Vascular Remodelling

Question 1

Layers of vessel

Answer 1

Tunica externa
Tunica media
Tunica intima

Question 2

Tunica externa of artery

Answer 2

vasa vasorum

nervi vasorum

Question 3

Tunica media of artery

Answer 3

external elastic membrane
smooth muscle
elastic fibre

Question 4

Tunica intima of artery

Answer 4

internal elastic membrane

endothelium

Question 5

tunica externa of vein

Answer 5

vasa vasorum

smooth muscle

Question 6

tunica media of vein

Answer 6

smooth muscle

Question 7

tunica intima of vein

Answer 7

endothelium

Question 8

Features of endothelial cells

Answer 8

main cellular component of blood vessels
vessel wall homeostasis
non-thrombogenic interface
vascular resistance 
metabolise hormones
regulate inflammation 
affect growth of other cells
tight endothelial junctions

Question 9

4 endothelial cell functions

Answer 9

haemostatic functions
barrier + transduction functions
control of vascular wall functions
leukocyte/endothelial cell adhesive function

Question 10

Haemostatic functions of endothelial cells

Answer 10

Provide TF = encourage clot formation

PROTHROMBOTIC MOLECULES - VWF/TF/Plasminogen activator inhibitor

Question 11

Barrier + transducing functions of endothelial cells

Answer 11

maintenance of permeability + regulation of cell growth

- stimulator

Question 12

Control of vascular wall functions endothelial cells

Answer 12

vasoconstrictors = endothelin/ ACE

vasodilator - NO/ Prostacyclin

Question 13

Leukocyte/endothelial cell adhesive function - endothelial cells

Answer 13

regulation of inflammation + immunity

chemokines + adhesion molecules

Question 14

Intimal thickening process

Answer 14

1) migration (+ proliferation) of smooth muscle cells to intima
2) smooth muscle mitosis
3) elaboration of extracellular matrix

Question 15

endothelial activation - types

Answer 15

inflammation - cytokines/bacteria
atherosclerosis - haemodynamic stress/lipids
diabetes - glycosylation end products

Question 16

result of endothelial activation

Answer 16

production of cytokines/growth factors + vasoactive molecules

affect vasoreactivity of smooth muscle
- relax (NO) + contract (endothelin)

Question 17

endothelial dysfunction

Answer 17

altered phenotype impairs vasoreactivity + induces thrombogenic surface/ abnormally adhesive to inflammatory cells

thrombus + atherosclerosis + vascular lesions of hypertension

Question 18

Inflammation

Answer 18

1) adhesion to monocytes + T cells
2) adhere + migrate to intima
3) macrophages engulf lipoproteins
3) activated macrophages
4) smooth muscle cell proliferation
5) T cells activated inflammatory cytokines
6) stimulate macrophages + EC + smooth muscle
7) growth factor release + smooth muscle proliferation + extracellular matrix synthesis

Question 19

Vascular remodelling definition

Answer 19

active process of structural change

• cell growth/cell death/cell migration + synthesis or degradation of extracellular matrix
• can contribute to vascular disease

Question 20

remodelling in hypertension

Answer 20

increased width to lumen ratio

Question 21

remodelling due to aneurysm

Answer 21

cell loss/matrix proteolysis

Question 22

Remodelling process

Answer 22

changes in haemodynamic conditions
relay of signal within and in adjacent cells
synthesis/release of cell growth/death/migration substances
structural changes in vessel wall

Question 23

Saccular aneurysm

Answer 23

TRUE
one sided
- intact wall

Question 24

Fusiform aneurysm

Answer 24

TRUE
2 sided
intact wall

Question 25

False aneurysm

Answer 25

wall defect - blood through defect to media and adventitia

causes - haematoma + dilation

Question 26

Dissecting aneurysm

Answer 26

dual flow - intima/media
blood enters through wall - defect in intima = creates turbulent flow
HAEMATOMA
vasa vasorum can’t reach endothelial cells

Question 27

Aneurysm definition

Answer 27

localised abnormal dilation of a blood vessel or the heart

- congenital or acquired

Question 28

Cause of aneurysm in ascending aorta

Answer 28

hypertension