ILA atherosclerosis

Question 1

what makes up the tunica intima?

Answer 1

• endothelial cells within a subendothelium of connective tissue and discontinuous elastic laminae

Question 2

what makes up the tunica media?

Answer 2

• fenestrated elastic membranes
• smooth muscle cells and collagen between lamellae

Question 3

what makes up the tunica adventitia?

Answer 3

thin layer of connective tissue containing lymphatics, nerves and vasa vasorum (blood vessels that supply blood to the artery)

Question 4

which layer is the thickest of an elastic artery?

Answer 4

tunica media

Question 5

which arteries in the body are the thickest and why?

Answer 5

arteries conducting to the heart due to containing higher amounts of collagen

Question 6

what are the main stages involved in the formation of an atherosclerotic plaque?

Answer 6

initial lesion, fatty streaks, intermediate lesions, fibrous plaques, plaque rupture, plaque erosion

Question 7

what are the constituents of fatty streaks?

Answer 7

foam cells and T-lymphocytes

Question 8

what are the constituents of intermediate lesions?

Answer 8

foam cells, smooth muscle cells, T-lymphocytes, platelet adhesion, extracellular lipid pools

Question 9

what are the constituents of fibrous plaques?

Answer 9

fibrous cap overlying lipid core and necrotic debris, smooth muscle cells, macrophages, foam cells, T-lymphocytes

Question 10

why might plaque rupture occur?

Answer 10

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

Question 11

state the non-modifiable risk factors for atherosclerotic formation

Answer 11

• age
• gender (men>)
• family history
• racial origin

Question 12

state the modifiable risk factors for atherosclerotic formation

Answer 12

• eating less cholesterol
• stopping smoking
• hypertension
• DM
• obesity
• lack of exercise

Question 13

how will eating less cholesterol help with control of atherosclerosis?

Answer 13

directly related to levels of serum LDL cholesterol and inversely related to levels of HDL - bad cholesterol that builds up in vessels

Question 14

how will stopping smoking help with control of atherosclerosis?

Answer 14

reduces reactive oxygen species and nicotine in the blood within hours to days

Question 15

how will control of hypertension help with atherosclerosis?

Answer 15

controlling this with medication will reduce the shearing forces affecting the endothelium

Question 16

how will control of diabetes help with atherosclerosis?

Answer 16

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

Question 17

how will control of obesity help with atherosclerosis?

Answer 17

losing weight could improve insulin resistance, blood pressure, reduce circulating lipids and glucose, and reduce strain on the heart and vasculature

Question 18

how will exercise help with atherosclerosis?

Answer 18

Exercise also helps rebalance LDL/HDL, reduces BP and improves cardiovascular efficiency and cardiac function, and also reduces insulin resistance

Question 19

describe some primary preventative measures for the formation of atherosclerosis

Answer 19

• balanced diet
• exercise more / weight loss
• stop smoking

Question 20

describe some secondary preventative measures for the formation of atherosclerosis

Answer 20

• statins
• antihypertensives (ACEi, CCB etc)
• diabetes control
• healthy eating and exercise info
• smoking cessation advice

Question 21

define the term “co-benefits” in relation to health and climate change

Answer 21

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