Term
| What is the primary reason to have an aorta ultrasound performed? |
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Definition
| It is to identify aneurysms and stenosis of the arteries |
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Term
What effects the aorta and its main branches? |
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Definition
Atheroma
aneurysm formation
connective tissue disorders like
- cystic medial necrosis and
- marfan's syndrome
Rupture
Thrombosis
Infection - like syphilis
Displacement by and invasion from diseases in adjacent structures |
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Term
| This is a vascular wall disorder characterized by the presence of lipid deposits in the intima |
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Definition
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Term
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Definition
| Atheroma is a fatty deposit that builds up in the lining of the arteries throughout the body over a number of years. This deposit narrows the artery and eventually reduces the amount of blood that can get through |
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Term
| What does plaque in the vessel cause? |
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Definition
| Plaque causes mural irregularity and frequently narrows the vessel lumen |
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Term
| A disease of the arteries in which fatty material and plaque are deposited in the wall of an artery, resulting in narrowing of the arterial lumen and eventual impairment of blood flow is called - |
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Definition
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Term
| The condition of having plaque in the artery is called - |
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Definition
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Term
| ____________ is hardening of the arteries |
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Definition
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Term
| Which condition not only thickens the wall of the arteries but also causes stiffness and a loss of elasticity? |
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Definition
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Term
| When is Arteriosclerosis disease a concern? |
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Definition
| Arteriosclerosis may be present in any artery of he body but the disease is most concerning when it attacks the coronary arteries and threatens to cause a heart attack |
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Term
| What is the most common type of arteriosclerosis? |
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Definition
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Term
| A patient with arteriosclerosis may not have ___________ but a patient with atherosclerosis does have _____________ |
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Definition
| atherosclerosis / arteriosclerosis |
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Term
| What disease most often occur in he infrarenal portion of the aorta |
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Definition
| Stenotic or occlusive disease |
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Term
| The incidence of Atheromatous disease increases with _____ and effects more _____ than ______ |
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Definition
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Term
| What vessels are involved with Artheromatous? |
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Definition
| Aorta, iliac arteries and other aortic branches |
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Term
| Where in the vessel is Atheroma commonly seen? |
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Definition
| On the posterior wall of the vessel |
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Term
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Definition
Cigarette smoking
diabetes
HTN (hypertension)
Increased cholesterol (LDL) |
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Term
| Any swelling or localized dilation in a blood vessel, either focal or diffuse, with atleast a 50% increase over normal aortic diameter is called |
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Definition
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Term
| What are the types of aneurysm? |
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Definition
1. True Aneurysm
2. False Aneurysm (Pseudoaneurysm)
3. Dissecting aneurysm |
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Term
| Who are 4 times more likely to have AAA? |
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Definition
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Term
| What are the symptoms of aneurysm? |
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Definition
Usually there are no obvious symptoms of the disease but if any symptoms are present they can be
abdominal pain (that may be constant or come and go)
pain in the lower back that may radiate to the buttocks groin or legs
the feeling of a heartbeat or pulse in the abdomen |
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Term
| Ultrasound findings for aneurysm are - |
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Definition
1. increased aorta diameter (greater than 3 AP dimension)
2. focal dilation
3. lack of normal tapering distally
4. presence of thrombus - thick echogenic echoes, sometimes with shadowing
5. occasional dissection
6. rupture |
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Term
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Definition
1. Maximum true length, width and transverse dimensions
2. Documentation of shape
3. Documentation of location, including suprarenal exension orinvolvement of common iliac vessels
4. Nature and type of wall thickening(calcified or soft plaque)
5. Patent channel found and flow pattern characterized with doppler
6. Examine both kidneys if AAA involves renal arteries |
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Term
| Types of true aneurysm are - |
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Definition
Berry aneurysm
saccular aneurysm
fusiform aneurysm |
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Term
| A minoriy of true aneurysms are due to which underlying disease? |
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Definition
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Term
| The size of a berry aneurysm is - |
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Definition
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Term
| What is the size and shape of a saccular aneurysm? |
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Definition
Spherical and larger
5 - 10 cm |
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Term
| Describe Saccular aneurysm - |
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Definition
| Saccular aneurysm is an aneurysm connected ot the vascular lumen by a neck and outpouches from one side of the vessel wall |
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Term
| Saccular aneurysm can be partially or completely filled with _______ |
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Definition
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Term
| What is the most common type of aneurysm? |
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Definition
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Term
| Describe fusiform aneurysm |
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Definition
| Fusiform aneurysm is a gradual and uniform dilation or spindle shaped dilation of the arterial walls |
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Term
| Fusiform aneurysm can be _________, so one aspect of the vessel wall may be more severely affected |
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Definition
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Term
| The common iliac arteries are considered enlarged once the diameter exceeds ______ |
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Definition
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Term
| The aorta hat is found to be enlarged throughout and curving without an actual bulge is called - |
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Definition
