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71 Cards in this Set
- Front
- Back
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Hyaline arteriosclerosis is common in
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Benign nephrosclerosis
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Hyaline arteriosclerosis is caused by
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1- Plasma protein accumulation
2- Increased ECM production |
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Onion skinning of arterioles is what
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Hyperplastic arteriolosclerosis
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Hyperplastic arteriolosclerosis is caused by what
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1- SM proliferation
2- Duplication of BM material ONION SKINNING! |
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What is Necrotizing Arteriolitis?
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Fibrinoid necrosis of vessel
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Complications of HTN (6)
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1- CHD
2- CVA (Cerebrovascular Accidents) 3- Cardiac failure 4- Renal Failure 5- Aortic Dissection 6- Retinopathy |
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50% of HTN cases die due to
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Coronary heart disease and cardiac failure
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Most common cause of RHF is
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Left heart failure
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What is cor pulmonale?
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Enlargement of the right ventricle due to high blood pressure in the lungs
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2 proposed mechanisms of HTN
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1- Decreased renal Na excretion
2- Vasoconstriction and vascular hypertrophy |
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What is a true vs false aneurysm?
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True is bounded by arterial wall or heart
False- break in vessel wall to form a hematoma |
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What is a dissecting aneurysm or arterial dissection?
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-Blood enters the wall of an artery, forming a hematoma b/w its layers
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What are some causes of anuerysms? (3)
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1- Congenital
2- AS 3- Trauma |
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Sites of Atherosclerotic Aneurysms
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1- Abdominal Aorta
2- Arch of aorta 3- Descending aorta 4- Common iliacs |
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90% of aortic dissections occur in what population?
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Men 40-60 yrs old
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Type A dissection
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Involves ascending aorta
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Type B dissection
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Involves Aorta distal to subclavian artery, ascending Aorta NOT INVOLVED
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Most common cause of death of aortic dissection
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Rupture
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Clinical features of aortic dissection (6)
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1- Sudden chest pain
2- Sudden death/RUPTURE 3- MI/Cardiac tamponade 4- Aortic valve insufficiency 5- Occlusion of vessel orifices 6- Compression of spinal vessels (myelitis) |
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what are the tactile receptors?
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Meissner (touch, pressure), Pacinian (deep pressure, vibration), Ruffini (stretch), Merkel (touch, pressure)
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What substance counteracts aldosterone?
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Natriuretic peptide
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What is malignant hypertension?
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Rapidly rising BP (200/120) or more
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Favored mechanism of hypertension
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Decreased Na excretion theory
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What % of cases of HTN are essential?
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95%
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What causes essential HTN?
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Unknown cause
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Onion skinning
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Hyperplastic arteriosclerosis
-Duplication of basement membrane -Malignant hypertension -Fibrinoid necrosis |
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Know what hyaline arteriosclerosis looks like
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Notes
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What is cor pulmonale?
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Right ventricular hypertrophy
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Acquired causes of aneurysms (5)
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1- Trauma
2- AS 3- Syphilitic 4- Mycotic (infections) 5- Vasculitis |
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Most common site of AS aneurysm
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Abdomen
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Pulsatile abdominal mass may indicate
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AS Anuerysm
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At what size do you have to worry about rupture of aneurysms?
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Above 5 cm
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Biggest concern of aneurysms
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Rupture
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In syphilitic aneurysm, aortic valve ring dilatation causes
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Valve incompetence
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Tree barking of aorta
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Syphilis
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Remember what cystic medial degeneration looks like, lots of black elastic fibers
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Notes
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Why do varicose veins occur?
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1- High intravascular pressures
2- Tone of vein is lost |
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Varicose veins affect what veins
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Saphenous Veins
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What is the cause of Essential HTN?
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Unknown
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Blood pressure =
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CO X PR
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What does Natriuretic peptides do?
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Counteract Aldosterone
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Hyperplastic Arteriolosclerosis
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Onion skin
Diastolic BP>120 |
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Hyaline Arteriolosclerosis
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common in Benign Nephrosclerosis
Endothelial damage and leakage of plasma proteins into subintimal tissue, Increased ECM production by smooth muscle cells |
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What is AAA?
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Abdominal Aortic Aneurysm
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Atherosclerotic aneurysm
Location Genetic defects Presentation |
Common in Abdominal aorta
MMP>TIMP (Matrix Metalloproteinases>Tissue inhibitors of Metalloproteinases) 1. Abdominal mass, rupture, obstruction, embolism, pressure on ureters, vertebrae |
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Syphilitic Aneurysm
Cause Location Morphology Common cause of death |
Treponema Pallidum
Thoracic aorta, ascending aorta Tree barking, aortic valve ring dilatation-aortic incompetence, Massive left ventricular enlargement (cor bovinum-cow's heart) Cause of death- valve incompetence |
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Aortic dissection
Types of causes Microscopic Classification Common cause of death |
Spontaneous, antecedent HTN, connective tissue disorder like Marfan's
Medial cystic necrosis, elastic tissue fragmentation and loss with cleft-like spaces (cysts) seen in the wall, filled by ECM -No necrosis or inflammation Type A- ascending aorta or entire length of aorta Type B- aorta distal to subclavian artery CCOD- Rupture |
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Rupture triad- clinical features
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1) Left flank pain
2) Hypotension 3) Pulsatile mass |
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Fungal vessel invaders
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1) Aspergillus
2) Candida 3) Mucor |
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Bacterial VESSEL invaders
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1) Bacteroides fragilis
2) Pseudomonas 3) Salmonella |
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Aortic regurgitation and bounding pulses
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Syphilitic Aneurysm
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Cystic medial degeneration
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Aortic dissection
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Pain radiates into the back, absent pulse
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Aortic dissection
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Most common cause of death of aortic dissection
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Cardiac tamponade
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What is phlebothrombosis?
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Thrombosis of a vein WITHOUT inflammation
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What is thrombophlebitis?
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Pain and tenderness along superficial vein
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What is superior vena cava syndrome?
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Compression of SVC by primary lung cancer
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Acute lymphangitis caused by
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Cellulitis by Strep pyogenes
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Cystic hygroma causes what
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Webbed neck in Turner's Syndrome
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Angiomyolipoma
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Kidney hamartoma (benign)
Composed of blood vessels, muscle, and mature adipose tissue Associated with tuberous sclerosis |
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Capillary hemangioma
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Facial lesion in newborns that regresses with age
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Cavernous hemangioma
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Most common benign tumor of liver and spleen
-May rupture if large |
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Hereditary telangiectasia
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Dilated vessels on skin and mucous membranes in mouth and GI tract
-Chronic iron deficiency anemia |
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Spider telangiectasia
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AV fistula
-Hyperestrinism (cirrhosis, pregnancy) |
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Sturge-Weber Syndrome
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Nevus flammeus (birthmark) on face in distribution of ophthalmic branch of trigeminal nerve (CN V)
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Von Hippel-Lindau Syndrome
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Cavernous hemangiomas in cerebellum and retina
-Increased incidence of pheochromocytoma and bilateral renal cell carcinomas |
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Desquamation of the skin of toes- what disease?
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Kawasaki Disease
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Most common cause of secondary hypertension
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Renovascular hypertension
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Renovascular hypertension in elderly men- cause
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AS
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Renovascular hypertension in young to middle aged women- cause?
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Fibromuscular hyperplasia
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Complications of hypertension (3)
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1) Acute MI
2) Stroke 3) Renal failure |
