Atherosclerosis Flashcards
What vessels does atherosclerosis occur in?
large and medium sized arteries
in their normal state are endotelial cells more vasodilated or constricted?
dilated…they also are anticoag and inhib growth in normal state
name an important activator that will change the endothelial cell function?
lipid products/advaned glycosylation products
when endothelial cells are injured, what 5 things can occur?
constrict coagulate inflammation (cytokine) increase permeability growth promotion
with an endothelial injury what cell types can leak in or adhere to the area (3)?
leukocytes
lipid deposition
platelet adhesion
in LDL…what modifications happen that cause it to deposit in endothelial cells?
it will have chemokine receptors, activate platelets, and have adhesion molecule expression
after lipid deposits in tunica intima…what happens?
smooth muscle will emigrate from media to intima and macros are activated
what can macrophages and smooth muscle cells do to the lipid deposits? what does this lead to?
they can engulf them
inflammation
what are the smooth muscle and macros called when they engulf the lipids?
foamy cells
foamy cells are the cause of what in vessels?
the fatty streak
now that inflammation, foamy cells, and lipid is all present, what happens in the tunica intima of the vessel?
smooth muscle proliferates with collagen and other ECM matrix deposition..more lipids too
what does all the deposition lead to?
a necrotic core from foamy cell apoptosis and a fibrous cap made of collagen ECM and SMC
in general terms what is the trigger of atherosclerosis and what is the mediator?
trigger is lipid metabolism problems and mediator is the endothelial dysfunction and immune response
with worsening atherosclerosis…what are the three things that can lead to a clinical effect?
aneurysm from weakening wall
occlusion by thrombus
critical stenosis from growing plaque
what age do we start to get fatty streaks?
about age 10
after the fatty streak…what occurs next in formation of plaque?
fibrofatty plaque forms which is now a raised lesion with fibrous cap and necrotic core
after the fatty streak and fibrofatty plaque what happens to the atherosclerosis plaque?
you get a complicated lesion from weakening tunica media or massive calcification or focal rupture of luminal surface that causes clotting
angina definition
limiting flow in coronaries
claudication definition
limiting flow in peripheral vessels
two ways plaque buildup can cause infarcts
acute thrombosis from plaque rupture of intra plaque hemorrhage
or acute infarcts from emoblization of plaque fragments or thrombus
what are the two most common artery for atherosclerosis
abdominal aorta and the coronary arteries
name six risk factors for atherosclerosis
smoking, sedentary lifestyle, dyslipidemia, diabetes, hypertension
age and sex and genetics
