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Disease Mechanisms > Ch 11: Blood Vessels > Flashcards

Ch 11: Blood Vessels Flashcards

1
Q

what are the main cellular components of blood vessels

A

endothelial cells (EC)
smooth muscle cells (SMC)
extracellular matrix (ECM)

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2
Q

what three things make up the extracellular matrix of blood vessels

A

elastin
collagen
glycosaminoglycans

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3
Q

what are the 4 main roles of the blood vessels

A

transport blood to tissues
regulate blood flow to tissues
control blood pressure
secrete chemicals

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4
Q

what are the three layers of arteries and veins

A

intima
media
adventitia

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5
Q

the aorta is which type of vessel

A

elastic

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6
Q

middle sized arteries are what type of vessels

A

muscular

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7
Q

the smallest arteries are called what

A

arterioles

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8
Q

what is blood pressure

A

outward force that blood exerts on walls of blood vessels
unit it mmHg

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9
Q

where is blood pressure the highest and lowest

A

highest: systemic arteries
lowest: systemic veins

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10
Q

what are the two factors that determine arterial blood pressure

A

cardiac output and peripheral resistance

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11
Q

what is the relationship of cardiac output and peripheral resistance to blood pressure

A

as they both go up, blood pressure goes up
as they both go down, blood pressure goes down

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12
Q

what three parts of the nervous system affect vessel regulation

A

sympathetic and parasympathetic effects
baroreceptor reflex
chemoreceptor reflex

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13
Q

what three endocrine hormones affect vessel regulation

A

vasopressin
epinephrine
atrial natriuretic peptide

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14
Q

what is vasopressin and what does it do

A

endocrine hormone whose release is stimulated by anti-diuretic hormone (ADH)
increases blood pressure by causing the reabsorption of water by the kidney

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15
Q

what is epinephrine and what does it do

A

endocrine hormone that raises blood pressure by increasing heart rate, cardiac contractility, and vascular tone

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16
Q

what is atrial natriuretic peptide (ANP) and what does it do

A

endocrine hormone that acts as a vasodilator to decrease blood pressure

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17
Q

what is hypertension

A

disorder caused by effects from multiple different genetic and environmental factors
mostly affects small muscular arteries and arterioles
can lead to degenerative changes in vessel walls

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18
Q

which hypertension reading requires intervention

A

anything over >130/80 mmHg (ACC)
anything over >140/90 mmHg (ESC)

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19
Q

what are the two types of hypertension

A

primary and secondary

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20
Q

what is primary hypertension and what are three things that it influences

A

essential or idiopathic (unknown origin)
makes up 95% of cases
usually caused by increase in CO/PR
influences sodium reabsorption, aldosterone pathways, and the RAAS

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21
Q

how do genetic factors play a role in hypertension

A

single gene disorders lead to rare forms of hypertension
60 genetic loci that are susceptible

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22
Q

what are four environmental factors that play a role in hypertension

A

stress
obesity
physical inactivity
heavy salt consumption

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23
Q

what drugs are used to treat hypertension

A

diuretics
beta blockers
ACE inhibitors
calcium channel blockers
alpha blockers

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24
Q

what is secondary hypertension

A

5-10% of cases
altered hemodynamic (blood flow) functions due to primary disease/condition
usually due to an underlying renal or adrenal disease or renal artery stenosis (RAS)

