Pathologie de l'aorte et des art
Understanding Aortic Pathology Quiz
Test your knowledge on vascular pathology, particularly focusing on the aorta and associated arterial structures. This comprehensive quiz covers critical concepts such as blood flow dynamics, hemodynamic significance, and characteristics of vascular resistance.
Key Features:
- 103 detailed questions
- Multiple choice format
- Ideal for students and professionals
Diastolic flow reversal is a hallmark of vessels that supply-
Low resistance peripheral vascular beds
High resistance vascular beds
High resistance peripheral vascular beds
High resistance peripheral beds
Vasodilation is produced by body heating, exercise and stenosis.When vasodilation occurs, what happens to the flow reversal?
Increases
Is present
Decreases or is absent
Is always absent
The flow of a continuous nature throughout systole and diastole feeding a dilatedvascular bed is known as-
Low-resistance flow
High-resistance flow
High-assistance flow
Low-assistance flow
66. The internal carotid, vertebral, renal, celiac, splenic and hepatic arteries are characterized by-
Low-resistance flow
High-resistance flow
high-assistance flow
Low-assistance flow
The external carotid, subclavian, aorta, iliac, externity arteries and fasting superior mesenteric arteries are characterized by-
Low-resistance flow
High-resistance flow
High-assistance flow
Low-assistance flow
What are the reasons for the characteristic reversal of flow in a biphasic or triphasic high resistance disappears distal to a stenosis?
Decreased peripheral assistance as a result of relative ischemia
Increased peripheral resistance as a result of relative ischemia
Decreased peripheral resistance as a result of relative ischemia
Increased peripheral assistance as a result of relative ischemia
How is the pulsatility flow in response to vosoconstriction ?
In medium and small size arteries of the limbs increases
In minute arteries, arterioles and capillaries increases
In medium, minute arteries and arterioles increases
In small, medium and minute arteries increases
How is the pulsatility flow in response to vosodilation ?
In medium and small size arteries of the limbs decreases
In minute arteries, arterioles and capillaries decreases
In medium, minute arteries and arterioles decreases
In small, medium and minute arteries decreases
Compensatory responses of the microcirculation tend to maintain pressure and flow. When it is important to obtain information about pressure and flow patterns?
At rest
After the exercise
At rest but not after exercise
Both at rest and after exercise
In an extremity at rest and in the presence of severestenosis or complete occlusion of the main artery, how is the blood flow?
Partial blood flow may be fairly normal
Partial blood flow may be abnormal
Total blood flow may be fairly normal
Total blood flow may be abnormal
What can an arterial obstruction do?
Decrease the volume flow
Forward the flow direction
Decrease velocity
Alter flow in nearby
Exercise should induce peripheral vasodilation in the microcirculation. As a result we can get-
Both distal peripheral resistance and blood flow markedly increases
Distal peripheral resistance decreases and blood flow markedly increases
Distal peripheral resistance increases and blood flow markedly decreases
Nearby peripheral resistance decreases and blood flow markedly increases
Vasoconstriction and vasodilation of the blood vessels within skeletal muscles are also influenced by sympathetic innervation fibers. The job is-
To regulate body control
To regulate body resistance
To regulate body temperature
To maintain antibody
Autoregulation controls vasoconstriction and vasodilation which is accounted for the ability of most vascular beds-
To maintain an increased level of blood flow
To maintain a decreased level of blood flow
To maintain a constant level of blood flow
To maintain an increased level of plasma flow
A low resistance, monophasic Doppler flow signal may be present normally in an extremity artery after vigorous exercise because the exercise causes peripheral dilatation and reduced flow resistanc What decision can we adopt from this example?
