Pathology Of The Heart And Blood Vessels

Front 1

Which gender is most prone to heart disease?

Back 1

Until old age, women are more prone to heart disease. As age increases, men are more at risk.

Front 2

Towards what disease are men at more risk?

Back 2

cancer

Front 3

Why are the predictions for higher rates of heart disease incorrect and leveling off?

Back 3

There are improved early detection and treatments.

Front 4

What are the causes of heart disease over which we have no control?

Back 4

age, sex, hereditary background.

Front 5

What are the causes of heart disease over which we do have control?

Back 5

The greatest cause is smoking. The others are exercise (30 mins of walking a day will suffice), alcohol consumption, salt and sugar intake, fatty diet.

Front 6

What is the structure of a healthy artery?

Back 6

The lumen which is the inside of the vessel has blood flowing through it. It is lined with epitheal cells. Behind it are two layers; The media which is the medium level, made of fibroblast cells and strong smooth muscle cells which keep the artery's diameter and elasticity. Behind that is the adventita, the layer which provides nutrition to the walls of the blood vessel.

Front 7

How does the structure of the arteries change as they branch off? How does this affect function?

Back 7

The arteries have less layers as they branch and become smaller. The largest arteries have all the layers. The capillaries do not have the adventita and this structure enables the direct communication with the surrounding tissues. Both pressure and flow velocity decrease as the vessels get smaller.

Front 8

The basement or basaly layer is present in which blood vessels? what are they made of?

Back 8

The basement of basaly layer of blood vessels is present in all the layers; arteries, arterioles and capillaries. This is because they are formed by the epitheal layers discharge.

Front 9

What is the size relationship between the capillary and the red blood cells?

Back 9

The capillary is only slightly larger than the rbc. That is why any other object such as blood clot, air bubble will consist a blockage and disturb the diffusion process.

Front 10

Why is there decreased pressure in the arterial capillary bed?

Back 10

The lower pressure in the capillary bed allows greater exchange of blood out to the tissues.

Front 11

Since the level of albumin in the blood defines the osmotic pressure, if someone has poor liver function and cannot synthesize albumin, which results in less albumin protein in the blood, how will this affect him due to the imbalance in osmosis?

Back 11

If there is less protein in the blood, the osmotic pressure increases outside and water will leave the blood vessel to dilute the external hight concentration. He will have a great deal of edema.

Front 12

What prevents blood backup in the veins? What happens if this system is faulty?

Back 12

There are leaflife valves which allow blood flow forward in the right direction and prevent it flowing backwards. Faulty valves cause disease.

Front 13

What other system is parallel to the blood system? what does it do? How is it different to the circulatory system? What disease is related

Back 13

The lymph system is the drainage system of our body fluid. It drains water that went out to the tissue and returns it to the venous system. Many diseases come from a faulty lymphatic system. There are no red blood cells in the lymphatic system. For more information see http://www.energiseforlife.com/wordpress/2006/06/30/the-lymphatic-system/#

Front 14

What is a hemodynamic disease?

Back 14

A hemodynamic disease is connected to the blood flow in the body. Some are related to artery flow, venous flow or lymphatic system flow.

Front 15

What is erythema?

Back 15

Erythema is a hemodynamic disease.
The subcutaneous blood capillaries dilate from radiation or adrenalin and the veins cannot cope from the imbalance of higher arterial blood than venous blood. There is more blood flow than drainage. Congestion prevents venous drainage and there is more venous blood than arterial.

Front 16

What is vasoconstriction?

Back 16

Vasoconstriction is a hemodynamic disease. This occurs during extreme cold. In order to decrease the transfer and to retain body heat, the blood vessel shuts itself off. This happens with mountain climbers; Nasal capillaries shut off, fingers, toes and ears may become necrotic.

Front 17

What is Quincke disease?

Back 17

Quincke disease is a hemodynamic disease. If you press the tissue, it keeps the print. This is an edema and water escapes the blood and enters the tissue.

Front 18

What is edema of peritoneum?hydrothorax, pericardium?

Back 18

Edema of the peritoneum is when there is an abundance of water which exits the blood and organs and collect in the tissue lining the stomach and may come from scites or chirosis, a liver disease.

Front 19

What is edema of the pericardium?

Back 19

The edema of pericadium is when fluid presses on the heart and it cannot function.

Front 20

What is edema of hydrothorax?

Back 20

This is when the pleura which surround the lung tissue are filled with fluid. It is caused by left heart failure and hydrostatic pressure imbalance.

Front 21

Why does edema develop?

Back 21

There are five main reasons for the development of edema.
1. increase in hydrostataic blood pressure and poor venous return from heart failure, blockage or arterial dilation.
2.
Decrease in colloidal osmotic blood pressure causing loss of protein in urine (nephrotic syndrome) or decreased protein formation (liver disease), poor nutrition or maladsorbtion.
3. Increased retention of fluids due to kidney failure (Na)
4. Lymphatic blockage (inflammation or tumor)
5. Inflammation

Front 22

What is in transsudat?

