Week 9 lec - vascular pathology Flashcards
In Australia , 1 person dies every __min from CVD
12
what are the CVD and vascular disease shared risk factors?
Genetic&lifestyle
– Age
– Male gender (risk is similar after menopause)
– Family history
– High blood pressure
– High cholesterol
– Overweight/obese
– Physical inactive
– Smoking
– Dietlowinfruits&vegetables
– Excessive alcohol consumption
– Glucose intolerance/insulin resistance/type2diabetes
Vascular disease can affect veins, arteries and ____ vessels
lymph
vascular disease can be through damage, blockage, or ______ of the vessel
rupture
Vascular disease is present in all forms of ___
CVD
which are the elastic arteries?
aorta & major branches
list 4 features of elastic arteries
- elastic tissue
- expand & recoil
- are pressure reservoirs
- conducting arteries
why are elastic arteries very important in the heart?
they have the ability to expand and recoil
features of muscular arteries
- thick walls – 25+ layers of muscle
- undergo vasoconstriction & vasodilation
- distributing arteries
example of muscular arteries
medium size arteries
feature of arterioles
- small muscular arteries
- decreasing in size with gradual loss of wall layers down to terminal arterioles
what is the peripheral venous pressure?
about 5-10mmHg
the endothelium in the heart is called?
the endocardium
The majority of our NO is produced endogenously by ___ ____ ___ enzymes (remaining small portion comes from the diet)
nitric oxide synthase (NOS)
NO is a free radical with a rapid half-life, which is an important vascular signalling molecule that also functions as a potent ______
vasodilator
ageing has the most significant effect on _____ arteries
elastic
what are the vascular changes which occur with ageing?
– Hypertrophy of the tunica intima and tunica media
– Increase in smooth muscle and elastic tissues
– Elastic tissue forms concentric layers in the tunica intima – becomes less elastic
– Collagen fibres start to replace smooth muscle tissue – stiffening walls of vessel
– Calcium deposits in the tunica media
– Reduction in vessel elasticity & hardening of the vessel walls
what is the sum of the changes which occur in the arteries with ageing?
hardening of the arteries
what could cause a reduction in the bioavailability and/or bioactivity of NO?
– Degradation of NO
– Decreased NOS activity
– Decreased availability of NOS substrates & co-factors
what could cause damage to the endothelium?
– Turbulent blood flow
– Increased blood pressure
– Lifestyle factors – smoking, alcohol, excessive fats &/or sugars
– Inflammation & infection
A reduction in the bioavailability and/or bioactivity of NO and damage to the endothelium results in what alterations to the endothelium?
– Inflammation
– Increased vaso-tone
– Increased thrombotic activity
– Reduced dilation
– Damaged endothelium
what are the types of vascular diseases?
- Hypertension
- Peripheral vascular disease
- Atherosclerosis & arteriosclerosis
- Cerebrovascular disease – ischaemic & hemorrhagic stroke
- Aneurysm – excessive localised swelling in the wall of an artery
- Varicose veins, lymphedema, claudication, phlebitis, other rare disease
final consequences of vascular disease?
– Angina – chest pain
– Myocardial infarction – heart attack
– Heart Failure
what tells you the most about peripheral resistance: systolic or diastolic pressure?
diastolic
Hypertension can be classified as: (5)
– Essential – no specific medical cause to explain hypertension (~90%)
– Secondary – results from a specific underlying condition with a well-known mechanisms
– Malignant – extremely high & uncontrolled hypertension
– Pre-eclampsia – pregnancy induced hypertension
– White coat – elevations due to seeing your GP!
give an example of hypertension can be caused by single gene mutations
altered renal salt handling
how can hypertension caused by autonomic nervous system?
SNS affects pressure, volume and chemoreceptor signals
how can hypertension be caused by renin-angiotensin-aldosterone system?
Ang II, ADH and Aldosterone production which can affect Na+ & water reabsorption/secretion
how can hypertension be caused by vascular dysfunction?
reduction in NO, thickening of vessel wall & impaired vessel response
how can hypertension be caused by lifestyle factors?
overweight, excessive alcohol consumption, elevated glucose levels, high potassium and/or calcium levels
which has a wider distribution in the body - SNS or PSNS?
SNS
does PSNS innervate cardiac arteries?
no
why does the human nervous system promote high pressure mode?
because there is no antagonist for vasoconstriction
Symptoms of hypertension?
usually has no symptoms, can cause headaches or pressure in the eyes
hypertension causes significant damage to blood vessels, heart and ______
kidneys
what is a peripheral vascular disease?
circulation disorders that affect vessels outside the heart or brain
Causes of peripheral vascular disease
Blood vessels become narrowed, leading to a decrease in blood flow. Largely due to arteriosclerosis – thickening & hardening of vessel wall
Drug treatment for hypertension
- ACE inhibitors – prevent conversion of Ang I to Ang II
- AngIIreceptorblockers–blocktheactionsofAngII
- Ca+2 channel blockers – block intracellular Ca+2 concentration
- increases
- Beta blockers – block stimulation of adrenergic receptors responsible for cardiac activity
- Diuretics – promote water loss
Symptoms of peripheral vascular disease
- Legs cramp sand/or pain-exercise
- Numbness, tingling, coldness and/or ”pins & needles”
- – at rest
- Cuts or sores on lower legs or feet that don’t heal
- Necrosisoftissue
- Symptomscanbemildandmaybemistakenfor exercise cramps etc
how do you diagnose peripheral vascular disease?
By ankle-brachial index – compares the BP in your arm to the BP in your ankle. Additional diagnosis via MRI angiography or doppler ultrasound
treatments of peripheral vascular disease?
Lifestyle: reducing weight, improving diet, increasing physical activity, quitting smoking, monitor BP
Drug therapy:
• BP drugs
• Antiplatelet drugs, aspirin or other blood thinners
• Monitor diabetes and/or cholesterol – drug treatments
Serious cases require surgery
• Balloon angioplasty
• Arterial bypass
Arteriosclerosis is
a degenerative thickening or hardening of the arteries, making them less elastic
Atherosclerosis is
deposition of material in the vessel walls leading to plaque formation
Accumulation of lipid in the intima of a blood vessel & formation of an ______
atheroma
learn all this stuff
here are the steps that mauro was trying to explain
