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Pathology > Vascular pathology > Flashcards

Vascular pathology Flashcards

1
Q

list the causes of general cardiovascular disease

A
  • atheroma
  • thrombosis
  • embolism
  • aneurysm
  • cerebrovascular - stroke
  • cardiovascular - heart attack
  • senile arteriosclerosis
  • hypertension
  • arrhythmia
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2
Q

what is the most common cause of death in the US in 2005

A

heart disease 26.6%

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3
Q

what is heart disease related to (most common in)

A

age related disease, more common with older population

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4
Q

what is the pulmonary circuit part of the circulatory system

A

blood vessels which go to the lungs

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5
Q

in the circulatory system, where is deoxygenated blood located and where does it go into

A

located in the vena cava & goes into the right atrium

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6
Q

which blood vessels do most cardiovascular disease involve

A

the arteries

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7
Q

what is the smooth inner lining of the artery made of

A

endothelial cells

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8
Q

what type of composition are blood vessels mainly

A

elastic

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9
Q

what does the elasticity of arteries enable them to do and when

A

allows them to dilate, during cardiac systole

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10
Q

what are the elasticity of arteries good for

A

preventing extreme rises in blood pressure & elastic recoil during diastole will facilitate the movement of blood

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11
Q

what is arteriosclerosis

A

a group of diseases characterised by loss of elasticity/hardening of the artery

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12
Q

what is arteriosclerosis linked to

A

increased blood pressure

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13
Q

who is arteriosclerosis most common in and what is it called

A

old age called senile arteriosclerosis

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14
Q

what is arteriosclerosis characterised by

A

a degeneration of smooth muscle in the artery’s tunica media, the cross linking of collagen and elastin, a thickening of the blood vessel wall and a deposition of calcium salts

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15
Q

what is the most important form of arteriosclerosis

A

atherosclerosis (or atheroma)

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16
Q

what is atherosclerosis (atheroma) the principle cause of

A

heart attack, stroke and gangrene of the extremities

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17
Q

how many % of mortality is atherosclerosis (atheroma) responsible for in the USA, Europe and Japan

A

50%

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18
Q

what is atherosclerosis (atheroma) characterised by

A

the deposition of fibrous growths (plaques) within the tunica interna (walls) of arteries

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19
Q

what is the first event in atheromatous plaque formation

A

injury/damage to the blood vessel wall due to smoking (carbon monoxide), virus, hypertension

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20
Q

what happens in atherosclerosis, following the damage to the blood vessel wall

A

damaged endothelial cells release chemotactic factors leading to the accumulation of low density lipoproteins (LDLs) from the plasma which oxidise.

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21
Q

what do LDLs do

A

deliver cholesterol to tissues

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22
Q

how are the fatty yellow streaks in the vessel’s tunica interna formed

A

macrophages/monocytes ingest the oxidised lipids, forming ‘foam cells’ which cause the formation of a fatty ‘yellow streak’ in the vessel’s tunica interna

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23
Q

what happens in the last stage of atheromatous plaque formation

A
  • smooth muscle migrates from the tunica media to the tunica interna
  • migrated smooth muscle cells replace and produce connective tissue
  • calcium deposits (from the plasma) are formed and infiltration of wbc
  • tunica media is starved of oxygen, muscle cells degenerate and scar tissue forms
    = blood vessel lumen is decreased
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24
Q

describe the characteristics expressed by an arteriopath (aetiology of atheroma)

A
  • male and >40
  • overweight
  • no exercise
  • diet - more processed food & high saturated fat
  • stress - sympathetic nervous system
  • alcohol
  • smoking - 17x more likely
  • diabetes - esp type 2
  • oral contraceptives
  • genetics
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25
Q

list the 4 consequences of atheroma

A
  1. smaller vessels may become blocked
  2. plaques may become the site of a thrombosis
  3. a piece of plaque becomes detached and forms an embolism
  4. a plaque can be the site of an aneurysm
26
Q

how may smaller vessels become blocked as a consequence of atheroma

A

arteries become narrowed and blood flow decreases due to the build up of fatty substances in the wall of the artery in atherosclerosis

27
Q

how may plaques become the site of a thrombosis as a consequence of atheroma and give an example

A

thrombus is a blood clot on the atheromatous plaque which also blocks the BV e.g. deep vein thrombosis

28
Q

what can deep vein thrombosis be caused by

A

caused by:

