Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

AP II > Vascular Disease > Flashcards

Vascular Disease Flashcards

2
Q

What are the physiological functions of blood vessels? (3)

A

Regulation of blood to tissues

Synthesis/secretion of vasoactive/antithrombic substances

Delivery of immune cells

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

What are the measurement of the aorta in cm?

A

~3cm from the origin

~5-6 cm long

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

What are the 3 branches off the arch of the aorta from left to right?

A

Brachiocephalic

Left common carotid

Left subclavian

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

What are the layers of the aorta?

A

Intima (innermost)–endothelial cells

Media–smooth muscle cells, elastic/collagen fibers 2:1

Adventitia–collagen (strength), vaso vasorum (vasculature that perfuses the outer layer)

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

What factors constitute an AAA? (3)

A

50% increased localized diameter

>4 cm in thoracic aorta

>3 cm in abdominal aorta

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

Define a true aneurysm.

A

Involves all 3 vessel layers

2 types: fusiform, saccular

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

Define a pseudoaneurysm.

A

Only involves the inner 2 layers: intima and media.

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

Pseudoaneurysms are more unstable. True or false?

A

False affects the intima and media and is contained in the adventitia.

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

Label the types of aneurysms.

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

________ is the origin of 90% of aneurysm cases.

A

Atherosclerosis

Note: Usually occurs in males > 50 y/o.

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

What are cofactors leading to the cause of aneurysms? (4)

A

Smoking

Hypertension

High cholesterol

Loss of elastin

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

Men are ___ times more likely to have an aneurysm than women.

A

8

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

Abdominal aneurysms are often asymptomatic. True or false?

A

True

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

What are the clinical presentations of an aneurysm in the following areas:

Compression of esophagus/trachea
Recurrent laryngeal nerve
Dilation of aortic ring

A

Compression of esophagus: Wheezing, coughing, dyspnea, difficulty swallowing

RLN stretching: hoarseness

Aortic ring: Pt presents with aortic regurge

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

What are classic signs of an aortic aneurysm rupture?

A

Hypotension

Low back pain

Pulsative abdominal mass

Note: Only 1/2 pts present with these signs.

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

What is the gold standard for treating AAA?

What is the treatment for less severe ones?

A

surgical repair with prosthetic graft

endovascular graft

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When is surgical repair of a AAA considered? (Think of diameter.)

A

> 4.5 - 5 cm in diameter

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

What other co-existing conditions with pts with AAA have? (5)

A

Ischemic heart disease

HTN

COPD

Diabetes

Renal dysfunction

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

What kind of access do we need prior to surgery?

A

Large IV

Art line

Central line

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

What important factors do we need to consider intra-op?

A

Smooth induction to prevent cardiovascular swings.

Major blood loss may occur.

Hemodynamic changes that can occur during clamping/unclamping.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What hemodynamic changes occur during cross clamping?

A

Increased afterload–> increased BP

Decreased preload

Decreased perfusion distal to the clamp

Note: Depending on where the clamp is placed, renal perfusion can be compromised.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What hemodynamic changes occur during unclamping? (3)

A

Sudden decreased afterload –> decreased BP

**need vasoconstrictor to anticipate the change

Lactate washout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is an aortic dissection?

A

The splitting of the intima from the adventitia along the length of the vessel.

25
Q

What are the 2 types of aortic dissection?

A

Type A

Type B

26
What is a "Type A" aortic dissection? (3)
Involves the proximal, ascending aorta Represents 2/3 of dissections High risk of extruding into coronary and arch vessels
27
What is a "Type B" aortic dissection?
Distal dissection limited to the thoracic and abdominal aorta
29
What is the pathogenesis of aortic dissection? (4)
Chronic HTN Aging Connective tissue disorder like Marfan's Trauma
30
What type of aortic dissection presents as: sudden, severe pain with ripping/tearing in anterior chest
Type A
31
What type of aortic dissection presents as: sudden severe pain between scapulae
Type B
32
What other catastrophic events can occur from a dissecting aorta? (4)
MI Stroke Renal failure Loss of pulse in extremities Note: All occur as a result of occlusion of the propagating hematoma.
33
What are complications of aortic dissection?
Rupture Occlusion of aortic branch vessels Distortion of the aortic annulus
34
What does the rupture of aortic dissection result in?
cardiac tamponade hemomediastinum hemothorax
35
What does occlusion of the aortic vessels result in?
carotid stroke coronary MI
36
How do we treat an aortic dissection intra-operatively?
Stop progression of the dissection by: decreasing BP --\> **Beta Blockers** decreasing LV contraction --\> **Sodium Nitroprusside**
37
Symptomatic pts with \>\_\_\_\_% blockage yield the greatest benefit from an endarterectomy.
50%
38
Pts who have already suffered a stroke will yield the most benefit to a carotid endarterectomy. True or false?
False, yields minimum benefit.
39
What do you consider during a carotid endarterectomy pre-op evaluation?
Neurological status CAD Renal disease Chronic HTN Effect of changes in head position
40
What is the anesthetic technique for carotid endarterectomies?
Regional: Cervical Plexus Block allows trial occlusion of carotid to evaluate neuro changes. Pt is awake. GA: **Infer** neuro changes from EEG
41
What are the cons to performing a cervical plexus block for a carotid endarterectomy?
no cerebral protection
42
What are the benefits to GA for a carotid endarterectomy?
decreased CMRO2 ability to regulate PO2, PCO2
43
What are the drugs of choice for induction for a carotid endarterectomy? (2)
Thiopental Propofol Note: Because they lower CMRO2 and redistribute blood flow to potentially ischemic areas. Etomidate for hemodynamically unstable pts. Fentanyl/Alfentanyl
44
What are anesthetic considerations intraoperatively for carotid endarterectomies?
Control BP Carotid cross-clamping/unclamping PROMPT emergence to assess neuro function
45
What are post-operative concerns for carotid endarterectomies? (5)
HTN (carotid sinus activation) / Hyptension (baroreceptor reactivation) MI/Infarction (MI is leading cause post-op complications) Neurological complications Airway obstruction Nerve injury (hypoglossal, RLN, SLN)
46
In what time frame does a carotid endarterectomy incident occur?
8-12 hours post op
47
Peripheral disease may result from: (3)
atherosclerosis thromoembolism (acute) vasculitis
48
70% of pts \> 75 y/o are affectedby peripheral atherosclerosis. True or false?
true
49
What are the clinical presentations of peripheral atherosclerosis? (4
Claudication (cramping) Ulceration Skin necrosis Decreased arterial pulses
50
How do we pharmacologically treat peripheral atherosclerosis? (4)
Anti-platelet therapy Lipid-lowering therapy DM meds HTN meds
51
What are causes of acute arterial occlusions? (4)
Thrombi originating from: heart stenosed aorta damaged endothelium bypass grafts
52
What condition: vasospasm of digital arteries with cold/stress extreme vasoconstriction tricolor phasic response- white/blue/red Affects women 20-40 y/o
Raynaud's Syndrome
53
What medications alleviate symptoms of Raynauds? (2)
Calcium channel blockers Alpha antagonists
54
Avoid EPI in local anesthetics when treating pts with Raynaud's. True or false?
True
55
Where do DVTs normally occur and what is a considerable risk of a DVT?
Calf veins or more proximally Pulmonary embolism
56
What are the clinical symptoms of a 2º DVT, or, pulmonary embolism? (4)
Acute dyspnea Tachypnea Chest pain Non-productive cough
57
What are DVT risk factors? (5)
Morbid obesity Stasis of blood flow vascular damage Hypercoagulable states Advanced age

AP II (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions