Vascular Disease Flashcards
What are the 4 subcategories of Vascular disease?
- arteries
- veins
- all vesels
- tumours
What is vascular disease of the arteries?
atherosclerosis
What is vascular disease of the veins?
- thrombosis
- formation of varicosities
What 2 ways does vascular disease affect all vessels?
- vasculitis
- radiation damage
What does atherosclerosis affect? How is it characterised?
- large and medium sized arteries
- lipid deposition, fibrous and chronic inflammation
Describe the morphology of atherosclerosis.
- atheromatous- fibro-fatty plaque
- core of lipid
- fibrous cap- smooth muscle cells, macrophages, foam cells
- necrotic centre- cell debris, cholesterol crystals, foam cells
What 2 complications can atheroma cause in the head and neck?
- cerebral infarction
- carotid atheroma- emboli causing transient ischaemic attaks or cerebral infarcts
How does atheroma affect the heart?
- myocardial infarction
- cardiac failure
What type of aneurysm is atheroma related to? What can happen to the aneurysm?
- aortic aneurysms
- ruptures leading to sudden death
What is peripheral vascular disease?
- atheroma of distal aorta, iliac, femoral arteries
- leads to ischaemia of lower limbs
What are the 4 potential consequences of peripheral vascular disease?
- intermittent claudication
- pain
- ulcers
- gangrene
What is intermittent claudication?
pain in calf related to exercise
What are the 6 different classifications of aneurysm?
- atherosclerotic
- dissecting
- berry
- micro aneurysms
- syphilitic
- mycotic
What describes true aneurysms?
saccular or fusiform
Describe the morphology of atherosclerotic aneurysm. Which vessel does it usually affect?
- saccular or fusiform, contains mural thrombus (thrombus caused by lots of turbulent blood flow)
- distal abdominal aorta, distal to renal arteries
What are the clinical consequences of atherosclerotic aneurysms? How does it present clinically?
- thrombosis
- embolism
- rupture
- obstruction of branch vessel leading to ischaemic injury
- impingement of adjacent structure
-presents as an abnormal mass
What is a dissecting aortic aneurysm?
wall of blood vessel is split into parts, split in tunica and hence blood can spill in-between the layers forming the blood vessel
Describe the morphology of dissecting aneurysm. Which two directions can the dissection occur in?
- usually begins with just an initial tear
- dissection can extend along the aorta retrograde towards the heart out distally sometimes to iliac and femoral arteries
what are the clinical symptoms of the dissecting aortic aneurysm? Describe the pain experienced as a result of the aneurysm.
- sudden onset of excruciating pain
- begins anterior in chest and radiates to back between the scapula and radiates inferiorly as dissection progresses
what is a berry aneurysm? which group is most commonly affected?
- aneurysm of the circle of willis in the brain
- young people
What is a berry aneurysm most commonly associated with?
sub-arachnoid haemorrhage
What is a capillary micro-aneurysm?
small aneurysms of branches of the middle cerebral artery
What are capillary micro-aneurysms associated with?What can they lead to?
- hypertension and diabetes mellitus
- intra cerebral haemorrhage
Which vessel does a syphilitic aneurysm usually affect?
thoracic aorta
What causes a mycotic aneurysm? Where are they most common?
- wall of the artery is weakened by infection of bacteria or fungi
- brain
What are varicose veins?
abnormally dilated, torturous veins produced by prolonged increased intraluminal pressure and loss of vessel wall support
What happens if venous valves become incompetent, with relation to varicose veins?
leads to stasis of blood, congestion, oedema can occur and pain, at risk of thrombosis
Where can varicosities arise?
-lower limb
oesophageal varices
-haemorrhoids
What is vasculitis?
inflammation of vessels
What is the pathogenesis of vasculitis?
- immune mediated inflammation- deposition of immune complexes, direct attack by circulating antibodies
- direct invasion of vascular wall by infectious pathogens
What are the 4 types of vasculitis?
- giant cell arteritis
- takayasu
- polyarteritis nodosa
- kawasaki disease
What is giant cell arteritis?
- granulomatous inflammation of large to small sized arteries
- temporal, vertebral, oplathmic
Explain Takayasu disease
- no or weakened pulse in upper limb
- granulomatous vasculitis of median and larger arteries of upper limbs
Which vessels are involved in Polyarteritis nodosa?
kidneys, heart, liver and gastrointestinal tract
Which group does kawasaki disease affect? What is it associated with?
- children younger than 4
- high fever
What are the two types of vascular tumour?
- benign
- malignant
Wat is a benign vascular tumour?
angioma
What are the two types of angioma?
- haemangioma -capillary and cavernous
- lymphangioma- capillary and cavernous
describe the appearance of the angiomas:
- what are the 3 different types?
- how do they appear?
- what structures do they affect?
- Juvenile= strawberry usually shrink over time, skin
- Capillary= ruby red spot, skin spleen kidneys
- cavernous= port wine stain, skin liver spleen
What is a malignant vascular tumour called? What can it affect?
- angiosarcoma
- skin, soft tissue, breast, bone, liver, spleen
What is Kaposis sarcoma?
- associated with HIV/AIDS
- angioproliferative tumour derived in endothelial cells
