Disorders of Arteries II Flashcards
What are common symptoms of stroke?
Neurological symptoms -> impaired innervation
Speech problems
Why are their neurological symptoms involved in stroke?
Clots in arteries supplying the brain
What are vulnerable points for thrombosis?
Branch points
Why are branch points susceptible for clotting?
Low oscillatory blood flow
Flow is not homogenous
What are two theories about branch points?
Cholesterol particles have an easier time to get stuck
Shear stress EC theory - changing type of pattern of slow is not ideal -> cells express adhesion cells
Which cerebral arteries supply the basal ganglia & thalamus?
Small deep perforating central branches of middle, anterior and posterior cerebral arteries
What regions do the lateral striate arteries supply?
Striatum & internal capsule
What area of low shear stress can arterial thrombotic disorders occur?
Left atrial appendage of the heart
What can occulsion of left atrial appendage cause?
Embolisms & stroke
Why do clots form in the left atrial appendage of the heart?
Due to atrial fibrillation with reduced motility of atrial wall
What are 5 causes of thromboembolic ischaemic stroke?
Local atherosclerosis of larger cerebral arteries
Cardio embolism
Occlusion of small deep penetrating arteries in brain
undetermined
Bleeding into brain due to spontaneous arteries
What are 5 areas where cardioembolism can occur?
Venous circulation (septum)
left atrium (atrial fibrillation)
Left ventricle (MI)
damaged cardiac valves
aortic arch
What are 3 treatments/preventions of IS?
Reperfusion strategies (tPA)
Antiplatelet therapy (aspirin)
Anticoagulants (warfarin)
What is disseminated intravascular coagulation (DIC)?
Heterogenous group of disorders associated with severe bleeding and/or thrombosis
What does DIC result from?
Overwhelming activation of clotting system that consumes platelets and clotting factors
What is DIC defined as?
Intravascular activation of coagulation without a specific localization & arising from different causes
What are conditions that can lead to DIC?
Severe infection
Trauma
Severe blood loss
heat stroke
childbirth (rare)
What does massive activation of SNS in trauma?
Massive arteriolar vasoconstriction -> capillary hypoperfusion, hypoxia, activation & damage to ECs
What protein does massive activation of thrombin induce?
APC -> bleeding
What are 6 main goals for DIC treatment?
clotting inhibitors
anti-platelet drugs
clotting factor replacement
plasma transfusion
platelet transfusion
oxygen therapy
