Vascular Disease Flashcards
What are the Variety of conditions that alter blood flow in and out of organs
Increase in vessel pressure Thrombus/tumor invasion Atherosclerosis Congenital abnormalities Aneurysms
What is key in assessing vascular function
Understanding normal blood flow patterns
What are proximal abdominal aortic flow patterns
Moderate waveform
What is a normal distal abdominal aortic flow pattern
High resistance waveform
What is the normal renal artery flow pattern
Low resistance
What is the normal flow pattern in the SMA pre-prandial
High resistance
What is the normal flow pattern in the SMA post-prandial
Low resistance
What is normal portal venous flow
Hepatopedeal
Monophonic flow with slight undulations
What is normal flow patterns in the hepatic veins and IVC
Hepatofugal (hepatic veins)
Phasic flow
What is the flow in the hepatic veins and IVC influenced by
Cardiac and respiratory cycles
What is the IVC waveform pattern often described as
Sawtooth
What are the normal measurements for the aorta
Prox: 2.0-2.5cm
Distal: ~1.5cm
When the aorta measures 3cm or greater AP what is it then considered
Aneurismal
When is the IVC considered dilated
When it exceeds 3.7cm
On initial inspiration what happens to the IVC
Decreases in size
When respiration is suspended what happens to the IVC
Increases in size
What are the indications that a patient would have, that would get them set for an atrial assessment
Pulsatile abdominal mass
Abdominal pain
Abdominal bruit
Hemodynamic compromised lower limbs
Define arteriosclerosis
Hardening of the arteries
Define atheroma
Lipid deposit in the arterial intima
Define atherosclerosis
Form of arteriosclerosis in the large and medium arteries
Define plaque
Platelets forming a cap over a fat deposit
What is atheromatous disease
Lipid deposits on the intimal lining of any artery
What does alteration of the artifact; lining provoke and cause
Fibrosis and classification
-causes the wall to become damaged
What is atheromatous disease associated with
HTN
Smoking
Diabetes
Does the incidence of atheromatous disease increase with age
Yes
What is the appearance of atheromatous disease
Wall irregularities
Tortuous vessel
Calcifications
Narrowed vessel lumen
What can an aneurysm affect
Any artery
What are the 6 different types of aneurysms
AAA Splanchnic Artery aneurysm(mesenteric aneurysm) Iliac Artery Aneurysm Mycotic Aneurysms Inflammatory Aneurysm
define AAA
Abdominal Aortic Aneurysm
What is a AAA
A weakening of the aortic wall that leads to a focal dilatation
What does a true AAA involve
All 3 wall layers
What does ectasia of the aorta mean
Slight widening of the aorta up to 3cm
Most AAA occur mainly below the level of what
Renal vessels (infrarenal)
What are the causes of a AAA
Atherosclerosis Syphilis Systemic infections Cystic medial necrosis Other diseases- Marfan’s: connective tissue disorder
What are the risk factors for a AAA
Men >60 years of age
HTN
FHx (first degree relative)
Hypercholesterolemia (chronically high cholesterol)
What are the signs and symptoms of a AAA
Generally asymptomatic Palpable mass Incidental finding on X-Ray Lower back pain Abdominal pain Leg pain
What are the different types of AAA
Fusiform
Saccular
What is a fusiform AAA
Uniform tubular dilatation
What is a saccular AAA
Sac-like protrusion towards one side connected to the aorta
A fusiform AAA is the most what
Common appearence of a AAA
A saccular AAA is most often due to what
Trauma
Infection
What is the sonographic appearance of a AAA
Dilatation of the aorta >/3cm
Aorta is typically projecting anterior and left
Aortic wall irregularities
Thrombus; usually seen on the anterior and lateral walls
What is thrombus
Clot attached to the vessel wall
What is thrombus caused by
Slowing of the blood stream, injury to the vessel and alterations to the blood constituents
What can poorly attached thrombus result in
Release of emboli
What are associated findings of a AAA
Iliac artery aneurysms
Popliteal aneurysms
What is the most important measurement of a AAA
AP
What is the protocol for measuring a AAA
Place calipers outer-outer wall Measure perpendicular to the vessel Document -L, W, AP dimensions -shape -Location - if it involves the renal/iliac arteries -describe wall thickening -flow pattern
What does it mean if a AAA extends beyond the infrarenal
It becomes more difficult to treat
What is the follow up and treatment for an AAA that is between 3-5cm
Serial US, monitoring if it is increase in size 2-5mm/yr
If it is increasing 10mm/yr than surgery
