Atherosclerosis Flashcards
أ أبيت ليلي سهران الدجي وتبيته نوما ! وتبغي بعد ذاك لحاقي ؟!!
تصلب الشرايين هو اشهر سبب لحدوث نقص الدم في عضلة القلب المؤدي لموت عضلة القلب وذبحة صدرية
اشهر سبب يسد التاجية هو ATHEROSCLEROSIS
ACCUMULATIVE DISEASE ASYMPTOMPATIC
في ضوء هذه العبارة عرف تصلب الشرايين
It is progressive disese degenrative increasing with age accumulative
it is intimal thikeneng due to lipid depsition in small and medium and large arteries
causing inflammationand fibrosis induction and calcification !
الدهون بداية التصلب يعني هي مش هي الجزء المتصلب الناتج عنها هو التصلب
this forming atheroma !
degenrative مرض مع تقدم السن مشاكل متراكمة !!
نمت وأدلج الناس !!!
Mention risk factors of atherosclerosis
the nod modifiable rfs ?
1- age
2- sex male are more because androgen increasing lipid in blood and in female estrogen reduce it and smoking in male
3-genetic : familial hypercholesterolemia
the modified RF ? 4H MAJOR 4S MINOR
MAJOR MODIFIED :4H
1-Heavy smoking damage to BV ENDOTHELIUM indue deposition of lipid
2-Hypertenision induce …..
3-hyperglycemia leads to hyperlipidemia
4-hyperlipidemia obesity animal fat intake hypothroidism nephrotic syndrome
Minor modified : 4s Sugar intake steroid intake anabolics stress type a sedentary life style
the nod modifiable rfs of atherosclerosis ?
ASF
1- age
2- sex male are more because androgen increasing lipid in blood and in female estrogen reduce it and smoking in male
3-genetic : familial hypercholesterolemia
the modified RF ? of atherosclerosis
MAJOR MODIFIED :4H
1-Heavy smoking damage to BV ENDOTHELIUM indue deposition of lipid
2-Hypertenision induce …..
3-hyperglycemia leads to hyperlipidemia
4-hyperlipidemia obesity animal fat intake hypothroidism nephrotic syndrome
Minor modified : 4s Sugar intake steroid intake anabolics stress type a sedentary life style
Theories of Atheroscelrosis
Insudation
thrombogenic
Show insudation theory ?
the atherosclerosis begins with Endothelial injury due to smoking , hypertension,fat oxidation
then the lipid LDL enters insudates into the intima and the MQ goes After it
The Mq eat it and it will be called the foam cell surprisingly the smooth muscles fibers was hungry and also eat it so it shares the name with MQ !
This will stimlate growh factors and cytokines like fibroblast growh facrot and platelet derived growh factors for along time causing porliferation of smooth muscles and fibroblast casuing them to appear in intima forming an atheroma and THE IS
NEOVASCUARIZATION by growh factors may exaggarate the condition
the LDL-CHOLESTEROL CALLED CHOLESTEROL Clefts in intima
___________________________
o Endothelial injury → deposition of LDL due to high blood
pressure
o Attraction of macrophage → phagocytosis of Lipid (Foam
cells)→ lipid oxidation → more endothelial damage
o Platelets & macrophage secrete → cytokines & GF (PDGF, FGF,
TNf)
o Proliferation of smooth muscles & Matrix protein in intima
o Excessive vascularization of the wall
MQ is dangerous in atherosclerosis GR .
o Attraction of macrophage → phagocytosis of Lipid (Foam
cells)→ lipid oxidation → more endothelial damage
cytokines & GF released in atherosclerosis in the light of the theory of insudation .
cytokines & GF (PDGF, FGF,
TNf)
o Proliferation of smooth muscles & Matrix protein in intima
o Excessive vascularization of the wall
Describe the thrombogenic theory .
It depends mainly on the Endothelial damage as the insudation theory
by smoking , hypertension , lipid oxidation
It is due to formation of the thrmobosis on the damaged endothelium
and its organization and fibrosis and incorporation into the wall becasue the endothelium regenrated cover it and the lipids came from the death of cells rbc and wbcs and the phospolioids are releasesd also lipids inside cells
why not trusted why isn’t there venosclerorsis although thrmobsis formed there more and more !?
Mention site of atherosclerosis .
Small arterirs like coronaries and cerebral esepcially at bifurations becaus of damage
large arteris like renal and mesenteric popliteal and especially Aorta at the ostium due to hemodynamic circulation and endothelial damage
Morphology of Atherocelrosis in brief show .
1-Fatty streaks
2-atheromatus plaques
3-cmolicated atheroma
describe the faty streaks phase of atheroscleroisis
Yellow streaks
and under microscope you show foam cells and cholesterol clefts
Describe atheermoatus plaque .
there is cape shoulder and core base
Cap : smooth muscles and fibrous tissue collagen !
shoulder : inflammatory cells and no more lipids
core : foam cells and lipids cholesterl clefts
base : neovascularirziton
▪ Atrophy of the media
Complications of atherosclerosis Mention .
1-small and midum arteries like the coronary casusing ischemia and (myocadrdail infarction )
2- Leg ischemia in case of femoral artery atherosclerosis casuing ischemia and( intermittent caludications )on calf muscles after walking
3-Big arteries like aorta casuing (aortic aneyrusm) as wall lost its elasticity
and mural thrombosis جلطات جدارية !
Inhibitor of lipolysis
Nicotinic acid MECHANISMS
↓mobilization of FFA to the liver → ↓ VLDL ( after few hours) & ↓LDL (after few days) SIDE EFFECT Glucose intolerance
