Handout Packet Ischemic and Valvular Heart Diseases Flashcards
Media what layer is this and is it the thickest
Thickest layer of artery made of smooth muscle in a matrix of collagen, elastin, and proteoglycans
middle layer right after the internal elastic lamina
Atheroscleroiss what is this
The inner layer of the artery becomes ardended because of fatty deposis and fibrous tissueand and frequentyl involves the coronary and cerebral areteries
Adventitia whatr layer is this and what is it made of and whats another name for it
made up of fibroblasts and collagen contains the blood vessels nerves and lymphatics that serve the artery. External Elastic Lamina secrond to outermost layer tunica externa outermost layer
Tunica intima what layer is this and what does it house and what is it made of????
composed of a single layer of endothelium that rests on a bed of connective tissue housese the circulating blood within the lumen of the artery serves many metabolic signaling functions that help maintain the intergrity of the wall
things disrupt the intergrity of the artery and make it hard
fatty streak, fiborous plaque, complicated lesions
Fatty streak.. is it earliest visible lesion does it pertrude into the lamina??? what else are they called??
Fatty streak also called foam cells… they dont disturb the blood flow usally made of lipids from marcophages they dont pertrude into the lumen of the artery its like the beginning stages of the block
Where do most artery changes occur where are foam cells derived from and what do they contain
most changes appear in the intimall layer fo am cells derived from smooth muscle
often contain debris, of nercotic other dead cells and cholestrol crystals which are seperated from the aterial lumer by a fibrous cap?
fibrous plaque - is it this more serious than the foam cells or the fatty streak if so why??
This is a more serious form of clot it develops from fatty streaks and its a fibrous plaque an elevated lesion that projects into the lumen and can cause reduced blood flow
how does a hemmorrhage come about within a firbrous plaque and what does this cause
The fibrous plaque may burst or the caps that vascularize the plaque may result in a hemoattoma that may block the cell wall. and this bursting may form an embolism that may result in a MI , PE, or stroke very serious issue
What is the role of the Endothethial wall and what antitrhombotic surface molecules play a role in the maintainece of the anit-clotting police
the wall forms a barrier that contains cirulating blood within the lumen. some clot busters are herapen sulfate, thrombomodulin, plasomingen activators, prostacyclin, endothelium-derived relaxing factor
secretes vasoactive substance that directly modulates the contraction of smooth muscle in the medial layer on the other side of the wall
inhibits smooth muscle cell migration and proliferation
Two types of lesions tell me each type
Calcification - of a fibrous plaque that results in pipelike rigidity of the vessel wall. This increaes the its fragility
Ruputure of a fiborous plaque- exposes thrombogenic material throughout the body. and weaking of the walls may result in an aneurysm
Modified Respones to injury of Hypothesis
What intially causes the secrement of smooth muscle cells
it is then the endothethilial cells become injured or dysfunctional that atheroscelerosis occurs
what intially attracts the cells into the intimia is the release of platelet growth factor and secretion of chemotactic factors that attract other cells
Dyslipidemias what is this about
abnormal amount of circulating lipid levels are a major risk factor for heart disease
countries with low sat fat counts have less risk for heart disease go figure.
Dyslipidemias what is this about
abnormal amount of circulating lipid levels are a major risk factor for heart disease
countries with low sat fat counts have less risk for heart disease go figure.
injury to the endothethial cells what happens when the endo layer is injuried couple of things
increased premability therefore the smooth muscles can get into the intimia layer and into the blood faster
decreased antithrombitcs properties probadly can’t cant signal for them as fast.
reduced secretion of vasodilators impairing smooth muscle relaxation of the medial layer.
injury to the endothethial cells what happens when the endo layer is injuried couple of things
increased premability therefore the smooth muscles can get into the intimia layer and into the blood faster
decreased antithrombitcs properties probadly can’t cant signal for them as fast.
reduced secretion of vasodilators impairing smooth muscle relaxation of the medial layer.
Cardiac risk factors major modfiable
At individual at what cholestrol level will be at risk for cardiac disease twice the risk with someone at what level
What do you want your HDL, Total, and LDL cholestrol levels to be
Tobbacco smoking, DM, HTN, and Dyslipidemas (high cholestrol essentially because this is what help form the “foam cells” in the first place and eventually into the fibrous plaques.
240 mg/dl places someone at twice the risk verse if they were say at 200 mg/dl
total you want 200 mg Dl
LDL normal 130
people with caridac issues less than 100
HDL greater or equal to 35
Cardiac risk factors major modfiable
At individual at what cholestrol level will be at risk for cardiac disease twice the risk with someone at what level
What do you want your HDL, Total, and LDL cholestrol levels to be
Tobbacco smoking, DM, HTN, and Dyslipidemas (high cholestrol essentially because this is what help form the “foam cells” in the first place and eventually into the fibrous plaques.
240 mg/dl places someone at twice the risk verse if they were say at 200 mg/dl
total you want 200 mg Dl
LDL normal 130
people with caridac issues less than 100
HDL greater or equal to 35
