abd art/vasc system

the circulatory system includes the ___ and __ system

arterial and venous

What system transports gases, nutrient materials, and other essential substances to the tissues?

Arterial

What system transports waste products from the cells to the appropriate sites for excretion?

Venous

____ carry blood away from the heart

Arteries

Arteries carry blood away from the heart, except for the _____ arteries and the ____

coronary, vasa vasorum

Arteries divide into progressively smaller branches, the smallest of which are the __

arterioles

Arterioles lead into the capillaries, which are minute vessels that branch and form a network in which materials are exchanged between ___ and ___

blood and tissue

Arterioles lead into the ____

capillaries

After the blood passes through the capillaries, it is collected in the small ___ or ___

veins or venules

Veins or venules collect blood that was passed through the ___

capillaries

____ unite to form larger vessels that eventually return the blood to the heart for recirculation

Venules

The three layers of blood vessels:

Tunica intima, tunica media, and tunica adventitia

The tunica intima has __ layers

three

The tunica intimia has a layer of ___ cells lining the arterial passage (lumen)

endothelial

The tunica intima has a layer of delicate ____ tissue

connective

The tunica intima has an elastic layer made up of a network of ______

elastic fibers

The tunica media contains

Smooth fibers with elastic and collagenous tissue

Tunica adventitia is made of

Loose connective tissue with bundles of smooth muscle fibers and elastic tissue

The ___ ____ make up the tiny arteries that supply the walls of blood vessels

vasa vasorum

The vasa vasorum are located within the

Tunica adventitia

Arteries are

Hollow elastic tubes that, in general, carry blood away from the heart

Arteries are Enclosed within a sheath that includes a ___

vein and nerve.

The Elasticity of the larger arteries is important for maintaining steady ___ ___

blood flow

The ___ will not change in diameter with changes in respiration

pulsatile aorta

Veins are

Hollow collapsible tubes with diminished tunica media that generally carry blood toward the heart

Veins have a total larger diameter than

arteries

Compared to arteries, veins move blood more

slowly

Veins Contain special valves that

prevent backflow and permit blood to flow only in one direction—toward the heart

The IVC should dilate

slightly with suspended respiration

The aorta is the

Largest principal artery in the body

The aorta is divided into 5 sections

Root, ascending, aortic arch, descending, abdominal

____ arteries arise from the lateral walls of the aorta to supply the diaphragm

Phrenic

___ is the first anterior branch of the aorta, arising 1 to 2 cm inferior to the diaphragm

Celiac trunk

The celiac trunk is the first

anterior branch of the aorta

_____ is the second anterior branch, arising approximately 2 cm from the celiac trunk

Superior mesenteric artery

The superior mesenteric artery is the

second anterior branch of the aorta

____ are lateral branches arising just inferior to the superior mesenteric artery

Renal arteries

The inferior mesenteric artery arises

anteriorly near the bifurcation

The distribution of these branch arteries is to the

visceral organs and the mesentery

The celiac trunk branches to the

Common Hepatic Artery (CHA), Left Gastric Artery (LGA), Splenic Artery (SA)

The celiac trunk (CT) is also known as

Celiac Axis, Celiac Artery

The celiac trunk is the first

major anterior branch of the abdominal aorta

The SMA supplies the

Pancreas, Duodenum, Colon

The SMA is the second

major anterior branch of the abdominal aorta

The IMA is the third

major anterior branch of the abdominal aorta

The IMA supplies the

left transverse colon, descending colon, sigmoid colon, rectum

Lateral branches of the aorta include the

Phrenic Arteries, Renal Arteries and Gonadal Arteries

_____ Arise from the bifurcation of the abdominal aorta at the 4th lumbar vertebra

Common Iliac Arteries (CIA)

CIA divides into the

internal and external iliac arteries

_____ divides into anterior and posterior branches.

Internal Iliac Artery

Clinical reasons for an abdominal sonographic evaluation

 Pulsatile abdominal mass

 Abdominal pain radiating toward the back

 Abdominal bruit

 Hemodynamic compromise in the lower legs

Pulsatile abdominal mass is a

Clinical reason for an abdominal sonographic evaluation

Abdominal pain radiating toward the back is a

Clinical reason for an abdominal sonographic evaluation

Abdominal bruit is a

Clinical reason for an abdominal sonographic evaluation

Hemodynamic compromise in the lower legs

Clinical reason for an abdominal sonographic evaluation

Pathologies of the aorta include

Aneurysm

Pseudoaneurysm

Dissection

Ectasia

An aneurysm is a

Pathology of the aorta

A psuedoaneurysm is a

Pathology of the aorta

A dissection is a

Pathology of the aorta

An ectasia is an

Pathology of the aorta

An ___ is defined as a permanent localized dilation of an artery, with an increase in diameter of greater than 1.5 times its normal diameter

aneurysm

Types of aneurysms:

bulbous, saccular, and dumbbell

true aneurysms involve

all three layers of the blood vessel

95% of aneurysms are

infrarenal

Anteroposterior (AP) diameter is measured on ___ views

sagittal

AP diameter is measured on sagittal views to

Help ensure measurements is at the widest dimension

Surgery is considered when an aneurysm is ___ cm.

>5

___aneurysm is the result of infection

Mycotic

___aneurysm is located in the cerebrum

Berry

_____aneurysm results from the weakening of the medial layer in severe atherosclerosis

Atherosclerotic

The majority of AAA occur below the kidneys (infrarenal) with the remainder occurring at the ____

level of or above the kidneys

Aneurysm I is ___

infrarenal

Aneurysm II is ___

juxtarenal

Aneurysm III is

pararenal

Aneurysm IV is

suprarenal

Aneursym risk factors

• Tobacco use

• Hypertension (HTN)

• Vascular disease

• Chronic obstructive pulmonary disease (COPD)

• Family history of abdominal aortic aneurysm

Tobacco use is a risk factor for

Aneurysm

Hypertension is a risk factor for

Aneurysm

COPD is a risk factor for

Aneurysm

Vascular disease is a risk factor for

Aneurysm

Causes for aneurysms

– Atherosclerosis

– Trauma

– Congenital defects

– Syphilis (involving the ascending aorta and arch)

– Mycosis (fungal dissection)

– Cystic medial necrosis (e.g., Marfan syndrome)

– Hypertension (HTN)

Atherosclerosis is a cause for

Aneurysms

Trauma is a cause for

Aneurysms

Syphilis (involving the ascending aorta and arch) is a cause for

Aneurysms

Mycosis (fungal dissection) is a cause for

Aneurysms

Cystic medial necrosis (e.g., Marfan syndrome) is a cause for

Aneurysms

Symptoms for an aneurysm

– Palpable pulsatile abdominal mass

– Back pain

– Drop in hematocrit may indicate a ruptured AAA

– May be asymptomatic

Aneurysms ____ in diameter are followed every 6 months with intervention if the patient becomes symptomatic.

<4cm

For aneurysms ___ in diameter, surgical intervention may be suggested if the patient is in good health

4-5cm

Aneurysms ____ may benefit from surgical repair, especially if patient has other factors for rupture (e.g., hypertension, smoking, COPD).

5-6cm

Aneurysms ___ in diameter pose the greatest risk for rupture; risk increases with age and other medical issues.

>6cm

Aneurysm of < 4cm

No intervention if asymptomatic

Aneurysm of 4-5cm

Surgical intervention if pt. is in good health

Aneurysm of 5-6cm

Surgical intervention, if pt. has other risk factors

Aneurysm of > 6cm

Surgical intervention

Surgical intervention for aneurysms is suggested when associated with ____

renal and iliac involvement

The Length of an infrarenal aneurysm is important to help determine the ___

surgical approach

_____ for treatment are a less invasive approach to the repair of an aneurysm

Endovascular stent grafts

Endovascular stent grafts are a less ___ way to repair an aneurysm

invasive

Aneurysm rupture has a ___ mortality rate

50%