Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ALU 201 > Chapter 14 > Flashcards

Chapter 14 Flashcards

1
Q

what are the 3 specialized components that make up the vascular system?

A

arterial, venous and lymphatic systems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the purspose of the arterial system?

A

carries O2 blood to the itssues of the body after it leaves the heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the purpose of the lymphatic system?

A

a seperate vessel system that is responsible for carrying excess fluid from the tissue spaces back to the bloodsteream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the purpose of the venous system?

A

transporting deoxygenated blood back to the heart and lungs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the most prevalent disease of the arteries?

A

Atherosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

VEssels beyong a cetain diameter generally consist of 3 defined layers. Name and define them

A
  1. intima- single layer of endothelial cells on innermost section
  2. Media- refers to the middl esection of the vessel wall and consist of smooth muscle cells surronded by collagen and elastic tissue
  3. adventita, outermost layer covering the vessel wall. its a mixture of collagen, elastic tissue, smooth muscle, nerve fibers, vasa vasorum and lymphatic vessels.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

The structural elements most common to arterial vessels consist of 5 tissue components.

A
  1. endothelium
  2. basement membrane
  3. elastic tissues
  4. collagen
  5. smooth muscle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

below the endothelium is the basement membrane composed of various proteins and polysaccharides that serve what purpose?

A

support structure and transport medium for various materials.
it is emcompassed to the endothelium layer via elastic tisssue.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the purpose of collagen and smooth muscle found in the vessel walls?

A

collagen- resists stretching and prevents over-distension of the vasculature
smooth muscle- provides contracting component of the vascular system that regulates vasoconstriction and dilation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

The vascular system later devides into a smaller subcategory of vessels. define them

A

elateric arteries (arota and major pulmonary)
muscular arteries (renal/femoral)
arterioles
capillaries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which arteries are major regulators of systemic blood pressure?

A

Muscle arteries. they can constrict and dilate to allow varying degrees of blood flow to certain tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Define arterioles

A

small arteries which lead to capillaries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Define capillaries

A

smallest blood vessels, have an endothelium but no intima.

  • RBC pass through this vessel in single file *slowly.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the route of blood after leaving capillaries

A

capillaries > post-capillary venules > collecting venules > small viens > medium viens > large veins > vena cavae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

define the veins system

A

larger diameter, larger lumens, and thinner more distensible walls making the venous sytem capable of holding 2/3 of the totaly blood in the body.

there are also valves present in some parts to prevent reverse flow or pooling of blood.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Define lymphatics

A

THIN-walled, endothelial-lined channels that collect excess fluid in the tissue and inflammatory cells, transporting them back to the blood.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How is atherosclerosis characterized?

A

intimal leasions called atheromas or fibrofatty plaques

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is an atheroma?

A

cone of cholesterol joined ot proteins with a fibrous intravasular covering. It can eventually protrude into the vascular lumen and weaken the underlying media.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How many Atherosclerotic lesions categories are they?

A

6 types- from fatty dot (Type 1)

to stages of fatty streaks, > intermediate lesions > atheromas > fibroatheromas, to complicated type 6 lessions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Define fatty streaks

A

early lesion, composed of foam cells and occurs usually in the first year of life.
- not raised, and does not disturb flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

where does atherosclerotic plaques develop?

A

primarily in elastic arteries, and large and medium-sized muscle arteries.
- usually becomes symptomatic when it affects blood vessels that carry blood to the lower extremities, brain, and kineys.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are some complications related to atheroscleroris?

A

claudication and gangrene of the legs, stroke, CAD, and aortic aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Define the characteristics of atherosclerotic plaque

A

raised focal lesion initiating within the intima containing a soft yellow lipid core covered by a fibrous cap.
- in advanced stages the lesion can rupture, ulcerate, or erode which allows exposure of highly thrombogenic substances that can induce formation of a thrombus and subsequent acute obstructiong of blood flow. Small pieces of plaque released in blood stream can also microemboli.

24
Q

What are some atherosclerotic risk factors?

A
  1. age
  2. gender: males > female prior to menopause.
  3. genetics
  4. hyperlipidemia
  5. HTN
  6. DM
  7. tobacco
  8. homocysteinemia
  9. lipoprotein - form of LDL
  10. other: type A personality, sedentary lifestyle, obesity, and stress
25
Q

Define Peripheral arterial disease (PAD)

A

occlusive disease of the aorta, the iliac arteries and the arteries of the lower extremities.
- marker for systemic vascular disease and confers sharply increase risk of coronary/cerebrovascular events

26
Q

What is the clinical presentation of PAD?

A
  • gradual onset of lower extemity claudication characterized by aching, tiredness, or burning pain and frequently goes unrecongnized for an extended period of time.
  • sxs brought on by walking and relieved with rest
  • will usually go misdx’d
27
Q

What are the physical symptoms of PAD reviewed upon examination of a suspected diagnosis ?

