CARDIAC Section 4: Great Vessels

Question 1

The most common variant in branching of the great vessles?

Answer 1

Bovine Arch

Question 2

Describe the Bovine arch

Answer 2

The brachiocephalic artery and left common carotid artery arise from a common origin.

Question 3

The terminology right arch / left arch is described based on what?

Answer 3

Aortic arch’s relationship to the trachea

Question 4

When 1say Right Arch with Mirror Branching, You say?

Answer 4

Congenital Heart

Question 5

There are 5 types of right arches, but only two are worth knowing. What are they?

Answer 5

Abberent Left and Mirror Branching

Question 6

Identify this arch anomaly. What cardiac anomaly is this type associated?

Descibe

Answer 6

Mirror Image. Associated with congenital heart disease specially TOF

Question 7

Identify the arch anomaly and describe

Answer 7

Originating from the Back of the Arch

Question 8

I f there is a mirror image right arch, then 90% will have?

Answer 8

TOF (6% Truncus)

Question 9

Percentage if the person has Truncus, then they have a mirror image right arch

Answer 9

33% Mirror image (TOF 25%)

Question 10

The last branch of the Right Arch with aberrant left Subclavian

Answer 10

Left subclavian artery.

Question 11

What completes the ring in the Right Arch with Aberrant Left subclavian encircling the trachea?

Answer 11

Ligamentum arteriosum (on the left)

Question 12

Most common arch anomaly.

Answer 12

Left Arch Aberrant Right Subclavian

Question 13

What is associated with the most common arch anomaly?

Why?

Answer 13

Dysphagia Lusoria

RSCA passes posterior to the esophagus

Question 14

Identify.

Describ

Answer 14

Diverticulum of Kommerell

origin of the RSCA may be dilated

Question 15

The most common vascular ring

Answer 15

Double Aortic Arch

Question 16

What are the symptoms of Double aortic arch and when does it start?

Answer 16

tracheal compression and/or difficulty swallowing - may begin at birth

Question 17

What is Subclavean Steal phenomenon?

Answer 17

Stenosis and/or occlusion of the proximal subclavian with retrograde flow in the ipsilateral vertebral artery.

Question 18

What is Subclavean Steal Syndrome?

Answer 18

Stenosis and/or occlusion of the proximal subclavian artery with retrograde flow in the ipsilateral vertebral artery AND associated cerebral ischemic symptoms.

Question 19

When does reversal of flow happen in the vertebral artery in the setting of Subclavian Steal?

Answer 19

If the level of stenosis and/or occlusion is proximal to the vertebral artery resulting in the theft of blood from the posterior circulation.

Question 20

When the u?pper limb is excecised, blood i sdiverte away from the brain to the arm resulting to cerebral symptoms (dizziness, syncope), and these symptoms depende on the integrity of what vessel?

Answer 20

Collateral intracranial flow (PCOMs)

Question 21

Subclavian Steal is almost always caused by?

Answer 21

Atherosclerosis (98%) - ADULT

OTher causes include:
Takayasu Arteritis - TEENS
Radiation, Preductal Aortic Coarctation, and Blalock- Taussig Shunt.

Question 22

Identify

Answer 22

Subclavian Steal