26 Atherosclerosis Flashcards
T/F large arteries and medium arteries are all >2mm in diameter?
True for this lecture
which vessels (size) are within the range of 2mm and 100um?
small arteries
which vessels (size) are within the range of 100-20um?
arterioles
The tunica media of large and medium sized vessels is characterized by? small arteries? arterioles?
1) multiple layers of smooth m.
2) a few layers of smooth m.
3) 1-2 layers of smooth m.
what is the difference between atherosclerosis and arteriosclerosis?
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.
What are the 3 forms of arteriosclerosis?
1) atherosclerosis
2) monckeberg medial calcific sclerosis
3) arteriolosclerosis
what is arteriolosclerosis?
a form of cardiovascular disease affecting the small arteries and arterioles.
what is monckeberg medial calcific sclerosis?
deposits of calcium in the muscular arteries which do not encroach the lumen.
T/F atherosclerosis is the leading cause of cardiovascular disease?
true (nearly 75%)
what percentage of TOTAL deaths in the US is due to atherosclerosis?
30%
T/F CVD has been the #1 killer in the USA every year since 1900?
Almost true. (The only exception was in 1918 because of the pandemic flu)
what is considered the most important modifiable risk factor for atherosclerosis?
Hyperlipidemia
what are considered the four major modifiable (you are able to do something about them) risk factors for atherosclerosis?
1) hyperlipidemia
2) hypertension
3) smoking
4) diabetes
what are considered the four major non-modifiable (you are not able to do something about them) risk factors for atherosclerosis?
1) increasing age
2) male gender
3) family history
4) genetics
T/F Men are always at a higher risk for CHD?
true. (this is opposed to hypertension where women become more prone to hypertension after menopause.)
where do atherosclerotic plaques form (layer)?
The tunica intima
what are the 4 stages of plaque formation?
1) endothelial dysfunction
2) fatty streak formation
3) plaque growth and maturation
4) unstable fibrous plaque
what causes increased permeability to circulating lipids and emigration of monocytes?
endothelial damage
what causes the fatty streak?
accumulation of lipids and moncytes in the arterial intima
what is the earliest stage at which the developing atherosclerotic plaque can be recognized at the gross and microscopic level?
the fatty streak formation stage
what does oil red stain do the the lumen of a vessel?
allows you to see fatty streakes
The maturation process of a plaque is best exemplified by?
formation of the fibrous cap which is composed mainly of smooth muscle cells that have migrated from the tunica media.
what does cholesterol look like within an atherosclerotic plaque?
crystals
T/F Large atherosclerotic plaques become vascularized?
true
what happens when an atherosclerotic plaque ruptures?
it triggers clot formation at the surface of plaque causing it to worsen.
T/F T lymphocytes have a role in atherosclerosis?
true. (there is also a lot of inflammation involved)
what is thought to be the #1 cause of endothelial dysfunction?
shear stress
what is thought to be the #1 cause of fatty streak formation?
macrophages engulfing oxidized lipids
what is the reason behind plaque growth and maturation?
chronic inflammation and growth factors
what is the reason why atherosclerotic plaques become unstable?
angiogenesis, unstable fibrous plaque, and apoptosis
what 3 areas (arteries) are most affected by atherosclerosis?
1) aorta
2) coronary arteries
3) carotids
what are the 3 major consequences of chronic atherosclerosis?
1) myocardial infarction
2) cerebral infaction (stroke)
3) aortic aneurysm
T/F arterial branch points are particularly susceptable to the formation of atherosclerotic plaques?
true
T/F an aneurysm is an abnormal dilitation of wall of the heart?
True as well as any vessel
what is the difference between a true aneurysm and a false aneurysm?
True involves all layers of the wall
False involves ruptured layers with a hematoma
what is the most common cause of aortic aneurysms? Second most common?
1) atherosclerosis
2) cystic medial degeneration (marfans)
What are 3 other less common causes of aotic aneurysms?
1) tertiary syphilis
2) infections
3) trauma
where is the most common area for the formation of an aortic aneurysm?
abdominal aorta
T/F males over 50 who smoke are most likely to have an abdominal aortic aneurism?
True (3 of the most common factors)
if you have an aortic aneurysm that is under 4 cm, what is the chance that it will rupture each year? over 5 cm?
under 4cm = 2%
over 5cm = 10%
what are the chances you will die from repair of an aortic aneurism that is not ruptured? ruptured?
not ruptured = 5%
ruptured = 50%
