Lecture 23 & 24: Pathology in Practice Flashcards
what sort of vessel is the pulmonary trunk and what sort of blood does it carry
artery but carries deoxygentaed blood
what are the vasa vasorum of the heart
coronary arteries that supply the heart with nutrients and oxygen
what do the coronary arteries branch off
aorta
what is significant about the coronary arteries
there are few anastomes/collaterales, so each section of the heart is exclusively supplied by one vessel
what is atherosclerosis
when fats deposit in the arterial wall and narrow the lumen. coronary artery disease
what are the stages of plaque progression
1) fatty streak
2) pathological intimal thickening
3) plaque expansion
4) thin cap, thick cap or fibrotic plaque
5) becomes clinically relevant: suddenly rupture, erode or fibrocalcify. rupture and erosion lead to thrombosis
what does a rupture look like microscopically
a gap in the inner membrane, into which blood rushes in and clots
what is a thrombus
blood clot within a vessel
what is an embolus
a dislodged blood clot moving within a vessel
how do atheromas lead to thrombosis
they have a thin fibrous cap that may rupture, which leads to a thrombus
consequences of a thrombus or embolus
- occlusion (blockage of the vesel)
- ischaemia (lack of blood flow) in the downstream areas supplied by the vessel
- hypoxia
- accumulation of harmful metabolites
- reversible / irreversible cell injury
- cell death
what does ischaemia lead to
coagulative necrosis, clinically called infarction
sequence of events in myocardial infarction
1) coagulative necrosis and haemorrhage
2) acute inflammation, with oedema and neutrophils
what can a myocardial infarction lead to the formation of
- a haemopericardum (massive blood clot) due to a myocardial rupture
- aneurysm