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25
what is the mechanism of secondary hypertension
renovascular HTN: renal arterial sclerosis causes decrease in glomerular flow and pressure in afferent arteriole; increased renin secretions; increase blood volume and vascular tone primary hyperaldosteronism: most common cause; idiopathic or aldosterone secreting adenomas single gene defects: increase aldosterone and reabsorption of sodium
26
what are the four types of secondary hypertension
renal endocrine cardiovascular neurologic
27
what is the mechanism of primary hypertension
insufficient renal sodium excretion leads to increased volume increased volume leads to increased CO/PR which increases blood pressure
28
what are the three general patterns of thickening of the vessel walls
arteriolosclerosis monckeberg medial sclerosis atherosclerosis
29
what is arteriolosclerosis
affects small arteries and arterioles leads to luminal narrowing and ischemic injury two types: hyaline and hyperplastic
30
what is monckeberg medial sclerosis
calcium deposits in the media of muscular arteries common in those older than 50 doesn't cause big issues because the diameter of the lumen stays the same
31
what is atherosclerosis
most common affects elastic and muscular arteries; begins in the intima accumulation of plaque (atheromas) which narrows lumen of vessel can obstruct flow, rupture, or form aneurysms
32
what are some acquired risk factors that can cause atherosclerosis
hypertension cigarette smoking hyperlipidemia (excess fat in blood) diabetes inflammation
33
what is hyperlipidemia
excess amounts of fat in the blood due to a low amount of low density lipoprotein (LDL) removing it
34
what are 2 inherited risk factors can cause atherosclerosis
family history genetic abnormalities
35
what are gender and age associated factors that can cause atherosclerosis
increasing age male gender
36
what are the two portions of an atherosclerotic plaque
fibrous cap and necrotic center
37
what is the fibrous cap of an atherosclerotic plaque made of
smooth muscle cells, macrophages, foam cells, lymphocytes, collagen, elastin, proteoglycans, and new vasculature
38
what are foam cells
macrophages that engulf lipids
39
what is the necrotic center of an atherosclerotic plaque made of
cell debris, cholesterol crystals, foam cells, and calcium
40
what are the five steps of atherosclerosis
1.) chronic endothelial injury 2.) endothelial dysfunction 3.) macrophage activation with smooth muscle recruitment 4.) macrophages and smooth muscle cells engulf lipids 5.) smooth muscle proliferation, collagen deposition, and extracellular lipids
41
what is the overall pathophysiology of atherosclerosis
plaque lesion involves: lipoproteins, macrophages, and T cells interacting with endothelial and smooth muscle cells of arterial wall
42
what are the four main complications of atherosclerosis
myocardial infarction (heart attack) cerebral infarction (stroke) aortic aneurysms peripheral vascular disease (gangrene)
43
what is a true aneurysm
all layers of vessel involved blood confined within vessel two types: saccular and fusiform ex. ventricular aneurysm
44
what is a saccular true aneurysm
one area of lumen is weakened and bulged
45
what is a fusiform true aneurysm
entered area of vessel is weakened and bulged
46
what is a fake aneurysm (pseudo aneurysm)
defect in vascular wall causes extravascular hematoma (out pouching of blood) ex. ventricular rupture after MI
47
what is an arterial dissection
defect in intima of vessel wall where blood tunnels through the medial and advential layers
48
where is the most common area to get an intimal tear
ascending aorta
49
can all aneurysms and dissections rupture?
yes
50
what are the three things that directly cause structural weakness of arterial walls
aberrant TGF-beta signaling loss of smooth muscle cells changes in extracellular matrix
51
what three things cause structural weakness in vessels
genetic defects, ischemia, or defective matrix remodeling
52
what are some risk factors that lead to aneurysms
older age smoking trauma vasculitis congenital defects infections
53
what are the two most important causes of aortic aneurysms
atherosclerosis and hypertension
54
what is an abdominal aortic aneurysms (AAA)
dilation of abdominal aorta more common in men and smokers can rupture, cause obstruction, embolism, or cause impingement usually do to atherosclerosis
55
what is a thoracic aortic aneurysm
dilation of thoracic aorta presents with chest pain, ischemia, difficulty swallowing, hoarseness, and respiratory complications usually do to hypertension
56
what causes hoarseness in those with thoracic aortic aneurysms
recurrent laryngeal nerve
57
what is an aortic dissection
blood separates from vessel wall and forms a blood filled channel within aortic wall caused by hypertension affects older men or those with diseases affecting aorta can be iatrogenic (caused by a procedure) or from pregnancy two types: A and B
58
what is a DeBakey 1 type A aortic dissection
more common and devastating affects ascending and descending aorta
59
what is a DeBakey 2 type A aortic dissection
more common and devestating only affects ascending aorta
60
what is a DeBakey 3 type B aortic dissection
begins distal to subclavian artery only in descending aorta
61
what is vasculitis
inflammation of vessel wall
62
what are some systemic manifestations of vasculitis
fever, malaise (unhappiness), myalgias (muscle pain), and arthralgias (joint pain)
63
what are the two main causes of vasculitis
immune mediated inflamamtion invasion of pathogens into vascular walls
64
what is large cell vasculitis
usually caused by granulomatous disease ex. giant cell arteritis
65
what is giant cell arteritis
affects aorta and medium sized vessels granule builds up in head vessels like superficial temporal artery affects older than 40 or those with poly myalgia rheumatica cells: lymphocytes and macrophages presents with: facial pain or headache treated with: steroids
66
what is medium vessel vasculitis
can be caused by anti-endothelial cell antibodies ex. Kawasaki disease
67
what is Kawasaki disease
inflammation of medium and small sized vessels presents with: fever, enlarged lymph nodes, rash, swelling of hands and feet, coronary artery aneurysms, mucositis, and bilateral conjunctivitis treated with: aspirin
68
what is small vessel vasculitis
eosinophilia, asthma, and granulomas (seen in infection/hypersensitivities) ex. churg-strauss syndrome
69
what is churg-strauss syndrome
immune complex mediated disease that affects medium and small sized vessels cells: lymphocytes, macrophages, neutrophils, and lots of eosinophils presents with: renal problems, GI bleeding, and skin involvement seen in those with asthma and atopy (tendency to develop allergies)
70
what's another name for buerger disease
thromboangiitis obliterates
71
what is thromboangitis obliterates (buerger disease)
affects medium and smaller sized arteries (tibial and radial arteries) as well as veins cells: lymphocytes, macrophages, neutrophils, and eosinophils causes thrombosis, fibrosis, scar tissue, and nerve involvement common in young, male smokers presents with: pain, claudication (muscle pain), and venous inflammation
72
what are three complications of buerger's disease
ulceration, gangrene, and amputation
73
what are some characteristics of primary Raynaud phenomenon
affects 3-5% of population usually young women symmetrically triggered by hyperactivity of smooth muscle cells
74
what are some characteristics of secondary Raynaud phenomenon
secondary to systemic diseases like SLE, scleroderma, buerger disease, and atherosclerosis asymmetric involvement that worsens over time
75
what are varicose veins
abnormally dilated and tortuous veins caused by increase intraluminal pressure by loss of support of vessel wall usually involve superficial veins of leg caused by prolonged standing, pregnancy, obesity, or a genetic predisposition presents with: aching, swelling, eczema, and ulcerations treated with: stockings or surgery
76
what are the two most common sites for varicose veins
esophageal varies and hemorrhoids

Disease Mechanisms (19 decks)

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