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My own anatomy > Diseases of thoracic Aorta > Flashcards

Diseases of thoracic Aorta Flashcards

1
Q

Describe the tunica intima

A
  • Layer of endothelial cells
  • Subendothelial layer - collagen and elastic fibres
  • Separated from tunica media
    via interanal elastic membrane
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2
Q

Describe the tunica media

A
  • Smooth muscle cells

- Secrete elastin in the form of sheets or lamellae

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3
Q

Describe the tunica adventitia

A
  • Thin connective tissue layer
  • Collagen fibres and elastic fibres
  • The collagen in the adventitia prevents elastic arteries from stretching beyond their physiological limits during systole
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4
Q

Define an aneurism

A

A localised enlargement of an artery caused by a weakening of the vessel wall

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5
Q

Describe the two types of classifying aortic aneurisms

A

True/False

By location

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6
Q

Describe a ‘true’ aneurism

A
  • Weakness and dilatation of wall involving all 3 layers
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7
Q

Describe a ‘false’ aneurism

A
  • Rupture of wall of aorta with the haematoma either contained by the thin adventitial layer or by the surrounding soft tissue
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8
Q

State the 4 locations used to classify aortic aneurisms

A
  • Ascending
  • Arch
  • Descending
  • Abdominal
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9
Q

Describe the signs/symptoms of an aneurism

A
  • Could be asymptomatic
  • Based on location of aneurysm
  • SOB
  • Dysphagia and hoarseness
  • Back pain
  • Pulsatile mass
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10
Q

Describe the investigations for a suspected aneurism

A

CXR
Echo
CT angiogram aorta
MRI aorta

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11
Q

What are the 2 diagnostic tests for an aneurism

A

CT angiogram aorta

MRI aorta

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12
Q

What would a CXR show for an aneurism

A

Widened aneurism

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13
Q

What does an echo do in terms of assessing for an aneurism?

A

Assess aortic root size and aortic valve (limited views of distal ascending aorta and arch)

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14
Q

What is an aortic dissection?

A

Tear in the inner wall of aorta

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15
Q

Describe the aeitology of an aortic dissection

A
  • Hypertension
  • Atherosclerosis
  • Marfa’s syndrome
  • Bicuspid aortic valve
  • Trauma
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16
Q

What is a false lumen?

A

It occurs when blood enters the medial layer of the aortic wall through a tear or penetrating ulcer in the intima and tracks longitudinally along with the media, forming a second blood-filled channel (false lumen) within the vessel wall

17
Q

What may the dilation of ascending arota cause?

A

Aortic regurgitation

18
Q

What are some complications of aortic dissections?

A
  • False lumens
  • May occlude branches (coronary, mesenteric, carotid, renal, spinal)
  • Rupture - back into the lumen or externally into the pericardium (tamponade) or mediastinum
19
Q

Describe what is meant by a Type A aortic dissection - defined by the stanford classification system

A

All dissections involving the ascending aorta, regardless of origin

20
Q

Describe what is meant by a Type B aortic dissection - defined by the stanford classification system

A

All dissections not involving the ascending aorta

21
Q

Describe what is meant by a type I aortic dissection as classified by the DeBakey classification system

A

Originates in the ascending aorta, propagates at least to the aortic arch and often beyond it daily

22
Q

Describe what is meant by a type II aortic dissection as classified by the DeBakey classification system

A

Originates in and is confined to the ascending aorta

23
Q

Describe what is meant by a type III aortic dissection as classified by the DeBakey classification system

A

Originates in the descending aorta and extends distally down the aorta or rarely retrograde into the aortic arch and ascending aorta

24
Q

Describe the presentation of someone with an aortic tear

A

Chest pain - severe, sharp, radiating to back
Collapse - tamponade, acute AR, external rupture
Stroke - Involvement of carotid arteries

25
Q

Describe the signs of an aortic tear

A
  • Reduced or absent peripheral pulses
  • Hyper/hypotension
  • BP mismatch between sides
  • Soft early diastoic murmur (aortic regurg)
  • Pulmonary oedema
  • Signs of CVA
26
Q

Describe the investigations used for an aortic dissection and what they may show?

A

ECG - might show ST elevation indicating coronary involvement
CXR - widened mediastinum
CT angiogram aorta - confirms diagnosis
Transthoracic echocardiogram (TEE) - assess aortic root, aortic regurg, pericardial effusion

27
Q

Describe both treatment options for an aortic dissection

A 
Blood pressure control:
- B blocker
- IVI nitrate
- CCB
- IVI Na Nitroprusside
AND EITHER 
- emergency surgery OR percutaneous (endovascular) intervention
28
Q

Describe what is meant by a bicuspid aortic valve

A
  • 2 leaflets in aortic vlaves fuse
  • Most common congenital abnormality
    1-2% prevalence
  • Prone to aortic valve stenosis and or regirg
  • Associated with regurgitation
  • Abdominal aorta has reduced tensile strength
  • Prone to aneurism/Dissection
  • Monitor with echo/MRI

My own anatomy (34 decks)

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