systemic pathology 400 (CV class 3) Flashcards
arteriosclerosis
Group of diseases characterized by thickening and loss of elasticity of arterial walls
arterio
sclerose
sclerosing of arteries
arteriosclerosis also refers to…
“Hardening of the arteries”
and/or
“clogged arteries”
three forms of arteriosclerosis
Atherosclerosis
Monckebergs Arteriosclerosis
Arteriolosclerosis
arteriolosclerosis
Arteriolosclerosis is a form of cardiovascular disease involving hardening and loss of elasticity of arterioles or small arteries
is most often associated with hypertension and diabetes mellitus.
atherosclerosis
Atherosclerosis thickening or hardening of the arteries.
It is caused by a buildup of plaque in the inner lining of an artery.
Plaque is made up of deposits of fatty substances, cholesterol, cellular waste products, calcium, and fibrin.
As it builds up in the arteries, the artery walls become thickened and stiff.
Monckeberg’s arteriosclerosis
(Mönckeberg’s sclerosis)
is a non-inflammatory form of arteriosclerosis,
differs from atherosclerosis traditionally.
Calcium deposits are found in the muscular middle layer of the walls of arteries with no obstruction of the lumen.
It is an example of dystrophic calcification.
This condition occurs as an age-related degenerative process.
dystrophic calcification
Dystrophic calcification (DC) is the calcification occurring in degenerated or necrotic tissue,
E.g.
as in hyalinized scars, degenerated foci in leiomyomas, and caseous nodules.
This occurs as a reaction to tissue damage,[1] including as a consequence of medical device implantation.
Dystrophic calcification can occur even if the amount of calcium in the blood is not elevated
dystrophy define
a disorder in which an organ or tissue of the body wastes away.
can the same person have all forms of arteriosclerosis?
yes.
All three forms of arteriosclerosis may be present in the same person in different blood vessels.
a note about the use of the terms atherosclerosis vs arteriosclerosis
technically, atherosclerosis is a type of arteriosclerosis
Frequently the terms arteriosclerosis and atherosclerosis are used interchangeably,
although technically atherosclerosis is the most common form of arteriosclerosis.
most common type of arteriosclerosis
atherosclerosis
atherosclerosis
Plaques or fatty deposits
form in the inner layer (intima)
of arteries
—> in lumen
“athero” = gruel;
“sclerosis” = hardening
simultaneous arterial hardening and softening (???)
atherosclerosis
—>
“Indicates simultaneous arterial
hardening and softening”
Monckebergs Arteriosclerosis
Involves the middle layer of arteries with destruction of muscle and elastic fibers and formation of calcium deposits
Age related
“Senile”
Arteriolosclerosis
Arteriolar sclerosis
Thickening of the walls of small arteries (arterioles)
Hypertension related
Doesn’t involve ATHEROMA
atheroma
“tumor/mass full of gruel-like matter”
“groats” –> hulled/crushed grain/oats
atheroma define
Atheroma refers to the fatty material that clogs your arteries.
It builds up over time and can lead to complications.
Atheroma (plaque) is the defining feature of a disease called atherosclerosis.
atherosclerosis… what accumulates in the lumen of arteries?
lipids,
macrophages,
T lymphocytes,
smooth muscle cells,
ECM (/ECF),
calcium,
necrotic debris
accumulation results in
Accumulation results in formation of plaque and narrowing of arterial lumen
atherosclerosis classificaitons (TYPES)
Coronary artery disease
Peripheral vascular disease
Cerebrovascular disease
Coronary artery disease
atherosclerosis of the coronary arteries
myocardial infarction
Peripheral vascular disease
atherosclerosis of the arteries supplying the extremities and organs
Cerebrovascular disease
atherosclerosis of the arteries that supply the brain
stroke
atherosclerosis – clinical manifestations
It can be asymptomatic
Ischemia
Infarct
atherosclerosis etiology and risk factors
Higher cholesterol levels
High blood pressure
obesity (visceral, abdominal fat)
diabetes
Smoking
Genetics
Age
atherosclerosis – Dx
Cholesterol checkups (blood work)
Angiogram
ECHO
Stress test
Ultrasound
MRI
atherosclerosis – Tx
Modify and reduce risk factors
Exercise
Medications
atherosclerosis (and relating Sx) — MEDICATION
ACE inhibitors and beta blockers help lower blood pressure and lower the heart’s workload.
