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blood vessels Flashcards

1
Q

what is the number one cause of morbidity and mortality in the US?

A

atherosclerosis

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2
Q

what are the two mechanisms of a vascular disease

A

narrow/obstruct the lumen or weakening of the walls.

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3
Q

are normal vascular structures similar or different throughout the cardiovascular system?

A

similar

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4
Q

the tunica intima is separate from the tunica media by what structure ?

A

internal elastic lamina

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5
Q

the tunica media is separated from the tunica adventitia via what structure?

A

external elastic lamina

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6
Q

Interior: the tunica intima and the inner half of the tunica media get their blood supply via what?

A

diffusion from the lumen

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7
Q

Exterior: the outer half of the tunica media and the tunica adventitia is supplied by what?

A

Vasa vasorum

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8
Q

in a muscular artery the tunica media will be___?

A

enlarged

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9
Q

in veins the tunica media will be_____?

A

smaller than arteries

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10
Q

is it possible that ALL vessels can spread disease ?

A

Yes

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11
Q

what type of cells line all blood vessels?

A

endothelial cells

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12
Q

what is the special thing that endothelia cells do?

A

they provide a non-thrombogenic interface

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13
Q

what does the non thromogenic interface do?

A

makes sure clots do not form!!!!! modulates inflammation and regulates vasoreactivity and cell growth

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14
Q

what is it called when a vessel becomes pro-inflammatory?

A

Endothelial activation

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15
Q

what can cause endothelial activation?

A

Atherosclerosis, Hypertension, diabetes. thrombosis.

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16
Q

are most vascular anomalies symptomatic or asymptomatic

A

asymptomatic

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17
Q

what are the three main vascular anomalies

A

berry aneurysm, arteriovenous fistula, fibromusclar dysplasia

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18
Q

which type of vascular anomaly is prone to rupture ?

A

berry aneurysm (CNS)

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19
Q

Are berry aneurysms lethal?

A

they can be! subarachnoid hemorrhage

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20
Q

what is a arteriovenous fistular?

A

A large artery inappropiately connects to a vein

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21
Q

an AV fistula bypasses (skips) what?

A

the capillaries

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22
Q

local thickening of arterial walls can lead to what?

A

fibromuscular dysplasia

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23
Q

Fibromuscular dysplasia is most common in who?

A

woman

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24
Q

Fibromuscular dysplasia can lead to what?

A

Renovascular Hypertension

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25
Q

what numbers indicate hypotension?

A
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26
Q

what numbers indicate hypertension ?

A

> or = to 140/90

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27
Q

what are the two main things that regulate blood pressure?

A

cardiac output and peripheral vascular resistance

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28
Q

an increase in BP stimulates what?

A

Atrial natriuretic peptide (ANP)

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29
Q

what does Atrial natriuretic peptide do?

A

increase diuresis (reduces around of sodium reabsorption)

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30
Q

What does atrial ANP do to the blood vessel?

A

vasodilation

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31
Q

a drop in blood pressure stimulates what?

A

renin-angiotensin system

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32
Q

The renin angiotensin system (low BP) does what do the blood vessel

A

vasoconstriction

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33
Q

what kind of medication is used to reduce blood pressure?

A

Diuretic meds “water pills”, ace inhibitors, Angiotensin 2 receptor blockers

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34
Q

a hypertensive emergency is also called what?

A

malignant hypertension

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35
Q

What are the numbers for malignant hypertension

A

> 180 systolic OR >120 DBP

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36
Q

without treatment of hypertension (HTN) what will happen

A

50% die of myocardial infarction or CHF

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37
Q

in those with untreated hypertension that don’t die of ischemic heart disease what can happen to them?

A

1/3 die of stroke

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38
Q

what is known as the silent killer and why is it called that?

A

hypertension. because it is typically asymptomatic

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39
Q

what percent of adults have HTN?

A

25%

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40
Q

what type of damage do we see with HTN? and what are some examples?

A

END organ damage (heart kidneys, brain, eyes)

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41
Q

HTN puts you act risk for what things?

A

renal failure, CAD, vascular dementia, MI, stroke, CHF

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42
Q

most cases (%?) of HTN are called what?

A

Essential hypertension (95%)

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43
Q

in malignant hypertension how can we diagnose this early ?

A

papilledema, retinal hemorrhage

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44
Q

in malignant hypertension how can we diagnose it late?

A

renal failure, stroke

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45
Q

when a vessel wall is injured what happens? which leads to what?

A

irreversible intimal thickening (leading to stenosis)

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46
Q

what type of arteriolosclerosis is associated with benign hypertension or from diabetes?

A

Hyaline arteriolosclerosis

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47
Q

what type of arteriolosclerosis is associated with Severe (malignant) HTN?

A

Hyperplastic arteriolosclerosis

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48
Q

what is classic sign of hyper plastic arteriolosclerosis?

