, disections or other pathological process

measurements, including dilated segments

adjacent organs and structures

A

aorta assessment

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34
Q

reverse

tapers from cranial to caudal

  1. 5 to 1.8cm
  2. 5 at diaphragm
  3. 0 midline
  4. 8 distal

95% of people aorta less than 2.3 in men, 1.9 in women

increases with age

A

normal aorta measurements

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35
Q

reverse

acts as resevoir in response to pulsitile flow received from left ventricle

A

aorta in systole

36
Q

reverse

decreases in size by discharging blood to rest of ciculation

considered high resistance flow in aorta

A

aorta in distole

37
Q

reverse

shart increase in antegrade velocity during systole

sharp decrease in velocity and brief period of reversed flow in distole

A

high resistance blood flow

38
Q

reverse

main aortic branches to

kidneys

liver

postprandial bowel

A

low resistance blood flow

39
Q

reverse

validate entire aorta and branches by determining patency

detect atheromatous stenoses, aneurysms, dissections or other pathology

characterize abnormalities with spectral doppler

determine high/low resistance in vessels to determine if possibility of pathological process

A

Goals of Doppler aorta

40
Q

reverse

doppler shows increased pulsatility proximal

increased systolic/diastolic velocities

turbulence immediately after

A

Stenosis

41
Q

reverse

vascular wall disorder with presence of lipid deposits in intima

atheromatous plaque is soft, porridge like material that may discharge into the vessel causing distal embolus or local thrombus or both

palques cause mural irregularity and narrowing of the vessel lumen with distal ischemia

A

Atheromatous disease

arteriosclerosis

42
Q

reverse

incidence increases with age

affects more men than women

involves aorta and iliac arteries and branches

most common on posterior wall in aorto-iliac area

A

Atheromatous disease factors

43
Q

reverse

smoking

diabetes mellitus

hypertension

increased levels of low density lioprotein of serum cholesterol

A

atheromatous disease associations

44
Q

reverse

significant lower limb pain

ectasia occurs when aorta increases in length and diameter causing it to kink usually anteriorly and left

A

atheromatous disease signs

45
Q

reverse

very new=hypoechoic 1 hr or so

newer clot=hyperechoic due to fibrinogin

old clot=hypoechoic with debris

A

arterial thromus

46
Q

reverse

swelling in bloos vessel eith focal or diffuse

2 types

true

false (pseudo)

A

Aneurysm

47
Q

reverse

all 3 layers affected

A

True aneurysm

48
Q

reverse

does not affect all 3 layers

A

pseudoaneurysm

49
Q

reverse

Marfan’s syndrome

ehlers-danlose syndrome

annuloaortic extasia

famlial aortic dissection

intimomeidal mucoid degeration

MOST true are idiopathic

A

Predispostion to aneurysm

50
Q

reverse

blood escapes through a hole in intima but is contained in deeper layers of aorta by adjacent tissue

most are round or oval proituberances from the artery

blood circulates in and out with cardiac cycle

can be cause by infection, trauma, surgery or interventional procedures

A

Pseudoaneurysms description

51
Q

reverse

95% are infrarenal

30-60% are assymptomatic

may have ab, leg or back pain

higher ince=idence in Men over 60

incidence of AAAis 70-90% in men over 65

A

abdomial aorta aneurysm

AAA

52
Q

reverse

rupture

thromsosis

dissection

distal embolism

infection

obstruction and invasion of adjacent structures

A

complications of AAA

53
Q

reverse

branch artery occlusions or stenosis

most common in IMA and renal arteries

A

Most common complications of AAA

54
Q

reverse

type of pseudoaneurysm

blood leaves lumen through intimal defect and course as variable distance in the wall and reenters aorta farther distal in the arterial system

A

Dissecting aneurysm

55
Q

reverse

most catastrophic of AA complications

mortality rate at least 50%

some contained in the retroperitoneum and are chronic

retroperitoneal fluid collections are the most common findings

A

aortic rupture

56
Q

reverse

prevalent in most large AAA

thrombus poorly attached and friable meaning it can be distant source of emboli

thrombus has no bearing on whether the AAA will rupture or not

A

mural thrombus AAA

57
Q

reverse

variant of atherosclerotic AAA

wall of aneurysm is thickened and surrounded by fibrosis

surgical repair has high mortality rate

pain present in 84%

A

inflammatory AA

58
Q

reverse

focal dilation of aorta larger than 3cm

elongate as the grow

most deflect to left or kink anteriorly or both

aventitia is generallly echogenic from adjacent fibrofatty tissue

mural thrombus is usually low to med echogenicity and makes up most of wall

intimal lining may be smooth or irregula with calcifications

A

Sonographic appearance of AAA

59
Q

reverse

measure outer to outer

maximum true lenght and width and transvers dimensions

document locatoin include suprarenal extension or iliac involvement

document wall type: calcified plaque, flowing blood, soft plaque or well established plaque

