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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
Q

function of smaller muscular arteries

A

resistance arteries

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26
Q

media of larger muscular arteries

A

3/4 of wall thickness

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27
Q

how many layers of SM cells do smaller muscular arteries have?

A

3 to 25

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28
Q

what determines blood pressure in muscular arteries?

A

peripheral vascular resistance

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29
Q

What determines peripheral vascular resistance?

A

muscle tone (contraction) in small muscular arteries and arterioles

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30
Q

What factors affect muscle tone?

A
  • ANS
  • circulating hormones
  • local, endothelial-derived vasoactive mechs
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31
Q

describe arterioles

A

30-400 microns in diameter

1-2 SM layers

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32
Q

What is the main site of blood pressure regulation?

A

arterioles

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33
Q

small changes in muscle tone induce –

A

large changes in resistance

34
Q

functions of arterioles

A
  • regulate bp
  • redistribute blood
  • shunt blood
35
Q

what is the function of metarterioles?

A

connect arterioles and capillaries

36
Q

– constrict to reduce or shut off blood flow to their respective capillaries, shunting blood elsewhere

A

precapillary sphincter

37
Q

capillaries’ caliber

A

5 microns

38
Q

Describe capillaries

A

single layer of endothelial cells, basement membrane and pericytes

39
Q

what are pericytes?

A

contractile cells that reside outside of the basement membrane

40
Q

Most common type of capillary found in skeletal muscle, cardiac muscle, brain, skin, lung, exocrine glands

A

continuous capillaries

41
Q

How does endothelial cells’ function helpful for continuous capillaries?

A

Endothelial cells have no fenestrae and are anchored together by tight junctions, which prevent diffusion between cells.

42
Q

describe and give the function of fenestrated capillaries

A

Have fenestrae (60-80 nm in diameter) with or without diaphragms that allow relatively free passage of substances

43
Q

where are fenestrated capillaries found

A

renal glomeruli, endocrine glands, and intestinal villi

44
Q

describe sinusoid/discontinuous capillaries

A

Large diameter, discontinuous endothelial layer, and discontinuous basal lamina

45
Q

what are usually within the vicinity of sinusoid?

A

macrophages

46
Q

what does veins and venules mostly function as?

A

reservoir vessels

47
Q

Describe Post-capillary venules

A

Appear similar to capillaries except wider lumens and more pericytes

Discontinuous elastic lamina with relatively thick adventitia

48
Q

Preferential site for WBC migration

A

Post-capillary venules

49
Q

what happens when venules become larger

A

fewer pericytes and more smooth muscle to form muscular veins (not as thick as arteries)

50
Q

describe the adventitia of veins and venules

A

thick but no well-defined internal and external elastic laminae

51
Q

how do veins maintain unidirectional flow?

A

valves

52
Q

function of lymphatic vessels

A

removes excess interstitial fluid and immune cells to lymph nodes

53
Q

describe lymphatic vessels

A

Larger vessels have thin muscle layer and adventitia

Have blind ends and valves

Similar histologically to veins except have no RBC

54
Q

what is an aneurysm?

A

localized dilation of vessel or heart

55
Q

true aneurysm

A

All 3 layers of the arterial wall (or heart)

56
Q

what is a false aneurysm?

A

contained rupture

57
Q

what is a contained rupture/false aneurysm?

A

Transmural tear of vessel wall and blood clot formation in the perivascular soft tissue.

58
Q

histological features of aortic aneurysm

A

atherosclerosis and medial degeneration

59
Q

Most common pre-existing histologic finding in aortic dissection if present

A

medial degeneration

60
Q

Describe a medial degeneration

A

elastic tissue is fragmented

61
Q

medial degeneration may indicate –

A

collagen vascular disease (Marfan syndrome, Loeys-Dietz syndrome, Ehlers-Danlos, syndrome, familial thoracic aortic aneurysm & dissection)

62
Q

other causes of aortic aneurysm

A

Infections (AKA mycotic aneurysms)
Traumatic
Inflammatory (e.g. vasculitis, syphilis)
Congenital defects (e.g. berry aneurysms)

63
Q

Most common atherosclerotic aneurysm

A

abdominal aortic aneurysm

64
Q

prevalence of abdominal aneurysm

A

Rare before age 50 years and more frequently seen in men

65
Q

where does abdominal aortic aneurysm occur?

A

below renal arteries and above aortic bifurcation

66
Q

abdominal aortic aneurysm: Complicated atherosclerotic plaques result in –

A

destruction and thinning of aortic media

67
Q

what partially or completely fills abdominal aortic aneurysm?

A

thrombus (blood clot)

68
Q

complications of aneurysms

A

rupture –> hemorrhage
vascular obstruction
atheroembolism
compression of adjacent structure

69
Q

what is a dissection?

A

A partial tear within the wall of a blood vessel

70
Q

what does dissection allow for?

A

blood to separate the layers of the media

71
Q

intimal tear

A

inner 2/3 of media separated from outer 1/3 creating 2 lumens (passages w/in vessel)

72
Q

what is the false lumen created by a dissection?

A

new space within the wall of the artery

73
Q

what is aortic dissection?

A

passage of blood within the media, which often ruptures outward causing massive hemorrhage

74
Q

who does aortic dissection affect?

A

> 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
Q

name other predisposing factors of aortic dissection

A

pregnancy and iatrogenic

76
Q

aortic dissection type A

A

involves ascending aorta

77
Q

aortic dissection type B

A

involves descending aorta only

78
Q

which type of aortic dissection requires medical emergency?

A

type A

79
Q

aortic dissection based on site of intimal tear

A

DeBakey

80
Q

aortic dissection based on site of dissection

A

Stanford

Systems 1 (22 decks)

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