A

onion skinning

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49
Q

what type of arteriosclerosis is associated with Ca++ being deported into media but not causing stenosis?

A

Monckeberg Medial sclerosis

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50
Q

Is monckebuerg medial sclerosis dangerous

A

NO

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51
Q

what type of arteriosclerosis has is caused by hypertension

A

arteriolosclerosis

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52
Q

what type if arteriosclerosis is most common?

A

atherosclerosis

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53
Q

what are the plaques called that cause atherosclerosis ?

A

atheroma

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54
Q

___%of arteriosclerosis is _____**?

A

99%, atherosclerosis

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55
Q

what type of cell is found in antheroms**?

A

foam cell (fat laden macrophage)

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56
Q

what is the 3 step process of anthreoms**?

A

protrude into lumen, prone to rupture (massive thrombosis), weakens tunica media (aneurism risk)

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57
Q

what % occlusion of coronary arteries = CAD?

A

70%

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58
Q

Atherosclerosis is accelerated by what two things?

A

Hemodynamic stress, hyperlipidemia

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59
Q

A weak vessel wall can lead to?

A

aneurysm

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60
Q

a ruptured plaque can lead to?

A

thromboembolism

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61
Q

what is metabolic syndrome centered around?

A

Central obesity

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62
Q

metabolic syndrome puts you at risk for what?

A

cardiovascular disease

63
Q

What are the THREE major risks for M.I.?

A

Hyperlipidemia, HTN, smoking, (any 2= 4x risk, all 3 = 7x

64
Q

what is the most common point of atherosclerosis ?

A

Branch or turbulent points

65
Q

what is an aneurysm?

A

local areal dilation/ballooning of a vessel wall

66
Q

What is a true aneurysm?

A

dilation of ALL 3 layers of vessel wall?

67
Q

what is a false aneurysm ?

A

isolated defect in a vascular wall, produces an extravasular hematoma

68
Q

what are the 3 MC locations for an aneurysm?

A

abdominal aorta, silica arteries, aortic arch

69
Q

what are risk factors for aneurysms?

A

HTN, infection, syphilis, marfa, ehlers-danlos

70
Q

what is an AAA

A

less than or equal to 50% dilation of normal abdominal aorta size

71
Q

what are the normal and AAA measurements?

A

normal 3, abnormal 5

72
Q

what two arteries is AAA usually found?

A

renal and common silica arteries

73
Q

is an AAA and contraindication to adjusting?

A

yes

74
Q

an AAA of 4-5 is what percent increase of rupture?

A

1%

75
Q

an AAA of 5-6 is at what percent increase of rupture?

A

11%

76
Q

an AAA

A

25%

77
Q

what percent of ruptured AAAs are fatal?

A

50%

78
Q

what is an aortic Dissection?

A

blood splays apart the laminar planes on the media to form a blood filled channel

79
Q

what is the major risk factor for aortic dissection?

A

HTN

80
Q

directions are usually common is 40-60 year old males, but what young people are at risk?

A

people with CT disorders (marinas, ehlers-danlos, Wilson’s

81
Q

what is pericardial tamponade?

A

fluid accumulates in pericardium

82
Q

the filling of the pericardium produces____and is called?

A

heart failure, pericardial tamponade

83
Q

A sudden and sever stabbing or tearing on the anterior chest and between the shoulder blades is a symptom of what?

A

aortic dissections

84
Q

Where is a Type A aortic dissection located?

A

ascending aorta

85
Q

where is a type B aortic dissection?

A

distal to the LT. subclavian artery

86
Q

where type of aortic dissection is most common and most severe?

A

Type A

87
Q

What is vasculitis?

A

inflammation of the vessel wall

88
Q

what can cause infections vasculitis(vascular invasion) ?

A

Hep B, syphilis

89
Q

what can cause immune mediated vasculitis ( type III hypersensitivity) ?

A

lupus, PAN, ADRs

90
Q

what is another name for temporal arteritis ?

A

Giant Cell Arteritis

91
Q

what is the most common cause of vasculits in the elderly?

A

Temporal (giant cell) arteritis

92
Q

What are some symptoms of temporal arteritis ?

A

facial pain, HA, diplopia

93
Q

what vessel is most commonly effected in temporal arteritis

A

Ophthalmic

94
Q

What is system wide vasculitis?

A

polyarteritis nodosa

95
Q

what type of arteries does polyarteritis nods effect?

A

small to medium

96
Q

where are the most common locations for polyarteritis nodosa?

A

kidneys, heart, liver, G.I.

97
Q

what arteries does polyarteritis nodosa spare?

A

pulmonary

98
Q

what is another name for Takayasu arteritis?

A

pulseless disease

99
Q

what is takayasu arteritis?

A

Autoimmune, narrowing of the aortic arch (and branches)

100
Q

what is a sign of Takayasu arteritis ?

