Artherosclerosis

Question 1

What is the normal structure of an artery?

Answer 1

Tunica intima, Tunica media and tunica adventitia

Question 2

What is arthersclerosis?

Answer 2

Atherosclerosis is the term used to describe the build of of fatty ‘plaques’ on arterial walls.
It is the underlying pathological cause for cardiovascular disease

Question 3

Tunica Adventitia

Answer 3

Fibrous connective tissue.
External elastic lamina separates this from the media.
Very small blood vessels can be found in this layer called vasa vasorum and these filter down to supply the media.

Question 4

Tunica Media

Answer 4

Separated from the intima by the internal elastic lamina.
Made up of smooth muscle and elastic tissue.
In the heart, the elastic tissue is most predominant, but in most arteries, this layer is mostly made up of smooth muscle.

Question 5

Tunica Intima

Answer 5

Innermost layer.
Single layer of endothelium, with a sparse supportive tissue.
This layer is very very thin!

Question 6

What are the modifiable risk factors for artherosclerosis?

Answer 6

Hypertension
Smoking
Obesity
Sedentary life style
High saturated fat diet

Question 7

What are the non-modifable risk factors for artherosclerosis

Answer 7

Age
Male gender - premeno women VERY low risk
Diabetes
Low socio-economic status
High LDL
Low HDL
Genetics - diabetes, hypertension and hyperlipidaemia can run in families

Question 8

What are the components of an artherosclerotic plaque

Answer 8

Lipid, calcium, plaque haemorrhage (PH) and fibrous cap (FC)

Question 9

What is the primary prevention of artherosclerosis?

Answer 9

Cessation of smoking
Control of BP
Weight reduction
Regular exercise
Dietary modifications - low in saturated fat
Fatty acids found in fish also have cardio-protective effects – thus it is recommended you eat at least 2 portions of oily fish per week.

Question 10

What are the secondary preventions of artherosclerosis?

Answer 10

ACE inhibitor
Aspirin
Β-blocker
Statin

COBRA
C – Clopidogrel – anti-platelet agent
O – Omacar – Omega 3
B – Bisoprolol – β-blocker
R – Ramipril – ACE-i
A – Aspirin

Question 11

Describe the formation of a plaque

Answer 11

1. Chronic endothelial damage
2. Accumulation of lipids (LDL) and monocytes within the tunica intima
3. Oxidation of lipids
4. Phagocytosis of lipids by macrophages
5. Macrophages -> foam cells
6. Smooth muscle cells -> tunica media = fatty streak
7. ^^^ foam cells and muscle cells = growth of plaque
8. SMC on surface form a fibrous cap (reinforced with collagen and elastin)
9. Endothelium stretches over the plaque & platelets adhere to gaps
10. cells in centre die -> necrosis
11. small vessels grow into plaque from T.adv
12. calcification

Question 12

Which contain more elastic tissue, arteries or arterioles?

Answer 12

Arteries contain more elastic tissue and arterioles contain more smooth muscle

Question 13

What is the difference between muscular and elastic arteries

Answer 13

Muscular arteries contain more smooth muscle cells in the tunica media. Elastic arteries are nearer the heart and contain more elastic tissue in the tunica media