Lecture 3 - Arterial Pathologies

Question 1

define ‘aneurysm’

Answer 1

abnormal stretching/dilation in the wall of an artery, vein or heart with a diameter that is at least 50% greater than normal

Question 2

list 5 causes of aneurysms

Answer 2

atherosclerosis
trauma
congenital vascular disease (Marfan's)
infection (bacterial, syphilis)
familial factors (genetics)

Question 3

list 3 types of ‘true’ aneurysms

Answer 3

saccular - saclike budging on one side
fusiform - elongated, spindle-shaped dilation
dissecting - splitting or dissection of arterial wall via blood entering through a tear of inner lining or interstitial hemorrhage

Question 4

when can a ‘false’ aneurysm occur?

Answer 4

when the wall of the bv is ruptured, blood escapes into surrounding tissue forming a clot

Question 5

where is the most common site for an aneurysm?

Answer 5

aorta

Question 6

are thoracic or abdominal aortic aneurysms more common?

Answer 6

abdominal are 4 times more often (less life threatening)

Question 7

what symptoms can a thoracic aneurysm present with? (rare)

Answer 7

chest and/or upper back pain
coughing up blood
difficulty swallowing
wheezing

Question 8

abdominal aneurysms are more likely to cause symptoms that….

Answer 8

pulsate in abdomen

upper abdominal pain and/or sever lower back pain

Question 9

list 4 treatment options for an aneurysm

Answer 9

clipping (metallic clip along neck)
occlusion and bypass
endovascular embolization
stent graft

Question 10

what 2 organs are most affected by PVD?

Answer 10

kidneys

intestines

Question 11

what are 4 underlying pathological conditions that PVD stems from?

Answer 11

arterial occlusive disorders
inflammatory disorders (vasculitis)
venous disorders
vasomotor disorders

Question 12

define ‘arterial occlusive disorder’

Answer 12

a very common and slow process where arteries throughout the body become progressively narrowed and eventually completely blocked - caused by atherosclerosis

Question 13

what is the most common form of PVD?

Answer 13

intermittent claudication

Question 14

damage to blood vessels can result in….

Answer 14

end-stage organ damage

Question 15

vasculitis can cause what 2 things…

Answer 15

narrowing/occlusion of lumen

aneurysm formation

Question 16

define ‘polyarteritis nodosa’

Answer 16

multiple sites of inflammatory and destructive lesions in the arterial system where the lesions form small masses = nodes in artery (serious bv disease) caused by autoimmune disease

Question 17

what do neutrophils do to vessels in polyarteritis nodosa?

Answer 17

destroy the vessel wall causing necrosis as a result of an autoimmune disorder that is related to the deposit of immune complexes

Question 18

arteritis/giant cell arteritis commonly involves what arteries?

Answer 18

head and neck (aka temporal or cranial arteritis) (unknown cause)

Question 19

what symptoms does arteritis/GCA present with?

Answer 19

sudden symptoms are related to the area supplied by affected artery but includes: persistent, severe head pain (temporal), vision loss (sudden, permanent loss in one eye)/double vision, jaw pain, scalp tenderness, fever

Question 20

how do you treat GCA?

Answer 20

corticosteroids

Question 21

what is Buerger’s disease (thromboangiitis obliterans)?

Answer 21

inflammation and swelling of bv’s that affects peripheral arteries and veins - primarily in extremities with an unknown cause (men younger than 40 and heavy smokers)

Question 22

with Buerger’s disease what is inflammation accompanied by?

Answer 22

thrombus formation and vasospasm occluding and destroying the bv = gangrene

Question 23

what are 3 signs and symptoms of arterial insufficiency?

Answer 23

intermittent claudication
redness of distal limb - elevated foot increases pallor
gangrene

Question 24

what is the difference in symptom experience with arterial (PAD) and venous insufficiency (PVD)?

Answer 24

PAD - symptoms worsen with activity and improve with rest

PVD - pain worsens with standing and improves with leg elevation and activity