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72 Cards in this Set

  • Front
  • Back
3 forms of arteriosclerosis
1. atherosclerosis
2. Monckeberg medial calcific sclerosis
3. arteriololsclerosis
The principal points of physiologic resistance to blood flow.
2 principal mechanisms of vasucular disease
1- narrowing or obstructing vessel
2- weakening of vessel walls
what are the 3 layer of blood vessels?
intima, media, adventitia
pathology affecting elastic and muscular arteries

(b/c of size range)
pathology affecting small muscular arteries and arterioles

(b/c of size range)
different types of vasculitis affect different _______
calibers of vessels
classification of coronary and renal arteries

(smooth muscle)
vasoconstriction and dilation occur in the _______ arteries
small arteries
blood flow in the small arteries is steady and ________
small arteries are < ____mm in diameter
Capillaries, which are approximately the diameter of a red blood cell (7 to 8 µm), have an endothelial cell lining but no ________.
In many types of inflammation, vascular leakage and leukocytic exudation occur preferentially in ______________.
postcapillary venules

(site of WBC migration)
____________ constitute an important pathway for disease dissemination through transport of bacteria and tumor cells to distant sites.
Among the diverse congenital vascular anomalies, two have importance: ____________ and ______.
1- developmental or berry aneurysms and
2- arteriovenous fistulas.
AV fistulas may cause ______-output heart failure.
a generic term for thickening and loss of elasticity of arterial walls:
a) atherosclerosis
b) arteriosclerosis
c) arteriolosclerosis
d) Monkeyberg medial calcific slerosis
3 types of arteriosclerosis
1 atherosclerosis
2 Monckeberg medial calcific sclerosis
3 arteriolosclerosis
The least clinically important arteriosclerosis type
Monckeberg medial calcific sclerosis
Arteriosclerosis found in muscular arteries of people over 50.
Moncheberg medial calcific sclerosis
2 types of arteriolosclerosis
hyaline and
hyperplastic arteriolosclerosis
type of arteriosclerosis assoc. with DM and HTN
hyaline arteriolosclerosis
cause of 50% of all death in US, Europe and Japan:
a) arteriosclerosis
b) atherosclerosis
c) arteriolosclerosis
d) Monkeyberg
Arteriolsclerosis - Zamam ("US, Europe, Japan")

Atherosclerosis - Robbins ("Western World")
Atherosclerosis is characterized by intimal lesions called _______
Arteriosclerosis results from an excessive ________ and proliferative response to various forms of injury to the endothelium and
smooth muscle of the arterial wall.
Factors thought important in Arteriosclerosis' pathogenesis include:
- changes in lipid metabolism,
• increased endothelial permeability to serum lipoprotein complexes,
• susceptibility of the intima to mechanical injury from flow turbulence at
major bifurcations,
• presence of hypertension, elastic tissue fragmentation and thrombosis or
disruption of vasa vasorum.
Surgical therapy is now commonplace for occlusive disease of the ________(3) arteries
coronary, carotid, and
Arteriosclerosis may present as an occlusive process
when the disease attacks the intima more rapidly than
the media and adventitia, but may present as an __________
when the reverse is true.
Arteriosclerosis may present as an ___________________
when the disease attacks the intima more rapidly than
the media and adventitia
occlusive process
Arteriosclerosis may present as an ______________
when the disease attacks the media and adventitia more rapidly than intima.
the ,
early human lesions begin at sites of ___________ endothelium.
morphologically intact

Thus, nondenuding endothelial dysfunction causing increased endothelial permeability, enhanced leukocyte adhesion, and alterations in expression of EC gene products is critical to the human disease.
Chronic or repetitive endothelial injury is the cornerstone of the "response to injury" hypothesis of arteriosclerosis.
Intimal plaques are composed of lipid deposits and
proliferated spindle cells made up of ______ and ________.
fibroblasts and smooth muscle cells
What is the stereotypic response to vascular injury?
The earliest changes, which are considered to be reversible, are
____________of the intima.
fatty dots and fatty streaks
Atheromatous plaques, the typical lesions of atherosclerosis, consist of an irreversibly altered softened central area filled with _____________and__________ surrounded by collagenous fibrous tissue
cholesterol crystals and cell debris
Atheromatous plaques aka
composed of lipid-filled foam cells, are not significantly raised and thus do not cause any disturbance in blood flow.
fatty streaks
Fatty streaks appear in the aortas of some children younger than 1 year of age and all children older than ______ years, regardless of geography, race, sex, or environment
large lipid-laden cells that derive predominantly from blood monocytes (tissue macrophages), but SMCs can also imbibe lipid to become them
Foam cells
The four major risk factors of atherosclerosis that can be modified
hyperlipidemia, hypertension, cigarette smoking, and diabetes.
Describe monocytes role in atheromas
Macrophages produce interleukin 1 and tumor necrosis factor, which increase adhesion of ________
Macrophages produce toxic oxygen species that also cause oxidation of the _____ in the lesions
Macrophages eat the oxidized LDL to become _____
foam cells
an age-related degenerative
process in which the media of large and medium-sized muscular arteries undergoes calcification.
Monckeberg medial
calcific sclerosis
Hypertension is associated with two forms of small
blood vessel disease:
1- Hyaline arteriolosclerosis
2- Hyperplastic arteriolosclerosis
Left: hyaline arteriolosclerosis