A

AAA measurement

60
Q

reverse

patent channel should be documented

look for dissection

look at both kidneys checking flow of renal arteries, especially if kidney is shrunken of if patient has hypertension

A

AAA analysis

61
Q

reverse

Bulbous

fusiform

saccular

dumbell

A

Descriptive terms for AAA

62
Q

reverse

sharp junction between normal and abnormal

A

Bulbous AAA

63
Q

reverse

gradual transition between normal and abnormal

A

Fusiform AAA

64
Q

reverse

sharp sudden transition between normal and abnormal

A

Saccular AAA

65
Q

reverse

figure 8 appearance

A

Dumbell AAA

66
Q

reverse

surgery with aortic grafts

many factors to weight in repair decision

arterial grafts very echogenic and textured

native aorta usually wrapped around graft, may see fluid between aorta and graft

A

Repair of AAA

67
Q

reverse

patients with iliac have higher incidence of aneurysms elsewhere in body

trauma, syphili and mycotic disease shoujld all be considered if aneurysms are found suprarenally

A

Iliac and suprarenal Aneurysms

68
Q

reverse

defect in intima and internal weakness in wall must exist

most are idiopathic

begins in thorax and extends into the abdomen

less than 5% begin in abdomen

A

Dissections

69
Q

reverse

marfan’s disease

pregnancy

bicuspid aortic valve

trauma

focal stenoses

hypertension

A

Dissection relations

70
Q

reverse

Type 1

Type 2

Type 3

A

Types of dissections

71
Q

reverse

begins at root of aorta and may extend entire length of arch, descending aorta and even inot the abdominal aorta

most dangerour kind

A

Type 1 dissection

72
Q

reverse

starts at left subclavian artery and extends down towards the descending aorta

it may or may not extend in to the abdominal aorta

associated with Marfan’s disease

A

Type 2 dissection

73
Q

reverse

begins at the descending aorta and extends into the abdominal aorta

may block renal arteries

A

Type 3 dissection

74
Q

reverse

may invade a precediong aneurysm and produce a focal abcess

septic emboli often associated with valvular heart disease often cause the disease

A

aneurysm infection

75
Q

reverse

most result at site of angiographic puncture or at site or surgical anastomosis

hs a neck to aneurysm

during systole can see blood enter and diastole can see turbulent blood flow with color doppler

can be treated with ultrasound guided thrombin injection

A

pseudoaneuryms

arteriorvenous fistula

76
Q

reverse

artery has high resistive pattern at its origin with a small amount of reversed early diastolic flow

as go more distally it loses the reversed flow component

splenic and hepatic areteries are usually low resistance

splenic artery is tortuous

A

Celiac/mesenteric arteries

77
Q

reverse

blood flow pattern depends on whether patient is fasting or has eaten

fasting pattern is high resistance

eaten pattern is low resistance

low resistance pattern in most prominent 45 min after eating

A

SMA

78
Q

reverse

deficiency in blood delivery to bowel

usually has a significant narrowing or obstruction of both the celiac axis and SMA

A

Intestinal Ischemia

79
Q

reverse

aneuryms in the hepatic artery, plenic artery, SMA, GDA, IMA

may be saccular or fusiform

can be congenital, artherosclerotic, post trauma, mycotic or inflammatory

A

Splanchic aneurysm

80
Q

reverse

22% have 2 to one kidney

should show low resistance waveform

velocities should decrease as once goes farther into kidney

A

Renal arteries

81
Q

reverse

produces rare but treatable cause of hypertension

may be due to atherosclerotic disease or fibromuscular hyperplasia (rare disease affecting young women)

RA stenosis is treatable with angioplasty

A

Renal artery stenosis

82
Q

reverse

mostly acquired

may be post trauma or post large bore needle biopsy

usually pseudoaneurysms

1/4 are congenital

produce a mosaic color in kidney (doppler image)

A

Reanl aneurysms

AV fistulas

83
Q

reverse

Abdominal > 3 cm

Common iliac >2cm

Popliteal >1cm

25% of popliteal also have AAA

A

Aneurysm measurements

84
Q

reverse

5 cm=5%

6cm=16%

7cm=75%

A

rupture risk in AAA in 5 yrs

85
Q

reverse

decreased hemocrit

hypotension

pulsitile abd mass

abd bruit

back pain

abd pain

lower extremity pain

A

clinical findings of aortic rupture

86
Q

reverse

tube graft

aortoiliac graft

aoto-bifemoral graft

wrapped-native aorta is opened longitudinally and the graft is placed inside

A

aortic grafts

Abdomen Section 1 (10 decks)

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