Back 22

Transsudat which is the liquid resulting from pressure difference is made of clear water and contains no cells, perhaps a bit of protein and no inflammatory cells.

Front 23

What is in exudate?

Back 23

Exudate, the water which fills the tissues in inflammation, is filled with protein and immune cells.

Front 24

What will left heart failure cause?

Back 24

In left heart failure, the backup will cause lung edema.

Front 25

What will right heart failure cause?

Back 25

In right heart failure, the backup will result in foot edema.

Front 26

What special problem is when the brain has edema?

Back 26

Edema in an organ with a hard cover is problematic. The brain is an inflexible box. The edema causes continual pressure, lack of blood flow and cellular death.

Front 27

What are three reasons for edema?

Back 27

1. Heart failure, hydrostatic blood pressure increase in the capillary bed.
2. Decredased osmotic blood pressure, from porr nutrition or poor protein synthesis or protein loss which causes loss of albumin in the urine.
3. Heart failure which causes kidney failure, decreased renal flow, decreased renal angiosten, storage of Na, increased blood volume, water release from osmotic pressure.

Front 28

What causes decrease of plasma osmotic pressure and hypoproteinemia?

Back 28

Insufficient protein ingestion.

Front 29

What is hemmorhage?

Back 29

Excess bleeding.

Front 30

What are the causes of hemmorhage?

Back 30

1. trauma (incision)
2. increased blood pressure (capillary explodes in the body)
3. aneurysm (bubble develops, the lining weakens and it explodes)
4. hereditary faluty blood vessel
5. disease in the blood vessel lining.(such as atheroma which is the same as atherosclerosis)

Front 31

What are the results of hemmorhage?

Back 31

Hemmorhage results in
1. decreased blood volume, called hemorrrhagic shock or hypovolemy.
2. inflammation, tissue destruction, loss of function.
3. ischemia (heart failure)

Front 32

What does hemmorhage in the brain cause?

Back 32

Brain hemmorhage causes ischemia, tissue destruction, loss of oxygen and nutrients.

Front 33

What caused color change in hematoma?

Back 33

Hemoglobin breakdown exits the tissue and is eaten by enzymes.

Front 34

Where is willis's arteries found?

Back 34

In the brain. THe wall of the blood vessel weakens and blood presure makes it thin and swollen. It bursts and leaks.

Front 35

What is deep vein thrombosis and what is the threat?

Back 35

In deep vein thrombosis parts can break off and pass to other locations in the brain, lungs and cause an obstruction in the blood flow and may cause surrounding cell death.

Front 36

What causes too much blood coagulation?

Back 36

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Front 37

waht are the 4

Back 37

aaa

Front 38

thrombus

Back 38

1234

Front 39

pakeketaa

Back 39

aa

Front 40

pakeket in the veinaa

Back 40

aa

Front 41

mural thrombos

Back 41

aa

Front 42

What is an embolus?

Back 42

Anything which is carried away inte blood strem and does not dissolve in it; thromboses, bone marrow, air, fetal fluid.

Front 43

How might a person suffering from embolus present?

Back 43

Pulmonary embollism victim would have shortness of breath, lack of oxygen and pain in the ribs, decrease of PO2 and could have sudden death which may have been caused by a dislodged leg thrombosis.

Front 44

What causes lung embollism and how mich it be casued and what might it cause?

Back 44

A pulmonary embollism is usually from a thrombus in the lower libms and may cause pulmonary blockage. Bone marrow may exit a fracture and enter the blood stream and block air (happens to scuba divers) or fetal liquid can cause death.

Front 45

How might we treat someone we suspect has pulmonary embolus?

Back 45

rest, oxygen, anti coagulant such as warfarin, clexane, heparin and drugs for trombeleza, to dismantle the thrombosis.

Front 46

What conditions might cause a thrombosis and embolus?

Back 46

Being static in a constricted space for a sustained period of time may encourage this condition.

Front 47

What is a bone-marrow embolus?

Back 47

Usually after a lower limb fracture, particles of bone marrow may enter the blood stream and can enter the kidney or lungs or other organs.

Front 48

What is a gaz embolus?

Back 48

Divers descend and inhale oxygen and Nitrogen. The pressure increases as they descend and enters the tissues. They must come up slowly so the nitrogen is released in small bubbles. If the diver ascends too quickly, the nitrogen exits in large bubbles, boiling the blood which block and burst brain, lung and other tissue. If this occurs up to ten meters, it is possible to put the diver in a decompressor, add the bubbles and release them slowly.

Front 49

What is atheroma also called atherosclerosis?

Back 49

Hardening of the wall of the artery from fatty deposits and white blood cells in a critical blood supply location such as the heart.

Front 50

What are the causes of atheroma/atherosclerosis?

