Chapter 9 Flashcards
(98 cards)
1
Q
common, disabling lethal disease #1 cause of morbidity and mortality in US
A
vascular disease
2
Q
vascular disease MC involves _______
2 types: NARROWING of ______ or WEAKENING of ________
A
arteries
lumen
vessel wall
3
Q
hardening of arteries; non-specific
A
arteriosclerosis
4
Q
dilation of vascular wall
A
aneurysm
5
Q
passage of blood through layers of wall
A
dissection
6
Q
blood clot in a vessel
A
thrombus
7
Q
hardening of arteries, atheroma
A
atherosclerosis
8
Q
dilation of vein
A
varicosity
9
Q
open interior of a vessel
A
lumen
10
Q
_____ is similar throughout cardiovascular system with 3 layers: ____, ____ & ______
A
vascular structure
intima
media
adventitia
11
Q
smooth muscle in CVS is
A
involuntary
non-striated
12
Q
intima is made of _______ and is the _____ layer
A
endothelia cells
deepest
13
Q
media is made of ______ and is the ______ layer
A
smooth muscles
middle
14
Q
adventitia is made of ______ and is the _____ layer
A
CT, nerves, vessels
superficial
15
Q
DIFFUSION of blood from lumen occurs in _____ part of vascular wall
A
interior
16
Q
_____ supplies the exterior vascular wall
A
vasa vasorum
17
Q
tunica media is _____ in arteries than veins
A
larger (why cadavers have thicker arteries)
18
Q
veins have ____ lumen and ____ walls; LOW pressure, leads to prone to dilation/compression
A
larger
thinner
19
Q
lympathic vessels have ___ walls lined with _____ to drain ISF
A
thin endothelia
20
Q
continuous lining of all vessels
non-thrombogenic interface
regulate vasoreactivity
A
endothelial cells
21
Q
pro-inflammatory; trauma upsets homeostasis
A
endothelial activation
22
Q
3 types of congenital anomalies
A
berry aneurysms
arteriovenous fistula (AVF)
fibromuscular dysplasia
23
Q
dilation of cerebral vessels that leads to subdural hemorrhage
A
berry aneurysm
24
Q
connection of arterial and venous systems, bypass capillaries
A
arteriovenous (AV) fistula
25
local thickening of medium/large artery walls thats leads to ischemia
may involve *KIDNEYS*
MC in adult females
fibromuscular dysplasia
26
kidneys detect decrease in blood supply --> INCREASE in Na absorption --> INCREASE in water retention --> INCREASE BP
renovascular HTN
27
#'s for hypotension, which leads to _____
90/60 (or less)
| decrease perfusion, dysfunction
28
#'s for hypertension, which leads to _____
140/80 (or more)
| atherosclerosis, hypertensive retinopathy
29
blood pressure regulation influences: ____ & ____
cardiac output
| vascular resistance
30
INCREASE BP --> ____ heart --> _____
| causes: _______ and ______
stretch
ANP
REDUCED sodium resorption
vasodilation
31
DECREASE BP --> ________
| causes: ____ & _____
renin-angiotensin system
sodium resorption
vasoconstriction
32
normal #'s BP
120/80
33
BP > 140/90
damages vessels and end-organs
ASYMPTOMATIC -"SILENT KILLER"
25% of US adults
hypertension
34
95% of hypertensions cases are _______ aka "ESSENTIAL HTN"
| risks: age, stress, obesity, smoking, inactivity
idiopathic
35
vascular wall response to injury:
1 endothelial injury/dysfxn
