VASCULAR LECTURE 2: Arterial & venous conditions Flashcards
What causes an aneurysm in atherosclerosis?
Weakening of arterial wall through growth and remodelling of plaques
What is the term for thrombi that form along the edge of atherosclerosis plaque?
Mural thrombi
What are 3 potential consequences of mural thrombi?
- Further narrowing of vessel
- Thrombus incorporates into plaque
- Embolism
What is the term for a test comparing the blood pressure in the upper and lower limbs?
Ankle-brachial index
Explain the difference between an aortic aneurysm, dissection, and rupture
- Aneurysm: swelling or bulging of the aorta due to weakened wall
- Dissection: Tear in the weakened wall, causing blood to leak between layers
- Rupture: All layers of the aortic wall tear
What is the term for cramping pain in the leg induced by exercise that is typically caused by aterial obstruction?
Claudication
Which medications lower LDL cholesterol levels by inhibiting cholesterol synthesis?
Statins
What are 3 other pharmalogical treatments for atherosclerosis?
- Antihypertensives
- Antithrombotics
- Antiglycemics
What surgical procedure involves rerouting blood flow around a blocked arterial segment?
Vascular bypass surgery
What surgical procedure involves using a balloon to stretch open a narrowed/blocked artery?
Angioplasty/stenting
What surgical procedure removes plaque from a narrowed/blocked artery?
Endarterectomy
What are 2 complications of peripheral artery disease?
- Infection
- Gangrene
What is the ABI value to diagnose peripheral artery disease?
less than 0.9
What kind of aneurysm involves the formation of a hematoma within extravascular connective tissue?
False aneurysm
What kind of aneurysm are most common in the brain?
Berry aneurysm
Other than atherosclerosis and hypertension, what are 3 causes of aneurysm?
- Intrinsic quality of vascular wall is poor (genetic)
- Inflammation alters balance of collagen synthesis and degradation (genetic or due to infection e.g. syphilis)
- Trauma
What are 4 places of the thoracic aorta where aneurysm can develop?
- Aortic root
- Ascending aorta
- Aortic arch
- Descending aorta
What is the most common type of aortic aneurysm?
Abdominal aortic aneurysm (AAA)
What kind of true aneurysm bulges on only one side of the vessel?
Saccular
What kind of true aneurysm bulges on both sides of the vessel?
Fusiform
What are 3 signs and symptoms of AAA?
- Usually asymptomatic
- Abdominal or lower back pain
- Pulsatile abdominal mass
What are 3 signs and symptoms of TAA?
- Usually asymptomatic
- Dyspnea/cough
- Valvular insufficiency
Other than rupture, what are 3 consequences of aortic aneurysm?
- Obstruction of branch vessel
- Embolism
- Impingement on adjacent structures
What is a potential iatrogenic cause of aortic dissection?
Angioplasty/stenting
What are 4 signs and symptoms of aortic dissection?
- Sudden ripping pain in chest/back
- Hypotension/syncope
- Ischemia to extremities
- MI, valvular damage
What are 2 potential consequences for aortic dissection?
- Propagation of dissection into adjoining vessels
- Rupture and hemorrhage
What are 2 treatments for aortic dissection?
- Antihypertensives
- Excision of tear and vascular grafting
What is the term for episodes of excessive vasoconstriction of digital arteries/arterioles to cold temperature or emotional stress?
Raynaud’s syndrome
What kind of Raynaud’s is idiopathic and due to hyperreactivity of the sympathetic nervous system?
Primary
What kind of Raynaud’s occurs as a result of another condition, such as lupus, atherosclerosis, environmental factors, or drug use?
Secondary
What kind of skin colour changes may be observed in Raynaud’s syndrome?
- White attack
- Blue attack
- Erythema when blood flow restored
What kind of pharmacological treatments are used in Raynaud’s?
- CCBs
- Phosphodiesterase inhibitors
- Topical nitrates
What is a generalized term referring to inflammation and necrosis of blood vessels?
Vasculitis
How are types of vasculitis classified?
Cause, location, type of vessel, size of vessel
What kind of vasculitis involves immune attack on endothelial cells due to the deposit of immune complexes/antibodies?
Non-infectious
What kind of vasculitis involves pathogens invading the blood vessel wall, or antigenic mimicry?
Infectious
What are 3 signs/symptoms of immune related vasculitis?
- Systemic signs of inflammation
- Palpable purpura
- Blood pressure or pulse alterations
How is immune related vasculitis treated?
Glucocorticoids/other immunosuppressants
What condition involves abnormally dilated superficial veins?
Varicose veins/varicosities
What are 3 causes of varicosities?
- Chronically increased intraluminal pressure
- Weakened vessel walls
- Valve incompetence
What are 4 complications of varicosities?
- Deep venous insufficiency
- Edema and pain
- Thrombosis
- Ischemia leading to dermatitis and ulceration
Why may the skin overlying areas of varicosities appear darkly pigmented?
Accumulation of hemosiderin
What treatment for varicosities involves injecting a solution to constrict veins?
Sclerotherapy
What treatment for varicosities involves using a laser to shrink and seal off the vein with scar tissue?
Endovenous laser treatment
What condition involves a thrombus in a vein accompanied by inflammation of the vessel wall?
Thrombophlebitis (phlebothrombosis)
(most common type: DVT)
