Disorder of blood vessels Flashcards
Atherosclerosis 3 types
Coronary artery disease
Peripheral vascular disease - arteries supplying the extremities and organs
Cerebrovascular disease - arteries supply the brain
Arteriosclerosis (3 types)
- Atherosclerosis - fatty deposit in inner layer (tunica intima). MOST COMMON
- Monckeberg’s arteriosclerosis - middle layer (tunica media) of arteries with destruction of mm and elastic fibers, formation of calcium deposit. “SENILE”
- arteriolosclerosis (arteriolar sclerosis) - Thickening of the walls of small arteries (arterioles). HYPERTENSION RELATED. Doesn’t involve atheromas (depositing of plaque)
Atherosclerosis clinical manifestation
Asymptomatic
Ischemia
Infarct
Atherosclerosis risk factors
High LDL High BP Smoking Diabetes Obesity
Peripheral vascular/arterial disease (PVD/PAD)
Any disease of the circulating system outside of heart and brain LE>UE Most common atherosclerosis Intermittent claudication, cyanosis, Men>Women
Vasculitis 3 types
Arteritis - inflammation of arteries
Infective arteries - inflammation of an artery due to infection
Rheumatoid arteries - inflammation of an artery associated with RHD (Rheumatoid heart disease)
Rheuma - move, flow, pain moves around
Most common vasculitis
Giant cell arteritis (GCA) Cranial or temporal arteritis, multiple sites of temporal and cranial arteries affected
Female>male>age 50
Menopause, smoking heart murmurs, Idiopathic
Which vasculitis mimic migrane
Giant cell arteritis (severe, continuous, unilateral throbbing HA)
Visual disturbance, enlarged temporal artery, scalp sensitivity respiratory tract problem
Onset is usually sudden
Where does Giant cell arteritis pain radiate?
Radiated pain to Occipital area, face, side of neck.
Pain/paralysis of shoulder, claudication of arm and jaw,
Which vasculitis loses radial pulse
Giant cell arteritis
Which vasculitis loses tibial and dorsal pedis pulse
Thromboangiitis obliterans
What is Thromboangiitis obliterans
AKA Burger’s disease
Producing obstruction due to inflammation and fibrosis, peripheral blood vessels, primarily in extremities (hands and feet)
Idiopathic, episodic, move around, intermittent claudication
What is the first sign of Thromboangiitis obliterans
Intermittent claudication of center of arch of foot, palm of hand
Sign and Symptoms of Thromboangiitis obliterans
Edema, rubor (redness of the skin from dilated capillaries under the skin), cyanosis, thin shiny hairless skin,
Inflammation of superficial thrombophelebitis is common
Who gets Thromboangiitis obliterans
men Heavy smokers
Which vasculitis associated with Hepatitis B
Polyarteritis nodusa often invovle kidneys, heart, liver, GI tracts, muscles testes
Who gets Polyarteritis nodusa
Common among IV drug abusers - sensitivity III
What does Giant cell arthritis lead to
Blindness, stroke, heart attack, aortic dissection (type of aneurysm blood flows between layers (media, interna)
What does Thromboangiitis obliterans lead to
Inflammation superficial thrombophelebitis si common as is ulceration, amputation
Can result in progressive disability from pain and loss of function
what does Polyarteritis nodusa lead to
Pericarditis, myocarditis, arrhythmias, MI, aneurysm, hemorrhage, thrombosis, fibrosis
Prognosis poor without treatment, excellent with treatment
Treatment meds (corticosteroids, immunosuppressants)
What is aneurysm
An abnormal stretching (dilation or dilitation) in the wall of an artery, a vein or the heart with a diameter that is at least 50% greater than normal
3 types of Aneurysm
Aortic: MOST COMMON for an arterial aneurysm
(Thoracic - ascending, transverse or first part of descending portion of the aorta)
Mycotic: caused by bacterial or fungal infection. Salmonella and syphilis most common
Atherosclerotic: Due to the build up of fatty deposits on the inner wall of the arteries
Aneurysm etiology
age >50 Atherosclerosis Congenital connective tissue weakness such as marfan Genetics Trauma to the vessels Inflammatory disease infections
3 types of aneurysm formation
saccular, fusiform, raputered
Pathogenesis of aneurysm
Plaque formation - erosion of vessel wall - stretching of the inner and outer layer of the artery -formation of a sac- become more fibrotic-force of blood pressure can tear or rupture
Clinical manifestation of aneurysm
Asymptomatic, Distended neck veins MI Stroke (hemorrhagic stroke) Renal failure, paraplegia (impairment in motor or sensory function of the LE) , etc
Disorders of the small vessels (4 types)
Telangiectasia
Frostbite
Diabetic microangiopathy (3 types)
Decompression sickness (2 types)
What is telangiectasia
AKA spider veins
Vascular lesion formed by dilatation of a group of small blood vessels
May appear as a birth mark in young children
maybe associate with long term sun exposure, standing, age, varicose veins, gender, pregnancy, trauma, steroid teratment
Where is telangiectasia most commonly seen?