2 smooth muscle cel recruitment
3 growth of smooth muscle
4 irreversible intimal thickening (vessel stenosis)
36
benign HTN
| CHRONIC hemodynamic stress
hyaline arteriosclerosis
37
severe HTN
hyperplasia arteriosclerosis
38
hardening of arteries, decrease elasticity
arteriosclerosis
39
hardening of SMALL arteries, possible ISCHEMIC INJURY
arteriOLOsclerosis
40
Ca++ within arteries, no stenosis, NOT clinically significant
monckenberg medial sclerosis
41
```
MC type of arteriosclerosis
atheroma (plaque)
stenosis
rupture
thrombosis
```
atherosclerosis
42
99% of all arteriosclerosis is __________
atherosclerosis
43
atheromas:
1. protrude into ________, decrease flow, macrophages, lipids aka _________ , _____ debris and have a fibrous cap
2. prone to _____ plaque , --> massive THROMBOSIS
3. WEAKENS _______ --> risk for aneurysm
```
lumen
foam cells
Ca++
rupture
tunica media
```
44
70% of occlusion of coronary arteries lead to _______ (build of up atheromatous plaque)
CAD (coronary artery disease)
45
risks of atherosclerosis
family hx
age
males
GENETICS
46
MI (myocardial infarction) risks of atherosclerosis
- if you have 2 symptoms, ___ x MI risk
- if you have all 3 symptoms, ____ x MI risk
```
hyperlipidemia
HTN
smoking
4x
7x
```
47
central obesity, insulin resistance, HTN, hypercoagulability are all symptoms of _______; a modifiable part of atherosclerosis
metabolic syndrome
48
characteristics of TRUE aneurysms
all 3 layers of a vessel affected and heart wall
49
characteristics of FALSE aneurysms
defect in vascular wall
50
blood enters arterial wall, may lead to hematoma
DISSECTION
51
Abdominal Aortic Aneurysm (AAA) is a dilation of >___% of normal; and a surgical diameter > ___ cm
50%
| 5 cm
52
risks for AAA are
```
male
smokers
>50 y.o.
caucasian
facial history of AAA
atherosclerosis
HTN
```
53
____ may obstruct vessels branching off aorta, affects kidneys, legs, spinal cord, GI
*50% of ruptured ones are LETHAL*
4-5 cm: ___ % per year
>6 cm: _____ % per year
AAA
1
25
54
blood splays apart the laminar planes of the media to form a blood-filled channel inside aortic wall --> massive hemorrhage
MALES
*40-60 Y.O.*
ADOLESCENTS with CT disorders (marfans, ehlers-danlos)
aortic dissections
55
pain for aortic dissections is common ________
- type ___ is MC, near ______ and MOST SEVERE
- type ____ is distal to _________
between scapulae
type A
ascending aorta
left subclavian artery
56
inflammation of the vascular wall that is MC in SMALL ARTERIES
vasculitis
57
vascular invasion occurs in ______ vasculitis
| example -- ______
infectious
| hepatitis B
58
immune-mediated, ADRs is part of ______ vasculitis
| examples-- ____ & ____
non-infectious
SLE
penicilin
59
misc factors that may lead to vasculitis
irradiation
| trauma (physical or chemical)
60
MC type of vasculitis in OLDER ADULTS
| -idiopathic
giant cell arteritis (temporal arteritis)
61
```
artery affected with giant cell arteritis
causes:
diplopia
sudden blindness
facial pain
HA
PYREXIA
```
ophthalmic artery
62
MC vasculitis in YOUNGER INDIVIDUALS (<50 y.o.)
