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Pathobiology > Circulatory disorders > Flashcards

Circulatory disorders Flashcards

1
Q

What are the specific problems of plaque formation?

A
  • Myocarical and cerebral infarcts
  • Aortic aneurysms
  • Peripheral vascular disease
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2
Q

What is pulmonary embolism?

A

From venous emboli that pass through the right side of the heart into the pulmonary artery

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3
Q

What 3 alteration to blood constituents cause a thrombus?

A

1) Increase in cells/platelets and plasma proteins (solid)
2) Decrease in fluid (eg. after severe burns)
3) Blood becomes hypercoagulable (more likely to clot)

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4
Q

What makes up a thrombus?

A
  • Endothelial cells
  • Platelets (fragments of cells)
  • Coagulation cascade, leading to the production of fimbrin
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5
Q

How does damage to endothelial lining cause a thrombus?

A
  • Damage exposes highly thrombogenic sub epithelial tissue (due to physical, chemical or inflammatory disturbances)
  • Balance between release of thrombogenic and anti-thrombogenic stimuli is shifted
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6
Q

What is CHD also known as?

A

Ischaemic heart disease

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7
Q

In a consecutive clot, what can stabilize the thrombus?

A
  • The blood incoming from the end of a tributary
  • Platelets and fibrin
  • Can reattach the clot to the vessel wall, permitting further propagation
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8
Q

What are the disadvantages of drug-eluting stents?

A
  • Antiproliferative drugs which are released from the stent prevent the proliferation of endothelial cells
  • Not smooth surface
  • Platelet aggrucation
  • Thrombus formation

(Endothelial cells needed to grow over stent to produce smooth surface for blood flow)

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9
Q

How does turbulence cause a thrombus and where does it occur?

A
  • Occurs around the branches of arteries etc, where different blood flows are hitting each other
  • Alteration to the normal, lamellar flow pattern
  • Can damage the endothelium
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10
Q

What is a thrombus?

A
  • A solid mass of BLOOD formed within the cardiovascular system
  • A ‘clot’
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11
Q

What is restenosis?

A

The recurrence of abnormal narrowing of an artery or valve after corrective surgery (stenting)

  • Smooth muscle cells grow over the stent
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12
Q

What is ATHEROsclerosis?

A
  • Fatty deposits (lipid and cellular debry)
  • Disease of the tunica INTIMA

Damage to the endothelial lining which may lead to:

  • Narrowing of the vessels
  • Obstruction
  • THROMBOSIS
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13
Q

What is ‘thrombosis’ and how is it different to a ‘thrombus’?

A
  • Thrombosis is the presence of a clot within a blood vessel

- The clot itself is called the thrombus

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14
Q

What is ARTERIOsclerosis?

A

Disease of the tunica MEDIA which may lead to:

  • Increased wall thickness
  • Decreased wall elasticity
  • Leads to hypertension (smaller lumen)
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15
Q

What 3 things do the consequences of vascular occlusion depend upon?

A
  • Type of tissue involved (artery or vein)
  • How quickly the occlusion occurs (sudden or gradual)
  • The availability of collateral circulation (alternative circulation)
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16
Q

What is percutaneous coronary inverventions?

A

A combination of:

  • Angioplasty (balloon opening a blocked vessel
  • Stenting (wire mesh)

Maintains lumen size

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17
Q

What causes an arterial thrombus?

A
  • Middle age, elderly
  • May have underlying circulatory disorders
  • Increase risk by diabetes smoking
18
Q

What are the MODIFIABLE risk factors of CHD?

A

Strong association

  • Smoking
  • Diabetes mellitus
  • Obesity
  • Hypertension
  • Hyperlipidaemia

Weak association:

  • Lack of excersice
  • High alcohol
  • Type A personality (more prone to stress)
  • Soft water
19
Q

What attaches a blood clot to the endothelial wall?

A

Fimbrin and platlets

20
Q

What is embolisation?

A

Carrying of fragments of thrombus into the general circulation, when there is no tributary to able a consecutive clot to be reattached to the blood vessel wall

21
Q

Normally, where does the fastest blood flow?

A

In the middle of the bulk of blood

22
Q

What can 4 things can vascular occlusion be a result of?

A
  • Thrombosis (blood clot)
  • Embolism (detached blood clot, can move)
  • Atherosclerosis (fatty deposits)
  • External compression (eg during an accident)
23
Q

What is angina?

A

The pain of CHD, caused by narrowing of the arteries

24
Q

What are the major components of an atheromatous plaque?

A

1) Fibrous cap
- Smooth muscle cells
- Collagen
- Elastin
(New cell layer)

2) Cellular layer
- Macrophages, T cells
- Smooth muscle cells

3) Necrotic core
- Lipid and cellular debry
- Cholesterol clefts
- Foam cells

4) Calcification
- Deposition of calcium rich material

25
Q

What are the generalised consequences of plaque formation?

A
  • Narrowing and occlusion
  • Rupture
  • Emboli
  • Calcification
26
Q

What causes CHD?

A

1) Blockage in coronary artery

2) Decrease in oxygenated blood flow
- CO poisoning
- Anemia
- Hypotension

3) Increased demand
- Hypertrophy

27
Q

What are foam cells?

A
  • Fat-laden M2 macrophages that serve as the hallmark of early stage atherosclerotic lesion formation
  • Uptake lipids and undergo cell death
28
Q

What happens in a heart attack?

A

Lack of nutrients and oxygen to the cardiac muscle, leading to cardiac muscle cell death

29
Q

What causes CHD?

A
  • Narrowing of the CORONARY ARTERIES

- Can lead to a myocardial infarction if a complete blokage

30
Q

Why does vascular occlusion have a higher consequence in arteries than veins?

A

Arteries have less alternative routes than veins

31
Q

How can thrombus formation be described?

A

By Vircholu’s triad
1) Alteration to blood constituents

2) Damage to endothelial lining
3) Altered blood flow

32
Q

What is arteriogenesis?

A
  • Collateral vessel formation (birth of a new artery)
33
Q

How can you overcome restenosis?

A

Drug-eluting stents

  • Given with anti-platelet therapy to prevent aggrucation
34
Q

What causes an atheromatous plaque?

A

Aysymptomatic small fatty streak –> atheromatous lesion –> plaque

35
Q

What is the process of atheromatous plaque formation?

A

1) Endothelial cell activation and dysfunction, promoting lipid accumulation

2) Inflammatory response and immune cell recruitment
- Foam cells

3) Recruitment and proliferation of smooth muscle cells and extracellular matrix synthesis

36
Q

What are the FIXED rick factors of CHD?

A
  • Age
  • Male
  • Family history
37
Q

What causes a venous thrombus?

A
  • May be any age

- Due to prolonged periods of immobility

38
Q

What are ‘lines of Zahn’?

A
  • Banding of a venous thrombus
  • Formed by alternating red and white cell and platelet deposits
  • Orientated along axis of blood flow
  • Light = platelets and fibrin
  • Dark = red and white blood cells
39
Q

What are ‘consecutive clots’?

A
  • Unstable clot
  • Formed when the lumen is occluded
  • Slow flow
  • No lines of Zahn and no new platelets
  • Weakly attached to the wall and can easily be dislodged
40
Q

How does stasis cause a thrombus and where does it occur?

A
  • Occurs in venous thrombus
  • Speed of flow is reduced
  • Results in a change of thrombogenic and anti-thrombogenic stimuli
  • Thrombus occurs in the VALVE POCKET, where the platelets adhere to the surface
41
Q

What is systemic embolism?

A

From the arterial system to a variety of organs

Pathobiology (4 decks)

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