A

lowers pulse in radial and carotid arteries

101
Q

which type or vasculitis is deadly if untreated?

A

polyarteritis nodosa

102
Q

what disease is a pediatric vasculitis ?

A

Kawasaki disease

103
Q

80% of people with kawasaki disease are what age?

A

Less than 4

104
Q

what is the hallmark of kawasaki disease?

A

acute persistent server, with no response to ibuprofen or acetaminophen

105
Q

what is the most common cause pediatric CAD

A

kawasaki disease

106
Q

what are the two classic signs of kawasaki disease

A

cervical lymphadenopathy, STRAWBERRY TONGUE

107
Q

what is another name for Thromboangiitis Obliterans?

A

burger disease

108
Q

what is Thromboangiitis obliterans?

A

vasculitis due do heavy tobacco smokers

109
Q

where on the body do we see severe inflammation in patients with Buerger disease

A

Hands and feet

110
Q

what is a symptom on buerger disease

A

cyanosis(cold) painful extremities

111
Q

what geen is mutated in Wilsons disease ?

A

ATP7B

112
Q

What is abnormal in Wilson’s disease?

A

Abnormal copper ion transpiration

113
Q

what is Reye Syndrome ?

A

idiopathic swelling of the liver and brain

114
Q

Rene syndrom develops after exposure to what 2 things

A

Aspirin, Viral infection

115
Q

Rene sydrom is most common in____?

A

pediatric patiens (4-12)

116
Q

What is Ranaud phenomenon ?

A

Exaggerated arteriole vasoconstriction

117
Q

Raynaud phenomenon is possible in what disease?

A

Thromboangiitis obliterans

118
Q

Raynaud phenomenon is most common in who?

A

adoecent young females

119
Q

What are the symptoms of Raynaud phenomenon?

A

Pallor and Cyanosis

120
Q

what are the other names for Takotsubo Cardiomyopathy ?

A

broken heart syndrome and stress induced cardiomyopathy

121
Q

what is Takotsubo Cardiomyopathy?

A

heart condition, following extreme physiological stress

122
Q

in broken heart syndrome there is a surge of_____?

A

catecholamines

123
Q

what are the two causes of takotsubo cardiomyopathy?

A

coronary artery vasospasm, increased HR and contractility

124
Q

what 3 things make up 90% of all vein disease?

A

varicose veins, Phlebothrombosis, Thrombophlebitis

125
Q

Which vein disease has no previous inflammation?

A

Phlebothrombosis

126
Q

When superficial veins are dilated and TORTUOUS what is this called?

A

Varicose veins

127
Q

What is the cause of Varicose veins?

A

increased intraluminal pressure

128
Q

Varicose veins are most common in men or woman?

A

woman

129
Q

Most Thrombophlebitis are what?

A

deep vein thrombosis (>90%)

130
Q

does thrombophlebitis produce cyanosis or erythema (redness) ?

A

Either or

131
Q

what is lymphedema?

A

lymphatic obstruction

132
Q

what is a cause of primary lymphedema (RARE)?

A

Milroy disease

133
Q

what is the cause of secondary lymphedema?

A

something causes an obstruction of lymph vessels

134
Q

Congested UE veins means you have what?

A

superior vena cava syndrome

135
Q

congested LE veins means you have what?

A

inferior vena cava syndrome

136
Q

what is lymphangitis?

A

acute inflammation of a lymph channel

137
Q

what is the most common cause of lymphangitis ?

A

bacterial infection

138
Q

A painful red streak down the arm is a symptom of what ?

A

Lymphangitis

139
Q

what do vascular tumors develop from?

A

Endothelial cells, CT

140
Q

are more vascular tumors benign or cancerous?

A

benign

141
Q

what are most benign vascular tumors

A

Hemangioma

142
Q

what percent of hemangioma self resolve by age 7?

A

75-95%

143
Q

what disease is a malignancy of lymphatic endothelia?

A

Karposi Carcoma Herpesvirus

144
Q

what # herpes virus is Kaposi Sarcoma?

A

HHV-8

145
Q

Kaposi sarcoma is a ______ defining disease

A

AIDS

146
Q

What are the colors of the macules of Koposi Sarcoma?

A

“purpura”

147
Q

what is a malignancy of vascular endothelia ?

A

angiosarcoma

148
Q

which is more aggressive Kaposi sarcoma or anigosarcoma?

A

Kaposi sarcoma

149
Q

If you have a history of PVC or arsenic exposure what can you develop?

A

hepatic angiosarcoma

150
Q

which type of angiocarcoma is more agessive and wide spread with a poor prognosis ?

A

Anaplastic

151
Q

90% of all CAD surgeries involve what?

A

endovascular stenting

152
Q

what type of meds do you need to take if you have a stent ?

A

antithrombotic medication

153
Q

what works best for a vascular graph ?

A

Internal MAmmary artery

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