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40 Cards in this Set
- Front
- Back
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What are the 3 layers of a blood vessel? |
Intima Media --> smooth muscle Externa |
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What are the major manifestations of pathological atherosclerosis? |
Ischemic stroke Myocardial infarct Transient ischemic attack Angina (stable vs unstable) Peripheral arterial disease |
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What are the common risks factors for atherosclerosis? |
Hyperlipidemia, hypertension, smoking, toxins, hemodynamic factors, immune reaction, viruses obesity, metabolix syndrome, type 2 diabetes, high triglycerides, high LDL, low HDL, intra-abdominal adipocytes, inflammation markers these can all lead to endothelial injury |
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What is vaso vasorum? |
large arteries have external blood supply because their layers are so thick |
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What are the main 3 clinical phases of atherosclerosis? |
aneurysm and rupture occlusion by thrombus critical stenosis |
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What is a transient ischemic attack? |
Transient lack of blood flow to a region of the brain Spells of being frozen or trouble moving part of the body |
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What is angina? |
chest pain due to ischemia of a section of the heart can be stable (happens when you exercise) or unstable (unpredictable) |
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What is peripheral arterial disease? |
intermittent claudication: pain in leg when exercising (due to atherosclerosis in calf muscle arteries) can lead to gangrene or necrosis |
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What is the pathogenesis of atherosclerosis? |
Hemodynamic stress --> cell mediators/cytokines act on artery walls --> lipoprotein entry and accumulation |
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Where is the most common area for hemodynamic stress in arteries? |
where arteries bifurcate |
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What are the different types of lipoproteins? |
VLDLs (most lipid) LDLs HDL (more protein / less lipid) Chylomicrons |
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What is the flow of fat/cholesterol through the body (from digestion)? |
Digestion - chylomicrons facilitate absorption from intestines Move to the liver and are packaged into VLDLs VLDLs are oxidized into LDLs HDL picks up cholesterol (oxidized LDLs) and takes it back to the liver to be made into bile |
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What happens to smooth muscle in the blood vessels during atherosclerosis? |
migration to the intima and become synthetic cells that produce all the fibrous deposits overtop of the plaque |
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What are foam cells? |
Macrophages that have taken up oxidized LDLs So they're full of fat |
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What is metabolic syndrome? |
Classical features: abdominal obesity, hyperinsulinemia, high fasting plasma glucose, impaired glucose tolerance, hypertriglyceremia, low HDL, hypertension caused by overnutrition and physical inactivity leads to atherosclerosis |
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How does diabetes contribute to atherosclerosis? |
high glucose in blood tends to glycosylate various products on the endothelium --> leads to damage, oxidized LDLs, foam cell accumulation higher inflammation --> higher C reactive protein |
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What is atherothrombosis? What causes it? |
thrombus formation at sight of plaque formation Causes: endothelial injury (prostaglandin i2 isn't made), abnormal blood flow over the plaque, hypercoagulability hypercoagulability occurs in hemorrhage, surgery, childbirth (becuase of increase in platelets) |
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Common sites of thrombus formation |
periphery, coronary artery, cerebral artery |
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What is aortic dissection? |
weakening in a section of the wall of the aorta blood pulls apart the wall and creates a false lumen complications: ischemia, due to compressed blood flow |
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What is cardiac tamponade? |
compression of the heart by an accumulation of fluid in the pericardial sac can be fatal |
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Which coronary arteries are most commonly involved in ischemic heart disease? |
Right coronary artery Left anterior descending Left coronary artery |
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What is ischemic heart disease? |
a complication of hypertension presents as a lack of oxygen to the heart |
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What is coronary artery disease? |
atherosclerotic plaque in the proximal regions of the main coronary arteries #1 cause of death in most places stenosis is severe before symptoms start occurring Symptoms: angina, myocardial infarction, sudden death |
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What are the characteristics of a cardiac myocyte? |
high energy requirement low energy reserve (constantly using it up) must work continually for your whole life |
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Why do you feel angina in your arm/jaw instead of just in the chest? |
convergence of the nerves in the afferent pathway (brain thinks pain is coming from all the nerves) |
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Angina can be due to: |
athersclerosis atherosclerosis with blood clot coronary spasm sensitivity to cocaine |
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How is angina treated? |
Nitroglycerin (relaxes veins and arteries) Coronary artery bypass surgery (saphenous vein from the leg used) Coronary angioplasty (balloon) Stent insertion (on top of balloon to keep open after deflation) |
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What percentage of myocardial infarcts result in death? |
20% |
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Symptoms of myocardial infarct |
chest pain worse than angina systemic sensation of panic, dizziness and out of breath GI symptoms sense of impending doom SOMETIMES: left are and shoulder pain, but can be concentrated on the chest, the back (depends on the person) |
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What are the 2 typical scenarios that cause a myocardial infarct? Other possible causes? |
1. plaque ruptures and causes a thrombus 2. high amount of plaque that is easily blocked thrombus, embolus, hemorrhage, spasm |
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Common abnormalities in an ECG that aid in diagnosis |
Ischemia --> T wave inversion Injury --> S-T segment elevation Infarction --> pathologic Q wave |
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Possible complications from a myocardial infarct |
thinning of ventricular wall cardiac rupture --> cardiac tamponade thrombus on endocardium (can become embolus) rupture of papillary muscles ventricular septal defect ventricular aneurysm |
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What is timolol? |
beta blocker that keeps BP under control |
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What is rheumatic heart disease? |
follows reaction of body to B-hemolytic streptococcus (cross reaction of antibodies) attacks heart valves, causes calcification/depositions can also occur in joints |
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Symptoms of congestive heart failure |
edema cyanosis (turning blue due to lack of O2) dyspnea(difficulty breathing) orthopnea (difficulty breathing when lying down) fatigue / weakness nocturia (peeing a lot at night) increased venous pressure |
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Treatment for congestive heart failure |
Treat cause: hypertension / arrhythmia / valvular defect Reduce symptoms: myocardial contractility, diuretics for edema |
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What are the two types of strokes? |
Ischemic: blood flow cut of (85% of strokes caused by thrombus or embolus) Hemorrhagic: vessel ruptures and bleeds into brain (can be intracerebral or subarachnoid) |
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What is the circle of willis? |
system of blood vessels at the base of the brain if thrombus forms in it, collateral circulatino can compensate big problem if thrombus occurs after |
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Why are middle cerebral artery strokes so bad? |
middle cerebral artery supplies part that controls speech word reading, understand and formation can be affected MOST FREQUENT site of stroke |
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What is multi-infarct dementia? |
tiny emboli/thrombi and atherosclerotic lesions, which caused many infarcts and cause loss of cognitive function (similar symptoms to Alzeimers) |
