S2 L7.1 Diseases of the Aorta Flashcards
Conduit through which the blood ejected from the left
ventricle is delivered to the systemic arterial bed
AORTA
What is the diameter of the aorta?
○ 3 cm at the origin and in the ascending portion
○ 2.5 cm in the descending portion in the thorax
○ 1.8-2 cm in the abdomen
The following are true about the aortic wall, EXCEPT:
A. Thin intima composed of endothelium
B. Subendothelial connective tissue
C. Internal inelastic lamina
D. Thick tunica media composed of smooth muscle
cells and extracellular matrix
E. Adventitia composed primarily of Connective tissue
enclosing the vasa vasorum and nervi vascularis
F. None of the abovae
C. should be ELASTIC
T/F: The viscoelastic and compliant properties of the aorta
also subserve a buffering function
True
Pathologic dilatation of a segment of a blood vessel
AORTIC ANEURYSM
T/F: Proximal aneurysm is deadly because it is near the
branches
True
T/F: Commonly caused by hypertension and collagen
problems
True
Match the following tiems:
1. All three layers of the vessel wall
2. Intimal and medial layers are disrupted and the dilatation
is lined by adventitia only and, at times, by perivascular
clot
3. Affects the entire circumference of a segment of the
vessel, resulting in a diffusely dilated artery
4. Involves only a portion of the circumference, resulting in
an outpouching of the vessel wall
A. True Aneurysm
B. Pseudoaneurysm
C. Fusiform aneurysm
D. Saccular aneurysm
- A
- B
- C
- D
T/F about etiology of aortic aneurysm:
Result from conditions that cause degradation or
abnormal production of the aortic wall’s structural
components, elastin and collagen
True
Most common pathologic condition associated with
degenerative aortic aneurysms
ATHEROSCLEROSIS
Degeneration of collagen and elastic fibers in the tunica
media of the aorta, as well as the loss of medial cells that
are replaced by multiple clefts of mucoid material (weak
material)
CYSTIC MEDIAL NECROSIS
Match the following items:
1.Typically affect the thoracic aorta
2. Staphylococcal, streptococcal, Salmonella or other
bacterial or fungal infections of the aorta, usually at
an atherosclerotic plaque
3. Located in the ascending aorta or aortic arch
(proximal part)
A. Syphilitic Aneurysms
B. Tuberculous Aneurysms
C. Mycotic Aneurysm
- B
2.C - A
Identify which among the spefici causes of aortic aneurysm is being described:
● Inflammation of the arterial walls or autoimmune related
● Takayasu arteritis and giant cell arteritis
VASCULITIDES
Identify which among the spefic causes of aortic aneurysm is being described:
AS, RA, psoriatic arthritis, relapsing polychondritis, and
Reiter syndrome
Bechet syndrome
SPONDYLOARTHROPATHIES
Identify which among the spefic causes of aortic aneurysm is being described:
● May occur after penetrating or nonpenetrating chest
trauma
● Most commonly affect the descending thoracic aorta just
beyond the site of insertion of the ligamentum
arteriosum
TRAUMATIC ANEURYSMS
Identify what TYPE OF AORTIC ANEURYSM is being described:
● Clinical manifestations and natural history depend on their location
● Cystic medial necrosis is the most common cause ofnascending aortic aneurysms.
● Atherosclerosis is the condition most frequently
associated with aneurysms of the aortic arch and
descending thoracic aorta
● Most are asymptomatic
THORACIC AORTIC ANEURYSM
T/F: Thoracic aortic aneurysms associated with Marfan
syndrome or aortic dissection may expand at a greater
rate
True
T/F: Average growth rate of thoracic aneurysms is 0.1–0.2 cm
per year
True
Identify what TYPE OF AORTIC ANEURYSM is being described:
Occur more frequently in males than in females
Incidence increases with age
Infrarenal > suprarenal AAA
Incidence increases with age
Commonly asymptomatic
ABDOMINAL AORTIC ANEURYSM
90% of aneurysms >4.0 cm are related to ______
atherosclerotic
disease
○ Most are below the level of the renal arteries
T/F: Aneurysmal pain is usually a harbinger of rupture (aortic
dissection) and represents a medical and surgical
emergency.
True
T/F: Abdominal aortic aneurysm is related to Strong pulsations in the abdomen pain in the chest, lower
back, or scrotum
True
What are the diagnositcs for aneurysm?
● History, signs, and symptoms
● Chest X-ray
● CT scan
● MRI
● 2D echocardiogram
● Aortogram
Standard of choice for the diagnosis of aneurysm
Aortogram
● Inject into the femoral artery → inject dye → can be seen
in x rays
Aortogram
The following are management for aneurysm, EXCEPT:
A. Surgical management
B. The surgeon will cut off the aneurysmal area and replace with synthetic device (usually gore tex)
C. Connect the artificial artery back to the aorta
D. If in the LE: Can insert the gore tex device just like an angioplpasty on the femoral artery. The abodomen should be opened up
E. None of the above
D. Can insert the gore tex device just like an
angioplpasty on the femoral artery so there’s no need
to open up the abdomen
T/F: In aortic dissection, the dissected area is usually aneurysmal d/t
hypertension
True
Give me another common site for aortic dissection
Another common site is the descending thoracic aorta
just below the ligamentum arteriosum
T/F: Aortic Dissection usually propagates distally down the
descending aorta and into its major branches, but it may
also propagate proximally
True
What are common risk factors for aortic dissection?
○ HTN: a coexisting condition in 70% of patients
○ Cystic medial necrosis
T/F: Pregnancy in the 2nd trimester increases risk of
dissection
False. 3rd dapat
T/F: Men are more affected than women by a ratio of 2:1.
True
DEBAKEY CLASSIFICATION
intimal tear occurs in the ascending aorta but
involves the descending aorta as well; entire thing
Type I
DEBAKEY CLASSIFICATION
dissection is limited to the ascending aorta
Type II
DEBAKEY CLASSIFICATION
intimal tear is located in the descending aorta
with distal propagation of the dissection
Type III
More practical way to differentiate or classify
dissections; commonly used
STANFORD CLASSIFICATION
STANDFORD CLASSIFICATION
dissection involves the ascending aorta (proximal
dissection)
Type A
STANDFORD CLASSIFICATION
limited to the descending aorta (distal dissection)
Type B
What are the variatns for aortic dissection?
● Dissection
● Penetrating ulcer
● Intramural hematoma
Give me at least two (2) treatment for aortic aneurysm and dissection
- Medcial Mangement
- Surgical intervention
- Percutanous graft replacement
- Conservative management/close monitoring and
observation
