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Pathophys Ch8 test 2
Disorders of Blood Vessels
| Question | Answer |
|---|---|
| What are the types of blood vessels? | Venule (Tunica interna & tunica media); Capilary (Tunica interna [basement endothelium membrane]) Arteriole (Tunica interna, tunica media) Vein (contains a valve) Artery (no valve,tunica media:- elastic fiber and smooth muscle) |
| What does vein and artery have in common? | Vein(low pressure);- has also a valve Artery (high pressure);- no valve Both: - Tunica externa (adventitia) - Tunica media - basement membrane - Tunica interna (intima) - endothelium and lumen |
| What does blood pressure do? | Causes blood to flow. |
| What does plasma lipids do? | Influence vascular health and disease. |
| What is the basic structure of blood vessels? | the basic structure is uniform, but the thickness of layers varies according to local pressure and tissue demand (artery - thicker wall due to higher blood pressure) and (Vein - thinner wall due to lower blood pressure) |
| Arteriole are a key point in what and why? | Key point in blood pressure control b/c their muscular wall can contract and relax to change lumen diameter (adventitia, media, intima[endoth & bsmt membr], and lumen) |
| How can the blood pressure be measured? | By using a Sphygmomanometer; As cuff pressure lowers, Korotkoff sounds begin at the systolic pressure and disappear at the diastolic pressure. |
| What influences and regulates blood pressure? | Multiple factors influence blood pressure; Blood pressure is a product of cardiac output (volume and blood flow) and peripheral vascular resistance. |
| How do you calculate blood pressure? | BP= (CO)cardiac output(vol/min) x peripheral vascular resistance (PVR) |
| How is CO influenced? | Blood vol influenced by: -Sodium ingestion and excretion -Renin/aldosterone Cardiac factors influenced by: -beats per min -vol per beat |
| How is PVR influenced? | Vasoconstriction is infl by: -ANS -Kidney: renin/angiotensin -Adrenal medulla hormones Vasodilation influenced by: -ANS -Kidney: vasodilators -Hormonal factors Local factors infl by: PH & Hypoxia |
| What is the cause of HVD (hypertensive vascular disease), what is the damage and how can it be treated? | - the cause is unknown (few links to specific) - hypertension damages arteries and organs -diet and drug treatment is usually effective |
| What are the classifications of BPs in adults? | Normal = < 120(sys) and 80(dias) Prehypertension= 120-139(sys) or 80-89(dias) Stage 1= 140-159(sys) or 90-99 (dias) Stage 2= >eq 160(sys) or >eq 100 (dias) |
| How can cardiovascular risk can be cut in half? | By reducing total plasma cholesterol 50 mg/dL from any given initial point (e.g. cutting total cholesterol from 250-200 mg/dL in CHD) |
| Intimal thickening is the hallmark indicator of what? | Hypertensive endothelial injury. Normal endothelium is only one cell thick however it is showing markedly thickened intima. |
| What is characteristic in hyaline arteriosclerosis? | In this lesion of benign nephrosclerosis, the waxy, red change in the afferent arteriole (w/ hyaline arteriosclerosis) and atrophy of the nearby glomerulus are characteristic |
| What is hyperplastic arteriolosclerosis? | is showing a renal arteriole in sever chronic hypertension ("Onionskin" hyperplasia of renal arteriole) |
| Atherosclerosis is associated with what risk factors? | |
| What is the pathogenesis of atherosclerosis? | |
| What type of distinct vascular pathology does atherosclerosis has? | |
| What is the cause of most atherosclerosis complications? | Obstructed blood flow |
| What is the best treatment of atherosclerosis | Prevention |
| What is atherosclerosis (aka arteriosclerotic vascular disease or ASVD)? | A specific form of arteriosclerosis in which an artery wall thickens due to accumulation of calcium and fatty materials (cholesterol and triglyceride. It is commonly referred to as a hardening or furring of the arteries; |
| What does ASVD affect? | It is a syndrome affecting the arterial blood vessels, a chronic infl resp in the walls of arteries, caused largely by the accum of machrophages and WBCs and promoted by LDL w/o adequate remov. of fats and chol from the macroph by functional HDL |
| What the ASVD caused by? | it is cause by the formation of multiple plaques within the arteries |
| What is LDL and HDL? | LDL - low-density lipoproteins -> plasma proteins that carry cholesterol and triglyceride; HDl - high-density lipoproteins |
| How is an atheroma formed? | A. A subtle injury to intact endothelium B. Lipid accumulation C. Young atheroma - prone to ulceration, hemorrhage, thrombosis, and sudden vascular occlusion D. Old atheroma - fibrosis (scarring) and chronic inflammation |
| What is the blood flow and the progression of artherosclerosis in subclinical disease? | Subclinical disease: From normal blood flow (10yrs), the fatty streak (20yrs), to atheroma (30yrs) to atheroma with complications: - turbulent blood flow - thrombotic cap - erosion/ulceration -fissure hemorrhage |
| What is the blood flow and the progression of artherosclerosis in clinical disease? | (>eq 50yrs) Myocardial infarct Cerebral infarct Gangrene of extremities Abdominal aortic aneurysm |
| What are catheders used for in Coronary cathederization? | Catheders are used for injecting radiographic contrast media to visualize lumen size, to establish improved (From the heart down to femoral artery - catheder inserted then showing guide wire) |
| What is an aneurysm? | = dilation, is a localized, blood-filled balloon-like bulge in the wall of a blood vessel |
| Where can aneurysm occur? | in any blood vessel including aneurysm of the: -circle of Willis -aortic aneurysm affecting the aorta -abdominal aortic aneurysms *Can also occur in the heart itself *The more it increases in size the higher the risk of rupture |
| What can a ruptured aneurysm lead to? | Bleeding and subsequent hypovolemic shock, leading to death |
