Vascular Hemodynamics and Shock

Question 1

What is a thrombus

Answer 1

an unwanted clot formation inside a vessel (A or V) and most likely where endothelial damage is located

Question 2

what is an atherosclerotic area

Answer 2

the most common area for a thrombus because of its narrow lumen and irregular blood flow

Question 3

what are the causes of a thrombus (3)

Answer 3

irregular blood flow, endothelial damage, and hypercoagulability

Question 4

when are thrombi most frequent to form

Answer 4

during sleep when body is static and lowered BP which means lower perfusion pressure

Question 5

What are the two results of a thrombus

Answer 5

ischemia (decreased blood flow) or infarction (no blood flow)

Question 6

What is an aneurysm and where it is usually located

Answer 6

weakening of blood vessel wall and causes out-pouching

mostly artery&raquo_space; vein because high pressure

Question 7

what are the different forms of aneurysms

Answer 7

fusiform, dissection, or saccular

Question 8

Which arteries do aneurysms usually affect

Answer 8

cerebral + brainstem arteries, abdominal / thoracic and aoritic arch

Question 9

What are the risk factors for an aneurysm

Answer 9

TOBACCO USE**, increased age, atherosclerosis, M>F, CT disorders (marfans, etc), trauma, HTN, family history

Question 10

what are the complications of an aneurysm

Answer 10

rupture = hemorrhagic stroke, ischemia (dissection), or thrombus

Question 11

How do you treat aneurysms

Answer 11

Endovascular stent graft (within tissue to reduce pressure), traditional stent (in Sx), clipping, endovascular coil, liquid embolic agent (glue), blood thinner, HTN meds

Question 12

What are some ocular manifestations of aneurysms

Answer 12

posterior communicating artery (COW) is NEAR CN III
- Can cause Dilated pupil + down and out eye

Retinal vessels (microaneurysms), VF defect

Question 13

What is Virchow’s Triad

Answer 13

These factors lead to thrombus formation

1. Vascular Wall Damage: endothelial damage leads to exposed collagen to preclot factors
   - atherosclerosis** and anything that messes with endothelium of vessels
2. Circulatory Stasis: slow irregular or turbulent blood flow causes preclot factors to accumulate
   - immobility / paralysis or increased blood viscosity
3. Hyper-coagulability
   - altered blood chemistry

Question 14

what causes arterial thrombosis

Answer 14

afib, valvular disease, ATHEROSCLEROSIS**