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41 Cards in this Set
- Front
- Back
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Diseases of ______ cause more morbidity and mortality than any other category of human disease.
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Arteries
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Vascular abnormalities cause clinical disease by what 2 principle mechanisms?
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1. Narrowing or completely obstructing the lumina. (by atherosclerosis or thrombosis/embolism)
2. Weakening of vascular walls = dilation or rupture. |
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What cells line the entire vascular system? and what kind of storage organelle do they contain?
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Endothelial cells
Contain storage organelle for von Willebrand factor |
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What are the 3 concentric layers of normal vessels? From outermost to innermost.
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Adventitia
Media Intima |
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What does vasa vasorum mean?
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"Vessels of the vessels"
Small arterioles arising from outside the vessel that nourish outer portion of media |
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Arteries are divided into what 3 types based on size?
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Large (elastic)
Medium-sized (muscular) Small arteries (<2mm in diameter) |
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Medial smooth muscle cell contraction in arterioles regulate what?
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systemic arterial blood pressure
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Atherosclerosis (ATH) affects which types of arteries?
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Elastic and muscular arteries
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Hypertension affects which types of arteries?
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small muscular arteries and arterioles
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Capillaries have an endothelial cell lining but no ________.
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media
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In many types of inflammation, vascular leakage and leukocytic exudation occure preferantially in _________ venules.
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postcapillary
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about what % of systemic blood is in veins?
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66%
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What are 2 types of inducers of endothelial dysfunction?
What can they also cause? |
Cytokines and Bacterial products
Inflammatory injury Septic shock Hemodynamic stresses+lipid products |
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Where are smooth muscle cells (SMCs) predominant in the vasculature?
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MEDIA
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When do SMCs proliferate?
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AFTER vascular injury
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What are 3 promoters of vascular smooth muscle cells?
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Platelet-derived growth factor
Basic fibroblast growth factor Interleukin 1 |
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What are 4 inhibitors of vascular smooth muscle cells?
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Heparan sulfates
Nitric oxide Interferon gamma Transforming growth factor Beta |
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When does Intimal Thickening occur and what happens in this process?
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It occurs when there is vascular injury (constituting acute EC loss or chronic endothelial injury/dysfunction)
SMCs migrate from the MEDIA to the INTIMA and proliferate. |
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During vascular injury healing process, SMCs undergo changes resembling _________.
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dedifferentiation
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Exaggerated healing response in vascular injury leads to what?
What can this cause? |
Intimal Thickening
Can cause: Stenosis or Occlusion of small and medium-sized blood vessels |
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Among the diverse congenital vascular anomalies, which 2 have most importance?
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Developmental or BERRY ANEURYSMS (involve cerebral vessels)
Arteriovenous fistulas |
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Why would an arteriovenous fistula be intentionally created?
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To provide vascular access for chronic hemodialysis
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What is arteriosclerosis?
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"Hardening of the arteries"
Thicking and loss of elesticity of arterial walls. |
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What is the most frequent and important form of Arteriosclerosis?
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Atherosclerosis (ATH)
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What is Arteriolosclerosis and what is it most often associated with?
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It is a disease of small arteries and arterioles where there is thickening of these vessels.
Most often associated with hypertension and diabetes mellitus |
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What is Atherosclerosis characterized by?
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Intimal lesions (atheromas - atheromatous or fibrofatty plaques)
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Myocardial infarction alone is responsible for ___% to ___% of all deaths in the US
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20 - 25%
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Atherosclerosis primarily affects which arteries?
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Elastic arteries (aorta, carotid, iliac)
Large and medium-sized muscular arteries (coronary + popliteal) |
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Symptomatic atherosclerotic disease most often involves arteries supplying what 4 areas?
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Heart
Brain Kidneys Lower extremities |
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What are four MAJOR consequences of ATH?
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Myocardial infarction (heart attack)
Cerebral infarction (stroke) Aortic aneurysms Peripheral vascular disease (gangrene of the legs) |
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What 3 factors have contributed to improvement in ATH-related disease?
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Changes in life style (reduced smoking, altered diet, controlled hypertension)
Improved methods of treatment of myocardial infarction and other complications of IHD Prevention of recurrences in patients |
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What is the presumed precursor lesion for atheromas?
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FATTY STREAK
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Name the 5 most extensively involved vessels in ATH, from most involved to least involved.
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1. Lower abdominal aorta
2. Coronary arteries 3. Popliteal arteries 4. Internal carotid arteries 5. Vessels of the circle of Willis |
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In ATH, what vessels are usually spared?
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Vessels of upper extremities.
Mesenteric and renal arteries |
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Atherosclerotic plaques what 3 principal components?
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Cells (SMCs, macrophages, leukocytes)
Extracellular matrix (Collagen, elastic fibers, proteoglycans) Intracellular and extracellular lipids |
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Typically what are the 3 parts in the configuration of an atherosclerotic plaque?
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Superficial fibrous cap
Shoulder Necrotic core |
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In an atherosclerotic lesion:
What is the superficial fibrous cap composed of? The shoulder? |
SMCs and dense collagen
Shoulder is beneath and to the side of the cap. It is a cellular area consisting of macrophages, SMCs, and T lymphocytes |
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What does the necrotic core consist of in an atherosclerotic lesion?
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Necrotic core is deep to fibrous cap and contains a disorganized mass of:
lipid, debris from dead cells, fibrin, foam cells, other plasma proteins |
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Atheromas often ungergo ________.
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Calcification
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What is the most feared complication of an atherosclerotic plaque?
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Superimposed Thrombosis
Usually occurs on disrupted lesions, may partially or completely occlude the lumen |
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Regarding ATH, what appears in Aortas of some children <1 year of age and in all children >10 years.
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Fatty Streaks
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