A

physical exam shows decreased pilses, atrophic changes of skin, decreased capillary refilling, loss of hair, discoloration of skin and vascular bruits.
dx with review of 5 P’s. pulselessness, paralysis, paraesthesia, pain and paller.

28
Q

what is the difference between true claudication and pseudoclaudication due to lumbar canal stenosis?

A

true caludication: manifested by walking a certain distance and is relieved when the individual stops,
pseudoclaudication is when pain persists when standing and can nessitate sitting or changing possition.

29
Q

How is PAD dx’ed?

A
  1. Ankle-brachial index test-
  2. exercise treadmill testing- those with sxs with normal resting ABI
  3. Segmental limp pressures.- BP cuffs applied at different levels, 20 mmHG or greater difference in PP is considered sig
  4. ultrasound methods: gray-scale imaging, doppler pulzse and continous=wave spectral and doppler color flow
  5. MRI and MRA- sensitive and specific in evaluating arterial wall morphology and possible dissection
  6. angiography - definite dx
30
Q

When is an Ankle-brachial index test- ?

A

non-invasice, used for dx of lower extemity arterial stenosis of 50 or grater. done via doppler wave u/s assessment. by dividing ankle systolic pressure by arm systolic blood pressure before and after treadmill exercise. An ABI <0.9 indicates presence of obstructive disease.

31
Q

Define the difference in gray-scale imaging, and colour flow imaging in terms of PAD dx

A

gray: assesses the morphology of the vessel to determine plaque pressence and characteriastics
colour- evaluates subtotal occlusion of blood vessels and aneurysms, and localizing areas of stenosis

32
Q

How is PDA treated?

A

medical and surgical disiplines

  • servical is used for severe cases that do not respond to risk factor modification, exercise and drug.
  • modifications to risk include: smoking cessation, diet (reduce fat), exercise, drug therapy (antiplatelet agents, inhibitors for platelet aggregation, phosphodiesterase inhibitor, lipid lowering therapy)
33
Q

What are the surgical options for treatment of PAD?

A

percutaneous procedures suchs as PTA (percutanous transluminal angioplasty) ballon angioplasty and stenting.

surgical bypass and graft placement in occlusive disease is also directed at relieving persistent claudication and improving the level of ADLs but is used in more severe situations.

34
Q

What are the 3 main indications for utilizing angioplasty for PVD tx?

A
  1. persistent claification that significantly reduces ability of the individual to preform ADL
  2. pain at rest
  3. tissue loss.
35
Q

When do you see the greatest success rate for PTA?

A

when it is utalized for aortoiliac stenosis.

36
Q

What are some complications related to a PTA procedure?

A

direct arterial injury leading to groin hematoma
pseudoaneurysm
arteriovenous fistula
actual dilation of the vessel > distal embolization or thrombotic occlusion and rarely arterial rupsure

37
Q

What therapy is recommended prior to PVD tx surgery and required for life-long tx after?

A

ASPIRIN

dupyridamole can provide additional benefit in the prevention of graft failure

38
Q

Define fibromusclar dysplasia (FMD)

A

aterial disease of unknown etiology affection medium to large arteries in young females.

  • fibrous or fibromuscular thickening of intima/media and adventitia of arteries.
  • usually affects renal arteries but can cause stenosis of the carotid, cerebral and visceral arteries.
  • the lack of blood flow causes seceondary HTN in renal arteries,
39
Q

Define Raynauds Phenomenon (RP)

A

refers to the paroxysmal pallor or cyanosis of the digits of the hands and feet where body temperature is at its lowest, and digital arteries and arterioles are more susceptible to cold-induced vasoconstriction.

  • sxs: fingers change color, toes also reported to be affected
  • more common in females, and median age is 14 yo.
40
Q

Define Secondary Raynaud’s Phenomenon (Raynaud’s syndrome)

A
  • associated with connective tissue disease, drugs, occlusive vascular disease, hematologic abN, and environment
  • ## used to describe RP when an underlying causes has been dx’d.
41
Q

What tests should be completd to assess for systemic disease?

A 
CBC
general chemistry 
ANA 
Rheumatoid factor (RF)
disease specific antibodies 
evaluation of complement system
42
Q

Define small and medium vessel vasculitides

A

complex heterogenous group of disorders that involve inflammation and destruction of blood vessel walls.

43
Q

Define Polyarteritis nodosa (PAN)

A

medium vessel vasculitis (MVV) that affects arteries with muscular walls.

  • inflammation leads to aneurysmal formaiton
  • sxs: malaise fatigue, fever, and weight loss- can take weeks to months to clearly manifest.
  • affects: skin, peripherl nerves, GI tract and kidneys.
  • pt usually have vasculitic neuropathy in form of mononeuritis multiplex (MM)
  • dx with biopsy or angiogram demonstrating microaneurysm
  • tx’ed with immunosuppression in form of corticoasteroid and cyclophosphamide.
44
Q

What is postprandial periumbilical pain

A

intestinal angina.

