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Module 3 > Blood Vessel structure and hypertension > Flashcards

Blood Vessel structure and hypertension Flashcards

1
Q

What are the 3 layers of blood vessels

A

-tunica intima
-tunica media
-tunica adventitia

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2
Q

What is the structure of the tunica intima

A

-endothelium
-internal elastic lamina (subendothelial layer) which have proteoglycans and collagen
-squamous epithelium

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3
Q

What is the tunica media

A

-external elastic lamina (elastic fibers) which stretch and recoil during systole and diastole
-many smooth muscle cells

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4
Q

What does the tunica adventitia contain

A

-collagen and elastic fibers which anchor vessels to surrounding tissue
-vasa vasorum (oxygen and nutrients to outer layer of the vessel)

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5
Q

3 main types of arteries

A

elastic
muscular
arterioles

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6
Q

Elastic arteries

A

pressure reservoirs
contain many elastic fibers in the tunica media
receive blood directly from the heart

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7
Q

Muscular arteries

A

distributing arteries
thicker tunica media
more muscle cells
regulated blood flow to organs and tissues

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8
Q

arterioles

A

fewer muscle cells
highly responsive to changes in BP
regulate blood flow into capillaries

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9
Q

What are veins

A

drainage channels which carry blood from different parts of the body to the heart
work at lower pressure due to reduced muscle tone in tunica media

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10
Q

what are venules

A

smallest vessels in venous circulation

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11
Q

What is the venae cavae

A

venules come together to form larger veins into the greater vein

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12
Q

Tunica intima in arteries vs veins

A

Arteries - thin layer of endothelial cells/subendothelial layer/internal elastic lamina
veins - endothelial cells/subendothelial layer/lacks internal elastic lamina

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13
Q

tunica media in arteries vs veins

A

arteries - thicker, more smooth muscle/more elastic fibers/muscular arteries have more smooth muscle
veins - thinner/less elastic tissue

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14
Q

tunica adventitia in arteries vs veins

A

arteries - thinner tunica adventitia
veins - thicker tunica adventitia to provide greater structural support

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15
Q

What are valves

A

in veins
folds of tunica intima
prevent backflow of blood
important in lower extremities

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16
Q

What are arterioles

A

smaller diameter blood vessels with muscular walls
regulate blood flow and pressure
resistance vessels

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17
Q

Roles of the arterioles

A

vary diameter to prevent damage to tissue

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18
Q

What are capillaries

A

thin walled vessels which facilitate exchange of nutrients
link arteries and veins
contain endothelial cells (1 cell thick), basement membrane, collagen fibrils
5-8um diameter

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19
Q

why do capillaries have precapillary sphincters

A

regulate blood flow through contraction and dilation

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20
Q

types of capillaries

A

continuous
fenestrated
sinusoidal/discontinuous

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21
Q

What are continuous capillaries

A

-in many tissues (CNS/lymph nodes/muscle/skin)
-no opening on the walls
-continuous basement membrane
-joining of endothelial cells
-maintained by complex intercellular junction proteins

22
Q

What are fenestrated capillaries

A

-small pore called fenestrae
-in endocrine/GIT/kidney peritubular plexus
-continuous basement membrane
-fenestrations between endothelial cells, less complex intercellular proteins

23
Q

What are sinosoidal/discontinuous capillaries

A

-irregularly shaped endothelial cells with gaps
-in liver/bone marrow/spleen/lymph nodes
-large lumen
-discontinuous or absent basement membrane
-gaps have no diaphragm

24
Q

Lamina flow/streamlined/parabolic flow

A

Endothelium is smooth/non-stick which allows laminar flow. Blood in the centre is faster than vessel wall
most common

25
Q

What is turbulent flow

A

vessels branch when blood pressure is raised, flow is disrupted causing damage to the endothelium, this exposes blood to collagen and causes blood to clot

26
Q

What is pulsatile flow

A

periodic surges of blood due to heart’s rhythmic contraction e.g. arterial blood flow

27
Q

Functions of the endothelial cell

A

-blood vessel barrier
-regulates BP
-vasomotion (blood flow)
-produces NO (vasodilator/prevents platelet aggregation)
-immune response
-angiogenesis
-regulate blood clotting
-production of vasoactive substance
-nutrient exchange in capillaries

28
Q

Transport through the endothelial cells

A

paracellular (tight junctions)
transcellular (diffusion/vesicular/receptor-mediated)
active transport
pinocytosis (smaller molecules ingestion)

29
Q

What can dysfunction of microcirculation lead to

A

-CV disease
-DM
-Raynaud’s disease

30
Q

benign veins

A

varicose veins
most common in legs

31
Q

serious vein pathology

A

-venous insufficiency (leg swelling)
-superficial thrombophlebitis (red/tender/swollen)
-venous aneurysms (abdominal/pelvic regions)
-venous malformation

