Blood Vessels I

Question 1

vasculature organization

Answer 1

intima > internal elastic lamina > media > external elastic lamina > adventitia

also - vaso vasorum

Question 2

intima

Answer 2

single layer endothelial cells

Question 3

media

Answer 3

smooth muscle cells

-not very developed in veins

Question 4

adventitia

Answer 4

CT with nerve fibers and vaso vasorum

Question 5

three types of arteries

Answer 5

1 - large elastic
2 - medium muscular
3 - small arterioles

Question 6

ectatic

Answer 6

arteries in older individuals are more tortuous and dilated

Question 7

regional blood flow regulation

Answer 7

muscular arteries and arterioles

Question 8

principal point of physio resistance to blood flow

Answer 8

arterioles

Question 9

small arteries

Answer 9

<2mm

Question 10

vaso vasorum

Answer 10

feed medium and large arteries

outer 1/2 to 2/3 of media

Question 11

resistance vs. radius

Answer 11

fourth power relationship

Question 12

veins

Answer 12

thin
large diameter
valves in extremities
large lumen

Question 13

postcapillary venules

Answer 13

site of leukocyte exudation and vascular leakage

Question 14

malignancy invasion

Answer 14

easier to invade lymphatics and veins

thin walled

arterial invasion not common

Question 15

2/3 of blood volume

Answer 15

in veins

Question 16

lymphatic structure

Answer 16

endothelial cells with no media

vavles in large vessels

Question 17

pericytes

Answer 17

supportive cells

Question 18

metastasis to lymphatics

Answer 18

not necessarily to vasculature - may get trapped in nodes

Question 19

capillaries vs. lymphatics

Answer 19

both thin walled
-difference histologically - look for RBC presence

caps RBCs
lymph WBCs

Question 20

weibel palade bodies

Answer 20

in endothelial cells

contain vWF

Question 21

fenestrated capillaries

Answer 21

holes

-intestinal villi, endo glands, kidney glomeruli

Question 22

continous capillaries

Answer 22

fat, muscle, nervous system

Question 23

discontinuous capillaries

Answer 23

liver, bone marrow, spleen

aka sinusoidal

Question 24

anticoag from endo cells

Answer 24

prostacyclin
thrombomodulin
heparin-like mlcs
plasminogen activator

Question 25

procoag from endo cells

Answer 25

vWF tissue factor plasminogen activator inhibitor

Question 26

ECM production from end cells

Answer 26

collagen | proteoglycans

Question 27

vasoconstrictors from endo cells

Answer 27

endlthelin | ACE

Question 28

vasodilators from endo cells

Answer 28

NO | prostacyclin

Question 29

oxidation of LDL

Answer 29

by endo cells | -important - cholesterol that needs stored somewhere

Question 30

angiogenesis

Answer 30

neovascularization - new vessel formation in mature organism

Question 31

vasculogenesis

Answer 31

vessel formation during embryogenesis

Question 32

atreriogenesis

Answer 32

remodeling of existing arteries

Question 33

endothelial activation

Answer 33

normal situation GFs vasoactive mediators adhesion mlcs anti-coagulants**

Question 34

endothelial dysfunction

Answer 34

abnormal situations - HTN or turbulent flow ``` GFs chemokines/cytokines pro-coagulants** adhesion mlcs vasoactive mediators ```

Question 35

endothelin

Answer 35

vasoconstrictor

Question 36

regulation of vascular smooth muscle

Answer 36

promoters inhibitors RAAS catecholamines

Question 37

response to vascular injury

Answer 37

intimal thickening** smooth m cell growth and matrix synthesis -cells from: circulating precursors, adjacent uninjured endothelial, or medial smooth m. cells (non-contractile)

Question 38

berry aneurysms

Answer 38

congenital - developmental - born with - Gomez believes - defect in vessel wall allowing it to be weak - so gets blown out with high P commonly circle of willis

Question 39

headaches or sudden death

Answer 39

berry aneurysm

Question 40

AV fistula

Answer 40

can be congenital or acquired -abnormal artery > vein shunting lots of stress on heart > CHF chronic renal failure - fistula put in for dialysis

Question 41

fibromuscular dysplasia

Answer 41

focal irregular or intimal hyperplasia - thickening of walls of medium/large arteries - common in young women renal artery stenosis - renal hypotension

Question 42

rupture in brain

Answer 42

berry aneurysm and AV fistulas

Question 43

HTN

Answer 43

systolic > 140 diastolic > 90 over 60 yo - > 150/90

Question 44

general population with HTN

Answer 44

29%

Question 45

more important in determining cardiovascular risk

Answer 45

systolic blood pressure

Question 46

HTN risk for what?

Answer 46

``` CAD CVAs hypertensive heart disease aortic dissection*** renal failure ```

Question 47

pre-hypertension

Answer 47

initiate lifestyle changes

Question 48

majority of aortic dissection

Answer 48

with HTN also with marfan - but this is a smaller number of patients (rare disease)

Question 49

blood pressure factors

Answer 49

CO and peripheral resistance

Question 50

factors determining BP

Answer 50

age, gender, BMI, sodium intake also genetic variation of RAAS

Question 51

initiation of essential HTN

Answer 51

increased sodium retention

Question 52

ANP

Answer 52

vasodilation excrete Na and H2O response to volume overload