Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

cardiovascular (annie) > Peripheral Vascular Disease III - Abdominal Aortic Aneurysm (AAA) > Flashcards

Peripheral Vascular Disease III - Abdominal Aortic Aneurysm (AAA) Flashcards

1
Q

what is an aneurysm?

A

dilation of a vessel by more and 50% of its normal diameter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the normal aortic diameter?

A

1.2-2.0cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are the 2 types of aneurysm?

A

1) true aneurysm

2) false aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

in true aneurysm, describe the vessel wall?

A

= the vessel wall is intact (all 3 layers)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

in false aneurysm, describe the vessel wall?

A

= there is a breach in the vessel wall (surrounding structures act as vessel wall)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the 3 shapes of an aneurysm?

A

1) saccular
2) fusiform
3) mycotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how do mycotic aneurysms arise?

A
  • arises secondary to an infectious process, involving all 3 layers of the artery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

related to pathogenesis, what happens in abdominal aortic aneurysm?

A

= medial degeneration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what happens in medial degeneration?

A
  • regulation of elastin/collagen in aortic wall
  • aneurysmal dialtion
  • increase in aortic wall stress
  • progressive dilation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

who is at the greatest risk of developing abdominal aortic aneurysm?

A

1) increases with age
2) make gender
3) smoking
4) hypertension
5) diabetes
6) raised cholesterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what commonly happens in people with AAA?

A

popliteal aneurysms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what do the majority of AAA present with?

people who present with this, what are they at risk or?

A

asymptomatic

Risk of = rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

if people with AAA present with symptoms, what are they?

In people who present with symptoms, what can you exclude?

A

1) pain
- can mimic renal colic

2) trashing
= bits of plaque break off and travel through aorta

3) rupture

You can exclude rupture.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what sort of pain is AAA rupture?

A

sudden onset of epigastric, central pain.

- may radiate through back

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what may rupture of AAA mimic?

A

mimic renal colic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what does rupture of AAA result in?

A

collapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

on examination, what might you find in a patient with ruptured AAA?

A
  • may look well
  • hypo/hypertension
  • pulsatile, expansile mass +/- tender
  • transmitter pulse
  • peripheral pulses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are the 2 types of rupture?

A

1) retroperitoneal, contained rupture

2) free intra-peritoneal rupture = fatal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

how can you image AAA?

A
  • duplex ultrasound

= asymptomatic/surveillance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

in the duplex ultrasound, what are you looking at?

A

AP diameter and involvement of iliac arteries

= it only tells you there is an AAA or not and its AP diameter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what other imaging can you do for AAA?

A

CT scan

22
Q

what are you looking at in a CT scan?

A

= arterial phase

  • IV contrast
  • commence when contrast is in arterial system
23
Q

what is the only imaging method to identify ruptured AAA?

A

CT scan

24
Q

what are the 2 ways of managing an AAA?

A

1) open repair

2) endo-vascular aneurysm repair (EVAR)

25
Q

to repair an AAA, what 4 things can open repair involve?

A

1) laparotomy
2) clamp aorta + iliac
3) Dacron graft
4) tube vs bifurcated graft

26
Q

what is the other way of managing an AAA?

A

endo-vascular aneurysm repair

27
Q

what happens in endo-vascular aneurysm repair?

A
  • exclude AAA from inside the vessel
  • inserted via peripheral artery
  • X-ray guided
  • modular components
28
Q

what are the 3 types of acute limb threat?

A

1) acute limb iscahemia
2) acute or chronic limb iscahemia
3) diabetic foot sepsis

29
Q

what is acute limb ischaemia?

A

sudden loss of blood supply to a limb

30
Q

what causes acute limb ischaemia?

A

= occlusion of native artery or bypass graft

31
Q

what causes sudden occlusion in acute limb ischaemia?

A

1) embolism
2) athero-embolism
3) arterial dissection
4) trauma
5) extrinsic compression

32
Q

what are the 6 features of acute limb ischaemia?

