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48 Cards in this Set
- Front
- Back
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What is ARTERIOSCLEROSIS?
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Hardening and thickening of the artery walls
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What are the 3 types of Arteriosclerosis?
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- Atherosclerosis
- Medial Calcification - Arteriolar Sclerosis |
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PIC OF?
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ATHEROSCLEROSIS
- often used interchangeably with arteriosclerosis - intimal atheromas (fibrous plaques) |
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PIC OF?
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MEDIAL SCLEROSIS
- calcification and often ossification of the muscular media * "Medial Calcification" * "Mönckeberg's Sclerosis" (age related change and usually doesn't cause probs) |
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PIC OF?
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HYPERPLASTIC ARTERIOLAR SCLEROSIS
- intimal thickening |
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PIC OF ?
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HYALINE ARTERIOLAR SCLEROSIS
- acellular thickening |
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What are the Non-Modifiable Atherosclerosis Risk Factors?
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- Age
- Sex - Genetics |
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What are the Major -Modifiable Atherosclerosis Risk Factors?
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- Smoking
- Diabetes - Hypertension - Hyperlipidemia |
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What are the Minor - Modifiable Atherosclerosis Risk Factors?
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- Obesity
- Lifestyle |
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What two events lead to the pathogenesis of Atherosclerosis?
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- Intimal (endothelial) Injury
- Inflammation |
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What is the blood vessel's PRIMARY response to injury?
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SMOOTH MUSCLE PROLIFERATION
- Endothelial cells are most important in vessel integrity and response to injury |
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PIC OF?
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FATTY STREAK
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PIC OF?
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ATHEROMATOUS PLAQUE
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PIC OF?
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ATHEROMATOUS PLAQUE
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PIC OF?
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COMPLICATED PLAQUE
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What are the four main atheroclerosis sites?
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- Aorta
- Coronary Artery - Politeal Artery - Internal Carotid Artery |
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What are some complications of atherosclerosis?
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- Calcification
- Thrombosis - Embolism - Hemorrhage - Ulceration - Rupture - Aneurysm |
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List four clinical effects of atherosclerosis?
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- Arterial Narrowing
- Thrombosis - Embolism - Aneurysm |
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PIC OF?
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ARTERIAL NARROWING
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What is a blood clot formed at the site you find it ?
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THROMBUS
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What is THROMBOSIS?
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* ACUTE CHANGE IN PLAQUE
- erosion, ulceration, hemorrhage, rupture -Small to medium sized vessels * Typically in the setting of a VULNERABLE PLAQUE - THIN, FIBROUS CAP - Moderate luminal narrowing - Lipid Rich Center |
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What is a blood clot formed somewhere else and traveled to another site through vasculature?
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EMBOLUS
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How does an embolism occur?
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Initiated by rupture or erosion of plaque
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Most embolisms come from the aorta. Where would they travel to ?
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Travel to organs or lower limbs (cause dry gangrene on lower limbs)
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If the embolism were from the carotid, what would be noted on a phyical exam and what would it cause?
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- Carotid Bruit on Physical exam (atheroma)
- Result in Stroke |
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What would an arterial embolus lead to?
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- Stroke
- Heart Attack - Gangrene |
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What would a venous embolus lead to?
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- Pulmonary Embolism
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What is the pathophysiology of an ANEURYSM?
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Weakening of the vessel wall leading to dilatation or rupture
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TYPES OF ANEURYSMS
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- Saccular
- Fusiform - Dissecting ( Mycotic, Syphilitic) |
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DISSECTION vs FALSE ANEURYSM
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What are the most common aneurysms?
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- ABDOMINAL AORTIC ANEURYSM (AAA)
- AORTIC DISECTION - Cerebral Berry Aneurysm - Syphilitic Aneurysm - Mycotic Aneurysm |
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An AAA is due to what pathology?
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* ATHEROSCLEROSIS
* TRUE FUSIFORM ANEURYSM - abdominal aorta below the renal arteries - can extend into iliac arteries - usually over age 60 - Men > Women - Clinically significant when > 5cm in diameter |
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What is the Clinical Presentation of AAA?
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* PULSATILE ABDOMINAL MASS
- sudden death from rupture (leads to insanguination and hemodynamic collapse) - Tx by placement of aortic graft |
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What are the twp causes of Aortic Dissection?
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- Hypertensive / Atheroscleotic
- Gentic (Marfan Syndrome) |
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Where does the dissection usually start?
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Arch of aorta or aortic root
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Histological description of aortic dissection
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* CYSTIC MEDIAL DEGENERATION
- myxomatous degeneration of the aortic wall - fragments elastic fibers - weakens tunica media |
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What are the classic symptoms of aortic dissection?
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* SUDDEN ONSET of excruciating chest pain
- may radiate to the middle of the back |
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What are the classic X-ray findings of aortic dissection?
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- WIDENING OF THE MEDIASTINUM
(due to mediastinal hemorrhage) |
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What is the pathophysiology of Cerebral Berry Aneurysm?
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Congenital weakening of vessel wall ( not Atherosclerotic)
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Where does a Congenital Berry Aneurysm (CBA) occur?
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Branch points in Circle of Willis
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What are the clinical signs of rupture in a CBA?
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- sudden onset of excrutiating headache
- sudden loss of consciousness (rupture results in subarachnoid hemorrhage and intraparenchymal hematoma) |
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What causes Syphilitic (Luetic) Aneurysm?
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Tertiary Syphilis (not atherosclerosis)
- Treponema infects vasa vasorum resulting in linear calcification of elastic lamina |
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What is the pathophysiological result of Syphilic Aneurysm?
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- Dilatation of aortic valvular ring and ascending aorta
- Aortic insufficiency |
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What causes Mycotic Aneurysm?
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- Bacterial or fungal infection of blood vessel
- not syphilis and not atherosclerotic |
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What are varicose veins and what causes them?
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- Tortuous dilation of lower extremity veins
- Secondary to increased venous pressure ( standing for long periods, pregnancy) *LOW RISK OF VENOUS THROMBOSIS |
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What two illnesses result in deep vein thrombosis?
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- THROMBOPHLEBITIS (inflammation)
- PHLEBOTHROMBOSIS (no inflammation) - usually deep vein of lower extremities but also pelvic, prostatic and dural sinuses - hypercoagulable states can predispose |
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What is the major complication of Thrombophlebitis / Phlebothrombosis?
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PULMONARY EMBOLUS
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What is Superior / Inferior Vena Cava Syndrome?
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Obstrution of vena cava usually due to neoplasm (lung, liver)
- symptoms relate to area of obstruction |
