USMLE Abdominal Aortic aneurysm

[Dr.serotonin]

in pathology course i remember they were saying that Atherosclerosis weakens the vessel wall and is the cause of AAA, but while doing UW I did a Q wrong Bcz it said that transmural inflammation of Abdominal aorta is the cause of AAA. how can atherosclerosis or HTN leads to transmural inflammation?? and these 2 factors cause AAA.
plz throw some light on this. thanks

---

Members don't see this ad.

 

[StilgarMD]

Aneurysms in large vessels take place due to medial degeneration.

The thoracic aorta has a blood supply called the vaso vasorum which feeds its media. The Abdominal Aorta doesn't have a Vaso vasorum, so it relies on the blood flowing through the vessel to provide nutrients/oxygen through diffusion. In the abdominal aorta, if you get atherosclerosis, you create a patch of tissue underneath which is further away from its nutrient supply. I've never heard of it being called transmural inflammation, but if you cut off blood supply to tissue, the entire depth of it will die, and lead to transmural inflammation. Eventually the inflammation/lack of nutrients leads to weakening of the wall and AAA.

HTN predisposes to Atherosclerosis, so it predisposes to AAA as well.

 

[Dr.serotonin]

Thanks for your explanations

 

[Quizlet04]

Robbins is OBSESSED with syphilis causing thoracic aortic aneurysms due to vasculitis in the vaso vasorum. I just thought I should add that.

 

[Dr.serotonin]

So in a nutshell
Atherosclerosis for Abdominal aortic aneurysm
Syphilis for thoracic aortic aneurysm
Cystic medial degeneration for Marfansyndrome associated aneurysm / dissection

 

[Quizlet04]

Another unlikely bit of vasculature: the Artery of Adamkiewicz comes off the abdominal aorta and supplies the lumbosacral cord when it anastomoses with the anterior spinal artery. It can get damaged during AAA/AAA repair.

 

[zhopv10]

Syphillis is a big one for the proximal aorta but if I'm remembering right isn't the most common cause of proximal aorta aneurysm hypertension?

 

[masaraksh]

Syphillis is a big one for the proximal aorta but if I'm remembering right isn't the most common cause of proximal aorta aneurysm hypertension?

Thank you penicillin?

 

[zhopv10]

Probably, but I'm just saying it seems they would give something more in a stem if they were looking for syphillis ya? Like the bark, or some hx components etc right? Otherwise you would think now of hypertension being the number one cause unless we are led to believe otherwise, that sounds right?

 

[worldbeater]

The answer is for the cause of AAA is usually hypertension on UWorld, more so than atherosclerosis or some other pathologies.