(P4) Cardiac: Atheromatous plaque of the aorta (H&E) & (Sudan)

Question 1

Identify:

Answer 1

• Atheromatous plaque of the aorta (H&E)*
• 1. fibrous cap**
• 2. atheroma: necrotic mass of lipid laden foam cells (aka lipid laden macrophages)**
• 3. lipid
     
     4. cholesterol crystals/clefts*

Question 2

Identify:

Answer 2

Atheromatous plaque of the aorta (Sudan)

• 1. Sudan red stains lipids
     
     2. benign arteriosclerosis: mild chronic hypertension
     3. Sudan stain is used to stain the lipid in the lipid laden macrophages*

Question 3

Atheromatous plaque of the aorta

Define:

Answer 3

-it is a disease of large and medium-sized arteries that results in the progressive accumulation within the

intima of smooth muscle cells and lipid

-tunica intima of elastic and muscular arteries

Question 4

Define

Atherosclerosis:

Answer 4

Atherosclerosis

• the proliferation of intima smooth muscle cells and the accumulation of lipids
• endothelium breaks down and platelets are deposited
• neovascularization of plaque (vasa plaquorum)

Question 5

Identify slide:

Provide Gross features:

Answer 5

Atheromatous plaque of the aorta (H&E)

• 1-fibro-fatty plaque*
• 2-the fibrous cap – layer of connective tissue*
• 3-thick intima with fat-filled macrophages (foam cells) and smooth muscle cells*
• 4-early stage – fatty streak*
• 5-the atheroma – necrotic mass of lipid*:
• macrophages, debris, lipid*

Question 6

Atheromatous plaque of the aorta

Define “Foam Cells”

Answer 6

Fat-filled macrophages which are found in

thick intima

Intima contains: Smooth muscle cells

macrophages

Lymphocytes

Connective Tissue

Question 7

Atheromatous plaque of the aorta

Name the type of Lesion found

and

name all resulting complications:

Answer 7

-atherosclerotic lesion

Complications: ischemic heart disease

myocardial infarction

stroke

gangrene of the extremities

thrombosis, emboli

Question 8

Atheromatous plaque of the aorta

Consists of ______ Cap; explain

Answer 8

fibrous cap

– layer of connective tissue (thicker and less cellular than the normal intima) with fat filled macrophages (foam cells)

• and*
• smooth muscle cells smooth muscle cell, macrophages, foam cells, lymphocytes, collage, elastin, proteoglycans, neovascularization*

Question 9

Atheromatous plaque of the aorta

Causes what type of tissue damage?

Answer 9

endothelial damage→platelet accumulation→thrombus formation

wall is weakened, promotes aneurysm formation – in aorta aneurysm usually in abdominal part

Question 10

Atheromatous plaque of the aorta

Provide steps leading to endothelial damage:

Answer 10

Steps:

Normal artery→fatty streak→fibro-fatty plaque→advanced plaque→aneurysm/occlusion, thrombus/stenosis

Necrotic Center: cell debris, cholesterol crystals, foam cells, Ca2+

Question 11

Identify:

Answer 11

Question 12

Identify:

Answer 12

Question 13

Identify:

Answer 13

Question 14

Identify:

Define

Answer 14

Atheromatous plaque of the aorta (Sudan)

Benign arteriosclerosis

• -Mild chronic hypertension, increased thickness of vessel walls*
• -Deposition of basement membrane material and by the accumulation of plasma proteins.*
• -The small muscular arteries display new layers of elastin, presenting as a reduplication of the intimal elastic lamina*
• and increased connective tissue*

Question 15

Identify:

Answer 15

• Proliferation of smooth muscle cells, vessels thicken with onion like appearance.
• With time, plasma protein enters vessel wall, make wall more homogenous (hyaline arteriosclerosis (hyalinization).
• Elastin forms double layer of intima. Connective tissue makes artery thicker and more rigid.

Question 16

Identify:

Answer 16

Tunica Intima

Question 17

Q.

The structure indicated on the slide is ?

Answer 17

Tunica Intima

Question 18

The structure indicated on the slide?

Answer 18

Center necrotic atheroma

Question 19

Empty spaces indicated on the slide contains the following specific chemical compund?

Answer 19

Cholesterol Crystals