Anti-platelet or anti-clotting medicines
Calcium channel blockers lower blood pressure by relaxing blood vessels
Medicines to control blood sugar
Nitrates, such as nitroglycerin, dilate your coronary arteries and relieve or prevent chest pain from angina.
Statins treat unhealthy blood cholesterol levels.
Other cholesterol-lowering medicines, such as ezetimibe, PCSK9 inhibitor, bempedoic acid, and omega-3 fatty acids, may be used if you are unable to take statins or when statins have not worked to treat unhealthy blood cholesterol and triglyceride levels.
Thrombolytic medicines, sometimes called clot busters, may be used to treat blood clots resulting from atherosclerosis. These medicines can dissolve blood clot that block arteries
can glucose contribute to atheroma formation?
yes (?)
“Prolonged exposure to hyperglycemia is now recognized a major factor in the pathogenesis of atherosclerosis in diabetes.”
peripheral vascular disease
Narrowing of the circulatory system outside of the brain or the heart
Any pathological condition of the blood vessels that supply the extremities and major abdominal organs, often the intestines and kidneys
PVD incidence/gender/age distribution
Incidence increases with increasing age (>50)
Men > women
most common PVD
Peripheral Artery Disease (PAD)
PVD classified according to
Classified according to pathology and blood vessel
note that PVD is a TYPE/classification of ATHEROSCLEROSIS
however, one can say that PVD is most commonly occurring as a result of…
Most commonly occur as a result of atherosclerosis
—> I.e. other causes exist (?)
does PVD most commonly occur in the upper or lower extremity
LE > UE
They occur more commonly in the legs than in the arms because the blood vessels in the legs are further from the heart.
—> correlation (??)
PVD –> SSx, clinical manifestations
can include…
intermittent claudication,
pain,
cyanosis,
fatigue,
gangrene,
cold extremities
claudication define
a condition in which cramping pain in the leg is induced by exercise, typically caused by obstruction of the arteries.
claudication etymology
claudus = lame
claudicare = to limp
vasculitis
inflammation of a blood vessel; can affect any organ or system including the peripheral nervous system (PNS)
arteritis (type of vasculitis)
inflammation of an artery
infective arteritis
inflammation of an artery due to infection
rheumatoid arteritis
inflammation of an artery associated with RHD/RF
what other structures does RF affect?
arteries (?)
myocardium?
giant cell arteritis (TEMPORAL ARTERITIS)
AKA cranial or temporal arteritis
A vasculitis primarily involving multiple sites of temporal and cranial
arteries
(i.e. arteries of
the head, neck, and
aortic arch)
why is it called giant cell arteritis
The term “giant cell arteritis” is often used because when one looks at biopsies of inflamed temporal arteries under a microscope, one often sees large or “giant” cells.
giant cell arteritis incidence
Most common vasculitis in the US
Incidence increases with increasing age after 50
Women > men (2:1)
giant cell arteritis risk factors
Menopause
Smoking
Heart murmurs (?)
Arthritis-related diseases
—> SLE, RA
what is the most common vasculitis in the US?
GIANT CELL ARTERITIS
I.e.
temporal arteritis
giant cell arteritis etiology…
Idiopathic
Multifactorial
Genetic
Infectious (VSV)
Hormonal
VSV
Vesicular stomatitis virus
negative sense RNA virus from the family of Rhabdoviridae,
whose replication is relatively fast and with infection culminating in cell death mediated by apoptosis.
stomatitis define
inflammation of the mucous membrane of the mouth.
etymology:
mouth + itis
sense (molecular biology)
In molecular biology and genetics, the sense of a nucleic acid molecule, particularly of a strand of DNA or RNA, refers to the nature of the roles of the strand and its complement in specifying a sequence of amino acids.
IN VIRUSES:
In virology, the term “sense” has a slightly different meaning. The genome of an RNA virus can be said to be either positive-sense, also known as a “plus-strand”, or negative-sense, also known as a “minus-strand”.