7.3 Arteriosclerosis Flashcards
hyperplastic arteriolosclerosis
-appearance on histology
onion skin appearance
-growth of smooth m layers
Hyaline arteriolosclerosis
- what is it caused by? (2)
- mech of each
- benign HTN and diabetes cause proteins to leak into vessel wall
1. Benign HTN: increased pressure pushes proteins into wall
2. Diabetes: Glucose weakens vessel wall (non-enzymatic glycosylation of basement membrane), allowing proteins to leak into wall
arteriosclerosis
- 3 types?
- what vessels affected by each
- atherosclerosis–large/med size arteries
- arteriolosclerosis–arterioles
- Monckeberg medial calcific sclerosis–med arteries
hyperplastic arteriolosclerosis
-classic complication
- acute renal failure with “flea-bitten” kidney
- fibrinoid necrosis of vessel walls with hemorrhage
hylaine arteriolosclerosis
-the classic complication
arteriolonephrosclerosis (glomerular scarring)
- chronic renal failure
- glomerulus ischemia causes scarring of glomerulus
Atherosclerosis:
-progression of vessel damage
- Endothelial damage
- endothelium causes lipids to leak into intima - Fatty Streak
- Lipids are oxidized and consumed by macrophages, resulting in foam cells - Plaque
- inflammation and healing lead to deposition of ECM and proliferation of smooth m.
atherosclerosis
-the Big 4 modifiable risk factors
- HTN
- Hypercholesterolemia
- Smoking
- Diabetes
atherosclerosis
-what do you see in cross section of vessel wall
- necrotic lipid core (mostly cholesterol)
- fibromuscular cap
hylaine arteriolosclerosis
-appearance on histology
- vessel wall is pink from presence of hyaline.
- thickening of vessel wall
Monckeburg medial calcific sclerosis
-how is it related to breast cancer?
- mammograms look for calcifications in breast tissue
- you may see Monckeburg calcification in mammograms
what population is hormonally protected from atherosclerosis?
premenopausal women are protected by estrogen.
what layer of vessel does atherosclerosis affect?
Tunica intima
atherosclerosis
-4 important complications to know
- Ischemia
- can lead to peripheral vascular disease, angina, ischemic bowel disease - Thrombosis
- Plaque rupture exposes lipid core, leading to thrombus formation. (MI, stroke) - Embolism
- thrombus can embolize - Aneurysm
- vessel wall weakened b/c poor O2 transfer through thick wall
types of Arteriolosclerosis
- Hyaline–proteins leak into vessel wall
- Hyperplastic–hyperplasia of smooth m.
Monckeburg medial calcific sclerosis
- what happens
- appearance on histology
- calcification of media in med-sized arteries
- nonobstructive, not clinically significant
- you can see calcifications in media on histology
Fatty streak
the appearance of foam cells, which are macrophages that eat oxidized lipids that entered the intima through endothelial damage.
hyperplastic arteriolosclerosis
- main cause
- mech
- caused by Malignant HTN
- in response, vessel grows extra layers of smooth m.
(onion skin appearance)
what is the hallmark of atherosclerotic emboli on histology?
-presence of cholesterol crystals in embolus
what percentage of stenosis is required in artery before complications appear?
-must be over 70% stenosis before you get complications
