26 Atherosclerosis

Question 1

T/F large arteries and medium arteries are all >2mm in diameter?

Answer 1

True for this lecture

Question 2

which vessels (size) are within the range of 2mm and 100um?

Answer 2

small arteries

Question 3

which vessels (size) are within the range of 100-20um?

Answer 3

arterioles

Question 4

The tunica media of large and medium sized vessels is characterized by? small arteries? arterioles?

Answer 4

1) multiple layers of smooth m.
2) a few layers of smooth m.
3) 1-2 layers of smooth m.

Question 5

what is the difference between atherosclerosis and arteriosclerosis?

Answer 5

Atherosclerosis is a form of arteriosclerosis. Arteriosclerosis is a generic term for thickening and loss of elasticity of the arterial walls. (hardening of the arteries) that affects the LARGE and MEDIUM arteries.

Question 6

What are the 3 forms of arteriosclerosis?

Answer 6

1) atherosclerosis
2) monckeberg medial calcific sclerosis
3) arteriolosclerosis

Question 7

what is arteriolosclerosis?

Answer 7

a form of cardiovascular disease affecting the small arteries and arterioles.

Question 8

what is monckeberg medial calcific sclerosis?

Answer 8

deposits of calcium in the muscular arteries which do not encroach the lumen.

Question 9

T/F atherosclerosis is the leading cause of cardiovascular disease?

Answer 9

true (nearly 75%)

Question 10

what percentage of TOTAL deaths in the US is due to atherosclerosis?

Answer 10

30%

Question 11

T/F CVD has been the #1 killer in the USA every year since 1900?

Answer 11

Almost true. (The only exception was in 1918 because of the pandemic flu)

Question 12

what is considered the most important modifiable risk factor for atherosclerosis?

Answer 12

Hyperlipidemia

Question 13

what are considered the four major modifiable (you are able to do something about them) risk factors for atherosclerosis?

Answer 13

1) hyperlipidemia
2) hypertension
3) smoking
4) diabetes

Question 14

what are considered the four major non-modifiable (you are not able to do something about them) risk factors for atherosclerosis?

Answer 14

1) increasing age
2) male gender
3) family history
4) genetics

Question 15

T/F Men are always at a higher risk for CHD?

Answer 15

true. (this is opposed to hypertension where women become more prone to hypertension after menopause.)

Question 16

where do atherosclerotic plaques form (layer)?

Answer 16

The tunica intima

Question 17

what are the 4 stages of plaque formation?

Answer 17

1) endothelial dysfunction
2) fatty streak formation
3) plaque growth and maturation
4) unstable fibrous plaque

Question 18

what causes increased permeability to circulating lipids and emigration of monocytes?

Answer 18

endothelial damage

Question 19

what causes the fatty streak?

Answer 19

accumulation of lipids and moncytes in the arterial intima

Question 20

what is the earliest stage at which the developing atherosclerotic plaque can be recognized at the gross and microscopic level?

Answer 20

the fatty streak formation stage

Question 21

what does oil red stain do the the lumen of a vessel?

Answer 21

allows you to see fatty streakes

Question 22

The maturation process of a plaque is best exemplified by?

Answer 22

formation of the fibrous cap which is composed mainly of smooth muscle cells that have migrated from the tunica media.

Question 23

what does cholesterol look like within an atherosclerotic plaque?

Answer 23

crystals

Question 24

T/F Large atherosclerotic plaques become vascularized?

Answer 24

true

Question 25

what happens when an atherosclerotic plaque ruptures?

Answer 25

it triggers clot formation at the surface of plaque causing it to worsen.

Question 26

T/F T lymphocytes have a role in atherosclerosis?

Answer 26

true. (there is also a lot of inflammation involved)

Question 27

what is thought to be the #1 cause of endothelial dysfunction?

Answer 27

shear stress

Question 28

what is thought to be the #1 cause of fatty streak formation?

Answer 28

macrophages engulfing oxidized lipids

Question 29

what is the reason behind plaque growth and maturation?

Answer 29

chronic inflammation and growth factors

Question 30

what is the reason why atherosclerotic plaques become unstable?

Answer 30

angiogenesis, unstable fibrous plaque, and apoptosis

Question 31

what 3 areas (arteries) are most affected by atherosclerosis?

Answer 31

1) aorta 2) coronary arteries 3) carotids

Question 32

what are the 3 major consequences of chronic atherosclerosis?

Answer 32

1) myocardial infarction 2) cerebral infaction (stroke) 3) aortic aneurysm

Question 33

T/F arterial branch points are particularly susceptable to the formation of atherosclerotic plaques?

Answer 33

true

Question 34

T/F an aneurysm is an abnormal dilitation of wall of the heart?

Answer 34

True as well as any vessel

Question 35

what is the difference between a true aneurysm and a false aneurysm?

Answer 35

True involves all layers of the wall | False involves ruptured layers with a hematoma

Question 36

what is the most common cause of aortic aneurysms? Second most common?

Answer 36

1) atherosclerosis | 2) cystic medial degeneration (marfans)

Question 37

What are 3 other less common causes of aotic aneurysms?

Answer 37

1) tertiary syphilis 2) infections 3) trauma

Question 38

where is the most common area for the formation of an aortic aneurysm?

Answer 38

abdominal aorta

Question 39

T/F males over 50 who smoke are most likely to have an abdominal aortic aneurism?

Answer 39

True (3 of the most common factors)

Question 40

if you have an aortic aneurysm that is under 4 cm, what is the chance that it will rupture each year? over 5 cm?

Answer 40

under 4cm = 2% | over 5cm = 10%

Question 41

what are the chances you will die from repair of an aortic aneurism that is not ruptured? ruptured?

Answer 41

not ruptured = 5% | ruptured = 50%