Back 50

Out of our control causes are;
age, sex, heredity, background.
Causes we have control over;
High blood pressure, high LDL, low HDL, smoking, diabetes, lack of exercise, stress, menopausal lack of oestrogen, chlamydia pneumonia which is an infectious bacteria corellated with heart disease, overweight and poor nutrition.

Front 51

What is the French paradox?

Back 51

The French diet includes cheese and wine and it seems their damage is offput by the daily cup of red wine they drink.

Front 52

How does atheroma develop?

Back 52

1. damage to endotheal cells which line the inside of blood vessels and arteries. The damage can be direct from smoking or bloodstream or indirect from a virus or fats. Once damaged, they allow entry normally denied.
2. LDL enters the vessel lining and remain there, undergoes modification, releasing protein of inflammation damaging the tissue. The media is damaged.
3. Monocytes are activated and become macrophages to absorb inflammatory cells. Macrophages detect LDL with their receptors and eat the LDL creating foam cells. Function is now impaired. The vessel is constricted and the lining is sick and there is chronic inflammation.
4. Fibroblasts multiply and wander in the inner lining of the artery and secrete fibers like collagen.

Front 53

What is the makeup of the atheromic layer? What does it result in?

Back 53

The layer of atheroma is made up of
1. cells, smooth muscles, macrophages, T cells
2. Fibroblast products; collagen, elastin, protoglanicans
3. intercellular fat and extracellular fat and oxygenized cholesterol.
This results in decreased diameter to the artery. through which blood cannot flow beyond 80% blockage.

Front 54

Where does oscillatory blood stream take place?

Back 54

AT strategic spots the arteries take two 90 degree paths, like to the kidneys and lower limbs. There is a whirlpool effect and the endotheal feels the turbulence and if there is high LDL, responds by hyperplasia and by expressing proteins as if there were an inflammation.

Front 55

Where are these locations?

Back 55

1. stomach aorta
2. coronary arteries
3. popliteal arteries
4. internal carotid artery
5. small arterioles at the base of hte skull (circle of willis)
6. the kidney arteries

Front 56

The atheroma is either simple or complex. Describe the difference.

Back 56

The layer will differentiate the degree of disease and chance for embollism and way of treatment.

Front 57

When is the atheroma simple?

Back 57

When the fat increases and some accumulates in the smooth muscle cells of the media and secrete collagen which casue a fibrous cap above the fatty area with a necrotic center.

Front 58

When is the atheroma complex?

Back 58

When in additional to the simple scenareo there is also one or more of the following;
1 calcium deposits
2 thrombus
3 bleeding
4 weakening of the lining and aneurysm (blood escapes)
5 disintegration of the layer

Front 59

Describe two complex atheromas

Back 59

A thrombus includes platelet, white cells, fibrous cap over endetheal cells, plaque layer.
A thrombus may or may not become an embollism.
An aneurysm is when the lining is sick and can balloon and tear and the blood can enter the tissue.

A rupture is when the layer is torn inside and the foam cells circulate in the blood.

Front 60

What are complications of atheroma?

Back 60

Atheroma can lead to ischemia or blockage and necrosis.
Ischemia- poor blood supply.
Infarction- necrosis of cells of tissue or organ due to decrease of 90% and above of venous blood supply, causing heart attack.
Necrosis due to protallitean enzymes who eat proteins.

Front 61

What are the processes which occur in heart muscle cells which suffer from ischemia?

Back 61

Decreased ATP and inability to contract

Front 62

At 30% blockage what treatment can help?

Back 62

A maakaf of plastic or vein can be inserted surgically or the heart may create its own collateral pathway.

Front 63

What is the difference between ischemia and hypoxia?

Back 63

In ischemia, there is lack of oxygen and nutrition. In hypoxia there is only lack of oxygen.

Front 64

What lower leg problems do diabetics have?

Back 64

Diabetics with artery blockage do not develep collateral arteries. Their tissues develop dead cells, necrotic foot and may need amputation.

Front 65

Why must a necrotic foot be amputated?

Back 65

The necrosis infection may develop and infect the entire body. Dead cells call to macrophages to eat and they damage and cause the necrosis to spread.

Front 66

What are the symptoms for arterial blockage?

Back 66

Depending on location, a blockage of over 70% will cause pain of ischemia in the chest, the lower limbs or stomach during stress. So we will see;
1. someone run and in great pain Angina Pectoris.
2. Someone walk and stop to breathe and seek relief from leg pain. Intermittent claudication.
3. stomach pain- bowel ischemia.

Front 67

What does ischemia in the brain do?

Back 67

Ischemia in the brain or Lacunae creates a hole in the tissue and if that area is resonsible for a certain function, it may be impaired.

Front 68

What does ischemia look like?

Back 68

Ischemia blockage appears white in the heart, kidney and spleen.
Ischemia blockage appears very red in the region next to the intestine or lung which takes its blood supply.

Front 69

Why did a heroin taker's palate develop a hole?

Back 69

The artery which supplied blood was blocked and a necrosis developed.