Week 4- Vascular Flashcards
List the layers of walls in arteries and veins
Inner= tunica intima
Middle= tunica media
Outer= tunica externa
List congenital anomalies
Berry aneurysm= ballooning fo blood typically at branching of arteries in circle of Willis
Atriovenous fistulas= direct connections between arteries and veins bypassing capillaries. Normally occurs in the brain
Fibromuscular dysplasia = irregular thickening in large musclular arteries resulting in luminal stenosis
What is arteriosclerosis
Arterial wall thickening and loss of elasticity
- Arteriolosclerosis:
- Mӧnckeberg medial sclerosis:
- Fibromuscular intimal hyperplasia:
- Atherosclerosis: arteries become narrowed and hardened due to biild up of plaque. Plaque can burst leading to a blood clot
What is an atheroma
Intimate lesions of plaques that produce in vessel lumens
Mechanically obstructs. Blood flow
Causing injury and weakening of belles wall resulting in aneurysm formation
Factors for atherosclerosis
Non modifiable- increasing age, gender, genetic factors
Modifiable= hyperlipidimea, hypertension, cigarette, smoking, diabetes mellitus
Additional risk factors= inflammation, obesity
What is hypertension
Elevated bp. Anything over 140/80mm Hg
Can cause dementia, cardiac hypertrophy, heart failure, aortic dissection and renal failure
90% of this is primary idiopathic
What is the juxtraglomerular apparatus
Specialised structure in the kidneys that play a crucial role in regulating bp and filtration Tate of glomerulus.
Produce and secrete renin an enzyme that helps regulate bp
,what is vasculitides
Inflammation fo blood vess;eSS
Present with non-specific complains
Fever, myalgia, arthalgia
Immune mediated inflammation
Direct invasion m of vascular walls by infectious pathogens
What is infectious vasculitis
Less common, direct trauma, can be bacterial or fungal
What is giant cell arteritis
Chronic inflammation of large-small sized arteries
.
• Sites: Temporal (HA & facial px), vertebral, ophthalmic (blindness), aortic
(aneurysm) arteries.
• Age, sex, ethnicity: >50yrs, M=F, Nordic people
• Clinical Features: Facial px, HA, diplopia & blindness (most dangerous
sudden and permanent). 40-60% of pts with GCT also have polymyalgia
Rheumatica
• Pathology/morphology: intimal thickening, granulomas in vessel walls, giant
cells, segmental involvement, fragmentation of internal elastic lamina (IEL)
• Dx: Biopsy is important
• Tx: steroids save vision
What is takayasu (pulseless) arteritis
• Systemic vasculitis: granulomatous vasculitis of medium and large size
vessels.
• Sites: Aorta (aneurysm), Temporal (HA & facial px), vertebral, ophthalmic
(blindness).
• Age, sex, ethnicity: <40 years, F>M, Japanese, HLA subset haplotypes.
• Clinical: Marked weakening of the pulses in the upper extremities, decreased
BP, fever, weight loss, fatigue.
• Pathology/Morphology: fibrous thickening of aorta., granulomas in
vessel walls, giant cells (cells of Langerhan), fibrosis & lymphocytic infiltration
• Dx: Biopsy
• Tx: Steroids
• Complications: MI, Aortic regurgitation
Difference in bp from side to side
What is Kawasaki disease
Systemic vasculitis: of small and medium size vessels
Sites: Coronary, cutaneous vessels
Age, Sex, Ethnicity: Very young (<4 yrs), north America, Japan.
Clinical: Fever, conjunctival and oral erythema and blistering, oedema of hands and feet, erythema
of the palms and soles, a desquamative rash, cervical lymph node enlargement.
Prognosis: Spontaneous remission in most (4% develop CV sequelae).
Tx: Aspirin, immunoglobulins
Complications: Coronary an
What is Wegner granulomatosis
Necrotizing vasculitis characterised by a triad of:
1. Acute necrotizing granulomas of the upper respirator tract (ear, nose, sinus,
throat) or lower respiratory tract (lung) or both.
- Necrotizing or granulomatous vasculitis affecting small to medium sized
vessels most prominent in lungs but other sites as well. - Focal necrotising, often crescentic glomerulonephritis.
Age: >40 years, M>F
Pathogenesis: T-cell mediated hypersensitivity response to a normally
‘innocuous’ inhaled microbial or other environmental agent.
Clinical: B pneumonitis with nodules and cavity lesions, chronic sinusitis, mucosal
ulcerations of nasopharynx, renal disease
What is thromboangiitis obliterates (burgers disease)
Smoking disease
Yellow fingers
Inflammatory condition that affects small- medium sized blood Celebes. It is clot formation in arterie and veins
Severe cases gangrene
What is the difference between and aneurism and dissection
A= bulge
D= burst
What is the most common aneurysm
Abdominal aortic aneurysm
List causes of aneurysms
Atherosclerosis
• Smoking
• HT
• Vasculitis Thoracic AA
• Cocaine use
• Genetic factor
• Marfan Syndrome (long limbs scoliosis, eye issues and heart issue)
• Previous aorta injury
• Trauma
What are cerebral aneurysms caused by
Weakness in artery walls since birth
Hypertension
Arteriosclerosis
Most CA develop at forks of branches in arteries
Artiovenous malformation
Signs of abdominal aortic anbeurysm
Throbbing feeling in abdomen
Deep px in back or side of abdomen
Steadying px in abdomen that lasts for hours to days
Signs of cerebral aneurysm
Cerebral Aneurysm
• HA: acute onset of severe px, which pt’s often describe as “the worst HA of my life”
• Facial px, numbness or weakness
• Periocular px
• Visual disturbances (loss or diplopia)
• Difficulty speaking
• Difficulty concentrating or with short term memory
• Rupture:
• Manifestations of meningeal irritation; Cx px & stiffness
• Feeling or being sick
• Photophobia
• Diplopia
• Sudden confusion
• Loss of consciousness
• Seizures
• Weakness in 1 side of the body or any limbs
• Haemorrhagic stroke/intracranial haematoma
Diagnostic tests for AAA
Abdominal or chest x-ray
Ultrasound
MRI
What is Raynaud’s phenomenon
Exaggerated vasoconstriction of arteries and arterioles in response to cold or emotion
Affects fingers and toes
What is varicose veins
• Abnormally dilated, tortuous veins
produced by prolonged, increased
intraluminal pressure with vessel dilation
and incompetence of the venous valve
What is thrombophlebitis and phlebothrombosis
Venous thrombosis and inflammation
Deep leg bveins count for 90%
