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Cardio Exam 1 > Vascular Pathology and HTN > Flashcards

Vascular Pathology and HTN Flashcards

1
Q

Layers of the veins?

A

Internal: intima
Middle: media
External: adventitia

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2
Q

Where is the media thickest and why?

A

Arteries because it is composed of smooth muscle cells and ECM
It needs to be able to withstand high blood pressure

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3
Q

What is the intima composed of?

A

Endothelial cells and elastic connective tissue

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4
Q

Where is there the most elastic tissue?

A

Media because it needs to be flexible to the change in blood pressure

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5
Q

What is the aventitia composed of?

A

Mainly connective tissue and contains nerves and blood vessels!!!!!

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6
Q

What is the purpose of the aventitia?

A

To supply nutrients and oxygen to cells that are farther away from the blood and lumen

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7
Q

Which arteries are the most elastic?

A

Pulmonary

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8
Q

What arteries are the most muscular?

A

Coronary or renal

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9
Q

****What are the smallest arteries called and what happens here?

A

Arterioles and it is the site where regulation of blood pressure occurs

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10
Q

Define Peripheral resistance

A

Resistance that is encounterd by blood during blood flow in the arteries
Related to diameter size

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11
Q

Drugs that cause vasodilation do what? Vasoconstriction?

A

Lower blood pressure; increase blood pressure

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12
Q

What are capillaries important?

A

They are within every tissue and are drug targets

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13
Q

Nutrients and oxygen can only be carried?

A

100 mcL so lots of capillaries to make sure everyone gets what they need

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14
Q

What doesn’t have all three layers?

A

Pericytes and endothelial cells

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15
Q

What happens in the veins?

A

Blood slows down because there is an exchange of oxygen and nutrients

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16
Q

Most disease effect?

A

Arteries not veins

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17
Q

What is the major pump of the heart?

A

Left ventricle, that is why it has such a large myocardium

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18
Q

Where does the left ventricle send blood?

A

Through the aorta to the organs and tissues

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19
Q

Define pulmonary circulation

A

Veins collect the blood and return it to the right ventricle

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20
Q

What is the cause of pulmonary HTN?

A

Increased pressure in the lungs, somewhere between the blood being sent from the right ventricle to the lungs to the left ventricle

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21
Q

What if something happens to the left ventricle?

A

Hypoperfusion to the tissues or the return of the lungs from the LV will be impaired and it will be stuck in the lungs (stasis)

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22
Q

When could you see decrease in elasticity of the arteries?

A

Age or atherosclerosis –> cannot expand during systole or recoil during diastole

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23
Q

What are the regulating mechanisms of blood pressure?

A 
Autonomic nervous system (Sympathetic)
Metabolic factors (lactic acid)
Cellular interactions
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24
Q

How does lactic acid do anything for the blood pressure?

A

It decreases extracellular pH leading to vasodilation bc you need more oxygen and blood

