Chapter 8 Blood vessel disorders

Question 1

B/n arteries and veins which is more subject to disease?

Answer 1

Arteries because they contain much higher pressure than veins

Question 2

Blood pressure

Answer 2

a product of cardiac output & vascular resistance

Question 3

Which organ plays a major role in Blood Pressure?

Answer 3

○ Kidneys
If pressure falls, blood vessels constrict, including those of the kidney

Question 4

Atherosclerosis: Determinants

Answer 4

○ begins in the crib and progresses with age
○ begins with vascular endothelial cell damage and associated inflammation
accelerated by life-style

Question 5

Vascular disease is strongly associated with

Answer 5

○ Smoking
○ High blood pressure
○ Familial genetic influence

Question 6

Atherosclerosis

Answer 6

○ is a lifestyle disease related to smoking, lack of exercise, obesity, and a high-fat diet
○ Characterized by chronic inflammation, scarring, and cholesterol deposits in large and medium size arteries
○ accounts for about one third of the deaths in the industrialized world

Question 7

Arteriolosclerosis

Answer 7

○ a disease of small blood vessels that occurs mainly in patients with hypertension and diabetes
○ inflammation, scarring, and cholesterol are not significant factors
○ kidneys, retina, and small vessels in the legs and feet are most often affected

Question 8

Two types of arteriolosclerosis

Answer 8

Hyaline arteriolosclerosis & Hyperplastic arteriolosclerosis

Question 9

Hyaline arteriolosclerosis

Answer 9

○ a homogenous thickening of arteriolar walls
○ is an inevitable part of the aging process
○ it is accentuated by hypertension and diabetes
○ detected in the afferent arterioles

Question 10

Hyperplastic arteriolosclerosis

Answer 10

○ hyperplasia of cells in arteriolar walls, mainly
○ seen in the kidneys in very severe (malignant) hypertension
○ Malignant hypertension is very high blood pressure that comes on suddenly and quickly

Question 11

Atheroma

Answer 11

○ the basic lesion of atherosclerosis
○ Tend to obstruct arterial blood flow and cause hypoxia of downstream tissue (ischemia)
○ Weaken the arterial wall
○ Cause dilation and possible aneurysm
Takes decades before they become symptomatic

Question 12

the initial and most crucial lesion in the pathogenesis of atherosclerosis

Answer 12

Endothelial cell damage

Question 13

Which is an important element in the development of Atherosclerosis?

Answer 13

Cholesterol

Question 14

Which cell is important in the development of Atherosclerosis?

Answer 14

Arterial smooth muscle cells

Question 15

Risk Factors for Atherosclerosis

Answer 15

○ Age
○ Sex
○ Genetics
○ Cholesterol
○ Hypertension
○ Smoking
○ Diabetes
○ Homocysteine
○ C-reactive protein

Question 16

Optimal blood pressure

Answer 16

○ systolic 120 mm hg
○ diastolic 80 mm hg
○ or 120/80

Question 17

Normal BP

Answer 17

130/85

Question 18

Hypertension BP

Answer 18

systolic over 140 or diastolic over 90 mm hg

Question 19

Essential (primary) Hypertension

Answer 19

○ 90% of the hypertension
○ Cause unknown, however the kidney is the prime suspect

Question 20

Hypertension can do what with atherosclerosis?

Answer 20

initiate atherosclerosis or accelerate existing atherosclerosis

Question 21

Nephrosclerosis

Answer 21

normal wear and tear change that gradually increases with age

Question 22

Secondary hypertension may be caused by

Answer 22

○ Pheochromocytoma of the adrenal medulla
○ Tumor or hyperplasia of the adrenal cortex
○ Renal disease- disease of renal arteries that impairs renal blood flow

Question 23

Severe hypertension may cause

Answer 23

○ impaired vision subsequent to retinal disease
○ seizure when intracranial blood pressure (hypertensive encephalopathy), is increased

Question 24

Patients with significant nephrosclerosis may have

Answer 24

blood or protein in the urine and increased blood urea nitrogen (BUN) and creatinine

Question 25

Aneurysm

Answer 25

a weak area in the wall of a blood vessel that causes the blood vessel to bulge or balloon out

Question 26

cerebral aneurysm

Answer 26

When an aneurysm occurs in a blood vessel of the brain

Question 27

Dissecting hematoma

Answer 27

○ longitudinal tearing within the wall of an artery, most often the aorta ○ caused by blood that enters the wall through a defect in the lining

Question 28

LaPlace's Law

Answer 28

The larger the vessel radius, the larger the wall tension required to withstand a given internal fluid pressure

Question 29

Symptoms of cerebral aneurysm

Answer 29

○ "leak" a small amount of blood ○ severe headache that a patient may describe as "the worst headache of my life."

Question 30

Vasculitis

Answer 30

a general term that applies to a group of uncommon diseases that feature inflammation of blood vessels, especially arteries

Question 31

Necrotizing vasculitis

Answer 31

vasculitis with acute inflammation so intense that the vessel dies (necrosis)

Question 32

Polyarteritis nodosa

Answer 32

a distinctive clinical syndrome featuring autoimmune vasculitis of small to medium size vessels

Question 33

Takayasu arteritis

Answer 33

○ large vessel vasculitis ○ granulomatous inflammation in the aorta and main branches

Question 34

Temporal arteritis

Answer 34

○ AKA giant cell arteritis ○ chronic inflammation of the temporal and cranial arteries

Question 35

Thromboangiitis abliterans

Answer 35

○ affects small vessels in the hand and feet ○ Most common in young cigarette smokers ○ frequently leads to ulcers or gangrene of the fingers and toes

Question 36

Raynaud phenomenon

Answer 36

○ a common condition, usually of the hands and fingers ○ Small blood vessels exhibit exaggeration of normal vasoconstriction and vasodilation reactivity to cold or emotional stress ○ fingers blanches at the tip

Question 37

varicosity

Answer 37

○ abnormally dilated vein ○ Superficial veins are more often affected ○ Leg veins are most susceptible

Question 38

Hemorrhoids

Answer 38

○ varicose veins of the anus ○ drain into the portal system and be seen in conjunction with cirrhosis of the liver and portal venous hypertension

Question 39

lymphatics

Answer 39

Tumors of blood vessels

Question 40

Karposi sacroma

Answer 40

a malignant vascular tumor caused by an uncommon type of herpesvirus infection

Question 41

Angiosarcoma

Answer 41

a rare malignant tumor of vascular endothelial cells that can occur in almost any part of the body