ILA atherosclerosis Flashcards
what makes up the tunica intima?
- endothelial cells within a subendothelium of connective tissue and discontinuous elastic laminae
what makes up the tunica media?
- fenestrated elastic membranes
- smooth muscle cells and collagen between lamellae
what makes up the tunica adventitia?
thin layer of connective tissue containing lymphatics, nerves and vasa vasorum (blood vessels that supply blood to the artery)
which layer is the thickest of an elastic artery?
tunica media
which arteries in the body are the thickest and why?
arteries conducting to the heart due to containing higher amounts of collagen
what are the main stages involved in the formation of an atherosclerotic plaque?
initial lesion, fatty streaks, intermediate lesions, fibrous plaques, plaque rupture, plaque erosion
what are the constituents of fatty streaks?
foam cells and T-lymphocytes
what are the constituents of intermediate lesions?
foam cells, smooth muscle cells, T-lymphocytes, platelet adhesion, extracellular lipid pools
what are the constituents of fibrous plaques?
fibrous cap overlying lipid core and necrotic debris, smooth muscle cells, macrophages, foam cells, T-lymphocytes
why might plaque rupture occur?
plaques are constantly growing and receding, the fibrous cap must be resorbed and redeposited to be maintained. plaque can rupture in favour of inflammatory conditions
state the non-modifiable risk factors for atherosclerotic formation
- age
- gender (men>)
- family history
- racial origin
state the modifiable risk factors for atherosclerotic formation
- eating less cholesterol
- stopping smoking
- hypertension
- DM
- obesity
- lack of exercise
how will eating less cholesterol help with control of atherosclerosis?
directly related to levels of serum LDL cholesterol and inversely related to levels of HDL - bad cholesterol that builds up in vessels
how will stopping smoking help with control of atherosclerosis?
reduces reactive oxygen species and nicotine in the blood within hours to days
how will control of hypertension help with atherosclerosis?
controlling this with medication will reduce the shearing forces affecting the endothelium
how will control of diabetes help with atherosclerosis?
reducing the glucose content of the blood by upregulating or increasing the effects of insulin will reduce the oxidative and glycosylation effects on the endothelium
how will control of obesity help with atherosclerosis?
losing weight could improve insulin resistance, blood pressure, reduce circulating lipids and glucose, and reduce strain on the heart and vasculature
how will exercise help with atherosclerosis?
Exercise also helps rebalance LDL/HDL, reduces BP and improves cardiovascular efficiency and cardiac function, and also reduces insulin resistance
describe some primary preventative measures for the formation of atherosclerosis
- balanced diet
- exercise more / weight loss
- stop smoking
describe some secondary preventative measures for the formation of atherosclerosis
- statins
- antihypertensives (ACEi, CCB etc)
- diabetes control
- healthy eating and exercise info
- smoking cessation advice
define the term “co-benefits” in relation to health and climate change
co benefits: activities or changes people can make that will benefit the management of climate change as well as having positive effects on mental health, e.g. reducing red meat intake or walking not driving