| Aneurysm is a result of what? | Result of a weakened vessel wall, and can be a result of a hereditary condition or an acquired disease. |
| What is the difference between true aneurysm and false aneurysm? | True aneurysm= involves all three layers of an artery(intima, media, adventitia); False aneurysm (peudoaneurysm)= is a collection of blood leaking completely out of an artery or vein, but confined next to the vessel by the surrounding tissue. |
| Pseudoaneurysm can be caused by what? | By trauma that punctures the artery, such as knife and bullet wounds, as a result of percutaneous surgical procedures such as coronary angiography or arterial grafting, or use of an artery injection |
| Aneurysm presentation may range from what? | May range from life-threatening complications of hypovolemic shock to being found incidentally on the X-ray |
| Cerebral aneurysm occurrence and symptoms | it can occur when the aneurysm pushes on a structure in the brain. Symptoms will differ if an aneurysm has ruptured or not. |
| What are the ymptoms of an aneurysm that has not ruptured? | Fatigue; Loss of perception; Loss of balance; Speech problems; Double vision; |
| What are the symptoms of a ruptured aneurysm? | For a ruptured aneurysm, symptoms of a subarachnoid hemorrhage may present: Severe headaches; Loss of vision; Double vision; Neck pain and/or stiffness; Pain above and/or behind the eyes; |
| What are the symptoms of abdominal aneurysm? | Central back pain; Edema ; Deep pain thrombosis; Vomiting; Lower limb ischemia; |
| What are the symptoms of renal (kidney) aneurysm? | Flank pain and tenderness; Hypertension; Hematuria; Signs of hypovolemic shock; |
| What are the risks associated with aneurysm? | Diabetes, Obesity and Hypertension; Tobacco use and alcoholism; High cholesterol; Copper deficiency; Increasing age; Tertiary syphilis infection; |
| What are specific causes associated with aneurysm? | Advanced Syphilis infection resulting in syphilitic aortitis and an aortic aneurysm; Tuberculosis, causing Rasmussen's aneurysms; Brain infections, causing infectious intracranial aneurysms; A minority of aneurysms are associated with genetic factors; |
| What are the minority of aneurysms associated with genetic factors? | Berry aneurysms of the anterior communicating artery of the circle of Willis, associated with autosomal dominant polycystic kidney disease; Familial thoracic aortic aneurysms; Cirsoid aneurysms, secondary to congenital arteriovenous malformations; |
| What type of disease is vaculitis? | Most vasculitis is autoimmune; Infectious vasculitis is rare; |
| Vasculitis conditions | Temporal arteritis(small vessels); with polymyalgia rheumatic; Takayasy arteritis (large vessels); Specific autoimmune vasculitis; |
| Temporal arteritis | Giant-cell arteritis which is an inflammatory disease of blood vessels most commonly involving large and medium arteries of the head, predominantly the branches of the external carotid artery; It is a form of vaculitis; |
| What are the most serious complications of GCA (Giant-cell arteritis)? | Permanent blindess - which could be prevented by prompt treatment with corticosteroids. |
| What is Raynaud phenomenon? | It is excessively reduced blood flow in response to cold or emotional stress, causing discoloration of the fingers, toes, and occasionally other areas; May cause nails to become britlle with longitudinal ridges; |
| Raynaud phenomenon is the result of what? | It is believed to be the result of vasospasms that decrease blood supply to the respective regions. The phenomenon by itself is just a sign (hypoperfusion) accompanied by a symptom (dicomfort) |
| Raynaud Syndrome - primary and secondary | Primary: -8% of the cases;- Raynaud phenomenon-cause unknown Secondary: -Raynaud syndrome (secondary Raynaud's phenomenon)- caused by known primary disease, most commonly connective tissue, such as Lupus; Systemic sclerosis; Other autoimmune disorders; |
| What could chronic, recurrent cases of Raynaud phenomenon can result in? | Atrophy of the skin, subcutaneous tissues and muscle; In rare cases it can cause ulceration and ischemic gangrene; |
| Name diseases of veins | Varicose veins; Thrombophlebitis; |
| What are varicose veins? | Enlarged and tortuous veins; Usually on the legs, although can occur elsewhere. |
| How do varicose veins occur? | - Veins have leaflet valves (prevent backflow); - leaflets of the valves no longer meet properly-> valves don't work; - blood flow backwards and the veins enlarge more. |
| Where are varicose veins most common? | In the superficial veins of the legs, which are subject to high pressure when standing; Cosmetic problem; Painful when standing |
| What can severe long-standing varicose lead to? | Leg swelling; Venous eczema; Skin thickening and ulceration; |
| Are there any life-threatening complications in varicose veins? | Are uncommon but they may be confused with deep vein thrombosis, which may be life-threatening. |
| What are treatment alternatives for varicose veins? | Non-surgical: sclerotherapy, elastic stockings, elevating legs, and exercise; Surgical: vein stripping to remove affected veins; Alternative techniques: ultrasound guided sclerotherapy, radiofrequency ablation, and endovenous laser treatment. |
| What are secondary varicose veins? | Those developing as collateral pathways, typically after stenosis or occlusion of deep veins, a common sequel of extensive deep venous thrombosis (DVT) |
| Varicose veins are distinguished from what? | Reticular veins (blue veins) and telangiectasias (spider veins), which also involve valvular insufficiency, by the size and location of the veins. |
| How do patiens who suffer from varicose veins seek assistance? | Contact physicians specializing in vein care or peripheral vascular disease such as vascular surgeons, phlebologists, or interventional radiologists. |
Created by:
adrianaww
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