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41 Cards in this Set
- Front
- Back
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The intima is made up of what?
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One layer of endothelial cells, resting on connective tissue.
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What does the media consist of?
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Smooth muscle surrounded by internal and external elastic laminae.
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What is the function of the media?
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Determines resistance in small arterioles.
Determines stretch and recoil in large arteries. So, elastic part is more prominent in large arteries. Muscle part more prominent in small arteries. |
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In the media, the elastic lamina is more prominent in?
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Large arteries.
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In the media, the muscular component is more prominent in?
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Small arteries, arterioles.
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Why is the adventitia important?
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It contains nerves, lymphatics, collagen, and blood vessels.
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What are the blood vessels in the adventitia called?
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Vaso vasorum.
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What is another name for the subendothelial space?
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Subintima.
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What are the functions of the endothelial layer of the intima?
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1. Barrier. Keeps molecules from the subintima.
2. Inhibits smooth muscle cell migration and proliferation. 3. Antithrombotic Substances. Prevents thrombus from forming 4. Vascular function. Releases substances that constrict and dilate the media. 5. Immune function. |
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What do the endothelial cells release to stimulate contraction?
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Endothelin.
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What do endothelial cells release to stimulate dilation?
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NO
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How are endothelial cells anti-inflammatory?
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They resist leukocyte adhesion.
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How do endothelial cells react to local injury?
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They secrete cytokines, which attract white blood cells.
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The arterial wall is a _______ and ______ system.
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Dynamic and regulated.
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What is the key event in endothelial injury?
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A break in the barrier.
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Where does endothelial injury most often occur?
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Bifurcation.
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What causes endothelial dysfunction?
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Toxins: smoking, diabetes, hyperlipidemia.
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What does endothelial dysfunction mean?
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The protective function is impaired. It becomes:
Pro-inflammatory. Vasodilator and antithrombotic functions are altered. LDL enters the vessel wall. |
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There is endothelial injury and LDL is flowing in, now what?
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1. LDL moves in.
2. LDL is oxidized. Oxidation recruits monocytes to the vessel wall. 3. Monocytes become macrophages. 4. Macrophages eat oxidized LDL and become foam cells or "fatty streak". 5. Smooth muscle cells from the media to the intima begin the transition of fibrous plaque. Smooth muscle cells secrete connective tissue and creates a lipid core. |
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Once monocytes enter the vessel wall, what happens to them?
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They become macrophages.
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What does plaque form from?
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Fatty streak.
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Vulnerable plaque has a ______ cap.
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Thinner.
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What can inhibit the fortification of the fibrous cap?
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Inflammation.
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List the order of frequency of fibrous plaque.
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Abdominal aorta
Coronary arteries Popliteal arteries Descending aorta Internal carotid artery Renal arteries |
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What are the complications of plaque?
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Fragility
Hemorrhage Embolism Aneurysm Thrombus formation |
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How important is narrowing in MI?
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Not very, the problem is with acute events in which plaque ruptures.
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What are modifiable risk factors of atherosclerosis?
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Dyslipidemia (high cholesterol)
Hypertension Smoking Diabetes Sedentary lifestyle and obesity |
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What are non-modifiable risk factors of atherosclerosis?
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Age
Gender (male) Genes |
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What are the family history risks of atherosclerosis?
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CAD in males under 55 or females under 65
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What stimulates c-reactive protein?
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Cytokines
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What is the importance of CRP?
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It is a marker of low grade systemic inflammation. So, high levels of CRP indicates a higher risk of atherosclerosis.
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What are possible infectious causes of atherosclerosis?
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Clamydia, helicobactor pylori, herpes, cytomegalovirus.
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What lipoprotein, determined by inheritance is a risk factor for atherosclerosis?
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Lp(a)
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High levels of what, which can be treated with folic acid, may cause endothelial dysfunction?
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Homocysteine.
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What is metabolic syndrome?
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A descriptor of a clustering of risk factors.
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What makes up the metabolic syndrome cluster?
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Hyperlipidemia
Hypertension Reduced HDL Insulin resistance Belly fat. |
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What percentage of Americans have metabolic syndrome?
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44%
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What is the goal of lipid altering therapy?
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Dietary or pharmacological reduction of serum cholesterol because it can slow the progression of atherosclerosis.
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What is the optimal LDL cholesterol level?
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Less than 100mg/dL
or 70 for those at risk. |
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What drugs are the most effective in lowering LDL?
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Statins
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What triggers cytokine release?
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LDL entry into subintima
Myocyte infiltration Smooth muscle cell migration |