By increasing resistance in the working muscle, exercise normally decreases reflection of the Doppler flow signal in the exercising externity
By decreasing resistance in the working muscle, exercise normally increases reflection of the Doppler flow signal in the exercising externity
By decreasing resistance in the working muscle, exercise normally decreases reflection of the Doppler flow signal in the exercising externity
By decreasing resistance in the working muscle, exercise normally shows constant reflection of the Doppler flow signal in the exercising externity
When a high resistance signal may occur?
at increased vasoconstriction at the arteriolar level
at normal vasoconstriction at the arteriolar level or from distal arterial obstruction
at decreased vasoconstriction at the arteriolar level
at normal vasoconstriction at the arteriolar level or from nearby arterial obstruction
What does the proper characterization of velocity waveforms require?
an understanding of the normal flow characteristics of a particular artery
an understanding of the psychologic status of the circulation
an understanding of both the normal flow characteristics of a particular artery and the psychologic status of the circulation supplied by vessel
an understanding of the normal flow characteristics of a particular artery but not the psychologic status of the circulation supplied by vessel
How one can examine the externity cooled or warmed?
Flow to a cool, vasodilated externity will have pulsatile signals
Flow to a cool, vasoconstricted externity will have pulsatile signals
Flow to a warm, vasodilated externity will have pulsatile signals
Flow to a warm, vasoconstricted externity will have steady signals
If good collateralization is present, proximal or distal Doppler velocity waveform qualities-
May be altered
May not be altered
Must be altered
Must not be altered
How is the distribution of frequencies of Laminar flow
Even distribution of frequencies at diastole
odd distribution of frequencies at systole
Even distribution of frequencies at systole
odd distribution of frequencies at diastole
A critical, hemodynamically significant stenosis causes a major reduction in volume flow and pressur What is the percentage of cross-sectional area of the arterial lumen reduction and a diameter reduction?
75% and 50% respectively
50% and 75% respectively
75% and 25% respectively
25% and 75% respectively
Diameter reduction is a-
One-dimensional measurement
Two-dimensional measurement
Three-dimensional measurement
Four-dimensional measurement
Area reduction is a-
one-dimensional measurement
Two-dimensional measurement
Three-dimensional measurement
Four-dimensional measurement
What happens in the critical stenosis
Only pressure decrease
Only flow volume increase
Only pressure increase
Both pressure and flow volume decrease
The occurrence and degree of hemodynamic abnormality produced by a stenosis depend on many factors. One of thm is
Smoothness of surface
Depth of narrowing
Arteriovenous pressure gradient
Arterial resistance nearby to the stenosis
Critical arterial stenosis produces certain identifiable hemodynamic phenomena that are described in the literature as -
Arterial profile
Stenosis profile
Peripheral profile
Collateral profile
The flow enters, passes through and/or exists the stenosis. As a result there is a/an
Decrease in Doppler shift frequencies but increase in velocities
Increase in Doppler shift frequencies but increase in velocities
Increase in Doppler shift frequencies and in velocities
Decrease in Doppler shift frequencies and in velocities
When the poststenotic arterial lumen widens rather quickly, large flow separation patterns are observed at the walls as a result of velocity gradients. Who described this?
Reynold’
Boussineq’
Bernoulli
Navier
Why the energy is expected largely in the form of heat
Eddy currents work for and vortices work against the viscosity of blood
Vortices work for and eddy currents work against the viscosity of blood
Eddy currents and vortices work for the viscosity of blood
Eddy currents and vortices work against the viscosity of blood
Reduction in the diameter of a vessel increase the velocity of flow. The size of the vessel is inversely proportional to the velocity of blood flow. So we can form the equation like-
V=A/Q
A=Q/V
Q=V/A
V=QA
Due to what disease the patient notes muscle fatigue with work and the discomfort is usually predictable ,occurring with the same amount of work and disappearing within minutes of activities cessation-
A) Chronic occlusive
B) Claudication
C) Acute arterial occlusion
D) Ischemic rest pain
If the patient complains of pain in a specific part of the leg after walking two city blocks. What note may include in the history of the patient?
A) Block claudication
B) Thigh claudication
C) Calf claudication
D) 2 block claudication
Buttock claudication, which strongly suggests artoiliac diseas What can be suggested if the symptoms are unilateral?
A) Distal iliac disease
B) Common femoral disease
C) Iliofemoral disease
D) Popliteal disease
If a patient feels pain at rest when the limb is not in a dependent position and the patient blood pressure is decreased, which one of the following is responsible for this situation?
