Vascular Path Robbins Part 1 Flashcards Preview

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Flashcards in Vascular Path Robbins Part 1 Deck (66)
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1

blood vessels- 3 concentric layers

-intima
(internal elastic lamina)
-media
(external elastic lamina)
-adventitia

2

intima- consists of

-endo cells (single layer) on basement membrane
-demarcated from the media by internal elastic lamina

3

media- consists of

smooth m cells

4

media- in elastic a's (aorta)

-have high elastin content

5

media- in muscular a's

-composed predominantly of circumferentially oriented smooth m cells
-smooth m contraction and relaxation- reg by inputs from autonomic NS and local metabolic factors

6

principal points of physiologic resistance to blood flow

arterioles

7

adventitia- consists of

-separated from the media by external elastic lamina
-loose CT containing n fibers, vasa vasorum (small arterioles that supply the outer portion of the media)

8

a's divided into 3 types

-large/elastic arteries (aorta, major branches of aorta)
-medium-sized/muscular a's- smaller branches of aorta)
-small a's (<2 mm diameter) and arterioles (20-100 um diameter)

9

capillaries- size? consists of

-7-8 um diameter (size of red cell)
-have endo cell lining, but no media
-pericytes (resemble smooth m cells) lie deep to endo

10

veins- diff from a's

-larger diameters, larger lumens, thinner/less organized walls
-contains 2/3 of total blood volume
-less rigid walls-subject to dilation and compression, as well as infiltration by tumors and infl process

11

lymphatics

-thin-walled channels- lined by specialized endo
-provide conduits to return interstitial tissue fluid and infl cells to bloodstream
-can also transport microbes and tumor cells- important potential pathway for disease dissemination

12

vascular anomalies

-berry aneurysms
-arteriovenous fistula
-fibromuscular dysplasia

13

berry aneurysms- found where? asssoc with? can cause?

-circle of willis
-autosomal dominant polycystic kidney disease
-fatal subarachnoid hemorrhage

14

arteriovenous fistulas- arise from? can cause?

-direction connections b/w a's and v's that bypass the capillary bed
-most often developmental defects
-may arise secondary to infl, trauma, rupture
-can rupture- leads to hemorrhage
-can cause high-output cardiac failure- by shunting blood from arterial to venous circulation, forcing heart to pump additional volume

15

fibromuscular dysplasia

-focal thickening of intima and media of medium/large muscular a's- results in stenois
-"string of beads"
-young women- most often

16

endo cells- normal state

-nonthrombogenic surface

17

endo cells- activated state- what stimuli?

-turbulent blood flow
-HTN
-complement, bacterial products, lipid products, glycation end products
-viruses
-hypoxia, acidosis
-tobacco smoke components

18

activated endo cells- characterized by expression of?

-adhesion molecules
-procoagulants, anticoagulants
-vasoactive factors, GFs

19

endothelial dysfxn- characterized by?

-procoagulation
-proinfl
-smooth m stimulation
-partly responsible for initiation of thrombus formation, atherosclerosis, and vascular lesions of HTN

20

predominant cellular element of vascular media- fxns

vascular smooth m cells
-roles in vascular repair and pathologic processes
-can proliferate when stimulated
-can syn collagen, elastic, proteoglycans, GFs, cytokines
-responsible for vasoconstriction.dilation

21

vascular injury- assoc with?

endo cell dysfxn or loss
-stim smooth m recruitment/proliferation (from media to intima)
-assoc matrix syn

22

vascular injury- stereotypical response?

-intimal thickening!!

23

HTN- risk factor for?

-atherosclerosis, aortic dissection
-Hypertensive heart disease (cardiac hypertrophy and HF)
-stroke
-hypertensive renal disease

24

hypertensive vascular disease- increased prevalence in?

-advancing age
-african americans

25

90-95% of HTN- cause?

-idiopathic (essential HTN)

26

5% of HTN- cause?

secondary HTN
-renal or adrenal disease
-renal a stenosis
-endocrine
-CV
-neurologic

27

risk factors for essential HTN

-high Na intake
-obesity
-stress
-smoking
-physical inactivity

28

malignant HTN- characterized by?

-small % of HTN pts show a rapidly rising BP that if untreated leads to death within 1-2 yrs
-severe HTN (>200/120), renal failure, retinal hemorrhages/exudates

29

BP =

CO x PVR
(CO= SV x HR)

30

most important determinant of SV?

filling pressure- reg thru sodium homeostasis