Vascular Pathology Flashcards
What are the patient demographics of Atherosclerosis?
Males over 45yrs. Smoking Diabetes
Hypertension. Hyperlipidemia.
What is Atherosclerosis?
It is build up of cholesterol and triglycerides in the lumen of the arteries, clogging them, making blood pressure rise.
What are the clinical indications for Atherosclerosis?
Asymptomatic until vessel dilation….
Rapid full feeling
Vomiting
Nausea
Lower Back Pain that is not relieved with a changed position.
What is the sonographic appearance of Atherosclerosis?
New plaque- low-level gray mass in the lumen vessel, 2D gain may need to be increased to see.
Old plaque- shadowing echogenic cause necrosis making the walls irregular, danger for dissection
What are the scanning considerations for Atherosclerosis?
Measure thickest area of plaque in TRV
Measure length of plaque if possible in SAG
Evaluate blood flow reduction with color.
What is a Aneurysm?
Localized dilation of vessel walls do to weakening, most commonly caused by atherosclerotic changes in vessel.
May rupture or disect.
What are the patient demographics for a Aneurysm?
Over 60 yrs. Smoker
Hypertension Family history of AAA
What are the clinical indications for a Aneurysm?
Pulsating mass AO ABD LT midline
ABD back pain.
Nausea and vomiting
if ruptured a quickly expanding girth
What is the sonographic appearance of an Aneurysm?
Dilated AO
Thick accumulations of plaque/thrombus on walls
Tortuous of reduced flow on color doppler
What are the scanning considerations of a Aneurysm?
Measure in 3 planes (include neck with saccular)
Determine thickest wall area
Measure blood flow in lumen if significantly reduced
Evaluate blood flow with color doppler, ID AO branches
What are the types of Aneurysms?
Saccular: Punching bag shaped aneurysm. Can show yin-yang symbol
over Doppler
Fusiform: Focal dilation of vessel
Ruptured Aneurysm: Burst aneurysm, makes surrounding tissue
hypoechoic
What is a dissecting aneurysm?
It is caused when blood enters between the layers of a weakened wall focally dilating the vessel, causing the interlayers to peel, making canals in the inner walls, it involves the tunica intima and media layers.
What are the patient demographics for dissecting Aneurysm?
40 - 60 yrs old males
Hypertention
Conditions like Aneurysm, cystic medial necrosis
What is a psdoaneurysm?
hematoma from a punctured artery
Puncture or trauma done to a vessel causing it to bleed into surrounding tissues, making a pocket of flowing blood outside of those tissues.
What are the Patient demographics of a pseudoaneurysm?
Recent puncture or trauma to vessel
Recent operation
IV Drug user
What are the clinical indications of a pseudoaneurysm?
Red and swollen in area of puncture
Tender to touch
Pulsatile mass
What are the characteristics of a pseudoaneurysm?
Round pocket of anechoic fluid in tissue adjacent to blood vessel.
Supplied by neck connecting it to the vessel
Ying-yang sign over doppler showing flow.
may develop thrombus/clot
At risk of rupture
Scanning considerations of a pseudoaneurysm?
Scan gently
ID size and location
Measuring 3 dimensions and include neck
locate where it connects to artery
use doppler to prove
What is IVC thrombosis?
Clot formation in the IVC
Clinical indications of IVC Thrombosis
Asymptomatic unless enlarged causing blockage then…
distal swelling of limbs
GI/urinary changes
ABD/pelvis pain
What are the scanning characteristics of IVC Thrombosis?
New- Low-level gray mass in lumen of IVC
Old- meduim-level gray to echogenic if calcified
Moves with blood flow
Avascular
At risk of breaking off into emboli
May have areas of necrosis with in IVC walls behind thrombosis
What is a IVC tumor?
Growth/mass infiltrating into IVC or in IVC.
What are the patient demographics of IVC Tumor?
History of cancer especially with…
Renal cellulare Carcinoma
Hepatocellular carcinoma
What are the clinical indication of IVC Tumor?
Asymptomatic until big enough to block…
Swelling of distal limbs
GI/Urinary changes
pain in ABD/pelvis
What are the characteristics of a IVC tumor?
low-level gray mass in lumen
Vascular
normally found in inferior IVC
Normally close to tributaries
will not compress
Nearby masses may obstruct/stenosis
What are the scanning considerations of the IVC tumor?
Look for vascularity (Mass vs thrombus)
Have patient hold breath to dilate IVC
Look at neighboring structures for ABN
ID location
use doppler
measure in 3 plains
