Clinical pathophys of endothelium Flashcards
(66 cards)
normal endothelium is (3 things)
1) anti-inflamm
2) anti-thrombotic
3) vasodilatory
what is endothelium
single cellular layer lining blood/lymph vessles, heart, and other cavities
what does internal elastic lamina separate
intima and media
what does external elastic lamina separate
media and adventitia
tunica intima made of
endothleium + thin layer connective tissue
tunica media made of
vascular smooth muscle + connective tissue
tunica adventitia made of
loose connective tissue
distinguish large arteries, smaller arteries, and arterioles
large arteries = more elastin
smaller arteries = more collagen
arterioles = more smooth muscle
activated endothelium
1) permeable to macrophages and monocytes
2) incr inflammatory cytokins
3) incr leukocyte adhesion molecules
4) incr vasodilatory molec
5) incr antithrombotic molec
activated smooth muscle
1) incr inflammatory cytokines
2) incr ECM syntheiss
3) incr migration and proliferation into subintima
where is nitric oxide synthase expressed
on luminal side of endothelium
where does NO diffuse to?
smooth muscle in media
fxns of NO synthase
1) responds to multiple stimuli
2) make NO from arginine
3) cGMP-mediated vasodilation
what generates inflammatory state?
decr NO due to oxid stress
what are inflammatory molecules
in endothelium
1) selectins
2) cell adhesion molec
3) cytokines
what is process of forming atherosclerotic plaque
1) monocytes enter intima
2) macrophage engulf foam cells
3) smooth muscle activ/migr, apoptosis, fibrosis, ongoing inflamm
stages of atherosclerotic plaque
1) fatty streak
2) plaque progression
3) plaque disruption if lose endothelial cap
fibrous cap in atherosclerotic
Foam cells
MMP = degrade fibrous cap over atherosclerotic plaque
compare vulnerable vs. stable plaque
vulnerable plaque
1) less fibr tissue
2) less calcified
3) more lipid content
4) more inflamm
5) more apoptosis
much of thrombosis is regulated by _____ on ____
regulated by molec expressed
on surface of or secreted by endothelium
examples of molec expressed on or secreted by endothelium
1) hep sulfate/thrombin
2) NO/platelet activ
3) prostacyclin
risk factors for coronary atherosclerotic plaque formation
requires 3 risk factor
1) HTN
2) hyperlipidemia
3) smoking
4) diabetes
5) age
CAD can cause
1) MI
2) unstable angina
3) myocardial infarction
Renal artery disease can cause
1) atheroembolic renal disease
2) renal artery stenosis
