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CLS > Vascular Disease > Flashcards

Vascular Disease Flashcards

1
Q

Define arteriosclerosis

A

Thickening and hardening of the wall of an artery

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2
Q

Define Artheroma

A

Important disease of medium and alrge arteries in high-pressure systems, never venous

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3
Q

Define artherosclerosis

A

Arteriosclerossis due to artheroma

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4
Q

Development of hypertensive arteriosclerosis

A
  1. Hypertrophy of media
  2. Fibro-elastic thickening of smooth muscle intima
  3. Elastic lamina reduplication
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5
Q

Development of hypertensive Arteriolosclerosis

A

Replacment of wall structures by amourphous hyaline material causing decreased lumen size and lessening response to endocrine stimulus

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6
Q

Consequences of hypertensive vascular changes

A
  1. Reduction of vessel lumen; reduced flow; ischaemia
  2. Increased rigidity of vessel walls; loss of elasticity and contractility; unresponsive to control agents e.g. vasodilators
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7
Q

Stages of artheroma

A

Initially effects tunica intima, later tunica media, worsens with age

  1. Blood lipids enter intima by damaged epithelium
  2. Macrophages phagocytose lipids to make araise fatty streak
  3. Some lipid released forming a lipid plaque. M secrete cytokines, stimulate myofibroblasts to secre collages-> early damage of elastic lamina
  4. Collagen covers plaque forming fibrolpid plaque, muscle fibres replaced by collagen
  5. Lipids in intima calcified. plaque surface ulcerates, initates coagulation cascade leading to blood clot
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8
Q

How does ischaemic damage occur by artheroma?

A

Intima expansion; reduced lumen size; reduced blood flow; reduced oxygenation; ischaemic damge

Coronary arteries - Angina

Legs - Intermittent claudation

Mesenteric - Iscaehmic colitis

Cerebral/vertebral - Cerebral sichaemic event

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9
Q

Layers of artery from inner to outer

A

Lumen

Intima - connective tissue

Internal elastic lamina

Media

Adventia

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10
Q

Dietary cause of Artheroma

A

High LDL diet

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11
Q

Mechanism for developing aneurysms from artheroma

A

= Abnormal permanent focal dilation of an artery

  • Enlarging intimal artheroma plaque leads to atrophy of media, elastic fibres replasced by collagen
  • Collagen incapable of elastic recoil; arterial wall stretches with systolic pulse
  • Most common in abdominal aorta
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12
Q

Main cause of mycotic aneurysm

A

Endocaritis or bacterial sepicaemia

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13
Q

Risk factors for artheroma

A
  • High fat diet
  • High LDL:HDL ration
  • Smoking
  • High BP
  • Diabets
  • Obesity
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14
Q

Define Thrombosis

A

The process leading to formation of a thrombus

Can be physiological; preventing bleeding in breached vessel wall. Limited by fibrinolysis

Or pathological: not limited by fibrinolysis

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15
Q

Define thrombus

A

A solid mass composed of blood constituents which have aggregated together in flowing blood in the lumen

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16
Q

Events in physiological thrombosis

A
  1. Vessel wall is breached
  2. Circulating plateletes aggreagte and plug
  3. Platelets release factors which trigger coag cascade
  4. Cascade converts fibrinogen to large molecule sof insolube fibrin
  5. Fibrin binds platelets together and traps RBC/WBCs

Fibrinolysis

  1. Plasminogen activated
  2. Converted to plasmin
  3. Fragments fibrin; dissolves thrombus
17
Q

Events in pathological thrombus

A
  1. Normal thrombosis
  2. Reduced fibrinolysis
  3. Thrombus continues to enlarge over capacity of fibrinolysis
  4. Red/brown mass produced in lumen
18
Q

Virchows triangle

A

3 categories contributing to thrombosis

  1. Vessel: Disturbance/damage of the blood vessel
    • Exposes collagen in intima
  2. Blood Flow: Reduction in blood flow/stasis
  3. Blood: Disturbance of blood properties/character
    • Increased platelets, RBS numbers, Viscosity
19
Q

Consequences of arterial thrombosis

A

Stops flow of blood; cuts off oxugen; infarction

20
Q

Consequence of venous thrombosis

A

Prevents drainage; blood pools; congestion(+infarction)

e.g. DVT

21
Q

Define Thromboembolism

A

Thrombus fragments or detaches completely (breaks off) and travels elsewhere in the circulation (passes into bloodstrem) to a distal site where it occludes the vessel

22
Q

Circumstances under which a pulmonary thromboembolism can occur

A
  • Thromboembolism in a systemic vein
    • Eventually embolises to a pulmonary artery branch
    • large enough embolus will cause sudden death
23
Q

Risk factors in venous thromboembolism

A
  • Active cancer treatment
  • 60+
  • Dehydration
  • Obesity
  • HEart disease
  • hormone replacement therapy
  • Oestrogen contraception
24
Q

Other material than thrombosis that can embolise

A

Cancer cells/tumour

Air

Nitrogen(diving)

Amniotic fluid

25
Q

Define Infarct

A

An area of ischaemic necrosis due to abrubt cessation of the arterial supply

26
Q

Stages of venous infarction

A
  1. Veins become obstructed
  2. Tissues become congested with blood
  3. Pressure rises in capillariea and venules
    • Rupture
    • Pressure too highg for arterial blood to enter

e.g. hernial strangulation

27
Q

Causes of arterial infarction

A
  • 95% thrombotic or embolic
  • Arterial spasm
  • Arterial trauma
28
Q

Stages of arterial infarction

A
  1. 0-12H Swelling of cells; some death
  2. 12-24 Necrotic muscle fibres apparent
  3. 24-72 AIR to dead muscle
  4. 3-14D Macrophagic removal of debris
  5. Vascular granulation
  6. Fibrous grnulation
  7. Scar formation by mature fibrous tissue
29
Q

Common cause of renal infarct

A

Emboli from left side of heart

30
Q

Cerebral infarction

A

Emolisms

Liquefactive necrosis, heals by astrocytic gliosis

Commonly death

31
Q

Complication of MI

A

early

  • Sudden death by LV failure or dysrhytmia
  • Ruoture of myocardium
  • Rupture of papillary muscle; acute valve failure

Late

  • Chronic LVF
  • Ventricular aneurysm
32
Q
A

CLS (20 decks)

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