| granulomatous vasculitis, possibly from autoimmune disease
takayasu arteritis
63
```
system-wide vasculitis, transmural necrosis
SMALL and MEDIUM sized arteries
in KIDNEYS, VISCERA, HEART, LIVER
2/3 is IDIOPATHIC
*treatment= corticosteroids*
```
polyarteritis nodosa (PAN)
64
```
MC vasculitis in YOUNG ADULTS
EPISODIC/paroxysmal
weight loss
fatigue
*END-ORGAN DAMAGE*
renal and GI tract
```
polyarteritis nodosa (PAN)
65
_____ results in remission of cure in 90% of polyarteritis nodosa cases
immunosupression
66
```
pediatric vasculitis (80% ** MI
usually resolve within 2 years
```
kawaski disease
67
characteristics of kawaski disease
idiopathic
fever
cervical lymphadenopahy
STRAWBERRY TONGUE
68
uncommon type of vasculitis that causes inflammation
type II hypersensitivity
kidneys, upper/lower respiratory tract - nose, sinuses, trachea lungs
middle ages MALES
if untreated, lethal after 1 year
wegner granulomatosis
69
```
vasculitis that affects MEDIUM sized arteries
thrombosis --> vascular insufficiency
affects HANDS & FEET
PAINFUL extremities
CYANOSIS
GANGRENE
CIGRARETTE SMOKING
```
thromboangiitis obliterans
70
```
exaggerated arteriole vasoconstriction
pallor and cyanosis
chronic --> atrophy of skin
ADOLESCENT/YOUNG ADULTS
MC IN FEMALES
*may be secondary to atherosclerosis, buerger disease, lupus, scleroderma
```
raynaud phenomenon
71
broken heart syndrome or cardiac raynaud
stress cardiomyopathy
increase in catecholamine production (stress hormone)
may affect coronary arteries
takotsubo cardiomyopathy
72
3 types of venous diseases that make up 90% of all cases
varicose veins
phlebothrombosis
thrombophlebitis
73
venous thrombosis following inflammation
thrombophlebitis
74
-superficial veins are DILATED and TORTUOUS LEGS (MC)
- increase in intraluminal pressure
-congestion/edema, pain, thrombosis
1/3 females
varicose veins
75
varicose veins main risk is _____ & MC of _______ to people affected
obesity
| cosmetic concern
76
thrombophlebitis AKA
deep vein thrombosis (DVT)
77
90% of all vein issues are _____; symptoms include cyanosis/rubor, edema, dolor
risks: recent surgery, pregnancy, surgery, obesity, immobolization
possible PULMONARY EMBOLISM
DVT
78
bronchogenic carcinoma
mediastinal lymphoma
compression or invasion of area
congested UE veins, possible cyanosis, edema in arms, neck, head
superior vena cava syndrome
79
hepatocellular carcinoma
renal cell carcinoma
compression or invasion
congestion of LE veins; edema, proteinuria
inferior vena cava syndrome
80
obstruction --> tissue expansion
RARE
LYMPATHIC OBSTRUCTION
lymphedema
81
primary lymphedema is ________
| Kilroy disease, hypoplasia or agencies of lymph vessels
congenital
82
secondary lymphedema is _____
neoplasia
infection
thrombosis
obstruction (of previously normal lymph vessel)
83
two types of CHRONIC lymphedema
peau d'orange
| brawny induration
84
ACUTE lymphatic vessel inflammation
bacterial seeding
subcutaneous RED STREAKS, painful
lymphangitis
85
vascular tumors are MC ______; occasionally fairly _____, rarely highly _______
originate from ______ or ______
```
benign
aggressive
malignant
ENDOTHELIAL CELLS
CT tissue or vessels
```
86
common benign tumor in 1:200 newborns
increase LOCAL CAPILLARY growth
usually on head/face
75-90% resolve by 7 y.o.
hemangioma
87
malignancy of lymphatic endothelial cells
HUMAN HERPESVIRUS 8
AIDS
(rare in USA)
kaposi sarcoma
88
MALIGNANT endothelial neoplasia
extremely variable
RECUR locally, spread widely (lymph nodes)
MC among OLDER adults
angiosarcoma
89
2 types of angiosarcoma
differentiated
| anaplastic -- (INVASIVE, POOR PROGNOSIS)
90
MC locations of angiosarcoma
skin
breast
liver
91
irradiation, foreign bodies are risk for
angiosarcoma
92
arsenic, PVC, irradtionation and lymphedema are symptoms for
hepatic angiosarcoma
93
vascular interventions
endovascular stenting
94
endovascular stenting preserves __________, common in ______ cases and risk of thrombosis w/ ongoing ________
luminal patency
CAD
antithrombotic meds
95
vascular replacement
vascular grafts
96
REPLACE or BYPASS arteries
LT vessel patency is LIMITATION
can be autologous (transplant) or synthetic
vascular grafts
97
artery MC used in vascular grafts
internal mammary artery (USED TO BE great saphenous vein)
98
synthetic vascular graft may lead to
increase thrombosis
