Blood vessel disorder Flashcards
how many people in the UK with some form of heart disease
7.6 million
why is vascular disease important in dentistry?
Describe the structure and function of blood vessels
Blood vessels share and organisation
Epithelium
Tunica intima
Arteries tunica media
Tunica externa- loose connective tissue
Intima divided by internal elastic lamina
Media divided by external elastic lamina
Aorta - expanse and contract pulsatile nature of blood
Branches coming off aorta
Muscular arteries to contract and dilate according to various signals
Arterioles site depending on contraction
Capillaries facilitate nutrient and gas exchange
Oxygenated blood passes from left side
Deoxygenated blood passes from right side
what is age related vascular changes features
Result of chronic exposure to elevated blood pressure and toxins
Intima is much thicker
Media can be scarred and fibrotic
Fragmentation - elastic fibre can breakdown
Dystophic calcification
Arteriosclerosis - vessel exposed to high blood pressure, endothelium become stimulated which promotes smooth muscle proliferation, extracellular matrix deposition, fibrous thickening of the intima, the elastic lamina can break down
All the sorts of things can see high blood pressure
what is atherosclerosis
what does atherosclerosis result in and can be the pathogenesis for
what does the risk factors for atherosclerosis include
How does atherosclerosis occur in pathogenesis
- endothelial damage
- monocyte/platelet adhesion
- migrate into intima
- growth factors > SMCs
- take up lip to foam cells
- SMC/ECM proliferation
- progressive enlargement
what does atherosclerosis look like
describe the pre clinical phase of atherosclerosis
describe the clinical phase of atherosclerosis
Blood flow impaired
Give manifestations of angina
Cause symptomatic manifestations
Hearts moving much quicker
what can atherosclerosis result in and the clinical consequences
what is hypertension defined as
what is hypertension cause of and a major risk factor of
- causes degenerative changes in vessels
- promotes atherosclerosis
what’s the point of blood pressure
Systolic- max pressure when contact
Diastolic - lowest pressure when heart is refilling
why is blood pressure maintained within tight limits
how else can we classify hypertension
what is the etiological classification of hypertension
what are factors involved with secondary hypertension
Kidney secretes renin in response to a drop in blood pressure and activates the renin angiotensin system which ultimately produces vasoconstriction and retains salt and water and that increases the blood pressure
Anything that interferes with that process can obviously increase blood pressure
Renal artery stenosis - process where renal arteries are blocked through atheroscleortic process and they become stenosis
The kidney senses that decrease profusion , decrease blood flow and the kidney interprets that as a fall in blood pressure
Kidney then increases production of renin
Renin promotes the conversion through the angiotensin , renal to ultimately produce the retention of water and salt and vasoconstriction increasing blood pressure
If blood pressure is already normal or high and the kidneys are interpreting this through renal artery stenosis , then you will have a secondary cause of hypertension, because the renal angio system is inappropriately activated through renal artery stenosis
Endocrine cause
Anything that causes abnormal secretion of substances such as catecholamines can increase the blood pressure through various mechanisms
Endocrine cause are very big cause of secondary hypertension
what are factors involved in primary hypertension
How does renal artery stenosis cause secondary HTN
describe how cardiovascular and neurological factors relate with secondary hypertensions
what’s the difference between benign vs malignant hypertension