Face and thighs
What is frost bites
localized medical condition whereby damage is caused to skin and other tissue due to extreme cold
Frost bite two classification
Superficial frostbite -affects skin and subcutaneous tissue
Deep frostbite - extends beyond the superficial tissue white skin, pain blisters, tissue necrosis, gangrene
What is Diabetic microangiopathy
poorly controlled hyperglycemia leads to vascular complications that affect small (microvascular) vessels, large vessels or both
Diabetic microangiopathy 3 types
Diabetic retinopathy: MOST COMMON cause of ADULT BLINDNESS, characterized by retinal capillary microaneurysm
Diabetic neuropathy: nerve ischemia from microvascular disease, direct effects of hyperglycemia on neurons, and intracelluar metabolic changes that impair nerve function
Diabetic nephropathy: glomerular (part of kidney)sclerosis and fibrosis caused by metabolic and hemodynamic changes of DM. #1 cause of RENAL FAILURE
Diabetic Microangiopathy MOI
Glycosylation of serum and tissue protein
Superoxide production
activation of signaling molecules that increases vascular permeability and cause endothelial dysfunction
Hypertension and dyslipidemias
arterial microthromboses
Profinflammatory and prothrombotic effect of hyper glycemia and hyperinsulinemia that impair vascular autoregulation
What is decompression sickness
The bends, divers disease
Rapid pressure reduction causes gas previously dissolved in blood or tissues to form bubbles in blood vessles
N2 dissolves in fat, tissues with a high lipid content (e.g. CNS) are particularly susceptible.
Henry’s law
Amount of gas solved in a liquid is proportional to the pressure exerted on the gas and liquid
Type I and Type II Decompression sickness
Type I - progressively worsening pain in the joints and muscles. Pain intensifies during movements. Lymphadenopathy, skin mottling, itching
Type II-neurologic/respiratory, paresis, numbness, tingling, difficult urinate, Headache, dizziness, seizure, massive pulmonary embolism can result in circulatory collapse and death
What is Varicose vein
AKA varicosities
Abnormal dilation of veins leading tortuosity (twist and turn) of the vessel, incompetence of the valves, and a propensity to thrombosis
Who gets varicose vein
Women>men till 70 years old
70 % of women ages 60-70 have varicose vein.
Where is the common site for varicose vein?
LE, saphenous vein, rectum and anal canal (hemorrhoids), Variocele (scrotum), esophagus
What does varicose vein lead to
Ulcers, thrombosis, phlebitis (inflammation of the vein)
partial or full occlusion of a vein by a clot
Venous thrombosis
Partial or complete occlusion of a vein by a thrombus with a secondary inflammatory reaction in the wall of the vein
Thrombophlebitis
inflammation of a vein, predisposing a person to clot formation
Phlebothrombitis
Deep Vein Thrombosis
3rd MOST COMMON Cardiovascular disease after coronary artery episode (heart attack), Cerebrovascular accidents (stroke)
Usually in calf. lead to pulmonary emboli. Popliteal, femoral, iliac vein, inferior venacava
What does deep vein thrombosis associate with
Pulmonary emboli
What causes DVT?
Genetics, pills, smoking, venous stasis, hyper coagulability,
What is chronic venous insufficiency
AKA post phlebitis syndrome, venous stasis
Edema, reddish brown pigmentation at ankles and ulcers with white creamy to fibrous slough over a base of granulation tissue
what is Rhaynaud’s disease (2 type)
Raynad’s phenomenon: secondary to another disease or underlaying cause
Raynaud’s disease: primary vaso spastic
Raynaud’s color change
Blue - white - red
When does the person likely to get Chronic venous insufficiency
Secondary to Varicose veins, or severe cases of DVT, leg trauma, neoplasms
who gets Raynaud’s
Idiopathic, but smoking (men) marital status, alcohol (women) maybe the factor. More common in women.
What is Raynauds’ associated with
occlusive arterial disease, neurogenic lesions, TOS, frostbite, trauma, chronic use of vibrating equipment, injury to the small vessels of hands, repetitive stress
what is Raynaud’s
intermittent episodes of small artery or arteriole constriction of the extremities causing temporary pallor and cyanosis of the digits and changes in skin temperature
Occurs in response to cold temperature, anxiety or excitement