32
Q

Pathologies of arteries/arterioles

A

-atherosclerosis (fatty deposits in tunica intima harden walls and narrow lumen)
-arteriolosclerosis (wall thickening and hardening affecting small arteries and arterioles, risk: hypertension/DM)
-aneurysms (abdominal bulge)
-peripheral artery disease
-Reynaud’s disease (spasms in fingers/toes)
-arteritis (inflammation of arterial walls)
-vasculitis (inflammation of artery and arterioles)
-artery embolism (blood clot lodges in embolism)
-thrombus (solid mass)

33
Q

hypertension

A

persistent elevation of blood pressure levels in the arteries
damage to structure of blood vessels (small muscular and arterioles)
asymptomatic

34
Q

classification for hypertension

A

normal: <120/<80 mmHg
Pre-hypertension: 120-129/<80-89 mmHg
stage 1: 130-139/80-89 mmHg
stage 2: >=140/>=90 mmHg
urgency/emergency: >180/>120mmHg

35
Q

Risk factors

A

-age
-family history
-obesity
-sedentary lifestyle
-unhealthy (low potassium high sodium)
-excessive alcohol consumption
-smoking
-chronic conditions (diabetes/kidney disease)

36
Q

Hypertension classification

A

primary (essential/idiopathic 90%)
secondary (underlying conditions 10%)
malignant - dramatic rise over a short time
benign - stable elevation of blood pressure over several years

37
Q

What is secondary hypertension

A

caused by an external factor
renal disease (parenchymal/vascular)
-renal artery stenosis (reduced renal blood flow, RAAS activation, vasoconstriction, Na and H20 retention/hypertension
-acute kidney disorders (decreased urine formation/increased retention of Na/H20)
-chronic kidney disorders
-tumours (adrenal adenocarcinoma/pheochromocytoma)
-CV disorders (coarctation of aorta)
-obstructive sleep apnoea
-drugs (cocaine/amphetamines/licorice/oral contraceptives)
-hyperthyroidism/Cushing’s syndrome/adrenal hyperplasia/hyperaldosteronism

38
Q

complications of hypertension

A

-coronary artery disease (atherosclerosis)
-left ventricular hypertrophy (heart remodelling/hypertrophy)
-angina (pain)
-heart failure (heart weakens)

39
Q

What is an atheroma

A

Feature of atherosclerosis
affects large and medium arteries (not arterioles)
in systemic (high pressure systems) only
initially affects tunica intima then tunica media

40
Q

4 features of atheroma

A

-fatty streak (barely visible)
-lipid plaque (smooth/yellow/raised)
-fibrolipid plaque (hard)
-complicated atheroma

41
Q

Complications of atheroma

A

-stenosis
-predispose to thrombosis and embolism
-intima expansion/reduction to lumen size/reduce blood flow
-leg arteries
-mesenteric arteries - ischaemic colitis
-heart attack/stroke

42
Q

What is thromboembolism

A

acute rupture of an unstable atheromatous plaque, forming acute artery occulusion (thrombosis) and detaching (embolus)

43
Q

What can thromboembolism lead to

A

DVT
pulmonary embolism
stroke

44
Q

What is aortic dissection

A

70% due to hypertension
blood enters media causing a split in the vessel wall (unusual in atherosclerotic arteries)
rupture into adventitia causing haemorrhage into surrounding areas of the pericardium

45
Q

What is an aneurysm

A

abnormal, permanent focal dilation of an artery
atrophy of media
muscle and elastic fibers replaced by collagen (no recoil)

46
Q

Types of aneurysms

A

-saccular/berry (sac/pouch like due to arterial wall weakness)
-fusiform (gradual/symmetrical dilation/fusiform shape)

47
Q

Pathologies of arterioles

A

-Hyaline arteriolosclerosis (hyalin within arteriolar wall)
-hyperplastic arteriolosclerosis (concentric thickening of the arteriolar wall)
-vasospasms
-microangiopathy/arterioloar dysfunction
-ischaemia
-atherosclerosis
-inflammation

48
Q

What does hypertension result in

A

rupture (intracerebral haemorrhage due to microaneurysm - Charcot-Bouchard aneurysm)
microinfarcts due to thrombolytic events (hypertensive lacunae)
vascular dementia due to white matter loss

49
Q

Kidney victim

A

hypertensive nephropathy due to chronic high blood pressure

50
Q

kidney villian

A

disrupt electrolyte balance
leading to reactivation of the RAAS system

51
Q

How does hypertension cause eye damage

A

hypertensive retinopathy - renal arterioles
primary benign hypertension: silver wiring/arteriovenous nipping
malignant hypertension - flame haemorrhages/cotton wool spots/papilledema

52
Q
A

Module 3 (6 decks)

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