Lecture 10 Aortic/Peripheral Vascular Disease Flashcards
In aortic dissection, there is a tear in the _____ with blood flowing through the _____
intima, media
3 main risk factors of developing aortic dissection:
HTN, collagen disorders (ie marfan’s), pregnancy
Classification of Aortic dissection:
Type 1 =
Type 2 =
type 1 ascending, arch, and descending aorta affected
type 2 = ascending only
Classification of aortic dissection:
Type 3a =
Type 3b =
3a = descending aorta, but above diaphragm
3b = descending aorta and blow the diaphragm
most common symptom of aortic dissection
rippping pain
aortic _____ caused by aortic dissection may lead to cardiac _____
insufficiency, tamponade
management of type 3a aortic dissection:
what about type b?
type 3a = surgery
3b = medical management initially, surgery if increasing pain/HTN
abdominal aortic aneurysm is highly associated with aging and _______
atherosclerosis
the classic location of AAA is below the _____ but above the _____
renal arteries, bifurcation
Most AAA ruptures occur at widths greater than ____ cm
5
the hallmark of an AAA on physical exam is what
pulsatile/expansive abdominal mass
repair of AAA surgically can be ____, which is associated with better outcomes, or ____
endovascular, open
what disease process causes peripheral arterial disease (PAD)
atherosclerosis
PAD presentations include a _____ event, symptoms of _____ that get worse with exercise, or “my leg fell off”
thromboembolic, claudication
Arterial vs venous insufficency–match symptom with type:
symptoms worsen with exercise:
elevation worsens symtpoms:
arterial;
arterial
arterial vs venous insufficeincy:
normal pulses in lower extremity:
compression helps:
lack of oxygenated blood to tissue
venous;
venous;
arterial
an ankle-brachial bp index less than ___ indicates significant PAD
0.7
if claudication is mild, PAD should be treated with ____ and ____ therapy
anti-platelet, compression
in venous insufficiency, what kind of veins of typically affected
superficial veins
compared to muscular veins, superficial veins are more ____, less well ____, and lack ____ ____ from superficial tissue
fragile, developed; structural support
hyperpigmentation may occur in chronic venous insufficiency due to sustained venous ____, which causes _____ in RBCs –>pigmentation due to _____
pressure, hemolysis;
hemosiderin
eczematoid dermatitis may occur in venous issues due to inflammation typically adjacent to a _____ ____
bulbous tributary
_____ _____ = inflammation and scarring leading to plaques of skin without pigment (pre-ulcerous)
atrophie blanche
_____ ____ : red flare, precursor to stasis ulceration
corona phlebectatica
_____ ____ = heavy inflammatory changes in the gaiter area due to vein reflux
stasis dermatitis
____ aka ____ ____ = painful inflammatory lesion that is firm and contracted
lipodermatosclerosis aka sclerosing panniculitis
_____ _____ = firm palpable cords over superficial varices with overlying inflammation
superficial thrombophlebitis
____ _____ occurs in end stage venous disease
stasis ulceration
____ is defined as an imbalance between clot formation and dissolution
thrombophilia