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Term
| When is surgery an emergency for an anuerysm? |
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Definition
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Term
| What symptoms include when an aneurysm bursts? |
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Definition
1. Severe back or abdominal pain that begins suddenly
2. paleness
3. dry mouth/skin and excessive thirst
4. nausea and vomiting
5. signs of shock, such as shaking, dizziness, fainting, sweating, rapid heartbeat and sudden weakness |
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Term
| The biggest risk factor for an aneurysm to rupture is its ______ |
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Definition
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Term
| A pulsatile hematoma where blood escapes through a hole in the intima but is contained in the deeper layers of the aorta or by the adjacent tissue |
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Definition
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Term
| What are round or oval protuberances from the artery? |
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Definition
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Term
| In pseudoaneurysms blood circulates into them in ________ and out of them in ________ |
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Definition
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Term
| What are the causes of pseudoaneurysms? |
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Definition
1.Mycotic infection (Bacterial)
2. Trauma
3. Surgery
4. Interventional Procedures (Cardiac catheterization, etc) |
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Term
| What are the intervention for pseudoaneurysms? |
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Definition
1. Compression
2. Thrombin injection
3. Surgical repair |
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Term
| Describe compression pseudoaneurysms |
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Definition
Compression of the hematoma with a linear transducer at 20 minutes intervals may allow the lesion to close if the neck is small
Pseudoaneurysms that do not close with compression require surgical intervention as they become a source of emboli, infection or cause local pressure effects
Pseudoaneurysms may also rupture which may result in exsanguinations (to lose blood to the point at which life can no longer be sustained) |
|
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Term
| what is the downfall of Thrombin injection? |
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Definition
| The only pitfalls are inadvertent injection of the thrombin in the wrong location and possible allergic reactions. The inadvertent injections are unlikely when ultrasound guidance is used to place the needle tip in the pseudoaneurysm cavity and not in either the neck or the native artery |
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Term
| What is dissecting aneurysm? |
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Definition
An aortic dissection is a serious condition in which a tear develops in the inner layer of the aorta
Blood surges throught this tear into the middle layer of the aorta, causing the inner and middle layers to separate (dissect)
If the blood filled channels ruptures through the outside aortic wall, aortic dissection is usually fatal |
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Term
| Why does most aortic dissection occur? |
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Definition
| Because the artery's wall deteriorates. Most commonly such deterioration is associated with high blood pressure, which is present in more than 2/3rd of people who have an aortic dissection |
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Term
| What causes Aortic dissection? |
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Definition
Aortic dissection may be caused by hereditary connective tissue disorders, especially Marfan syndrome and Ehlers-Danlos syndrome
It may also be caused by birth defects of the heart and blood vessels, trauma, pregnancy or dissection of the thoracic aorta |
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Term
| Which kind of person is likely to get dissecting aortic aneurysm? |
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Definition
1. Typical patient is 40-70 years of age
2. HTN
3. Predominately males (Specifically African - Americans)
4. Have a known aneurysm
5. Those who have sudden excruciating chest and back pain |
|
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Term
| How can a dissecting aneurysm be diagnosed? |
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Definition
CT Scan
MRA
TEE - Transesophageal echocardiography |
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Term
| What does the doctor recommend for dissections? |
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Definition
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Term
| Where are people with an aortic dissection admitted |
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Definition
They are admitted to an intensive care units where their vital signs (pulse, blood pressure, and rate of breathing) are closely monitored. Death can occur a few hours after an aortc disscetion begins
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Term
| Other aortic abnormalities are? |
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Definition
1. Aortic grafts
2. AV fistulas |
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Term
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Definition
Flexible material inserted into the groin and deplored within the aorta
Used for access of blood into lower extremities or repairing of AAA weakened wallr |
|
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Term
| What are the types of prosthetic aortic grafts? |
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Definition
1. Aorta end- end graft
2. Aortailiac graft
3. Aortabifemoral graft
4. Fem Fem graft |
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Term
| What must the sonographer ask when a patient comes in who has a graft? |
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Definition
1. Ask the patient when the graft was placed (they have a card they carry with them with the information on it at all times)
2. Assess the upper and lower anastomoses
3. Check for stenoses, aneurysms & pseudoaneurysms with doppler
4. Identify and measure fluid collecions around the graft or anywhere in the abdomen
5. check the blood flow distally |
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Term
| Define arteriovenous fistula - |
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Definition
| Arteriovenous fistula per definition describes an abnormal communication between an artery and vein |
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Term
| What are the two types of arteriovenous fistula? |
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Definition
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Term
| What is congenital AV fistula? |
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Definition
| Congenital AV fistula is a birth defect which are not common. Lower extremities are more frequently involved than other areas of the body |
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Term
| What is acquired AV fistula? |
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Definition
| AV fistula develops after a person is born usually occurs when an artery and vein that are side by side are damaged and the healing process results in the 2 becoming linked |
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Term
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Definition
| May be due to - trauma, inflammation or neoplasm |
|
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Term
| What are the symptoms of AV fistula? |
|
Definition
1. It is present with low back and abdominal pain
2. A pulsatile mass with bruit
3. Massive swelling of the lower trunk and extremities
4. A progressive cardiac decompensation |
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Term
| Berry aneurysm is mostly seen in ____________ in the ___________ |
|
Definition
| cerebral arteries / brain |
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