Brainscape's Knowledge GenomeTM

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


See full index

FINALS > VASCULAR > Flashcards

VASCULAR Flashcards

1
Q

What is aortic dissection?

A

Tearing of the layers of the aorta - blood fills between the intima and the media.

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

Name the layers of the aorta.

A

Intima
Media
Adventitia

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

What is a false lumen?

A

Tear in the vessel wall forming a blood filled sac.

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

Which part of the aorta is most commonly affected?

A

Ascending aorta - right lateral area (vessel is under most stress from blood leaving the heart)
Aortic arch

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

What are the risk factors?

A 
Smoking
Age
Male
High cholesterol
Obesity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which conditions increase the risk of dissection?

A 
Conditions affecting the heart/aorta:
	• Coarctation of the aorta
	• Aortic valve replacement
	• CABG
Connective tissue diseases:
	• Marfan's
Ehlers Danlos
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Name two classification systems for aortic dissection

A
  1. Stanford

2. DeBakey’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the Stanford system?

A
  1. Type A - ascending aorta, before brachiocephalic artery

2. Type B - descending aorta, after left subclavian artery

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

What is the typical presentation of aortic dissection?

A

Tearing/ripping chest pain - pain may migrate
HTN
Syncope

Sometimes no chest pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is indicated by anterior or posterior chest pain in suspected aortic dissection?

A 
Anterior = ascending aorta
Posterior = descending aorta
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the signs of aortic dissection?

A 
HTN --> hypotension
Difference in BP in each arm
Diastolic murmur
Radial pulse deficit
Focal neurological deficit
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What type of murmur is associated with dissection?

A

Diastolic murmur

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

What is a radial pulse deficit?

A

Radial pulse in one arm is absent/weaker and does not match the apex beat.

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

Why is it important to measure the blood pressure in both arms in suspected aortic dissection?

A

> 20mmHg

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

What investigations should be ordered in suspected aortic dissection?

A

ECG and CXR - to exclude other causes
CT angiogram - diagnostic
MRI angiogram - for management

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

What is seen on ECG in aortic dissection?

A

Normal - or MI can occur in combination

17
Q

What is the initial investigation to confirm the diagnosis of aortic dissection? What investigation imaging will be needed for definitive management?

A

CT angiogram

MRI angiogram

18
Q

What is the immediate management of aortic dissection?

A
  1. Analgesia - morphine
  2. Control BP and heart rate - beta-blockers
  3. refer for Surgery - depends on classification
19
Q

What beta-blocker is used to control HR and BP in aortic dissection?

A

IV labetalol

20
Q

How is type A dissection treated?

A

Open surgery = sternotomy (aortic valve may need replacing during)

21
Q

How is type B dissection treated?

A

Conservative management

OR

TEVAR = thoracic endovascular aortic repair (catheter inserted via the femoral artery)

22
Q

Why should thrombolysis be avoided in aortic dissection?

A

Bleeding

23
Q

Name 6 complications of aortic dissection.

A 
MI
Stroke
Paraplegia
Cardiac tamponade
Aortic valve regurgitation
Death
24
Q

What is compartment syndrome?

A

raised pressure within a closed anatomical space. The raised pressure within the compartment will eventually compromise tissue perfusion resulting in necrosis

25
Q

Which two fractures are most likely to cause compartment syndrome?

A

supracondylar fractures and tibial shaft injuries.

26
Q

What are the signs of compartment syndrome?

A

Acute compartment syndrome presents with the 5 P’s:
• P – Pain “disproportionate” to the underlying injury, worsened by passive stretching of the muscles
• P – Paraesthesia
• P – Pale
• P – Pressure (high)
P – Paralysis (a late and worrying feature)

27
Q

What are the two types of compartment syndrome?

A

Acute or chronic

28
Q

Name a key differential for compartment syndrome.

A

Critical limb ischaemia

29
Q

What is the clinical difference between compartment syndrome and critical limb ischaemia?

A

Pulses remain intact

30
Q

How is compartment syndrome diagnosed?

A

Clinical

31
Q

What is the investigation used?

A

Needle manometry can be used to measure the compartment pressure. A device (manometer) measures the resistance to injecting saline through a needle into the compartment.

32
Q

What would happen if the patient was not treated?

A

tissue necrosis (death) and permanent damage can occur.

33
Q

What is the management of compartment syndrome?

A
  1. Escalating to the orthopaedic registrar or consultant
  2. Removing any external dressings or bandages
  3. Elevating the leg to heart level
  4. Maintaining good blood pressure (avoiding hypotension)
34
Q

What is the definitive treatment of compartment syndrome?

A

Emergency fasciotomy (within 6 hours)

Patients require repeated trips to theatre (every few days) to explore the compartment for necrotic tissue, which needs to be debrided.
As the swelling improves, the wound can be gradually closed, which can take several weeks.

35
Q

What is chronic compartment syndrome?

A

Chronic compartment syndrome (also called chronic exertional compartment syndrome) is usually associated with exertion.
During rest, the pressure falls, and symptoms begin to resolve.

36
Q

How does chronic compartment syndrome differ to acute compartment syndrome?

A
  1. Symptoms are usually isolated to a specific location at the affected compartment.
  2. Not an emergency.
  3. Associated with exertion.
37
Q

How is needle manometry used to guide the treatment of chronic compartment syndrome?

A

Needle manometry can be used to measure the pressure in the compartment before, during and after exertion to confirm the diagnosis. It may be treated with a fasciotomy.

38
Q

What treatment is recommended for superficial thrombophlebitis?

A

NSAIDs

Compression stockings

FINALS (26 decks)

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