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BHP Exam 2 > Cardiovascular 1 > Flashcards

Cardiovascular 1 Flashcards

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1
Q

3 layers of a muscular artery?

A

intima, media, adventitia

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2
Q

What is the term describing the thickening and hardening of arterial walls?

A

Arteriosclerosis

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3
Q

Does arteriosclerosis imply a cause?

A

no

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4
Q

Arteriosclerosis effects on:arterial lumen
blood flow
elasticity

A

lumen narrowerblood flow and elasticity decreased

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5
Q

Arteriolosclerosis affects what?

A

Small arteries and arterioles, esp. kidneys

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6
Q

Arteriolosclerosis - what kinds of changes to walls?

A

Hyaline thickening & hardening, proliferation

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7
Q

Arteriolosclerosis - condition of wall?

A

Wall usually completely effaced, destruction of SMC layer

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8
Q

Arteriolosclerosis - most frequently caused by?

A

systemic hypertension or diabetes mellitus

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9
Q

Atherosclerosis - affects what vessels

A

large and medium arteries, NOT veins

small arteries show signs of arteriosclerosis from hypertension

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10
Q

Atherosclerosis begins with damage to…Then leads to…

A

tunica intimadamage, thickening and hardening of tunica media

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11
Q

Most common cause of arteriosclerosis of medium and large-sized arteries

A

atherosclerosis

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12
Q

Atherosclerosis increases risk of (2)

A

thrombus formation, aneurysm

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13
Q

Atheroma is what? Found where?

A

Fibrous, lipid-rich plaques in intima of high-pressure arteries

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14
Q

Atheromas especially found in what vessels (6)

A 
Coronary
Carotid
Circle of Willis
Legs (large vessels)
Renal
Mesenteric
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15
Q

Where are atheroma NEVER found unless in hypertension?

A

Pulmonary arteries

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16
Q

Atheroma composition - 2 layers, 4 things in each layer?

A 
Central core:1. cholesterol
2. foam cells (macrophages)
3. Calcium
4. necrotic debris
Subendothelial fibrous cap
1. SMCs
2. foam cells
3. Fibrin
4. ECM
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17
Q

What is a fatty streak?

A

focal accumulation of foam cells in intima

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18
Q

Fatty streaks appear as early as…

A

first year of life

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19
Q

Atheroma formation steps (4)

A
  1. foam cells accumulate
  2. myofibroblasts proliferate and secrete collagen –> plaque now fibrotic and under pressure
  3. fibrous cap forms
  4. collagenization of media
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20
Q

Consequences of atheromas (6)

A
  1. Restrict blood flow
  2. Hemorrhage
  3. Calcification
  4. Thrombus/embolization
  5. Ulceration
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21
Q

Consequences of atherosclerosis

A
  1. ischemic heart disease/MI
  2. ischemic renal disease
  3. ischemic bowel disease
  4. thrombus/stroke/peripheral vascular disease
  5. aneurysm
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22
Q

Risk factors for atherosclerosis

A
  1. age
  2. male or menopausal women
  3. Familial
  4. high cholesterol
  5. htn
  6. diabetes
  7. smoking
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23
Q

Normal ratio of Total/HDL cholesterol?LDL/HDL?

