Vascular Disease Flashcards by Brianne Selin

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

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What is key in assessing vascular function

Understanding normal blood flow patterns

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What are proximal abdominal aortic flow patterns

Moderate waveform

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What is a normal distal abdominal aortic flow pattern

High resistance waveform

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What is the normal renal artery flow pattern

Low resistance

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What is the normal flow pattern in the SMA pre-prandial

High resistance

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What is the normal flow pattern in the SMA post-prandial

Low resistance

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What is normal portal venous flow

Hepatopedeal

Monophonic flow with slight undulations

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What is normal flow patterns in the hepatic veins and IVC

Hepatofugal (hepatic veins)

Phasic flow

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What is the flow in the hepatic veins and IVC influenced by

Cardiac and respiratory cycles

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What is the IVC waveform pattern often described as

Sawtooth

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What are the normal measurements for the aorta

Prox: 2.0-2.5cm
Distal: ~1.5cm

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When the aorta measures 3cm or greater AP what is it then considered

Aneurismal

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When is the IVC considered dilated

When it exceeds 3.7cm

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On initial inspiration what happens to the IVC

Decreases in size

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When respiration is suspended what happens to the IVC

Increases in size

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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

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Define arteriosclerosis

Hardening of the arteries

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Define atheroma

Lipid deposit in the arterial intima

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Define atherosclerosis

Form of arteriosclerosis in the large and medium arteries

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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

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