45
Q

Define Kawasaki syndrome (KS)

A

-acute vasculitis in childhood, that has a prediletion for the coronary arteries
- morbidity and mortality ^ d/t corinary aneurysm.
- sxs: fever > rash > conjunctival injection and oral lesions. Periungual desquamation or peeling of the skin around the fingers may appear 10-14 daya following fever.
- tx to prevent coronary artery anurysm vie IV gamma globulin.
aneurysms detected by transthoracic echo

46
Q

Define Wegener’s Granulomatosis (WG)

A

vasculitits of the small and medium vessels,
affectes promarily lungs, and kidneys.
- sxs of respiratory disorders attributed to asthma or infection- sxs lead to recurrent epistaxis, mucosal ulverations, nasal septal perforation and nasal deformity.
- 75% of people develop gloerulonephritis
- dx with blood test to identify ANCA in conjunction with an active urinary sediment, elevated ESR and unexplained anemia.
- if ANCA is -ve, a biopsy can be done.
-tx with immunosupressant agens, and remission is acheived in 75% cases. 50% of which will relapse.

47
Q

Define Thromboangiitis obliterans (Buergers disease)

A

vasculitits strongly linked to smoking,

  • cahracterized by segmental, thrombosing, acute/chronic inflammation of small and medium-sized vessels.
  • affects tibial and radial arteries, leaving to vascular insufficiency. later complications of chronic ulceration and gangrene of the fingers and toes.
  • dx: angiography, which demonstrates smooth, tapered, segmental lesions.
48
Q

Define Giant Cell arthritis (temporal arteritis)

A

GCA is characterized by inflammatory changes in one of the branches of the aorta- and target mostly extracranial branches of the carotid branches. It is most often in the superficial temporal, vertebral, opthalmic and posterior ciliary arteries. Vessels are thickened, tender and sometimes nodular. Pulse is reduced or absent

  • occuring in people >50
  • more common in females
  • two major sxs complexes: signs of vascular insufficiency and systemic inflammation.
  • sxs of sharp or dull headaches, temporal tenderness, vision loss is a serious complication- its painless and permanent.
  • dx with blood test, and +ve biopsy of the affected muscle.
  • tx with corticosteroids and reduce rate of blindness
49
Q

DEfine the term aortic arch syndrome.

A

In about 15% of GCA cases, the large arteries are targeted.
this syndrome causes claudation of teh upper arms, results in absent pulses, paresthesias, RP, and occasionally gangrene.
- dx with nonspecific blood tests, such as ^ ESR.

50
Q

define Takayasu’s arteries (TA)

A

large vessel vasculitis classically involving aortic arch and its main branches. Inflammation results in intimal thickening with subsequent stenosis and/or anruysm.

  • complete occlusion of upper extremity artery can occur
  • females <40 yo
  • sxs: myalgias, fever, malaise, wieght loss and anorexia- usually misdiagnosed. eventually ischemia becomes aparent
  • carotid and vertebral artery involvement can cause dizziness, tinnitus, syncope, stoke and visual disturbances.
  • best dx’ed with vascular imaging and is combined with angioplastic. Rx coritcosteroids.
51
Q

define aneurysm

A

localized, abnormal dilation of a blood vessel. It is considered a true aneurysm when it is bounded by the components of the vessel wall.

52
Q

What is a false aneurysm?

A

when there is a breach in teh vascular wall leading to an extravascular hematoma that freely communicates with the vessel lumen.

53
Q

What is the cause of an aortic aneurysm

A

atherosclerosis and cystic medial degeneration of teh arterial media. These can also be caused by systemic disease, trauma, amd mycotic (fungal) infections.

54
Q

Define an Abdominal Aortic Aneurysm (AAA)

A

caused by atherosclerotic process of plaque formation.

  • more common in males and >50,
  • predisposed risks: atherosclerosis, HTN and genetics.
  • aneurysms expand yearly, and are affected by HTN control. Risk of rupture is directly related to size of anuerysm.
  • most are clinically silent. usually dx’ed d/t pulsatile abdo mass, as it grows it can cause pain.
  • dx with u/s, CT or MRI.
  • tx’ed with surgical repair if sxs, or growing, or large
  • precutaneous stent grafts can also be sued
55
Q

How are Thoracic Aneurysms classified? what are the chategories?

A

classified based on their anatomic location

  1. ascending thoracic aneurysm
  2. aortic arch aneurysm
  3. descending aortic aneurysm
  4. thoracoabdominal aneurysm,
56
Q

how are thoracic aneurysms dx’ed and tx’ed

A

incidental finding on CXR - can lead to futher investigations but CT and MRI with contrasts used for dx.
surgical tx for those with accelerated growth rate and in those with end-diastolic diameter is ^ and found by radiologic intervention.

ALU 201 (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions