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Systems 1 > Vascular History and Diseases > Flashcards

Vascular History and Diseases Flashcards

1
Q

What does the innermost layer of a blood vessel consist of?

A

(tunica intima)
endothelial
subendothelial
elastic/fenestrated

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2
Q

which layer of intima directly contacts blood?

A

endothelial

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3
Q

what separates the endothelium from subendothelium?

A

basement membrane

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4
Q

what comprises the subendothelial layer?

A

delicate connective tissue and scattered stromal cells

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5
Q

what is the elastic/fenestrated layer?

A

membrane consisting of elastic fiber network

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6
Q

what forms the bulk of tunica intima?

A

elastic/fenestrated layer

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7
Q

what does the thickness of the elastic/fenestrated layer depend on?

A

type and size of vessel

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8
Q

what does the tunica media consist of?

A

concentric layer of SM cells and ECM

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9
Q

what does the thickness of SM cells of the tunica media depend on?

A

type and size of vessel

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10
Q

What does the SM cells of the tunica media produce?

A

ECM

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11
Q

What are the main functions of the tunica media?

A

conduct blood

control peripheral vascular resistance and maintain hydrostatic pressure

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12
Q

what is the tunica adventitia?

A

connective tissue layer surrounding blood vessel

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13
Q

What does the tunica adventitia consist of?

A

collagen, elastic fibers, vaso vasorum, and nerves

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14
Q

What is the function of vaso vasorum?

A

supplies nutrients to media and outer layer of larger blood vessels

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15
Q

What is the function of nerves of tunica adventitia?

A

regulate vascular muscle tone

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16
Q

What are special characteristics of adventitia?

A

vascular healing and pathology

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17
Q

Where does the inner layer of blood vessels receive nutrients?

A

directly from lumen

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18
Q

Which vessel has the greatest cross-sectional area?

A

capillaries

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19
Q

Describe blood velocity in vessel types

A

fast –> slow –> fast

arteries –> capillaries –> veins

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20
Q

what forms the bulk of elastic arteries’ wall?

A

media (1/3 SM cells and 2/3 concentric elastic tissue layers)

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21
Q

What maintains blood pressure during diastole?

A

elastic arteries

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22
Q

examples of elastic arteries

A

aorta and pulmonary trunk

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23
Q

Describe the structure of muscular arteries

A

prominent media with well-formed internal and external elastic lamina

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24
Q

function of larger muscular arteries

A

distributing arteries

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25
function of smaller muscular arteries
resistance arteries
26
media of larger muscular arteries
3/4 of wall thickness
27
how many layers of SM cells do smaller muscular arteries have?
3 to 25
28
what determines blood pressure in muscular arteries?
peripheral vascular resistance
29
What determines peripheral vascular resistance?
muscle tone (contraction) in small muscular arteries and arterioles
30
What factors affect muscle tone?
- ANS - circulating hormones - local, endothelial-derived vasoactive mechs
31
describe arterioles
30-400 microns in diameter | 1-2 SM layers
32
What is the main site of blood pressure regulation?
arterioles
33
small changes in muscle tone induce --
large changes in resistance
34
functions of arterioles
- regulate bp - redistribute blood - shunt blood
35
what is the function of metarterioles?
connect arterioles and capillaries
36
-- constrict to reduce or shut off blood flow to their respective capillaries, shunting blood elsewhere
precapillary sphincter
37
capillaries' caliber
5 microns
38
Describe capillaries
single layer of endothelial cells, basement membrane and pericytes
39
what are pericytes?
contractile cells that reside outside of the basement membrane
40
Most common type of capillary found in skeletal muscle, cardiac muscle, brain, skin, lung, exocrine glands
continuous capillaries
41
How does endothelial cells' function helpful for continuous capillaries?
Endothelial cells have no fenestrae and are anchored together by tight junctions, which prevent diffusion between cells.
42
describe and give the function of fenestrated capillaries
Have fenestrae (60-80 nm in diameter) with or without diaphragms that allow relatively free passage of substances
43
where are fenestrated capillaries found
renal glomeruli, endocrine glands, and intestinal villi
44
describe sinusoid/discontinuous capillaries
Large diameter, discontinuous endothelial layer, and discontinuous basal lamina
45
what are usually within the vicinity of sinusoid?
macrophages
46
what does veins and venules mostly function as?
reservoir vessels
47
Describe Post-capillary venules
Appear similar to capillaries except wider lumens and more pericytes Discontinuous elastic lamina with relatively thick adventitia
48
Preferential site for WBC migration
Post-capillary venules
49
what happens when venules become larger
fewer pericytes and more smooth muscle to form muscular veins (not as thick as arteries)
50
describe the adventitia of veins and venules
thick but no well-defined internal and external elastic laminae
51
how do veins maintain unidirectional flow?
valves
52
function of lymphatic vessels
removes excess interstitial fluid and immune cells to lymph nodes
53
describe lymphatic vessels
Larger vessels have thin muscle layer and adventitia Have blind ends and valves Similar histologically to veins except have no RBC
54
what is an aneurysm?
localized dilation of vessel or heart
55
true aneurysm
All 3 layers of the arterial wall (or heart)
56
what is a false aneurysm?
contained rupture
57
what is a contained rupture/false aneurysm?
Transmural tear of vessel wall and blood clot formation in the perivascular soft tissue.
58
histological features of aortic aneurysm
atherosclerosis and medial degeneration
59
Most common pre-existing histologic finding in aortic dissection if present
medial degeneration
60
Describe a medial degeneration
elastic tissue is fragmented
61
medial degeneration may indicate --
collagen vascular disease (Marfan syndrome, Loeys-Dietz syndrome, Ehlers-Danlos, syndrome, familial thoracic aortic aneurysm & dissection)
62
other causes of aortic aneurysm
Infections (AKA mycotic aneurysms) Traumatic Inflammatory (e.g. vasculitis, syphilis) Congenital defects (e.g. berry aneurysms)
63
Most common atherosclerotic aneurysm
abdominal aortic aneurysm
64
prevalence of abdominal aneurysm
Rare before age 50 years and more frequently seen in men
65
where does abdominal aortic aneurysm occur?
below renal arteries and above aortic bifurcation
66
abdominal aortic aneurysm: Complicated atherosclerotic plaques result in --
destruction and thinning of aortic media
67
what partially or completely fills abdominal aortic aneurysm?
thrombus (blood clot)
68
complications of aneurysms
rupture --> hemorrhage vascular obstruction atheroembolism compression of adjacent structure
69
what is a dissection?
A partial tear within the wall of a blood vessel
70
what does dissection allow for?
blood to separate the layers of the media
71
intimal tear
inner 2/3 of media separated from outer 1/3 creating 2 lumens (passages w/in vessel)
72
what is the false lumen created by a dissection?
new space within the wall of the artery
73
what is aortic dissection?
passage of blood within the media, which often ruptures outward causing massive hemorrhage
74
who does aortic dissection affect?
>90% occur in men between ages of 40 and 60 years with history of hypertension younger patients with systemic or localized connective tissue disorder that affects aorta
75
name other predisposing factors of aortic dissection
pregnancy and iatrogenic
76
aortic dissection type A
involves ascending aorta
77
aortic dissection type B
involves descending aorta only
78
which type of aortic dissection requires medical emergency?
type A
79
aortic dissection based on site of intimal tear
DeBakey
80
aortic dissection based on site of dissection
Stanford

Systems 1 (22 decks)

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