A) Buttock claudication
B) Ischemic rest pain
C) Acute arterial occlusion
D) Block claudication
Necrosis (tissue death), usually due to a deficient or absent blood supply. Necrosis is the most severe symptom of –
A) Arterial insufficiency
B) Acute arterial occlusion
C) Ischemic rest pain
Symptoms include the five Ps: pain, pallor, pulselessness, paresthesia, paralysis. Some include a sixth “P” for “polar”. Some even include a seventh “P” for “purplish”. Which one is represented by seventh “P”?
A) Arterial insufficiency
B) Ischemic rest pain
C) Acute arterial occlusion
D) Block claudication
What may result from thrombus, embolism or trauma & is an emergency situation since the abrupt onset does not provide for the development of collateral channels?
A) Arterial insufficiency
B) Ischemic rest pain
C) Acute arterial occlusion
D) Block claudication
For cold sensitivity symptoms include changes in skin color such as pallor (paleness), cyanosis (bluish discoloration) or rubor (dark red coloration) and the patient often experiences-
A) Paresthesia and pain
B) Paralysis and pain
C) Paresthesia and paralysis
D) Paralysis and pulselessness
In what condition symptoms of intermittent ischemia of the fingers or toes occur in response to cold exposure?
A) Mesenteric ischemia
B) Renovascular hypertension
C) Arterial insufficiency
D) Raynaud’s phenomenon
Raynaud’s phenomenon is a condition that exists when symptoms of intermittent ischemia of the fingers or toes occur in response to cold exposure as well as-
A) Physical stress
B) emotional stress
C) Physical pain
D) Physical & mental stress
What is more common form among diabetics and normally occurs at a younger age in human?
A) Diabetics mellitus
B) Medial calcification
C) Atherosclerosis
D) Diabetes
What is the disease of the distal popliteal artery and tibial vessels that diabetics have a higher incidence?
A) Occlusive
B) Occlusion
C) Claudication
D) Arterial insufficiency
There is a higher incidence of gangrenous changes and ultimately, amputations, poor sensation as a result of neuropathy leads to increases likelihood of-
A) Hypertension
B) Emotional stress
C) Physical stress
D) Trauma
It remains unclear whether high blood pressure is a causative factor or enhances and complicates the development of the atherosclerotic process in case of-
A) Trauma
B) Hypertension
C) Arterial insufficiency
D) Occlusion
What is associated with a greater incidence of coronary atherosclerosis and also increases an individual’s susceptibility to peripheral and cerebrovascular involvement?
A) Trauma
B) Renovascular Hypertension
C) Systemic Hypertension
D) Hyperlipidemia
Although increased lipids may result from metabolic problems associated with heredity, a diet high in certain types of fat is associated with hyperlipidemi As they are insoluble in water, elevated plasma lipids are closely associated with the development of-
A) Occlusion
B) Atherosclerosis
D) Mesenteric ischemia
C) Medial calcification
Studies have demonstrated that the chemicals in cigarettes irritate the endothelial lining of the arteries in addition to causing-
A) Vasoconstriction
B) Atherosclerosis
C) Medial calcification
D) Hyperlipidemia
The term “atherosclerosis” is applied to a number of pathological conditions in which there is thickening, hardening and loss of elasticity of the -
a) Media layers of vessel
B) Intima
C) Visceral vessel
D) Walls of the arteries
There are so many risk factors that cause atherosclerosis such as hypertension, hyperlipidemia, family history, diabetes mellitus, sedentary lifestyle and smoking. What are the major factors among them?
A) Hypertension, hyperlipidemia, family history
B) Smoking, hyperlipidemia, family history
C) hyperlipidemia, family history, diabetes mellitus
D) smoking, diabetes mellitus, sedentary lifestyle
Atherosclerosis most often occurs at the carotid bifurcation, origins of brachiocephalic vessel, origins of the visceral vessels, the infrarenal aortoiliac system, superficial femoral artery at the abductor canal, the popliteal trifurcation and-
A) The subclavian artery
B) The common femoral artery
C) The common femoral bifurcation
D) The common femoral trifurcation
Leriche syndrome, caused by obstruction of the terminal aort It usually occurs in males and is characterized by fatigue in the hips, thighs or claves on exercising, often coldness of the lower limbs and absence of pulsation. Where does the absence of pulsation occur?
a) Femoral arteries
b) subclavian arteries
c) Popliteal arteries
D) brachial arteries
Obstruction of a blood vessel by a foreign substances or blood clot, may be solid, liquid or gaseous and may arise from body or may enter from without is called –
A) Aneurysm
B) Emboli
C) Pseudo aneurysm
D) Atherosclerosis
Emboli move distally and become stuck in the vessels of the smallest caliber. Toe ischemia results, which often improves mainly as the result of blood flow from smaller –
A) Digital arteries
B) Femoral arteries
C) brachial arteries
D) Collateral arterial branches
A true aneurysm is different from false aneurysm which does not contain all arterial wall layers. What is a true aneurysm?
