Blood Vessels Flashcards
What arteries are affected in Atherosclerosis?
Lg, Medium sized elastic and muscular arteries
What accumulates in the intima of atherosclerotic arteries?
Inflammatory cells
Hyperplastic smooth muscle cells
lipids
connective tissue
Atheroma
lipid plaque [consists of extracellular lipid and lipid-laden macrophages aka foam cells……..Cholesterol carried by serum lipoproteins is deposited in the atheroma, where it is endocytosed by macropahges]
A mature atheroma is highly thrombogenic
Obliterative endarteritis is associated with what infection?
What other findings are expected upon microscopic examination of this infection?
Syphillis. Obliteration of the vasa vasoram causes focal necrosis and scarring of the media, with disruption and disorganization of the elastic lamellae. The inner surface of the affected aorta shows a typical TREE BARK appearance?
Endarteritis of the vasa vasorum / Syphilitic Aneurysm is associated with syphiliitic aneurysm of the Ascending Aorta.
The vasa vasorum ramify in the adventiia and penetrate the outer and middle third of the aorta.
Periarteritis of the vasa vasorum can also be seen
What organ specific disorders are seen with patients with severe atherosclerosis?
Intermittent claudication Abdominal Aortic Aneurysms CAD (chest pain) Cerebrovascular Disease PVD
On H&E stain, how would calcification appear?
As an irregular BLUE material
Xanthoma
papules or nodules of lipid-laden macrophages
What does the cell surface glycoprotein, the LDL receptor, regulate?
It regulates plasma choleseterol by mediating endocytosis and recycling of apolipprotein (apo)E.
Without the LDL receptor, accumulated LDL in plasma and are taken up by macrophages
Athereosclrotic “Restenosis”
atherosclerotic plaques that develop in venous grafts after 5-10 yrs. (Saphenous veins are used as autografts in coronary artery bypass surgery)
What orgnas are often damaged as a result of malignant HTN?
brain, heart, and kidney
What is the pathology seen in MH?
Injury of endothelial cells causes increased vascular permeability, which leads to the insudation (accumulation) of plasma proteins into the vessel wall and fibrinoid necrosis.
Filarial worm infestation of inguinal lymph node causes what clinical manifestation?
Elephantiasis- Lymphedema of the extremity or scrotum. It is high in protein content (lymph is the means by which proteins and IS cells are returned to the circulation)
The normal pattern of filtration is disrupted (Normal: more fluid is filtered into the IS than is reabsorbed into vascular bed and excess IS fluid is removed by lymphatics)
Indurated edema
Increased protein concentration may be a fibrogenic stimulus in the ormationof dermal fibrosis in chronic eedema
End result of autoregulation in patIents with systemic HTN is:
increased peripheral resistance
What imabalance is often seen in HTN cases?
renal function and sodium homeostasis
What is Conn Syndrome?
An endocrine disorder most commonly caused by an adrenal cortical adenoma that secretes Aldosterone.
Causes: HTN, Hypernatremia, Hypokalemia
What terms refer to vascular lesions confined to the skin?
Leukocytoclstic Vasculiitis
Cutaneous Vasculitis
Cutaneous Necrotizing Venulitis
Name the tumor seen in this pt ““48yom with painful, raised, red lesion on dorsal surface of left hand/Skin biopsy: round regular cells within connective tissue associated with branching vascular spaes”
Glomus tumor
lesions are usually smaller than 1 cm in diameter
Glomus bodies
normal neuromyoarterial receptors that are sensitive to temperature and regulate arteriolar blood flow
How would the arteries of a Monckeberg Medial Sclerosis appear on gross examination?
Involved arteries are HARD and DILATED. The MEDIA OF LG AND MEDIUM SIZED ARTERIES of NON-ATHEROSCLEROTIC persona are CALCIFIED.
(These arterial changes are usually asymptomatic)
What characterizes a Congenital cavernous hemangioma?
It’s a benign lesion
It consists of large vascular channels, frequently interpersed with small capillary-type vessels
They can undergo changes: thrombosis, fibrosis,cystic cavitations, intracystic hemorrhage
In the skin, they are called port-wine stains
In the brain, they can enlarge and cause neurologic symptoms
How does claudication occur in an atherosclerotic patient?
Chronic ischemia of the lower limbs due to Atherosclerosis causes hypoperfusion of the leg muscles. . When th eblood supply becomes inadequate, usually upon exertion, the muscles develop cramps (claudication)
Intermittent claudication is associated with PVD (atherosclerosis)
What characterizes Angiosarcoma?
MALIGNANT TUMOR
composed of masses of endothelial cells (malignant) most commonly in the skin, breast, bone, liver, and spleen.
Varies froom distinct vascular elements to undifferentiated tumors with nucleaer pleomorphism and frequent mitosis.
How do cystic spaces develop in dissecting aneurysms?
They are spaces filled with pools of metachormatic myxoid material from focal loss of elastic and muscle fibers in the aortic media.
Chilblains
itchy or tender red or purple bumps that occur as a reaction to cold
Hyaline arteriolosclerosis is \\ has markedly thickened ____ and ACCUMULATION OF ____
bASEMENT MEMBRANE MATERIAL AND accumulation of pLASMA PROTEINS
Diseases that affect the veins are mainly:
Thrombophlebitis (thrombosis-induced local inflammation) and Varicosities (enlarged/tortuous blood vessel)
What are Hemorrhoidsd?
Dilations of the beins of the rectum and anal canal, which may occur inside or outside the anal sphincter.
Can be aggravated by constipation and pregnancy
Can result from benous obstruction by rectal tumors
Which hemorrhoids bleed and/or pain?
Thrombosis of hemorrhoids is equistiely painful
Internal hemorrhoidsd typically bleed without pain
External hemorrhoids typically hurt but do not bleed.
describe the kidneys of a scleroderma patient?
In Sceroderma, MH can be manifested and lead to fatal renal failure .
Its interlobular ateries and affrent arterioles are severely affected vessels. Early fibromuscular thickening of the subintima causes luminal narrowing followed by fibrosis
What are the four fates of a thrombus?
- lysis
- growth and prpagation
- Detachment and embolization
- Organization or Canalization
