Flashcards in 11 Blood vessels Deck (11)
What are the consequences of atherosclerotic disease?
Acute plaque change
What are the types of acute plaque change?
Hemorrhage into the atheroma
What determines plaque stability?
Intrisinc factors: composition of plaque (foam cells, lipid), fibrous cap, inflammatory cells, expression of MMP and TIMPs
Extrinsic factors: statin use, systemic blood pressure, adrenergic tone, emotional stress, chronic inflammatory state
Contrast true aneurysms from false aneurysm.
True aneurysm arise from a dilation of the arterial or ventricular wall and include syphilitic, atherosclerotic and congenital vascular aneurysms. False aneurysms result from a defect in the vessel wall theat results to extravascular hematoma and includes post-MI ventricular rupture with pericardial enclosure, or suture leaks following vascular surgery.
By what mechanism do aneurysms arise?
Weakened vascular wall connective tissue (Marfan, EDS, Vit C)
Imbalance between collagen degradation and synthesis (inflammation, MMP and TIMP balance)
Loss of smooth muscle cells (ischemia by atherosclerosis)
Increased synthesis of non-muscular and non-elastic extracellular matrix (inflammation, atherosclerosis, hypertension)
What are diseases characterised by defective vascular wall connective tissue?
What are the consquences of AAA?
rupture with hemorrhage
obstruction of branch vessel
impeingement on adjacent structure
abdominal mass simulating tumour
What are predisposing factors to aortic dissection?
Connective tissue disorders (Marfans)
Iatrogenic - previous cannalisation
What are the major pathogenic mechanisms for vasculitis?
What are causes of secondary obstructive lymphedema?
lymph node dissection
post-inflammatory thrombosis and scarring