A dilatation of all Four layers of the arterial wall
A dilatation of all Five layers of the arterial wall
A dilatation of all Three layers of the arterial wall
A dilatation of all Two layers of the arterial wall
Arterial aneurysms can occur in nearly any artery of the body. What is the most common location for arterial aneurysms?
Infrarenal aorta
Aortic arch
Carotid artery
Thoracic aorta
Patients with one aneurysm have a higher chance of having second aneurysm. Which of the following is not included as other location for second aneurysm?
Carotid artery
Renal artery
Subclavian artery
Splenic arteries
The cause of aneurysm is unknown but may include poor arterial nutrition, congential defects, infection or trauma, iatrogenic injury and –
Occlusive
b) atherosclerosis
Hypertension
Medial calcification
Some terms that relate to aneurysm shape include focal aneurysm, fusiform aneurysm, saccular aneurysm and concentric aneurysm. What is a Fusiform aneurysm?
Localized out-pouching of an artery
Localized out-pouching of a vessel
Diffuse, circumferential dilatation of an artery
Diffuse, circumferential dilatation of an arterial segment
Any aneurismal formation has the propensity to form thrombotic material at the walls. The main complications of aneurysm include distal embolization of peripheral aneurysm and –
Rupture of aortic aneurysm
Circumferential dilatation of an arterial segment
Localized out-pouching of an artery
Embolization of pseudo aneurysm
Some terms that relate to aneurysm shape include focal aneurysm, fusiform aneurysm, saccular aneurysm and concentric aneurysm. What is a Saccular aneurysm?
Localized out-pouching of a vessel
Diffuse, circumferential dilatation of an arterial segment
Localized out-pouching of an artery
Rupture of aortic aneurysm
What occurs when a small tear of the intima allows blood to form a cavity between two wall layers and a new lumen, the false lumen is formed?
Pseudo aneurysm
Dissecting aneurysm
Aortic aneurysm
d) Peripheral aneurysm
Two conditions must usually be met for dissecting aneurysm to form. Among the two the second condition is: development of an intimal tear through which blood leaks to media and first one is –
Strengthening of the media of the vessel
Thickening of the media of the vessel
c) Weakening of the media of the vessel
Scratching of the media of the vessel
In case of a dissecting aneurysm atherosclerosis is not generally considered to be a causative factor. Where does a dissection most often occur?
Thoracic aorta
Infrarenal aorta
Subclavian artery
Thoracic artery
A pseudo aneurysm is essentially a pulsating hematom A hole in the arterial wall permits blood to escape under pressure, in to a contained area in the –
Media of the vessel
Adjacent tissue
Artery wall
Thoracic aorta
A hematoma forms in the tissue and if confined by the surrounding structures and if there is continuous blood flowing from the artery to the –
Pulsatile structure in the tissue
Adjacent tissue
Media of the vessel
Nonthrombotic region of the hematoma
A pseudo aneurysm is essentially a pulsating hematom To be considered a pseudo aneurysm, there must be a communication (channel) from the main artery to the –
Nonthrombotic region of the hematoma
Media of the vessel
Pulsatile structure in the tissue
Adjacent tissue
Adjacent tissue 67. . Arteritis – inflammation of the arterial wall – often results in thrombosis of the vessel and can affect tibial and peroneal arteries as well as the smaller and more distal arterioles and –
Media of the vessel
Thoracic aorta
Nutrient vessel
Nonthrombotic region of the hematoma
Arteritis – inflammation of the arterial wall – often results in thrombosis of the vessel and can affect tibial and peroneal arteries. There are several types of arteritis. Which of the following is not one of them?