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25
Where does the exchange of nutrients and oxygen occur?
Portal cells
26
Define hydrostatic pressure
Keep fluid in homeostasis; increased pressure would lead to accumulation of fluid in the tissue (edema)
27
Veins
2/3 blood is stored here Are easily penetrated by tumors Deep veins typically have really slow blood flow
28
Define Lymphatics
Draining system for returning interstitial tissue fluid and inflammatory cells to the blood
29
Define thoracic duct
Vessels that take the fluid back to the circulation
30
Lymph nodes are
where the collected viruses are sent
31
Fenestrated endothelium is important?
for filtration in the kidney and liver
32
The less amount of fenestrae is important because?
That prevent thrombosis and coagulation would occur immediately if it comes in contact with that layer
33
Define plasminogenosis
Breakdown of the clot
34
Blood clot =
Blood cells + plasminogen | Important to prevent hemorrhage
35
Define thrombus
Blood clotting in NORMAL blood vessels
36
Platelet Derived Growth Factor
Produced by endothelial cells and induce the proliferation of smooth muscle cells - Seen in injury and atherosclerosis
37
TGFbeta does what?
Stops proliferation of smooth muscle cells; contribute to ventricular remodeling in hear failure
38
LDL can be oxidated to?
Be incorporated into the wall of blood vessels (atherosclerosis)
39
What prevents thrombosis?
``` Prostacyclin NO Thrombomodulin Heparin Plasminogen activator ```
40
What causes clotting?
vWF tissue factor plasminogen inhibitor
41
Turbulent blood flow leads to?
Increased tendency for coagulation
42
Smoker differentiation
Endothelial cells can be damaged by smoke leading to thrombosis and increased permeability of endothelial surface
43
Normal SM cells
Do not divide or proliferate | The repair injured blood vessels
44
What is the response to injury process that causes artherosclerosis?
Recruitment of SM cells to the intima SM cells mitosis Elaboration of extracellular matrix (SM cells die and become debris)
45
Three types of vascular pathologies
Stenosis or complete obstruction of blood vessels Thrombus or embolus Artherosclerosis
46
Four types of vascular pathologies
Weakening of vessel walls Congenital Vasculitis Atherosclerosis
47
Chest pain is a symptom of
MI or infarction
48
Peripheral edema is a symptom of
Right sided heart failure
49
SOB is a symptom of
Pulmonary congestion or left sided heart failure
50
Fatigue is a symptom of?
CHF
51
Palpitations, dyspnea, hypoTN, syncope are symptoms of?
Arrhythmias
52
Why is it important to control blood flow?
Pressure determines flow and flow has a range it must be within and it will increase and decrease when needed?
53
What if we suddenly increased blood pressure?
Increased blood flow in tiny capillaries would cause damage to tissues and organs
54
********Blood pressure =
CO (Q) X Peripheral vascular resistance
55
********* Cardiac output =
Blood volume X heart function
56
Blood volume is dependent on?
The amount of fluids we intake and excrete
57
Hematocrit is based on
The amount of cells in the body | Higher cells = higher hematocrit
58
What decreases peripheral resistance?
NO Prostacyclin Kinins Histamine
59
What increases peripheral resistance?
Ang II Catecholamines Endothelin ADH
60
Sympathetic nervous system does what to BP?
Increases
61
Non-sympathetic nervous system does what to BP?
Decrease by inhibiting the sympathetic
62
Stretch receptors
When stretched, trigger the brain to decrease BP and cause vasodilation
63
Sympathetic Nervous System
Uses neurotransmitters Epi- Beta - dilation NE- Alpha- constriction
64
NE & Epi do what?
Postganglionic nerve is producing NE which binds to alpha 1 receptor and causes vasoconstriction & Epi binds beta 2 and causes vasodilation
65
Pharmacological aspect of receptors?
Stimulate B2 and inhibit A1
66
Beta 1
Increased CO | Increased BP
67
Alpha 1
Increased sodium reabsorption | Increased BP
68
Beta 2
Increased renin | Decreased BP
69
Renin cleaves?
Angiotensinogen to Ang1
70
ACE cleaves?
Ang 1 to Ang 2
71
Aldosterone is
Created from Ang 2 and causes sodium reabsorption and increased blood volume
72
Increased blood pressure --> increased stretch receptors --> ?
Naturetic peptide --> Na and water ecretion
73
What stimulates renin secretion?
Decreased NaCl Decreased pressure or stretch SNS stimulation
74
What inhibits renin secretion?
Increased NaCl Increased stretch AngII
75
How is renin secreted?
SNS innervates the juxtaglomerular cells which act on baroreceptors Decreased Na to the distale tubule activates these cells
76
What are baroreceptors?
Stretch receptors!!
77
Increased sodium excretion leads to?
Slower flow so more can be reabsorbed
78
Vascular relaxing factors?
NO | Prostaglandins
79
Define Hypertensive vascular disease
Systole > 139 | Diastole > 89
80
Define essential HTN
Don't know the cause
81
Define secondary HTN
Related to a disease (CKD, tumor, etc)
82
Risk Factors
``` Age Race Obesity >30 High NaCl Low Ca, K, D Alcohol Stress Low physical activty Family history High cholesterol Diabetes ```
83
HTN doubles the risk of what CV diseases?
``` Coronary heart disease Congestive heart failure Stroke Renal failure Peripheral arterial disease and aortic dissection ```
84
Define Atherosclerosis
Wall thickens up in hyaline arteriolosclerosis | - Important bc they regulate blood pressure → changes to lumen to regulate the BP would not happen at all or very little
85
Define Malignant HTN
Systole >200 Diastole >120 Leads to death within 1-2 yrs
86
Malignant HTN leads to
brain edema, renal failure or hemorrhages
87
Arterial HTN if left untreated will lead to death via
Ischemic heart disease CHG Stroke

Cardio Exam 1 (7 decks)

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