Chapter 9 Flashcards by gates maier

What are the 2 categories of vascular disease

Narrowing/obstruction

2. Damaged vessel wall

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What are some types of narrowing/obstructing vascular diseases

atherosclerosis=gradual

- thromboembolism=rapid

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What are some types of vascular diseases involving damaged vessel wall

dilation=aneurysm

- rupture=dissection

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List the layers of vascular structures

Intima: endothelia cells (internal elastic lamina)
Media: smooth muscles (external elastic lamina)
Adventitia: CT, nerves, vessels

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How does the interior and exterior of a blood vessel produce blood supply

interior=diffusion

- exterior=vasa vasorum

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What produce vascular resistance

Arterioles

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Where is the site for edema and WBC diapedesis

Post-capillary venules

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What are functions of endothelial cells

regulate clots
vasoreactivity
regulates smooth muscle cell growth

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What produces endothelial activation

Trauma causing pro-inflammatory effects

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What is a berry aneurysm

Subarachnoid hemorrhage

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What is it called when an artery inappropriately connects to a vein

Arteriovenous (AV) fistula

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What is fibromuscular dysplasia

Local thickening of an arterial wall producing ischemia (renovascular HTN associated with this)

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What are the numbers for hypotension and what happens

<90/60, decreased perfusion

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What are the numbers for hypertension and what happens

Greater than or equal to 130/80, damages vessels/organs

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What regulated blood pressure

Cardiac output and peripheral vascular resistance

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In the heart and kidneys what is involved with vascular tone/blood volume in peripheral vascular resistance

Heart: atrial natriuretic peptide (ANP)

- kidney: renin-angiotensin-aldosterone system

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What happens in blood pressure regulation in increased BP

Stretch and ANP is released producing diuresis ad vasodilation

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What happens in blood pressure regulation when there is a decreased BP

The renin angiotensin system is activated producing sodium resorption and vasoconstriction

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What medications impact blood pressure regulation

ACE inhibitors, angiotensin 2 receptor blockers, diuretics

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What are the categories and their numbers for blood pressure

normal = <120, <80
elevated = 120-129, <80
HTN 1 = 130-139, 80-89
HTN 2 = 140+/90+
hypertensive crisis = >180,>120

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What happens in HTN vascular disease without treatment

50% die of ischemic HA

- another 1/3 die of stroke

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What happens to vascular system in HTN

Bp >140/90

Damages vessels and organs

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What happens in HTN

Increased vascular resistance, decreased sodium excretion

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What are factors influencing HTN

Age, stress, obesity, smoking, inactivity, increased salt intake, genetics (African Americans)

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What is essential HTN and malignant HTN

- Essential HTN = about 90% of all HTN | - Malignant HTN = >180/120 (lethal, <5% cases)

What is a common identifier of malignant HTN

Papilledema, a retinal hemorrhage

What happens to endothelial in response to injury

Irreversible intimal thickening which produces stenosis creating tissue ischemia

What is arteriolosclerosis

- ischemic injury - affects small arteries (arterioles) - chronic HTN or diabetes

What is it called when the is Ca++ into the media, with no stenosis

Monckeberg Medial Sclerosis

What happens in atherosclerosis

- atheromas(plaques) - stenosis, aneurysm, dissection, thrombus - heart (CAD), brain, kidneys, GI

What happens if atherosclerosis ruptures

Thrombosis = macrophages + lipids(foam cells), debris which is MC cause of MI

What are foam cells

Fat laden macrophages

What produces 70% occlusion of coronary arteries in CAD

Artheromatous plaque

What is hemodynamic stress

Branch points or areas of turbulence

What happens when atherosclerosis weakens walls and what happens when it ruptures

Aneurysm and thromboembolism

What are the 3 major MI risk factors

Hyperlipidemia, HTN, smoking, any 2 risk increases 4x, any 3 risk increases 7x

What is metabolic syndrome

When you have any 3 of these 5 things: central obesity, HTN, insulin resistance, dyslipedemia

What is the difference between a true aneurysm and a false aneurysm

True is all 3 layers, false is defect in the inner wall causing extravascular hematoma

What happens in abdominal aortic aneurysm

The aorta is dilated by >50%. AAA is about 5cm normal is about 3cm

Who is more likely to get an AAA

Males, >50, smokers, caucasian, family history of HTN, atherosclerosis found by ultrasound

What are the chances of rupture for an AAA

4-5cm = 1% per year >6cm = 25% per year If ruptured 50% are fatal, decreasing by 5% during surgery

Who is most likely to have an aortic dissection

Males 40-60 years old

Early onset of aortic dissection is indicative of what

Marfans syndrome, ehlers danlos, wilson disease

Where does an aortic dissection project

May project posteriorly b/w scapulae

What describes an aortic dissection

Sudden severe tearing or stabbing

What are the two types of aortic dissections

Type A = proximal | Type B = distal

What is vessel wall inflammation

Vasculitis

What type of hypersensitivity is vasculitis

Type 3 immune mediated

What causes vasculitis

ADR’s (penicillin), irradiation, trauma

What is another name for temporal arteritis

Giant cell arteritis

What does temporal arteritis affect

50% of time ophthalmic artery

Who is effected by temporal arteritis

Elderly >50

What indicates temporal arteritis

Facial pain, HA, diplopia/sudden blindness, fever

What is polyarteritis nodosa

Autoimmune vasculitis affecting systemic, small/medium sized arteries

What is not affected by polyarteritis nodosa

Pulmonary arteries

What does polyarteritis nodosa produce and what are the symptoms

Ischemia/infarction; weight loss, fatigue, fever, malaise

Who is affected by polyarteritis nodosa

MC in young adults, 2/3 are idiopathic/autoimmune

What happens to the kidney and GI tract from polyarteritis nodosa

Sudden HTN (renovascular) and in GI abdominal pain and bloody stools

What is a symptom on the skin caused by polyarteritis nodosa

Widespread vascular lesions

What is kawasaki disease and who does it affect

Pediatric vasculitis and 80% are less than 4 years old

What are people with kawasaki’s disease at risk for?

Lethal MI (aneurysm or thrombi)

What causes kawasaki disease

It is rare and idiopathic mostly caused by genetics and viral antigens

What are indicators of kawasaki’s disease

Conjunctivitis, swollen extremities, desquamation, cervical lymphadenopathy

What symptom of the tongue is indicative of kawasaki disease

Oral erythema or “strawberry tongue”

What is reye syndrome

Damage to liver and brain by combination of aspirin and viral infection

What happens in reye syndrome

Encephalopathy and hepatic steatosis

What is a necrotizing vasculitis of kidneys and respiratory tract

Wegener granulomatosis

What type of hypersensitivity is wegener granulomatosis

Type 4 treated with immunosuppression

What are symptoms of wegener granulomatosis

Pneumonitis, sinusitis, kidney damage, nasopharyngeal inflammation/ulcers

What is another name for buerger disease

Thromboangiitis obliterans

Who is most affected by buerger disease

Tobacco smokers, males(3x), 25-35 years old show signs of vasculitis in hands and feet

What is raynaud phenomenon

Exaggerated arteriole vasoconstriction showing as pallor and cyanosis

What is primary raynaud phenomenon

Idiopathic, cold or strong emotions

What is secondary raynaud phenomenon

Atherosclerosis, SLE, buerger disease, or systemic sclerosis

Who is more likely to experience raynaud phenomenon

Onset during adolescent or young adult MC in females

Chapter 9 Flashcards

(75 cards)