Takayasu’s disease
Occlusive disease
c) Polyarteritis disease
Buergr’s disease
Arteritis – inflammation of the arterial wall. There are several types of arteritis. What is the most common form of arteritis among them?
Thromboangiitis obliterans
Polyarteritis disease
Takayasu’s disease
Occlusive disease
Arteritis – inflammation of the arterial wall – often results in thrombosis of the vessel and can affect tibial and peroneal arteries. They have some characteristics. Which of the following is not one of the characteristics?
Associated with heavy cigarette smoking
Patients present with occlusions of the distal arteries
Superficial thrombophlebitis is a primary result
Most often associated with collagen vascular syndromes
Arteritis is associated with heavy cigarette smoking and occurs primarily in men younger than 40 years of ag Patients present with occlusions of the-
Digital arteries
Carotid arteries
Femoral arteries
Distal arteries
One of the several congenital anomalies of the arterial system, coarctation of the aorta is congenital narrowing or structure of the thoracic aorta, what may as well affect by this?
distal arteries
Infrarenal aorta
abdominal aorta
digital arteries
One of the several congenital anomalies of the arterial system, coarctation of the aorta is congenital narrowing or structure of the thoracic aort Clinical findings may include hypertension due to decreased kidney perfusion or manifestations of lower extremity ischemi Which is not the example of these criteria?
Paralysis and trauma
Decreased pulse
Decreased segmental Doppler pressures
Decreased pulses and decreased segmental Doppler pressures
In dissection the media is weakened, the intima develops a tear through which blood leaks in to the -rue lumen
True lumen
Arterial lumen
false lumen
main lumen
In dissection the media is weakened, the intima develops a tear through which blood leaks in to the false lumen that has developed between the intima and medi Flow velocities differ in each lumen. Dissection can affect the aorta and -
distal arteries
peripheral arteries
digital arteries
Carotid arteries
What is divided in to two compartments by a thin membrane that plays the distinguishing feature of ultrasonographic?
true lumen
false lumen
main lumen
arterial lumen
Dissection can affect the aort Aortic dissections. Which can also extend to the iliac arteries, may occur as a consequences of hypertension or –
Severe chest trauma
Emotional stress
Physical stress
Hyperlipidemia
The complication is when the dissection enlarges, there is a risk of significant stenosis and/or occlusion of the -
Brachial arteries
digital arteries
main artery
σ carotid artery
Which one has the symptoms that include changes in skin color such as pallor (paleness), cyanosis (bluish discoloration), or rubor (dark red coloration) and the patient often suffers from paresthesia and pain?
Spastic Raynaud’s syndrome
Vasopastic disorders
Obstructive Raynaud’s syndrome
Ischemic ulceration
Raynaud’s phenomenon is a condition that exits when in response to cold as well as emotional stress fingers and toes shows symptom of -
Spastic Raynaud’s syndrome
Intermittent ischemia
Vasopastic disorders
Ischemic ulceration
Primary Raynaud’s disease may be heredity and very common in young women. Which is not the alternative name of Primary Raynaud’s phenomenon?
idiopathic Raynaud’s phenomenon
Spastic Raynaud’s syndrome
Intermittent ischemia
Obstructive Raynaud’s syndrome
Secondary Raynaud’s, also known as secondary Raynaud’s phenomenon. What may be the first manifestation of Secondary Raynaud’s?
Intermittent ischemia, anatomic abnormality
Anatomic abnormality, vasospastic disorder
Collagen disease, buerger’s disease, anatomic abnormality
Collagen disease, intermittent ischemia, anatomic abnormality
Entrapment of the popliteal artery is the most written about entrapment syndrom It is thought to be caused by compression of the popliteal artery by the medial head of the -
Gastrocnemius muscle
Fibrous muscle
Gastrocnemius muscle and fibrous bands
Gastrocnemius muscle or fibrous muscle
Pallor means paleness. Pallor term is used when skin becomes pal Which of the following is mainly the result of-Pallor or paleness of skin?
deoxygenated hemoglobin
reactive hyperemia
arterial obstruction
deficient blood supply
Rubor suggests damaged, dilated vessels or vessels dilated as a result of reactive hyperemia or infection. What is the meaning of rubor?