What 2 important features are important to gather in a history for people at risk of acute limb ischaemia?

A

1) pain (due to lack of blood supply to nerves)
2) pallor
3) pulseless
4) perishingly cold
5) paraesthesia = pins & needles/altered sensation
6) paralysis

  • no prior history of claudication
  • known cause for embolism
33
Q

describe the pain suffered in acute limb iscahemia.

A
  • severe, sudden onset, resistant to analgesia
34
Q

what happens with the calf muscles in acute limb ischaemia?

A
  • calf/muscles tenderness with tight compartment indicates muscle necrosis often irreversible iscahemia
35
Q

describe the pallor of the limb involved in acute limb ischaemia.

A

Initially
= limb white with empty veins

Later
= capillaries fill with stagnated de-oxygenated blood giving a mottled appearance

  • Arteries distal to occlusion fill with propagated thrombus with rupture of capillaries
36
Q

is blanching mottling salvageable?

is non-blachnig mottling reversible?

A

yes - if prompt re-vascualrisation

no - it is irreversible ischaemia

37
Q

why does paraesthesia/parlysis occur in acute limb ischaemia?

A
  • sensorimotor deficit are indicative of muscle & nerve ischaemia
38
Q

what time feature is acute limb iscahemia salvable?

A

0-4hours

  • white foot
  • painful
  • sensorimotor deficit
39
Q

what time feature is acute limb iscahemia partially reversible?

A

4-12hours

  • mottled
  • blanches on pressure
40
Q

what time feature is acute limb iscahemia non-salvageable?

A

> 12hours

  • fixed mottling
  • non-blanching
  • compartments render/red
  • paralysis
41
Q

how do you manage acute limb ischaemia?

A

1) ABC – resuscitate and investigate
2) FBC, U/Es, CK, Coag +/- Troponin
3) ECG – MI, dysrhythmia
4) CXR – underlying malignancy

5) anti-coagulants
= stops propagation of thrombus
- may improve perfusion

6) arterial imaging

42
Q

if limb is salvageable, what do you do?

A

= embolectomy +/- fascioteomies +/- thrombolysis

43
Q

what 3 things does diabetic foot sepsis encompass?

A

1) diabetic neuropathy
2) peripheral vascular disease
3) infection

44
Q

what does this triad in diabetic foot sepsis lead to?

A
  • tissue ulceration
  • necrosis
  • gangrene
45
Q

what causes diabetic foot sepsis?

A
  • simple puncture wound
  • infection from nail plate or inter-digital space
  • from neuro-iscahemic ulcer (occurs on areas of increased pressure)
46
Q

why is diabetic foot sepsis a problem?

A

= within the foot the intrinsic muscles of digits are confine within rigid compartments
- bounded by planter fascia, metatarsal bones and interosseous fascia

  • infection tracks in soft tissues into this rigid compartment
47
Q

what happens if the build up of pus cannot escape?

A
  • pressure builds up in rigid compartment leading to impairment of capillary blood flow & further iscahemia & further tissue damage

= can rapidly progress to sepsis & limb loss

48
Q

what 5 systemic things happen as a result of diabetic foot sepsis?

A
  • pyrexia
  • tachycardia
  • tachypnoeic
  • confused
  • kussmauls breathing
49
Q

what 7 local features happens as a result of diabetic foot sepsis?

A
  • swollen affected foot
  • swollen forefoot
  • tenderness
  • ulcer with pus extruding
  • erythema, may track up limb
  • patches of developing necrosis
  • crepitus in soft tissue of foot
  • pedal pulse may or may not be present
50
Q

how would you manage diabetic foot sepsis?

A

1) antibiotics
- gram +ve cocci (S. aureus + streptococcus sp)
- gram -ve bacilli (E. coli, klebsiella sp, enterobacter, proteus sp and pseudomonas sp.)
- anaerobes (bacteroides)

2) rapid surgical debridement of infected tissue
3) remove all infected tissue
4) wound open to encourage drainage

cardiovascular (annie) (36 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions