CVS 202 Exam 1 Review

Watt does Iatrogenic mean?

An event caused by surgery happening to the Artery or Vein

(Ex; Guide wire through artery causes a pseudo aneurysm)

What does Hemopytosis mean?

Coughing up blood

What is the largest artery in the body?

Abdominal aorta

The abd ao begins as is passes through what?

Diaphragm

What does the abd ao bifurcate (terminates) into?

RCIA and LCIA

What is the widest vein in the body?

IVC

The IVC is formed by the confluence of what?

RCIV ad LCIV

Where does the IVC terminate into?

Right atrium

What does IVC Suprahepatc stand for?

Proximal

What does IVC Intrahepatic stand for?

Mid

What ones IVC Infrahepatic stand for?

Distal

What is the normal abdominal aorta high resistance?

PSV = 80 - 100 cm/sec

The abd ao diameter tapers in diameter from _____ to _____

suprarrenal , infrarenal

What is the measurement from suprarenal to infrarenal?

2.0 cm to < 1.5cm

What does ABD AO Suprarenal (próx) stand for?

Diaphragm to the origin of the SMA

What does ABD AO Juxarenal (mid) stand for?

SMA to the renal arteries

What does ABD AO Infrarenal (distal) stand for?

Renal arteries to the aortic bifurcation

What are the two other names Celiac Artery is known for?

1. Celiac trunk

2. Celiac axis

What does the celiac artery give rise to?

Hepatic, splenic, and left gastric arteries

What is the 1st branch off the Abdominal aorta?

Celiac Artery

Is the normal Celiac Artery low or high resistance pre-prandial (fasting)?

Low

The normal celiac artery remains low or high for post prandial?

Low

What is the normal formula for celiac artery?

PSV = <200 cm/sec

What are the five things the celiac artery supplies too?

1. Liver

2. Gallbladder

3. Stomach

4. Intestines

5. Pancreas

What does SMA stand for?

Superior Mesenteric Artery

What is the 2nd branch off the abdominal aorta?

SMA

How many cm does the SMA Aries just below the celiac artery?

1-2 cm

What does pre-prandial stand for?

During fasting

What does post-prandial stand for?

After eating

Is the SMA normal pre-prandial (fasting) low or high resistance ?

High

Is the SMAnormal post-prandial (after eating) low or high resistance?

Low

What is the formula for the normal SMA resistance?

PSV = < 275 cm/sec

What are the five branches of the SMA?

1. Inferior pancreatic artery

2. Duodenal artery

3. colic artery

4. Ileocolic artery

5. Intestinal artery

What are the two things the renal arteries supplies too?

Kidneys and adrenal glands

The ranks artery is distal just before it enters what?

The hilum of the kidney

Is renal arteries low or high resistance?

Low

What s the formula for the renal arteries low resistance?

PSV = < 180 - 200 cm/sec

What does IMA stand for?

Inferior mesenteric artery

What is the last anterior branch of the abdominal aorta?

Inferior mesenteric artery

How many cm does the IMA arises above the aortic bifurcation?

3-4 cm

What is the IMA formula for pre and post prandial?

PSV = <275 cm/sec

what does the IMA supplies blood to?

Colon, rectum and majority of the large intestines

What are the 3 main branches of IMA?

1. Left colic

2. Sigmoid

3. Superior Rectal arteries

Wat are the 8 AA Risk factors?

1. Age

2. Smoking

3. HTN

4. Known atherosclerosis

5. Male

6. Caucasian

7. Immediate relative with history of AA (abdominal aorta aneurysm)

8. trauma (such as being i a car accident and seatbelt tightening)

What are the 9 indications for exam?

1. Known AA or any aneurysm

2. Abdominal bruit

3. Abdominal pain

4. Pulsatile aorta or mass

5. Cyanosis

6. Pulselessness

7. Claudicación of the hip/buttocks

8. History of HTN; age >50 w/family of AA

9. Distal emboli (without femoral-popliteal or cardiac source)

What are the 3 things you need to do for patient prep?

1. Fasting after midnight (6-12 hours)

2. Limit liquids

3. No smoking Or chewing gum

What are the three Contraindications/Limitations of ultrasound evaluation?

1. Obesity

2. Abdominal gas

3. Breathing difficulties

___ MHZ most commonly used

3.5

___MHz more obese patients

2.5

Is the abdominal aorta low or high resistance?

High

What will have more diastolic flow than infrarenal?

Suprarenal

How many degree angle is the abd ao during spectral Doppler assessment?

60

When does the Abdominal aorta become aneurysmal?

3 cm

When the abdominal aorta becomes aneurysmal at 3-4 cm how many months does it evaluated with unltrasound?

6-12 months

What cm is considered a medical emergency wen abdominal aorta becomes aneurysmal?

> (greater) 5-5.5

What does True Endoleaks mean?

Blood flow remains in the aneurysm after the graft is in place.

How many percentage does True Endoleaks occurs in patients?

20-50%

What does Psuedoleaks mean?

Move to of non clotted blood within the aneurysm.

When may Pseaudoleaks be seen?

Early post op period

Grafts are combinations of what?

Intravascular stent

What are Grafts held in place with that anchor the device?

Hooks and barbs

Where are Grafts placed and near what?

Below lowest renal artery (próx) and near the iliac bifurcation

What does EVAR stand for?

Endovascular aneurysm repair

What is the ecstatic aneurysm

The entire abd ao is aneurysmal (> 2.0 cm - < 3.0 cm)

What does Mycotic aneurysm mean

Existing aneurysm that becomes infected with bacteria.

What does mycotic aneurysm require?

Debridement and/or antibiotics

At what diameter is Iliac Aneurysm considered aneurysmal?

>1.5 cm

When is Iliac Aneurysm commonly seen?

Bilaterally

What is the most common type of aneurysm?

Fusiform

What are the 2 things Disserection causes?

1. True lumen

2. False lumen

What may happen if a dissection blood flow occurs in the false lumen?

Clot

When is false lumen dissection most common in?

Male hypertensive patients 40-60 years old

When does dissection begin with?

A tear in the íntima lining of the artery

What does Dissection syndrome mean?

Excruciating pain radiating to the back

How many types of DeBakey Classification Dissection are there?

3 types

DeBakey Classification Dissection:

Originates in ascending aorta, propagates at least to the aortic arch and often beyond it ditally.

Type 1

DeBakey Classification Dissection:

Originates in & is confined to the ascending aorta.

Type 2

DeBakey Classification Dissection:

Originates in descending aorta rarely extends proximally but will extend distally.

Type 3

What are the 4 Psuedoaneurysm etiologies?

1. Post-catheterization

2. Trauma

3. Surgery

4. Infection

What are the 4 evaluation of the pseudo aneurysm?

1. To and fro Spectral wave form

2. Yin-young Color flow

3. Large pulsating mass

4. Ultrasound guided compression technique ( below inguinal creaaase)

Why are the two most common locations for Psuedoaneurysm?

CFA and Abdominal Aorta

What are the 5 Mesenteric Examination Indications?

1. Abdominal pain and cramping associated with eating

2. Malnourished

3. Significant unexplained weight loss

4. Unexplained GI (Gastrointestinal) Symptoms

5. Post-op evaluations of a mesenteric vascular reconstruction

When you have a chronic mesenteric obstruction you would have abdominal pain normally how many minutes aftering and long does it last?

30 minutes ; 1-2 hours

When a patient has chronic mesenteric obstruction patients will usually develop what fear due to severity of pain?

“Food Fear”

Normally how many arteries are needed for obstruction for patients to be symptomatic?

Two

Significant stenosis or occlusion in the CA, SMA, or IMA may cause what?

Patients my experience pain after eating

Acute Mesenteric occlusion is ____ ______

LIFE THREATENING

In a life threatening acute mesenteric occlusion a high mortality rate will be?

85%

What does MALS stand for?

Median Arcuate Ligament Syndrome

What does Marian Arcuate Ligament Syndrome mean?

The compression of the celiac artery

What are the 3 Virchow’s Traid?

1. Stasis

2. Trauma

3. Hyper-coagulability

What are the 3 things that can occur to a Thrombus?

1. Stabilize

2. Propagate

3. Embolization

What does Stabilize mean?

Attach to the vessel wall

What does propagate mean?

Travel distally

What does Embolize mean?

A piece of the blood clot can break off or the entire blood clot travels and block a smaller artery.

What are the 8 Risk factors for Thrombus?

1. Age

2. Immobilization

3. Genetic clotting Disorders

4. Post-op

5. Catheters

6. Female (pregnancy, Birth control, estrogen replacement)

7. Cancer

8. Previous DVT

What are the 5 indications for Thrombus?

1. Edema/swelling

2. Limp pain/tenderness

3. Symptoms or pulmonary embolism (PE)

4. Hypercoagulable state

5. IVC filter insertion guided by ultrasound

What are the 2 reason to evaluate the IVC?

1. IVC filters

2. Extrinsic Compression