Vascular 1 Flashcards
Aneurysm is…
Abnormal stretching or dilation of the wall of an artery, a vein, or the heart
Amount of stretching to be considered aneurysm:
__% > normal
50%
(Dilating to greater than 50% of diameter)
How are aneurysms named?
According to site of formation
Stretching, as happens with aneurysm, produces expansion and eventually a ____ and ____ wall
Weak and thin
Are aneurysms more common in men women or equal?
Men (4x)
Most common type of aneurysm?
Triple A: Abdominals Aortic Aneurysm, more than 95% of them happen here
10% of aneurysms happen in _____ area, can be life threatening. Associated with hoarseness. Hypertensive men in 40s
Thoracic area
Most common site for an arterial aneurysm is the ____
Aorta
> 95% of AAA are located below ____ ____ and cause what type of pain?
Below the renal arteries
Cause low back pain
Aneurysm: Saccular
Unilateral outpouching of one side of vessel affects all layers
Aneurysm: Fusiform
Bilateral outpouching
Aneurysm: Dissecting
Bilateral outpouching but does not affect all layers
Aneurysm: False aneurysm
Wall ruptures and a blood clot is retained in an outpouching of tissues
Saccular, fusiform, dissecting, are ___ aneurysms.
True aneurysms
____can be caused by smoking, alcohol, HTN, genetics, atherosclerosis, infection, and trauma.
Aneurysm
Diagnosis of aneurysm can be via
CT scan, ultrasound, MRI, endocardiography
What is this?
Chest pain, palpable pulsating mass, abdominal heart beat felt by client when laying down, dull ache in mid abdominal, left flank, LBP, Groin or leg pain, weakness or transient paralysis
Clinical signs and symptoms of AAA - Aneurysm (non ruptured)
What is this?
Sudden, severe chest pain with tearing sensation. Pain my extended to neck, shoulder, low back or abdomen but rarely joints and arm which distinguishes it from MI. Systolic BP <100mmHg. Ecchyomosis (purple discoloration). Lightheadedness and nausea (syncope). More life threatening, tachycardia.
Clinical signs and symptoms - AAA (Ruptured Aneurysm)
Peripheral vascular disease is the broad term for
Both arterial and venous blood vessels diseases
How is peripheral vascular diseases organized?
based on underlying pathological finding (inflammatory, arterial occlusive, venous, or vasomotor disorders)
Peripheral vascular diseases are more common in UE or LE
LE (although UE involvement is not uncommon)
Peripheral vascular diseases affects approximately how many Americans over the age of 60
8 million
Peripheral vascular diseases can be categorized into 4 disorder categories which are…
Inflammatory, venous, arterial, vasomotor disorders
What is Vasculitis
Group of auto-immune multi-system diseases that can affect all ages, from infants up to elderly patients
Vasculitis is characterized by
Leukocytic inflammation of the vascular walls
Vasculitis:
-Pathogenesis is _____
- ____ _____ of any size, type, location, or system
- Acute or chronic
- Irregular and segmental
- Affects what part of the nervous system?
- Unknown
- Blood vessels
- Can affect the PNS and CNS
What is Polyarteritis Nodosa
Multiple sites (poly) of inflammation and destructive lesions in the arterial system (arteritis)
Polyarteritis nodosa
- Affects ____ and ______ sized blood vessels
- Manifestations depend on the ___
- What organs can it affect?
- small and medium sized
- site
- any organ in the body
While Polyarteritis nodosa cause is unknown, what are the things it is associated with?
-IV drug use
- Hep B, C
- HIV
Clinical manifestations of Polyarteritis nodosa
Typical onset of inflammatory response
(fever, chills, tachycardia, arthralgia, myositis) (abdominal pain, nausea, vomiting)
(Paresthesias, neuropathies, pain, weakness)
What is management of polyarteritis nodosa?
Improved 5 year survival rate to what percentage?
- Prolonged use of steroid therapy
- Immunosuppressant
- 90%
Arteritis (Giant Cell Arteritis) is considered a what?
Vasculitis
Giant cell arteritis typically involved what arteries?
Temporal and cranial arteries (large vessels)
Etiology and pathology of giant cell arteritis?
Most commonly affects who?
Unknown
Most common affects older people, and women
In giant cell arteritis, what layer becomes inflamed?
Middle layer (tunica media)
Clinical manifestation of giant cell arteritis:
- Sudden or gradual?
- Continuous, __ilateral throbbing headache in _______ area
- may radiate to eye, face, side of neck
- Visual disturbances due to injury to ____
- ____ sensitivity with chewing, talking, swallowing
- Sudden
- Bilateral; Temporal area
- Ophthalmic artery
- Scalp
- Medical management for giant cell arteritis
- Relief of symptoms in how many days?
- Resolved within how many months?
- Corticosteroids
- 3-5 days
- 6-12 months
- Allergic or Hypersensitivity angiitis is a type of….
- Commonly affect who?
- Vasculitis
- Children and young adults
In allergic or hypersensitivity angiitis, the etiology is unknown but follows what type of infection and people with what sensitivities?
Upper respiratory infection in people with allergy and drug sensitivity issues
Allergic or hypersensitivity angiitis has a classic triad of symptoms including
- Purpura (purplish spots under the skin)
- Arthritis
- Abdominal pain
Kawasaki’s Disease aka
mucotaneous lymph node syndrome
Kawasaki’s Disease
- affects what type arteries?
- Can occur in any ethnic group but prevalent in what populations?
- __% are children. __% develop cardiac complications
- Small and medium
- Asians
- 80%; 20%
Kawasaki’s Disease etiology
Unknown
Kawasaki’s Disease
vast majority of cases occur in <__ years
<5 years
Kawasaki’s Disease clinical manifestations
- Fever >__ days, _____ inflammation
- Conjunctivitis, cervical _____
- Rash: erythema of ___/___
- Abdominal pain/nausea/vomiting
- Complication:
- Tongue has what appearance?
- > 5 days; mucocutaneous
- Cervical lymphadenopathy
- palms/soles
- coronary aneurysm and cardiomyopathy
- Strawberry tongue
Describe Clinical manifestations, timeline, phases of Kawasaki’s Disease
3 phases
Acute - Sudden high fever, unresponsive to antibiotics and antipyretics. Extreme irritability
Subacute - Possible fever but irritability persists. Rash develops on trunk and extremities with skin desquamation (peeling), conjunctivitis, and oral mucosal changes. At risk for cardiac involvement.
Convalescent - 6-8 weeks after onset all clinical signs/symptoms should resolve with blood values returned to normal
Medical management of Kawasaki’s Disease
Prognosis?
High does intravenous gamma-globulin (antibodies) and salicylates therapy to reduce fever and control inflammation
Prognosis is for full recovery of function if no aneurysm develops
