Vascular Disease
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| where is atherosclerosis most commonly found | large and medium muscular arteries
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| where does atherosclerosis form most often | abdominal aorta
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| other common locations of atherosclerosis | thoracic aorta, carotid, Circle of Wilis, lower extremities
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| what is contained within the plaques | smooth muscle cells, lipids, Macrophages
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| Major risk factor for atherosclerosis | High cholesterol, LDL, BP, with smoking or diabetes
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| Minor risk factors for atherosclerosis | type A, age, male, inactivity, obesity, hereditary, high saturated fat, increased homocystein, CRP
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| what is the development of atherosclerosis | fatty streak, Fibrofatty plaque, adv. fibrofatty plaque
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| when fatty streaks form in children and teens where do they most often present? | thoracic aorta
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| what makes the cap of the fibrofatty plaque | smooth muscle, collagen, macs and lymphocytes
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| what is the core of the plaque | smooth muscle cells (foam), lipid filled macs, necrotic debris
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| what is a fatty streak | an elevation of the intima
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| what effect does the fibrofatty plaque have? | thins teh musculoelastic wall
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| what happens with adv. fibrofatty plaques | foam cells disintegrate and contents are released to the extracellular lipid pool
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| what happens with adv. fibrofatty plaques with regards to core | core is calcified with cholesterol crystals
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| what happens to the cap with adv. fibrofatty plaque | necrosis and ulceration with thrombis
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| when do neovasculation occur? | adv. fibrofatty plaque
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| when does the tunica media thin | in adv fibrofatty plaques
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| when does musculoelastic wal thin | in fibrofatty plaque stage
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| what are four complications of atherosclerosis | vessel occlusion, narrowed lumen, embolism, aneurysm formation
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| what is the main reason occlusion will occur | crack in the cap resulting in release of contents and propagation of plaque
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| what can happen when there is occlusion of the vessel | MI, Stroke, Gangrene
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| what is the therapy for vessel occlusion by thrombis | streptokinase and TPA
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| Narrowed lumen is due to? | progressive plaque development in the lumen
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| what does a narrowed lumen do? | causes chronic ishemia
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| what can a narrowed lumen result in? | like occlusion by thrombis it can cause stroke, MI and Claudication
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| Emboli from atherosclerosis requires | formation of a thrombus from an adv. fibrofatty plaque
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| how does atherosclerosis cause aneurysms | destruction of the media (weakened wall)
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| where are atheroscleritic aneurysms most common | abdomen
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| what suggest the etiology of viral atherosclerosis | intimal mass cells (SM cells) found in infants correspond to adult plaque sites and are often monoclonal
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| how is LDL taken up | receptor mediated, micropinocytes, macs
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| how does plaque cause damage to the endothelium | platelets and macrophages adhere and release growth factors causing SM to proliferate in the intima thickening the cap
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| what else besides the plaque can damage the endothelium | hemodynamic forces
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| Monckeberg Medial Sclerosis | degenerative calcifications of the Large and Medium muscular artery vessel wall media layer
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| aneurysms are caused by | localized dilations of the blood vessel from a weak media
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| where are atherosclerotic aneurysm found | distal aorta and common iliacs
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| where are dissecting aneurysms found | in the proximal aorta from an intimal tear 1 to 2 cm above the aortic valve
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| where is a syphilitic aneurysm found | ascending aorta and arch
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| what is the shape of atherosclerotic aneurysm | fusiform or saccular
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| what is the shape of the syphilitic aneurysm | fusiform
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| where does the dissection take place | inner 2/3 and outer 1/3 of the media
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| cystic medial necrosis refers to? | dissecting aneurysm media is replaced by matchromatic material
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| what is the most common complication of dissecting aneurysm | hemorrhage into the extravascular space
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| what is a common association with disecting aneurysms | hypertension
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| Etiology of a dissectin aneurysm | may be a defect in the collage or other media connective tissue
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| what syndrome is associated with dissecting aneurysms | Marfans
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| what is the pain associated with dissecting aneurysms | sharp pain that radiates to the back
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| what is the description associated with syphilitic aneurysm | Tree bark appearance, medial scarring and intimal surface roughening
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| what are varicose veins | dilated superficial veins
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| what are varicose veins in the rectum | hemorrhoids
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| why do variocose veins dilate | incompetent valves
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| what causes deep vein thrombosis | stasis and or inflammation
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| when do you see DVT | leg trauma and bed rest
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| what is lymphangitis | inflammation of the lymphatics usually in an area of previous trauma
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| what causes lymphangitis | GAS (B hemolytic)
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| where are hemangiomas found | in the skin and occasionally internal organs
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| what are the two kinds of hemanioma | neoplasm or hemartomas
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| a capillary hemangioma is called a | birthmark
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| a cavernous hemangioma is called a | port wine stain (large vascular channels)
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| where are angiosarcomas found | in the skin and soft tissue rare malignant neoplasm of the endothelial cells
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| angiosarcomas of the liver are associated with? | environmental carcinogens (arsenic and vinyl chloride)
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| Kaposi Sarcoma | on skin or mucus membranes, GI and Lungs in AIDS patients
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| What is Kaposi Sarcoma associated with | Herpes Simplex 8
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