  • endothelial damage
  • hyper coagulability
  • venous stasis
29
Q

what is hyper coagulability, which causes deep vein thrombosis

A

chemical changes in blood = more likely to coagulate

30
Q

what is venous stasis, which causes deep vein thrombosis

A

blood flow is less, can be from long haul flights

31
Q

list the main symptoms of deep vein thrombosis

A
  • pain
  • swelling
  • redness
  • warmness
32
Q

what is a possible complication caused by deep vein thrombosis

A

a venous thromboembolism - a part of the clot becomes detached and travels through the circulatory system, to the lungs

33
Q

how many a piece of plaque become detached and form an embolism as a consequence of atheroma

A

when a piece of embolus lodges within a vessel and blocks the blood supply

34
Q

how can a plaque be the site of an aneurysm which is a consequence of atheroma

A

a saccular aneurysm weakens the wall of the blood vessel, which becomes a fusiform aneurysm which causes a lump in the BV, which can get ruptured as the wall of the vessel is thin

35
Q

what can a burst aneurysm lead to

A

haemorrhage

36
Q

what are aneurysms often the site of

A

a thrombosis

37
Q

list the three things in which an atheroma can cause

A

aneurysm
thrombosis
embolism

38
Q

what are the events following a thrombosis

A

blockage, ischaemia (tissue doesn’t get enough oxygen), infarction (tissue dies)

39
Q

why is a myocardial infarction serious/dangerous

A
  • the heart needs to keep beating uninterrupted

- cardiac muscle is amitotic (cannot get replaced if dies)

40
Q

what are the coronary arteries which supply blood to the heart muscle itself, particularly susceptible to

A

plaque formation (the first few centimetres of arteries)

41
Q

what is ischaemic heart disease (coronary arterial disease)

A

the narrowing of the coronary arteries by atheroma, results in the heart muscle receiving insufficient oxygen, leading to impaired contraction

42
Q

how many deaths in the UK does ischaemic heart disease account for

A

1/3rd of all deaths

43
Q

what is the least severe consequence of atheroma in coronary arteries, and what is it caused by

A

angina pectoris
caused by short term inadequacy of the blood supply to the heart during times of increased demand (e.g. walking up stairs).
during an attack there is no tissue death

44
Q

what is a more severe consequence of atheroma in coronary arteries

A

ensues if coronary blood supply is disrupted for longer
e.g. if a thrombosis forms on an atheromatous plaque in the coronary arteries, heart muscle may die, known as myocardial infarction (heart attack)

45
Q

which part of the heart muscle being effected by/dyeing due to an atheromatous plaque in the coronary arteries is most dangerous

A

in the left ventricle

46
Q

what does the severity of the infarction depend on

A

size and location

47
Q

what does the pressure within the systemic circulation vary during

A

the cardiac cycle

48
Q

what is systolic pressure

A

pressure in system when heart contracts

49
Q

what is diastolic pressure

A

pressure when heart is relaxed

50
Q

what is blood pressure (systolic & diastolic pressure) measured with

A

sphygmomanometer

51
Q

what is the average blood pressure value

A

120/80 mm/Hg (younger have lower pressure)

52
Q

what does blood pressure tend to rise with

A

age

53
Q

why is blood pressure lower in the young

A

young people have arterial walls which are quite elastic, thus when the ventricle contracts, the systolic blood pressure is lowered by the vessel dilating somewhat

54
Q

how does the blood vessels lose some of their elasticity with increased age, and what is this called

A

senile arteriosclerosis:
the tunica interna becomes thickened and fibrosed and the smooth muscle and elastic tissue of the tunica media becomes partly replaced by collagen

55
Q

what does the hardening of the arteries lead to with age

A

high blood pressure

56
Q

what is a prolonged period of high blood pressure referred to as

A

hypertension

57
Q

what are the rough guidelines of normal, borderline and hyper tense blood pressure values issues by WHO

A

normal - 140/90 mm/Hg
borderline - 160/95 mm/Hg (hypertesnion)
hypertense - > 160/90 mm/Hg

58
Q

what is high blood pressure defined as

A

systolic pressure of 140 mm/Hg more more
diastolic pressure of 90 mm/Hg or more
or receiving medication for high blood pressure

59
Q

list what the long term effects of hypertension include

A
  • kidney damage (kidney involved in blood pressure regulation, so if damaged, kidney cannot have strength to regulate)
  • increased bulk of heart
  • damaged arteries leading to atherosclerosis
60
Q

how much % of output of the heart does the kidney take

A

25%

Pathology (20 decks)

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