Diseases of The Peripheral Vasculature *

Question 1

What is an aneurysm?

Answer 1

It’s an abnormal localized dilation of an artery. The diameter of a portion of the aorta is increased by at least 50%

Question 2

What’s a true aneurysm?

Answer 2

It’s a dilation of all three layers of the aorta creating a bulge of the vessel wall.

Question 3

What’s fusiform?

Answer 3

It’s symmetrical dilation of the entire circumference of a portion of the aorta.

Question 4

What’s saccular true aneurysm?

Answer 4

It’s localized out pouch of a portion of the circumference.

Question 5

What’s pseudoaneurysm?

Answer 5

It’s a contained rupture of the vessel wall when blood leaks from lumen through a hole in the intimal and media layers.

Question 6

What is ascending thoracic aortic aneurism characterized by?

Answer 6

Cystic medial degeneration which is the degeneration and fragmentation of elastic fibres and the accumulation of collagen in the media. It occurs with age, hypertension and inherited connective tissue disorders.

Question 7

What is descending thoracic aortic aneurysm associated with?

Answer 7

Atherosclerosis and it’s risk factors. Also genetic predisposition.

Question 8

What is aortic dissection?

Answer 8

It’s a tear in the intima and allows blood from lumen to enter medial layer and spread along the muscle layer of the artery. Aortic rupture can occur.

Question 9

What’s the pathogenesis of aortic dissection?

Answer 9

Chronic hypertension, aging, cystic medial degeneration, and traumatic insult.

Question 10

Where is aortic dissection likely to occur?

Answer 10

65% chance ascending
20% descending
10% aortic arch
5% Abdominal aorta

Question 11

What is peripheral atherosclerotic disease?

Answer 11

It limits blood flow, leads to endothelial dysfunction and limb ischemia. The most common cause is atherosclerosis.

Question 12

What’s acute arterial occlusion?

Answer 12

It’s caused by embolism from a cardiac or proximal vascular site, or by thrombus formation.

Question 13

What’s atheroembolism?

Answer 13

It’s peripheral arterial occlusion by atheromatous

material derived from more proximal sites. It’s the occlusion of small muscle or skin artery.

Question 14

What’s vasculitic syndromes?

Answer 14

It’s when the vessel wall’s inflammation results from an immune response.

Question 15

What’s takayasu arteritis?

Answer 15

Chronic vasculitis of unknown ethology that targets the aorta and its major branches.

Question 16

What’s giant cell arteritis (temporal) ?

Answer 16

Chronic vasculitis of medium to large arteries. (Cranial vessels and aortic arch and its branches)

Question 17

What’s throboangitis obliterans? (Buerger disease)

Answer 17

Segmental inflammation of the small and medium arteries, veins and nerves involving the distal vessels of the upper and lower extremities.

Question 18

What is raynaud phenomenon?

Answer 18

It’s a type of thing peripheral arterial disease characterized by vasospasm. In response to cold temperatures or stress.

Question 19

What’s the triphasic colour response?

Answer 19

1. Distinct blanch White due to blood flow being interrupted.
2. Cyanosis due to accumulation of deoxygenated blood.
3. Reddish-rosy colour as flow returns.

Question 20

What’s the mechanism of Raynaud Phenomenon!

Answer 20

Exaggerated SNS, excessive sensitivity to stimuli, excessive release of vasoconstrictor stimuli.

Question 21

Where does primary Raynaud Phenomenon occur?

Answer 21

Primarily in women between 20-40

Occurs in fingers (40% occurs in toes)

Question 22

What’s secondary Raynaud Phenomenon?

Answer 22

Secondary component to other causes (carpel tunnel syndrome, thoracic outlet syndrome)

Question 23

What’s varicose veins?

Answer 23

It’s dilated superficial vessels that often develop in lower extremities. Saphenous veins of the leg are most commonly affected. It results from intrinsic weakness of the wall from increased intraluminal pressure.

Question 24

What’s the difference between primary and secondary varicose veins?

Answer 24

Primary: originates in superficial system due to pregnancy, obesity, or prolonged standing

Secondary: Abnormality in the deep venous system is the cause of superficial varicosities.

Question 25

What’s deep vein thrombosis?

Answer 25

Thrombosis formation in a deep vein and it’s associated inflammatory response.

Question 26

What’s pulmonary embolism?

Answer 26

It’s dislodging of a clot from a DVT and travels to right heart via inferior vena cava. (Eventually instructs a portion of pulmonary vasculature)

Question 27

What’s postphlebitic syndrome?

Answer 27

It’s chronic deep vein insufficiency due to valve damage or persistent DVT. There’s chronic leg swelling, stasis pigmentation and skin ulcerations.

Question 28

What are risk factors for venous thrombosis?

Answer 28

1) stasis of blood flow
- disrupts laminar flow and allows platelet contact with endothelium

2) Hypercoagulability
- Various clinical disorders causing systemic hypercoagulability

3) Vascular damage
- external injury or by IV catheters cause endothelial injury and expose subendotheliak collagen.