Carotid_Artery_Disease

Carotid_Artery_Disease - CAROTID ARTERY DISEASE Vic...

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CAROTID ARTERY DISEASE Vic Vernenkar, D.O. St. Barnabas Hospital Dept. of Surgery
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Epidemiology 3 rd most common cause of death in the US Most common cause of long term disability 500,000 CVAs annually Contributes 200,000 deaths annually Of those that survive, 2/3 have disability, 1/3 require hospitalization for it. 16 trillion$ a year in costs
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Risk Factors Nontreatable Age Ethnicity Gender Family History Genetics
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Risk Factors Treatable Hypertension TIA’s Previous CVA’s Asx Bruit or Stenosis Cardiac Disease Aortic Arch atheromatosis Diabetes Mellitus Cigarette Smoking ↑fibrinogen, ↑homocysteine ↑anticardiolipin Oral contraceptives Obesity
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Anatomy Brain 2% of body weight but 17% of CO and 20% of O2 supply….so neural tissue can become necrotic within minutes Branches of aortic arch; inominate (Brachiocephalic), L common carotid and L subclavian.
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Anatomy Inominate branches to form R subclavian and R common carotid. 10% of population L common comes of inominate.
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Anatomy Brain supplied by 2 internals and 2 vertebrals. The internal supply 80-90% of total blood flow. The common carotids bifurcate at angle of mandible into external and internal. Branches if external are lingual, ascending pharyngeal, superior thyroid, occipital, posterior auricular. The terminal branches are int. maxillary and superficial temporal a.
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Anatomy Extensive collaterals between external and vertebrals in case of occlusion Periorbital collaterals connect through ophthalmic artery to internal carotid in case of occlusion in neck. Extensive side to side collaterals between L and R externals and L and R vertebrals.
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Anatomy Internals branch into anterior cerebral and middle cerebral arteries The L and R middle cerebrals connect at the circle of Willis via anterior and posterior communicating arteries. 15% have no connections between ant and post cerebral circulations, 35% lack connection between the two hemispheres.
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Anatomy Vertebrals arise from first portion of subclavian artery and enter 6 th cervical vertebra and ascend in foramen. Unite to form Basilar artery. The Basilar terminates as L and R posterior cerebral arteries posterior communicating arteries of the circle of Willis.
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Branches of external carotid can anastamose with orbital arteries
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This note was uploaded on 12/27/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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Carotid_Artery_Disease - CAROTID ARTERY DISEASE Vic...

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