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ZZZZ Pathophysiology (B) > Week 9 lec - vascular pathology > Flashcards

Week 9 lec - vascular pathology Flashcards

1
Q

In Australia , 1 person dies every __min from CVD

A

12

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2
Q

what are the CVD and vascular disease shared risk factors?

A

Genetic&lifestyle

– Age
– Male gender (risk is similar after menopause)
– Family history
– High blood pressure
– High cholesterol
– Overweight/obese
– Physical inactive
– Smoking
– Dietlowinfruits&vegetables
– Excessive alcohol consumption
– Glucose intolerance/insulin resistance/type2diabetes

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3
Q

Vascular disease can affect veins, arteries and ____ vessels

A

lymph

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4
Q

vascular disease can be through damage, blockage, or ______ of the vessel

A

rupture

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5
Q

Vascular disease is present in all forms of ___

A

CVD

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6
Q

which are the elastic arteries?

A

aorta & major branches

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7
Q

list 4 features of elastic arteries

A
  • elastic tissue
  • expand & recoil
  • are pressure reservoirs
  • conducting arteries
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8
Q

why are elastic arteries very important in the heart?

A

they have the ability to expand and recoil

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9
Q

features of muscular arteries

A
  • thick walls – 25+ layers of muscle
  • undergo vasoconstriction & vasodilation
  • distributing arteries
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10
Q

example of muscular arteries

A

medium size arteries

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11
Q

feature of arterioles

A
  • small muscular arteries
  • decreasing in size with gradual loss of wall layers down to terminal arterioles
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12
Q

what is the peripheral venous pressure?

A

about 5-10mmHg

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13
Q

the endothelium in the heart is called?

A

the endocardium

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14
Q

The majority of our NO is produced endogenously by ___ ____ ___ enzymes (remaining small portion comes from the diet)

A

nitric oxide synthase (NOS)

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15
Q

NO is a free radical with a rapid half-life, which is an important vascular signalling molecule that also functions as a potent ______

A

vasodilator

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16
Q

ageing has the most significant effect on _____ arteries

A

elastic

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17
Q

what are the vascular changes which occur with ageing?

A

– Hypertrophy of the tunica intima and tunica media

– Increase in smooth muscle and elastic tissues

– Elastic tissue forms concentric layers in the tunica intima – becomes less elastic

– Collagen fibres start to replace smooth muscle tissue – stiffening walls of vessel

– Calcium deposits in the tunica media

– Reduction in vessel elasticity & hardening of the vessel walls

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18
Q

what is the sum of the changes which occur in the arteries with ageing?

A

hardening of the arteries

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19
Q

what could cause a reduction in the bioavailability and/or bioactivity of NO?

A

– Degradation of NO
– Decreased NOS activity
– Decreased availability of NOS substrates & co-factors

20
Q

what could cause damage to the endothelium?

A

– Turbulent blood flow
– Increased blood pressure
– Lifestyle factors – smoking, alcohol, excessive fats &/or sugars
– Inflammation & infection

21
Q

A reduction in the bioavailability and/or bioactivity of NO and damage to the endothelium results in what alterations to the endothelium?

A

– Inflammation
– Increased vaso-tone
– Increased thrombotic activity
– Reduced dilation
– Damaged endothelium

22
Q

what are the types of vascular diseases?

A
  • Hypertension
  • Peripheral vascular disease
  • Atherosclerosis & arteriosclerosis
  • Cerebrovascular disease – ischaemic & hemorrhagic stroke
  • Aneurysm – excessive localised swelling in the wall of an artery
  • Varicose veins, lymphedema, claudication, phlebitis, other rare disease
23
Q

final consequences of vascular disease?

A

– Angina – chest pain
– Myocardial infarction – heart attack
– Heart Failure

24
Q

what tells you the most about peripheral resistance: systolic or diastolic pressure?

A

diastolic

25
Q

Hypertension can be classified as: (5)

A

– Essential – no specific medical cause to explain hypertension (~90%)

– Secondary – results from a specific underlying condition with a well-known mechanisms

– Malignant – extremely high & uncontrolled hypertension

– Pre-eclampsia – pregnancy induced hypertension

– White coat – elevations due to seeing your GP!

26
Q

give an example of hypertension can be caused by single gene mutations

A

altered renal salt handling

27
Q

how can hypertension caused by autonomic nervous system?

A

SNS affects pressure, volume and chemoreceptor signals

28
Q

how can hypertension be caused by renin-angiotensin-aldosterone system?

A

Ang II, ADH and Aldosterone production which can affect Na+ & water reabsorption/secretion

29
Q

how can hypertension be caused by vascular dysfunction?

A

reduction in NO, thickening of vessel wall & impaired vessel response

30
Q

how can hypertension be caused by lifestyle factors?

A

overweight, excessive alcohol consumption, elevated glucose levels, high potassium and/or calcium levels

31
Q

which has a wider distribution in the body - SNS or PSNS?

A

SNS

32
Q

does PSNS innervate cardiac arteries?

A

no

33
Q

why does the human nervous system promote high pressure mode?

A

because there is no antagonist for vasoconstriction

34
Q

Symptoms of hypertension?

A

usually has no symptoms, can cause headaches or pressure in the eyes

35
Q

hypertension causes significant damage to blood vessels, heart and ______

A

kidneys

36
Q

what is a peripheral vascular disease?

A

circulation disorders that affect vessels outside the heart or brain

37
Q

Causes of peripheral vascular disease

A

Blood vessels become narrowed, leading to a decrease in blood flow. Largely due to arteriosclerosis – thickening & hardening of vessel wall

38
Q

Drug treatment for hypertension

A
  1. ACE inhibitors – prevent conversion of Ang I to Ang II
  2. AngIIreceptorblockers–blocktheactionsofAngII
  3. Ca+2 channel blockers – block intracellular Ca+2 concentration
  4. increases
  5. Beta blockers – block stimulation of adrenergic receptors responsible for cardiac activity
  6. Diuretics – promote water loss
39
Q

Symptoms of peripheral vascular disease

A
  • Legs cramp sand/or pain-exercise
  • Numbness, tingling, coldness and/or ”pins & needles”
  • – at rest
  • Cuts or sores on lower legs or feet that don’t heal
  • Necrosisoftissue
  • Symptomscanbemildandmaybemistakenfor exercise cramps etc
40
Q

how do you diagnose peripheral vascular disease?

A

By ankle-brachial index – compares the BP in your arm to the BP in your ankle. Additional diagnosis via MRI angiography or doppler ultrasound

41
Q

treatments of peripheral vascular disease?

A

Lifestyle: reducing weight, improving diet, increasing physical activity, quitting smoking, monitor BP

Drug therapy:
• BP drugs
• Antiplatelet drugs, aspirin or other blood thinners
• Monitor diabetes and/or cholesterol – drug treatments

Serious cases require surgery
• Balloon angioplasty
• Arterial bypass

42
Q

Arteriosclerosis is

A

a degenerative thickening or hardening of the arteries, making them less elastic

43
Q

Atherosclerosis is

A

deposition of material in the vessel walls leading to plaque formation

44
Q

Accumulation of lipid in the intima of a blood vessel & formation of an ______

A

atheroma

45
Q

learn all this stuff

A
46
Q

here are the steps that mauro was trying to explain

A

ZZZZ Pathophysiology (B) (16 decks)

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