A

Total/HDL

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24
Q

How does HDL “protect” against atherosclerosis

A

removes cholesterol from tissues and plaques

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25
What is the primary event leading to pathogenesis of atherosclerosis?
chronic, low-grade injury or dysfunction of arterial endothelium
26
Response to injury triggering atherosclerosis can be due to (6)
1. hypercholesterolemia 2. mechanical injury 3. hypertension 4. immune mechanisms 5. toxins 6. viruses
27
What happens after the initial primary event in athersclerosis (reaction to injury)?
Entry of monocytes and lipids into subendothelium--> mitogenic factors released --> proliferation
28
Definition of aneurysm
abnormal focal dilation of artery or vein
29
Main complications of aneurysms
1. erode adjacent structures 2. rupture 3. predisposition to thrombosis
30
Atherosclerotic aneurysm most common site?
abdominal aorta
31
Berry aneurysm found where?
cerebral arteries
32
Berry aneurysm cause? Related to atherosclerosis at all?
congenital defect in elastic lamina | NOT related
33
Berry aneurysm leads to
intracranial bleeding
34
Dissecting aneurysm is A?
longitudinal tear in intima that leads to a second arterial lumen, NOT a true aneurysm
35
Dissecting aneurysm most commonly in...
aorta
36
Predisposing factors of dissecting aneurysm
1. Hypertension2. medial mucoid degeneration (marfan & ehlers-danlos syndromes)3. atherosclerosis4. instrumentation of artery
37
Dissecting aneurysm sign?
tearing chest pain radiating through to back
38
If a dissecting aneurysm ruptures, what 3 things might happen?External rupture...Retrograde spread...Internal rupture...
External rupture...massive fatal hemorrhage into thoracic Retrograde spread...fatal hemopericardium Internal rupture...double-channeled aorta
39
Hypertension is when diastolic BP is below
90mmHg
40
Htn can be benign when...
stable increase
41
Htn is malignant when...
severe elevation over short period of time
42
What is primary hypertension?
aka essential. Elevation of BP over age
43
Determinants of primary Htn (7)
(1) genetics - African (3) diet - obesity, sodium, alcohol (3) lifestyle - inactivity, smoking, stress
44
Primary htn can predispose to...
ischemic heart diseasestroke
45
Primary htn will lead to what if left untreated (3)
retinal changesleft ventricular hypertrophy & heart failurebenign nephrosclerosis
46
Secondary htn means it is due to..
OTHER CAUSES
47
Most common cause of secondary htn?
renal disease
48
Benign type hypertension leads to what changes in vessels?
Wall thickening, lumen thinning tissue ischemiabrain vessel fragility hemorrhage
49
Malignant htn leads to (3)
destructive changes & proliferative response in intima cessation of blood flow through small vessels foci of tissue necrosis
50
Malignant htn results in...
death through CHF, CVA, kidney failure
51
Malignant htn % cases of htn
5%
52
Htn pathology in brain?
rupture & microinfarcts/hypertensive lacunae
53
Htn pathology in heart?
left ventricular hypertrophy & failure
54
Htn pathology in kidney?
arteriosclerosis --> leads to progressive destruction of nephrons --> renal failure, benign hypertensive nephrosclerosis
55
Htn pathology in aorta
severe atherosclerosis, abdominal and dissecting aortic aneurysms
56
pulmonary arterial htn is a consequence of what?
Raised left atrial/ventricular pressure due to inadequate emptying of left heart, OR dstructino of lung capillary bed
57
pulmonary arterial htn underlying cause?
from ischemic heart disease, aortic or mitral valve stenosis (left heart emptying failure) emphysema, fibrosis of lungs (capillary destruction)
58
Vasculitis is what?
inflammation and damage to vessel wall
59
3 groups of vasculitis?
Small - wegener's, Churg Strauss, drug inducedMedium - polyarteritis nodosa, kawaski'slarge - takayasu, giant cell
60
Hypersensitivity vasculitis...type, cause?
immune complex, often because of drug allergy
61
Hypersensitivity vasculitis presents as what? mechanism?
skin rash due to antigen-antibody complex stuck in vessel walls promoting inflammation
62
Polyarteritis nodosa - destruction of what?
arterial media and internal elastic lamella --> aneurysmal nodules
63
Wegener's - vasculitis of vessels of what organs?
respiratory tract, kidneys, others
64
Wegener's - characterized by what type of damage?
necrotizing granulomatous vasculitis, fibrinoid necrosis
65
Buerger's disease - results in what?
Acute inflammatory occlusion of small to medium-sized arteries of upper and lower limbs
66
Buerger's disease related to what behavior?
heavy smoking
67
Buerger's disease patients succumb to what?
peripheral vascular insufficiency
68
Varicose veins - presentation?
persistent, distended, and tortuous superficial veins in lower limbs
69
Varicose veins due to what?
valve incompetence allow them to fill due to gravity
70
Varicose veins predisposed by?
increased venous pressure
71
Esophageal varices - what are they?
distended venous channels that develop in portal hypertension secondary to cirrhosis of liver
72
Venous thrombosis aka?
phlebothrombosis
73
Venous thrombosis arises most often where?
deep veins of lower extremities
74
Venous thrombosis predisposed by?
venous circulatory state or partially obstructed venous return
75
Kaposi's sarcoma 3 stages
patch, plaque, nodule
76
Kaposi's sarcoma - causative agent?
HSV8

BHP Exam 2 (6 decks)

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