Atherosclerosis Flashcards
what are the 3 layers of blood vessels?
tunica intima, media, adventitia
the tunica intima is composed of ____ which possess import multifunctional and metabolic properties
vascular endothelium
what are examples of inducers of endothelial activation?
cytokines
bacterial products
hemodynamic stress
lipid products
viruses
complement proteins
hypoxia
once endothelial cells are activated, what possible functions might they carry out?
- express adhesion molecules
- produce cytokines, chemokines
- produce growth factors
- produce vasoactive molecules
endothelial activation and subsequent pathological changes account for the condition known as ____
arteriosclerosis
arteriosclerosis (hardening of the arteries) are subdivided into what 3 distinct patterns?
- atherosclerosis (elastic arteries and muscular arteries- most clinically significant)
- monkberg medial sclerosis
- arterioLOsclerosis (affects small arteries and arterioles)
what is monkeburg medial sclerosis?
calcific deposits in muscular arteries (usually extremities)
atherosclerosis contributes to ____ of all deaths
half
death due to ischemic heart disease (which leads to MI) accounts for ____% of all deaths in the U.S
20-25
where do atherosclerotic lesions most often occur?
elastic and large and medium muscular arteries
what is the first clinical sign (visible lesion) of atherosclerosis?
fatty streak lesion
what is the next step after fatty streak?
type IV atheroma
what is the next stage after atheroma
type V (fibroatheroma)
what is after fibroatheroma
Type VI complicated lesion
when is the earliest that atherosclerosis might start to develop?
in the first decade of life
what is step 1 of atherosclerosis?
something happens that causes endothelial damage -> endothelial activation
once a fatty streak becomes a permanent fixture, it is called a(n) ____
atheroma
what is it called when CT is laid down around the atheroma?
fibroatheroma
what is the final step of atherosclerosis?
advanced plaque (complicated lesion); develop central zone of necrosis
what are the 2 things that can cause foam cells?
lipid-laden macrophages; lipid-laden smooth muscle cells
what are 3 possible outcomes that may occur at the clinical phase of atherosclerosis that can happen
- aneurysm and rupture
- occlusion by thrombus
- critical stenosis
what are the risk factors associated with atherosclerosis?
- hypertension
- hyperlipidemia (used if prone to ath.)
- cigarette smoking
- sex (males have higher chance)
- diabetes (uncontrolled; non-enzymatic glycosylation)
- soft risks: “sedentary life style, stress, obesity”
what are the new risks associated with atherosclerosis?
- homocysteinemia
- cytomegalovirus
- C.pneumoniae
- P. gingivalis
what is the only reversable part of atherosclerosis?
fatty streaks
what is a fatty streak?
early intimal lipid accumulation
what are atheromatous plaques?
raised subintimal plaques of necrotic tissue, lipid, extracellular matrix and cells
(irreversible)
what are the 2 components of an atherosclerotic lesion?
superficial fibrous cap (living), necrotic center (dead)
what are the clinical manifestations of atherosclerosis?
- acute occlusion
- chronic narrowing
- aneurysm formation
- embolism
what is acute occlusion?
a vascular emergency that occurs when a blood clot or other blockage prevents blood from flowing
what are the resulting lesions of atherosclerosis?
- ulceration (exposed -> ^thrombosis)
- thrombosis
- hemorrhage
- calcification (decreases elasticity, ^BP)
what is endothelial cell activation?
ability of endothelial cells to change their behavior based on various pathophysiological stimuli
what determines the severity of atherosclerotic disease?
persistence of risk factors