paleness
a dark reddish discoloration
bluish discoloration
purple patches
Cyanosis, a bluish discoloration of the skin and mucous membranes. What does the Cyanosis generally occur?
concentration of deoxygenated hemoglobin
deficient blood supply
reactive hyperemia or infection
dilated capillary and venue filling
When there are purple patches (similar to bruising) on the skin of the dorsum of the foot, usually the result of dilated capillary and venue filling is called
pallor
Cyanosis
livedo reticularis
rubor
It is essential to touch patient’s skin and feel the patient’s skin to determine the temperature of the skin. The patient’s skin should be
normal
Warm
cold
warm or cold
What are the results of arterial insufficiency those are usually deep and regular in shape, often located over the tibial area?
Ulcerations
Lesions
Cyanosis
venous ulcerations
It is important to elicit from the patient the length of time the ulceration has been present and also to examine and record observations of the -
foot and fingers
fingers and toes
foot and toes
foot and hand
Gangrene is usually caused by deficient or absent of blood supply. What is the Gangrene?
Arterial insufficiency
Reactive hyperemia or infection
deficient blood supply
Death of tissue
Loss of hair on the extremity may reflect a poor nutritional state caused by decreased circulation, although hair loss alone is poor indication of –
Peripheral occlusive disease
Peripheral vascular occlusive disease
vascular occlusive disease
Popliteal occlusive disease
The healthy flesh color branches in appearance as superficial vessels are constructed by manual pressure, normal skin color should return immediately upon the release of the pressur When does Arterial perfusion decrease?
Capillary refill time decrease
Capillary refill time remain constant
Capillary refill time increase
Capillary refill time reach at high
Elevating the extremity with impaired circulation produces a cadaveric pallor because of very poor arterial perfusion. With the extremity elevated only minimal arterial blood flow can make its way distally. Returning the extremity to a dependent position causes a slow return to normality followed by the -
Bluish discoloration called cyanosis
Red discoloration called dependent rubor
Bluish discoloration called dependent cyanosis
Red discoloration called rubor
Returning the extremity to a dependent position causes a slow return to normality followed by the red discoloration. The ruborous coloration caused by the large amount of blood flowing in to small vasodilated -
Superficial arteries
Carotid arteries
Digital arteries
Thoracic arteries
The rhythmic throbbing caused by the regular contraction and alternate expansion of an artery on time with the heartbeat usually signifies -
Arterial insufficiency
Arterial sufficiency
Inadequate circulatory status
Adequate circulatory status
Grading pulses on scale of 0 to 4= is fairly standar Always pulses palpated are compared on one side to the pulse at the same site on the other sid Which of the following grading is correct?
1+= weak, 4+=strong
2+=strong, 4+= standard
3+= strong, 4+= bounding
3+= good, 4+=strong
What are easily palpated and their pulses quite bounding in response to the pressure of palpation if present?
Aneurysms
Embolism
Atherosclerosis
Arteritis
Palpable pulses include the aorta, dorsal pedis, posterior tibial arteries et What is the name of the artery that cannot be palpated?
Femoral artery
peroneal artery
Popliteal artery
Thoracic aorta
Normal flow patterns evident when listening through a stethoscope are often described as a lub-dub sound that corresponds with the closure of the -
Pulmonary valves
Aortic valves
Ventricular valves
Artiventricular valves
What is abnormal low frequency sounds heard on auscultation, they can be caused by significant stenosis that sets up a vibratory response in the tissue distal to the stenosis?
Bruits
Elevation
Auscultation
Palpation
Because bruits are low frequency, and depending on the examiner's hearing range, they may or may not always be hear Bruits may be graded on the basis of their strength and duration. What are the grades of bruits?
1+=mild, 2+=good, 3+= strong
1+=poor, 2+=strong, 3+= bounding
1+=mild, 2+=moderate, 3+= severe
1+=mild, 2+=strong, 3+= severe
The rhythmic throbbing caused by the regular contraction and alternate expansion of an artery on time with the heartbeat usually signifies arterial insufficiency. Which of the following may not indicate a - palpable "vibration" or "thrill" over a pulse site?
Fistula
Aneurysms
Poststenotic turbulence
Patent dialysis graft.
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