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53 Cards in this Set
- Front
- Back
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What does ARTERIOsclerosis mean?
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hardening of arteries with loss of elasticity
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What are the three types of arteriosclerosis?
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1. Monkelberg Medial Calcific Sclerosis
2. Atherosclerosis - #1 cause of death in West 3. Arteriolosclerosis |
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Which type is the best to have? Why?
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Monkelberg medial calcific sclerosis
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What are some examples of medium sized arteries?
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radial and ulnar
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What is monkelburg's medial calcific sclerosis?
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It is when you patches of calcium within the muscular media.
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What vessels does Monkelburg's happen to?
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The medium sized arteries (aka muscular or distributive)
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Why is it the best?
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Because these lesions happen in the media where they won't disturb the endothelial cells and aren't prone to rupture.
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Who is most likely to get Monelkburg's arteriosclerosis? And where?
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Men older than 50 and in their radial and ulner arteries (muscular!)
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What may you do to find Monkelburg's when examining a patient?
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You feel their arm for very stiff, hard vessels.
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How can you be sure this isn't just the blood vessels ballooning up or something?
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If you occlude the brachial artery, it is still there.
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Would your blood flow be diminished in Monkelburg's? Why?
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No because it is in the media and non occluding.
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What do Monkelburg's cacifications look like on an arm CT?
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They have a pipestem appearance cause they can usually stretch for a while and overlap. Basically the vessels look like bones.
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Pic of Monckeberg's medial calcific sclerosis! (radiology)
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Histological pic of Monckeberg's!
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Why is mnkeburg an arteriosclerosis?
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It is literally a hardening of the arteries.
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What other vessels are Monckeburg's found in?
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Some of the leg arteries as well.
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What are some difference between atherosclerosis and Monckeburg's in body part location? (not layers)
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Atherosclerosis usually spares the upper limb arteries even though it affects muscular arteries.
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What are some difference between atherosclerosis and Monckeburg's in composition, layer affected, and morbidity>
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Atherosclerosis is fibrofatty, affects the intima, and has high morbidity.
Monckeburg's is calcific, affects the media, and doesn't cause any morbidity. |
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What percent of people in the western world will die of atherosclerosis related complication?
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50%
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Which types of arteries does atherosclerosis affect?
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elastic and medium sized arteries
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What are some examples of elastic artereies?
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aorta, carotid arteries, and iliac arteries
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What are some examples of medium sized muscular arteries?
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coronary arteries, circle of willis, and popliteal arteries
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from intima outward, name all the layers of the medium sized artery.
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endothelial, BM, internal elastic lamina, media/SM, external elastic lamina, adventitia
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Where does the plaque grow into?
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Both the lumen and the media.
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How can a plaque in the intima affect the media layer?
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It can lead to degeneration over time as it pushes into it's space.
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In smaller vessels with atherosclerosis, what happens?
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They become occluded since they are not very wide.
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In larger vessels with atherosclerosis, what happens?
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They are too large to occlude so they end up with long term modifications like the one described before and weaken and balloon out from the pressure.
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So what is the main complication with atherosclerosis of medium sized vessels?
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Aneurysm
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How come some of the elastic arteries (arch of aorta) aren't as prone to aneurysm from atherosclerosis? What is the aneurysm threat to the aortic arch?
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Because they have vaso vasorum giving them an alternate blood supply.
They are threatened by tertiary syphillis or something that inflames and closes off their vaso vasorum. |
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Which vessels most frequently get atherosclerosis? (5) (most common on top)
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1. Abdominal aorta
2. Coronary arteries 3. Popliteal arteries 4. Carotid arteries 5. Circle of Willis |
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What is arteriolosclerosis?
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hardening of the arterioles
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What are the two types of arteriosclerosis?
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1. Hyaline arteriolosclerosis
2. Hyperplastic arteriolosclerosis |
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Show a picture comparing normal to hyaline to hyperplastic.
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Is there adventitia in the arterioles?
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Yes!
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What layer does the hyaline arteriolosclerosis deposited?
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In the media
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What is deposited?
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There is protein there
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What does this look like on a slide?
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Since protein is pink, it looks like a big, solid, thick layer around the vessel.
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What is the pathological danger of hyaline arteriolosclerosis?
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The protein induces the SM cells to proliferate/secrete more ECM more and you can get a narrowing of the lumen this way. (esp cause these are small vessels)
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When is hyaline arteriolosclerosis normal to be seen in a person?
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If they are very old
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What two pathoiogies usually produce hyaline arteriolosclerosis?
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essential HTN and diabetes (most important)
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How do diabetes get hyaline arteriolosclerosis?
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Sugars make their way under the endothelium and glycosylate proteins or damage cell machinery and make the BM leaky. These glycosylated proteins induce the SM to lay down ECM, hence the thick layer.
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How does HTN cause hyaline arteriolosclerosis?
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They use brute force to push the proteins in and damage the endothelial cells.
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How can you tell if kidney hyaline arteriolosclerosis came from HTN or DM?
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If both efferent and afferent are affected, it is DM because sugar is in both, but HTN is mostly in the afferent (you lose like 20 mmHg through the bowman's capsule)
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WHat happens in the kidney when there is too much hyalinization?
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They get benign nephrosclerosis
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What is benign nephrosclerosis?
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When parts of the kidney becomes ischemic due to hyaline arteriolosclerosis (always associated), they will start to harden and die.
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Why is this benign again?
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Because it is only focal loss downstream of the arteriole and the kidneys can grow elsewhere to make up for it.
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Show me a picture!
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What pathology causes hyperplastic arteriolosclerosis?
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malignant HTN
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What clinical findings do you have to have in order to count as having malignant HTN?
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diastolic BP over 120 WITH hemorrhagic lesions in the retina (may or may not have papiledema)
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What is the histological morphology of hyperplastic arteriolosclerosis?
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The media SM have undergone concentric hyperplasia, hypertrophy with an onion skin and doubling of the BM.
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How is this different than hyaline?
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Hyaline is comosed of ECM secreted by the SM and doesn't look flakey.
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Which arteriolosclerosis involves necrosis of the tunica media?
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The hyperplastic one
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How do you remember that diabetes causes the BM to become leaky? (initial signs of the disease)
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It does the same thing to the glomerulus, which is why you have microalbuminurea as one of the first signs of DM.
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