What happens in atherosclerosis?
Thinning, hardening, LOSS OF ELASTICITY.
Name some of the commonly affected arteries by atherosclerosis.
Elastic - Aorta, Carotid and Iliac. Muscular - Coronary, Popliteal.
Describe the three patterns of arteriosclerosis.
Atherosclerosis, Monckeberg sclerosis and Ateriolosclerosis.
Medial calcific stenosis. Calcium deposits found in the muscular portion of the arteries (MEDIA); in atherosclerosis the problem is related to the intima.
How is atherosclerosis brought about.
Initiated as a response to injury. Intimal thickening, Intra and extra cellular lipid accumilation, Chronic inflammation.
Modifiable risk factors of atherosclerosis.
Hyperlipidemia, Hypertension, CIgarette smoking, Diabetes, Elevated Homocysteine, Infections: Herpes, Chlamydia pnemoniae, Obesity, Sedentry lifetsyle, Stress.
Atherosclerosis is a disease of the ________.
Two major processes in plaque formation.
Intimal thickening (Smooth muscle cell proliferation and Extracellular matrix Synthesis), Lipid accumalation.
How a response to injury in a vessel would lead to atherosclerosis.
Injury to DYSFUNCTIONAL ENDOTHELIUM, Chronic Inflammatory response - increased permeability, leukocyte adhesion, Adhesion of blood monocytes, transformation into macrophages and foam cells, Accumilation of LDL followed by Oxidation, Migration of Smooth Muscle Cell from MEDIA to INTIMA, Proliferation of smooth muscle cell in intima, Excess production of ECM, Enhanced Lipid accumulation.
Chronic Consequences of Plaque formation.
Stenosis leading to Ischemia or turbulence, Rupture, Embolus formation.
What has to happen to get rid of plaques?
Lower LDL, Macrophages should ingest lipids and there should be a reversal of cholesterol transport.
What effect would the loss of elasticity of the artery in atherosclerosis have on blood pressure?
Increase Systolic blood pressure.
What consequences would the weakening of the arterial wall as a result of atherosclerosis have on the artery?
What would fatty streaks indicate about the type of cells present?
Describe the differences between a smooth and a stable plaque.
A vulnerable plaque will have a thinner fibrous cap, will be richer in lipids and have more extracellular matrix.
Progression of atherosclerosis.
How would an aortic aneurysm present in a patient?
A pulsating abdominal mass accompanied by abdominal pain.
Transient Ischemic Attacks - a mini strokecause by partial blockage of an artery.
Cerebral involvement of atherosclerosis.
Result in memory loss due to cerebral atrophy (chronic).
Atherosclerosis of celiac and mesenteric arteries.
Can cause ischemic entercolitis if more than one artery is affected but is uncommon due to collateral supply.
Acute - gangrenous necrosis,
Chronic - Ischemic entercolitis.
Atherosclerosis of the renal artery.
Can lead to renal hypertension, progressive ischemic atrophy of the kidney leading to renal failure (nephrosclerosis).
Caused by ischemia of the leg muscles during exercise.