Cardiovascular Clinical Correlates

Question 1

Functions of normal endothelial cells (3)

Answer 1

Nonadhesive surface, laminar flow and growth factors

Question 2

How do endothelial cells vasoconstrict/vasodilate

Answer 2

By mediating auto-regulation

Question 3

What blood pressure is considered high

Answer 3

140/90

Question 4

3 main things that can cause hypertension

Answer 4

Over-activation of vasoconstriction signaling, vascular disease, and renal dysfunction

Question 5

Increased vascular resistance can do what to the heart?

Answer 5

Left ventricle hypertrophy (reversible)

Question 6

What is atherosclerosis and what arteries does it typically affect?

Where in the artery does the plague form?

What can the plague cause?

Answer 6

“Hardening of arteries”; typically medium to large arteries

Tunica intima

Emboli or thrombus formation

Question 7

Dysfunction in endothelial cells can lead to entry of LDL/VLDL. What does the body do when this happens?

Answer 7

Monocytes enter becoming macrophages and attack LDL making macrophages become foam cells

Question 8

What do smooth muscle cells do in order to contain the plague and avoid rupture into the lumen?

Answer 8

Release growth factors (PDGF) to produce more ECM (collagen) and have smooth muscle cells migrate forming the fibrous cap around the plague

Question 9

What are cytokines

Answer 9

Released by endothelium and trigger entry of lymphocytes which contribute to plague formation

Question 10

What size of fibrous cap will lead to most protection against rupture

Answer 10

Larger fibrous cap gives most stability

Question 11

What does cardiac muscle use for energy

Answer 11

Primarily fatty acids but can also use glycogen

Question 12

How long does ischemia have to last in order to produce permanent loss of cardiac muscle cells

What do the cardiac muscle cells get replaced by

Answer 12

20 minutes

Connective (scar) tissue

Question 13

Name some complications following acute MI

Answer 13

Valve dysfunction, myocardial rupture or hemorrhage

Question 14

Stenosis vs thrombus formation

Answer 14

Stenosis is progressive plague growth/build up

Thrombus formation is secondary to rupture of plague into lumen

Question 15

What is an aneurysm

Answer 15

Weakening of artery wall with an external ballooning on the surface

Question 16

Difference in the following types of aneurysms:

1. Saccular
2. Fusiform
3. False

Answer 16

1. Round shape (true aneurysm)
2. Not as defined round edge, more elongated
3. Hematoma shaped like an aneurysm (so artery wall is not actually bulging)

Question 17

Artery dissection is neither hematoma or hemorrhage; what is it?

Answer 17

Tear in tunica intima allowing blood from lumen to enter artery wall

(Hemorrhage would be if blood ruptured through tunica media and adventitia to the outside of artery wall)

Question 18

Risks with aneurysms

Answer 18

Rupture can lead to hematoma/hemorrhage; growth of aneurysm can lead to compression of a nearby artery

Question 19

What kind of aneurysms can branch at multiple points?

Answer 19

Saccular (true)

Question 20

Hyalinized vs hyperplastic arteriosclerosis

Answer 20

Both cause narrowing of lumen and increase vascular resistance

Hyalinized: can be caused by overproduction of ECM

Hyperplastic: “onion skin”; caused by proliferation of smooth muscle and basement membrane of endothelium

Question 21

What does vascilitis involve?

Answer 21

Invasion of WBCs causing inflammation in blood vessel wall (usually in arteries but can be any blood vessel)