Arteriosclerosis Flashcards
Vessels typically have what three layers?
- Tunica intima
- Tunica media
- Tunica adventitia
Tunica intima is composed of ___ which possess important multifunctional and metabolic properties
vascular endothelium
What are six functions of vascular endothelium?
- Semi-permeable membrane
- Maintenance of non-thrombogenic blood-tissue interface
- Modulation of blood flow and vascular resistance
- Regulation of immune an inflammatory reactions
- Growth regulation of other cells (especially smooth muscle cells)
- Endothelial activation
What is endothelial activation?
Ability of vascular endothelium to change their behavior based on various pathophysiological stimuli
What are seven inducers of endothelial activation?
- Cytokines
- Bacterial products
- Hemodynamic stress
- Lipid products
- Viruses
- Complement proteins
- Hypoxia
Anything that may potentially damage endothelium or act upon it is…
an inducer of endothelial activation
Once endothelial cells are activated, they may…
- express adhesion molecules
- produce cytokines, chemokines
- produce growth factors
- produce vasoactive molecules
The expressions/productions of activated endothelial cells may lead to…
- vasoconstriction/vasodilation
- pro/anticoagulant moieties
- influence subendothelial environment (smooth muscle cells)
through relaxing and contracting factors
Endothelial activation and subsequent pathological changes account for what condition?
Arteriosclerosis
What is arteriosclerosis?
Hardening of the arteries
What are the three distinctive patterns of arteriosclerosis?
- Atherosclerosis
- Monkeberg medial sclerosis
- Arteriolosclerosis
What is the most clinically significant pattern of arteriosclerosis?
Atheroscleosis
Which arteries are affected by atherosclerosis?
Elastic and large/medium muscular arteries
Atherosclerosis contributes to ___ of all deaths
half
atheroscleosis
Death due to ischemic heart disease, which leads to myocardial infarct, accounts for ___ of all deaths in U.S.
20-25%
When does atherosclerosis begin?
First decade of life (endothelial activation)
What is the histology of an initial lesion of atherosclerosis?
Isolated macrophage foam cells
When an initial atherosclerotic lesion accumulates lipids, it develops into…
fatty streak
An atherosclerotic fatty streak can accumulate more lipis
When atherosclerotic atheroma lays down connective tissue, it becomes…
fibroatheroma
Atherosclerotic lesion is clinically silent until when?
Atheroma (may still be silent, or become overt)
When will an atherosclerotic lesion accelerate smooth muscle and collagen increase?
Fibroatheroma
An atherosclerotic fibroatheroma may become…
advanced plaque, a central zone of necrosis
When will an atherosclerotic lesion be at most risk of causing thrombosis or hematoma?
Advanced plaque/complicated
What are five risk factors associated with atherosclerosis?
- Hypertension
- Hyperlipidemia
- Cigarette smoking
- Sex (biological males at risk)
- Diabetes (non-enzymatic glycosylation)
What are some “soft risks” associated with atherosclerosis?
- Sedentary life style
- Stress
- Obesity
What are some “new risks” associated with atheroscleosis?
- Homocysteinemia
- Cytomegalovirus
- C. pneumoniae
- P. gingivalis
atherosclerosis
What is a fatty streak?
Reversible early intimal lipid accumulation
atherosclerosis
What are atheromatous plaques?
Irreversible raised subintimal plaques of necrotic tissue, lipid, extracellular matrix, and cells
What makes biological males more at risk for atherosclerosis?
Decreased estrogen
What are foam cells?
Lipid-ladin macrophages or smooth muscle cells found in atherosclerosis
What are the components of an atherosclerotic lesion?
Which contain living and dead tissue?
- Fibrous cap (living tissue)
- Necrotic center (dead tissue)
What are four clinical manifestations of atherosclerosis?
- Acute occlusion
- Chronic narrowing
- Aneurysm formation
- Embolism
