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Cardiovascular Block Histology (Karen) > Vascular Pathology I > Flashcards

Vascular Pathology I Flashcards

1
Q

Ischaemia

A

deficiency of O2’d blood in a tissue causing impaired aerobic respiration and cell death

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2
Q

Hypoxia

A

deficiency of oxygen in tissues

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3
Q

Hypoxemia

A

deficiency of oxygen in blood

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4
Q

Infarct

A

area of necrosis caused by acute ischemia

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5
Q

Thrombus

A

clotted blood within the cardiovascular system

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6
Q

Embolus

A

intravascular solid, liquid, or gaseous mass carried in blood stream to some site remote from its origin (e.g. detached thrombus, CO2 poisoning in diving)

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7
Q

Atherosclerosis

A
  • underlying disease of most CVD
  • accumulation of lipid and fbirous CT = plaque
  • intima of MEDIUM and LARGE ARTERIES
  • caused by endothelial dysfunction and chronic inflammation
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8
Q

Risk factors for artherosclerosis include

A
  • High blood lipids
  • high BP
  • smoking
  • age
  • sex
  • genetics
  • diabetes (diabetic dyslipidaemia: altered balance of HDL & LDL; smaller denser LDL)
  • lipoproteins (genetics, diet) e.g. elevated LDL, VLDL
  • obesity, metabolic syndrome
  • proteinuria
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9
Q

What does dysfunctional endothelium lead to?

A

Increased permeability to LDL in blood

decreased production of NO (vasodilation) and prostacyclin (PGI2, inhibiton of platelet aggregation)

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10
Q

What are the 5 main classes of lipoproteins?

A
  1. chylomicrons
  2. very low density L
  3. LDL
  4. intermediate DL
  5. high DL
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11
Q

What happens when LDL enters the intima?

A

oxidized by ROS

trapped

inflammatory response

IL-8 –> macrophages

phagocytosed –> foam cells

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12
Q
A
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13
Q

What is the consequence of media smooth muscle cells migrating to the intima?

(due to PDGF, TGF-b, cytokines from macrophages, etc.)

A

generates ECM inside the intima

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14
Q

Where does lipid accumulate from in the plaque?

A

breakdown of foam cells

cholesterol from cell membranes (form cyrstals)

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15
Q

What contributes to increased disease risk (e.g. atherosclerosis, type II diabetes, hypertension, fatty liver disease) in metabolic syndrome?

A

cytokines and growth factors released from adipose tissue interfere with insulin signalling and BP regulation

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16
Q
A
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17
Q
A
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18
Q

What cell type is this?

A

Foam cells: macrophages with foamy cytoplasm from phagocytosed LDL

19
Q

What are 3 major complications of atherosclerosis?

A

Ischaemia

Infafction

Aneurysm

20
Q

What is the mechanism by which atherosclerotic plaque leads to aneurysm?

A
  • placque buildup in intima puts pressure on media, imparing O2 saturation (usually by lumen)
  • media atrophies and weakens and dilates
  • leads to aneurysm
  • possible thrombus, thrombo-embolis formation, rupture
21
Q

What atheroscleortic complication is this?

A

Fixed vessel narrowing (coronary artery)

Red circle denotes normal lumen size

H&E: fibrous placque (not as much lipid as L)

22
Q

What are important sites of atherosclerosis?

A
  • abdo aorta (AAAs most common)
  • corontary arteries (lead to CVAs, infarcts)
  • femoral arteries, popliteal
  • kidnes (renal arteries)
  • mesenteric arteries (small bowel)
23
Q

What is the character of a true/fusiform anuerysm?

A

entire circumference of vessel wall is dilated

24
Q

What type of aneurysm is this?

A

True/fusiform

complete circumferential dilation

25
Q

What type of aneurysm is this?

A

True: saccular

unilateral/focal dilation

26
Q

What is the character of a true/saccular aneurysm?

A

Focal/unilateral dilation

27
Q

What type of aneurysm is this?

A

False

Occur when local bleeding from a vessel is contained intissues surrounding it; appears as dilation from exterior

28
Q

What is the character of a false aneurysm?

A

appears dilated from exteriour

local vessel bleeding contained in pouch within surrounding tissue, not from within the vessel

29
Q
A
  • Dissection
  • NOT aneurysms
  • no ballooning/dilation
  • blood bleeds into wall (intima into media)
  • dissects along the wall, pushing them apart
  • shredding of vessel walls
  • usually aortic
30
Q

Where are the primary sites for aneurysm?

A

vessels w/weakened media (arteries)

sometimes in the LV

31
Q

What are the causes of aneurysms?

A
  • atherosclerosis
  • congenital media weakness (esp. berry/saccular in circle of Willis
  • systemic hypertension causeing microaneurysms in cerebral arterioles
  • infection of arterial wall (mycotic)
32
Q

What is the most common region of the aortia affected by dissection?

A

Proximal ascending aorta

also can arise in descending

33
Q

What is Marfan’s Syndrome?

A

Genetic abnormality of fibrillin, which is important in the formation of elastic tissue (e.g. in the aorta, tf predisposed to aneurysms)

34
Q

What is the main risk factor for aneurysm?

A

Hypertension

35
Q

Aneurysm

A

Weakened media due to thickened intima dilates and ruptures, causing an aneurysm

thrombus may form, which may embolise

36
Q

Dissection

A

Blood bleeding into the vessel wall, from the intima bleeding into and along the media

37
Q

Arteriosclerosis

A
  • Thickening of the arteries
    • +ECM deposition
    • media elastic tissue degenerates
      • fibrosis, loss of elasticity and dilation
      • intimal fibrosis
  • includes atherosclerosis and age related arterial changes
  • arteriosclerosis can be in larger arteries (athero) or arterioles
38
Q

What are age related arterial changes?

A
  • arteriosclerosis of large arteries (atherosclerosis)
  • intimal thickening of small arteries
  • arteriosclerosis (arterioles)
  • may cause slight +BP w/age
  • changes to smaller vessels exacerbated by systemic hypertension
39
Q

What is hyaline arteriosclerosis?

A
  • age-related change
  • occurs in arterioles
  • normally, wall is 1-2 layers of SM
  • wall is replaced with hyaline
    • amorphous, proteinaceous, eosiniphilic staining on H&E
40
Q

What is the mechanism of hyaline arteriosclerosis?

A
  • endothelial stress over time leads to leaky enodothelium
  • plasma proteins (albumin, fibrinogen) deposit into wall, some collagen by smooth muscle
    • seen as amorphous pink material (protein, tf eosinophilic)
  • narrows lumen (far right)
41
Q

What are the risk factors and outcomes of hyaline arteriosclerosis?

A
  • hypertension (as with atherosclerosis)
  • in hypertension, greater risk of rupture
    • stroke in brain
  • retinal ischaemia or infarction, exudates –> vision problems
  • chronic ischaemia in kidney, glomerular atrophy, kidney atrophy
42
Q

What is the mechanism of arteriosclerosis?

A
  • elastic media tissue of aorta and other elastic arteries degenerate with age
  • fibrous deposition, collagen deposition in media
  • -elasticity, -dilation
  • +systolic pressure
  • intimal fibrosis
    • occurs in aorta and ateries, not arterioles
    • does not narrow aorta
    • -distensibility
43
Q

What age related change is seen here?

What is each arrow?

A

Intimal thickening

  • blue arrow: media/smooth muscle cells w/long nuclei
  • yellow arrow: internal elastic lamina, wavy band around intima
  • red arrow: thickened intima with ECM

occurs in small, medium, large arteries and the aorta

Cardiovascular Block Histology (Karen) (6 decks)

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