Vascular Disease 1- Leah (6)- Arteriosclerosis* Flashcards Preview

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Flashcards in Vascular Disease 1- Leah (6)- Arteriosclerosis* Deck (53)
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List the three layers of an arterial wall.
What are they comprised of?

1) intima, made up of endothelium (blood/ tissue barrier)
2)Media, made up of Muscle "M"
3) Adventitia, made up of CT, nerves, vasa vasorum
*adventitia is outermost*


Describe the function of the vasa vasorum:

Supplies blood to the outer 1/2 --> 2/3 of a vessel


List the four types of arteries:

1. elastic
2. muscular
3. small arteries (less than 2mm diameter)
4. arterioles


Describe elastic artery properties.
Which arteries are classified as elastic?

-Large arteries that actively expand and contract (recoil) at systole and diastole
-Elastic, hence rich in elastic tissue
-Aorta and its large braches are elastic


Describe muscular arteries.
Which arteries are classified as muscular?

-rich in smooth muscle
1. smaller aortic branches (carotids)
2. coronary
3. renal vessels


Function of arterioles:

-maintain TPR
-transition blood from pulsatile --> steady state as enters capillary bed
-reduce pressure and velocity of blood


Describe makeup of capillaries: wall, diameter, xs surface area?

-made up of intima/ endothelial cells only
(lacks adventitia and media)

-diameter of a single RBC
(smallest individual vessel types)

-largest overall cross sectional area of all vessel tpyes


Preferred site of inflammation in vasculature?

post capillary venules


Describe structure of veins: lumen? wall thickness? special features?

-large lumens
-thin walls
-have valves to direct flow (loss of valves = venous insufficiency/ varicose veins)


Describe structure of wall (1) and function of lymphatic vessels (3):

- Thin walled, endothelium lined
- Fxn: drain interstitial fluid
-disseminate disease*
-play a role in edema*


Normal function of endothelial cells in vessels (5):

-prevent thrombosis (maintain blood/ tissue interface)
-metabolize hormones
-regulate immune/ inflammatory processes
-modulate resistance
-affect growth of other cells (mostly SMCs)

**Most "biochemically" active vascular cells**


Normal function of SMCs in vessels (3):

-synthesize ECM/ CT***
-migration/ proliferation
-contraction/ dilation

**Most "physically" active vascular cells.


How might tight endothelial junctions be loosened in the vasculature (2)?
What is the result?

-HTN or HISTAMINE most commonly loosen tight junctions.
-Result: EDEMA--> loss of leukocytes, proteins, and/or electrolytes


Basic definition of activation and dysfunction of endothelial cells:

Gaining some inducible property
(activation - good property; dysfunction- bad property)
*Not easy to distinguish the two processes, not testable


Describe abilities that an endothelial cell may gain during activation (4)

-production of adhesive molecule
-coagulants/ anticoagulants
-vasoactivators etc.


Describe abilities that an endothelial cell may gain during dysfunction:

adhesive/ thrombogenic properties


List three disease processes that involve endothelial cell dysfunction:

1) Hypertension
2) Thrombus
3) Atherosclerosis


Describe three events that may lead to vascular smooth muscle injury:

1. mechanical (angioplasty)
2. immunologic (i.e. transplant arteriosclerosis)
3. multifactoral (atherosclerosis)


"neointimal formation" may be used to describe?

"new intima" --> intimal thickening; a response to injury


Result of intimal thickening:

some stenosis and occlusion, but less so than atherosclerosis


What are three steps of intimal thickening after injury is induced?

1) recruitment of SM--> intima either from adjacent tissue or circulating precursors
2) SMC mitosis and proliferation
3) SMC elaborate intimal ECM; create new CT


Compare and contrast SMCs in normal vasculature vs during intimal thickening

-During intimal thickening, SMCs are in a *PROLIFERATIVE* state, located in the intima
-In a normal vessel, SMCs are in a *CONTRACTILE* state, located in the media


Define arteriOsclerosis.
What are three types?

"Hardening of the arteries"- blanket term that includes:
1- atherosclerosis
2- arteriOLOsclerosis
3- Monckeberg medial sclerosis


Arteriolosclerosis effects what vessels?
What are the causes of arteriolosclerosis?

-small arteries and aterioles (usually renal)
-caused by HTN and DM


What are two types of arteriOLOsclerosis?
What are their causes?

(mild chronic HTN, DM)

-HYPERPLASTIC thickening/ onion skinning
(malignant hypertension)


Monckeberg medial stenosis:
What is it and in what population is it observed?

- benign ring calcifications found in muscular arteries
- media layer
- elderly population
- may be palpable or visible on Xray (pipestem appearance)
- Does NOT lead to occlusion of vessels

*Common benign finding on mammogram*


Cause of 50% deaths in the western world?



Atherosclerosis effects what types of arteries?

Who gets atherosclerosis?

-Atherosclerosis = elastic and muscular
-ArteriOLOsclerosis = aterioles and small arteries

*Old men + post menopausal women, esp w. genetic risk*


Function of LDL and HDL

LDL (bad): transports cholesterol to tissue
HDL (good): transports cholesterol out of tissue and into the liver for biliary excretion


Dietary way to reduce LDL

Omega-3-FAs, statins