Right: hyperplastic arteriolosclerosis
What's this? What's the difference?
Describe hyaline arteriolosclerosis
The arteriolar wall is hyalinized and the lumen is markedly narrowed.
Describe hyperplastic arteriolosclerosis
(onion-skinning) causing luminal obliteration (arrow), with secondary ischemic changes, manifest by wrinkling of the glomerular capillary vessels at the upper left
characterized by narrowing of
the lumen of arterioles due to the concentric proliferation of smooth muscle cells in the vessel wall.
Hyperplastic arteriolosclerosis
Hyperplastic arteriolosclerosis is typically found in what conditions?
malignant hypertension,
progressive systemic
sclerosis (scleroderma),
chronic transplant rejection,
and after
The process of occlusion probably begins in the iliac
arteries near what landmark?
the aortic bifurcation
Thrombi and emboli can become secondarily infected by
what fungi?
particularly Aspergillus and Mucor.
Leriche's syndrome
The syndrome of distal aortic thrombosis
How does Leriche's syndrome manifest itself?
an insidious onset and gradual progression of symptoms of pain and easy fatigability in the legs, hips, and back;
intermittent claudication;
and sexual impotence,
absence of pulses below umbilicus
3 examples of arteries associated with some degree of fascial fixation.
1- ext. iliac artery behind inguinal ligament
2- superficial femoral artery (facial ring beneath adductor longus tendon)
3- anterior tibial artery (interosseous membrane)
Livedo reticularis
What are some complications of arterial occlusive disease?
Arterial embolism,
livedo reticularis,
gangrene of lower extremities, ocular symptoms, cerebral infarct, GI Bleeding, renal HTN and failure
What is livedo reticularis?
a vascular condition characterized by a purplish mottled discoloration of the skin, usually on the legs. This discoloration is described as lacy or net-like in appearance.
Livedo reticularis
In arterial occlusive disease, simulataneous embolism to various organs may lead to a mistaken clinical diagnosis of _________ (PAN)
polyarteritis nodosa
What is Polyarteritis nodosa?
is a rare autoimmune disease featuring spontaneous inflammation of the arteries (arteritis).
How do you diagnose Polyarteritis nodosa? (3 of 10 things)
1. Weight loss greater than/equal to 4 kg.
2. Livedo reticularis (a mottled purplish skin discoloration over the extremities or torso).
3. Testicular pain or tenderness. (occasionally, a site biopsied for diagnosis).
4. Muscle pain, weakness, or leg tenderness.
5. Nerve disease (either single or multiple).
6. Diastolic blood pressure greater than 90mmHg (high blood pressure).
7. Elevated kidney blood tests (BUN greater than 40 mg/dl or creatinine greater than 1.5 mg/dl).
8. Hepatitis B virus tests positive (for surface antigen or antibody).
9. Arteriogram (angiogram) showing the arteries that are dilated (aneurysms) or constricted by the blood vessel inflammation.
10. Biopsy of tissue showing the arteritis (typically inflamed arteries).
risk factors for atheroma
- Arterial hypertension
• Tobacco
• Heredity (familial hypercholesterolemia)
• Endocrine (DM, Postmenopausal, hypothyroidism
• Reduced physical activity
• Obesity
• Male
• Age
modifiable risk factors for atheroma
Hypertension, hyperlipidemia, DM, smoking, activity.
major risk factors for atheroma
Htn, hyperlipidemia, DM, smoking
minor risk factors for atheroma
Obesity, rich diet, physical inactivity, type A, stress.
the most important risk factors under age 45 for atheroma
Hyperlipidemia and especially hypercholesterolemia
Homozygotes for FH can die by what age?
Heterozygotes develop AS by what age?
What are the steps of the injury hypothesis of atherosclerosis