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NYCC Physiopathology > Atherosclerosis > Flashcards

Atherosclerosis Flashcards

1
Q

what are the 3 layers of blood vessels?

A

tunica intima, media, adventitia

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2
Q

the tunica intima is composed of ____ which possess import multifunctional and metabolic properties

A

vascular endothelium

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3
Q

what are examples of inducers of endothelial activation?

A

cytokines
bacterial products
hemodynamic stress
lipid products
viruses
complement proteins
hypoxia

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4
Q

once endothelial cells are activated, what possible functions might they carry out?

A
  • express adhesion molecules
  • produce cytokines, chemokines
  • produce growth factors
  • produce vasoactive molecules
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5
Q

endothelial activation and subsequent pathological changes account for the condition known as ____

A

arteriosclerosis

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6
Q

arteriosclerosis (hardening of the arteries) are subdivided into what 3 distinct patterns?

A
  • atherosclerosis (elastic arteries and muscular arteries- most clinically significant)
  • monkberg medial sclerosis
  • arteriLOsclerosis (affects small arteries and arterioles)
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7
Q

what is monkeburg medial sclerosis?

A

calcific deposits in muscular arteries (usually extremities)

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8
Q

atherosclerosis contributes to ____ of all deaths

A

half

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9
Q

death due to ischemic heart disease (which leads to MI) accounts for ____% of all deaths in the U.S

A

20-25

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10
Q

where do atherosclerotic lesions most often occur?

A

elastic and large and medium muscular arteries

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11
Q

what is the first clinical sign (visible lesion) of atherosclerosis?

A

fatty streak lesion

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12
Q

what is the next step after fatty streak?

A

type IV atheroma

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13
Q

what is the next stage after atheroma

A

type V (fibroatheroma)

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14
Q

what is after fibroatheroma

A

Type VI complicated lesion

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15
Q

when is the earliest that atherosclerosis might start to develop?

A

in the first decade of life

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16
Q

what is step 1 of atherosclerosis?

A

something happens that causes endothelial damage -> endothelial activation

17
Q

once a fatty streak becomes a permanent fixture, it is called a(n) ____

A

atheroma

18
Q

what is it called when CT is laid down around the atheroma?

A

fibroatheroma

19
Q

what is the final step of atherosclerosis?

A

advanced plaque (complicated lesion); develop central zone of necrosis

20
Q

what are the 2 things that can cause foam cells?

A

lipid-laden macrophages; lipid-laden smooth muscle cells

21
Q

what are 3 possible outcomes that may occur at the clinical phase of atherosclerosis that can happen

A
  • aneurysm and rupture
  • occlusion by thrombus
  • critical stenosis
22
Q

what are the risk factors associated with atherosclerosis?

A
  • 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”
23
Q

what are the new risks associated with atherosclerosis?

A
  • homocysteinemia
  • cytomegalovirus
  • C.pneumoniae
  • P. gingivalis
24
Q

what is the only reversable part of atherosclerosis?

A

fatty streaks

25
Q

what is a fatty streak?

A

early intimal lipid accumulation

26
Q

what are atheromatous plaques?

A

raised subintimal plaques of necrotic tissue, lipid, extracellular matrix and cells
(irreversible)

27
Q

what are the 2 components of an atherosclerotic lesion?

A

superficial fibrous cap (living), necrotic center (dead)

28
Q

what are the clinical manifestations of atherosclerosis?

A
  • acute occlusion
  • chronic narrowing
  • aneurysm formation
  • embolism
29
Q

what is acute occlusion?

A

a vascular emergency that occurs when a blood clot or other blockage prevents blood from flowing

30
Q

what are the resulting lesions of atherosclerosis?

A
  • ulceration (exposed -> ^thrombosis)
  • thrombosis
  • hemorrhage
  • calcification (decreases elasticity, ^BP)
31
Q

what is endothelial cell activation?

A

ability of endothelial cells to change their behavior based on various pathophysiological stimuli

32
Q

what determines the severity of atherosclerotic disease?

A

persistence of risk factors

NYCC Physiopathology (27 decks)

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