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PNS/Cardiology > Diseases of Aorta > Flashcards

Diseases of Aorta Flashcards

1
Q

What are the layers of the aorta?

A

Intima, media, adventitia

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2
Q

Which layer of the aorta is the layer that provides strength?

A

Adventitia

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3
Q

What are the two major structural proteins of the aorta?

A

Collagen

Elastin

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4
Q

What layer contains most of the collagen?

A

Adventitia (layer of strength)

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5
Q

What layer contains most of the elastin?

A

Media

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6
Q

What happens to the ratio of collagen:elastin as you go down the aorta?

A

Collagen:elastin increases

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7
Q

What will happen with elastin digestion?

A

Decreased compliance

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8
Q

What will happen with collagen digestion?

A

Decreased tensile strength, increased rupture risk

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9
Q

What is the deficiency of Marfan’s syndrome?

A

Fibrillin

Can lead to dilating disease of aorta

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10
Q

What is the deficiency of Ehler-Danlos?

A

Collagen

Can lead to dilating disease of the aorta

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11
Q

What is the function of matrix metalloproteinases (MMPs)?

A

Cause extracellular matrix breakdown, can lead to aneurysms

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12
Q

What is a major source of matrix metalloproteinases (MMPs)?

A 
Inflammatory cells 
Bacterial infection (hence why some bacterial infections can cause aneurysms)
- Maybe could use doxycycline to stop aneurysm growing?
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13
Q

What does the term ‘cystic medial necrosis’ refer to?

A

The connective tissue degeneration seen in Marfan’s syndrome

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14
Q

Describe a fusiform dilation

A

Diffuse weakness, circumferential
Spindle shaped
Less chance of rupture due to uniformity

Usually due to cystic medial necrosis, Marfan’s, primary diseases of arterial components

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15
Q

Describe a saccular dilation

A

Focal weakness, asymmetric
Greater chance of rupture

Usually due to invasion of the arterial wall by inflammatory cells, infective or immune aortitis, mechanical injury

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16
Q

Describe an ectasia

A

Enlarged aorta, but not yet characterized as aneurysmal

17
Q

What is the result of dilating disease?

A

Rupture, hemorrhaage, death

18
Q

What is the result of constricting disease?

A

Ischemia

19
Q

What are major causes of dilating disease of the aorta?

A 
Congenital (Marfans, Ehlers-Danlos, etc.)
"Nonspecific" aneurysm - multifactorial
Injury - dissection
Infection
Unusual causes
20
Q

What is the definition of an aortic aneurysm?

A

Dilation of an artery >1.5 times its normal diameter

21
Q

Where do most aneurysms occur?

A

Infrarenal segment of aorta

22
Q

What will occur over time to all aneurysms?

A

Will grow

And risk of rupture is proportional to aneurysm diameter

23
Q

What are complications of aneurysms?

A

Rupture
Thrombosis
Embolization
Compression of adjacent structure

24
Q

When should surgery be performed on aortic aneurysm?

A

Repair if AAA > 5.5 cm in diameter

25
Q

What is the definition of a pseudoaneurysm?

A

Dilation does not involve all layers of the aorta

Essentially a hole in the aorta

26
Q

What are the two types of pseudoaneurysms?

A 
Penetrating aortic (atherosclerotic) ulcer
Infection - "mycotic aneurysm" - mushroom shape
27
Q

How does an aortic atherosclerotic ulcer form?

A

Intimal tear
Calcium deposit
Ulcer formation

28
Q

What infectious organisms commonly cause mycotic aneurysms?

A

Salmonella

Syphillis

29
Q

Describe the initial and secondary events of an aortic dissection

A

Initial - rupture of intima and media, forming a cleavage plane
Secondary even - propagation proximally and distally within the aorta

30
Q

What are the Stanford type A and B aortic dissections and which is more common?

A

Type A - more common - involves ascending aorta, younger patients, high mortality
Type B - descending aorta, older patients, hypertension

31
Q

What is a major complication of the dissection?

A

Can occlude branch arteries like renal artery

32
Q

What occurs with a traumatic rupture?

A

Full thickness rupture with tamponade by periaortic tissues

33
Q

What are principal consequences of constricting disease of the aorta?

A

Restricted arterial flow
Reduced organ perfusion
Infarction

34
Q

Which layer of the aorta does atherosclerosis affect?

A

Intima

35
Q

Where is atherosclerosis of the aorta more common?

A

Abdominal aorta&raquo_space; thoracic aorta

36
Q

In what patients population will you see aortic atherosclerosis?

A

Small female smokers

37
Q

What are clues to abdominal aortic aneurysm?

A 
Abdominal pain (radiates to back)
Hypotension
Mass in abdomen

PNS/Cardiology (33 decks)

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