Patho chp 26

What are the 2 diseases of the arterial system?

dyslipidemia and atherosclerosis

what are the other diseases of the arterial system? (3)

vasculitis

arterial disease of the extremities

arterial aneurysms

condition of imbalance of the lipid components of the blood

dyslipidemia

greater than 240 mg/dL ; levels that contribute to a heart attack, stroke, or other cardiovascular event associated with atherosclerosis

hypercholesterolemia

high cholesterol

hypercholesterolemia

What is another name for hypercholesterolemia?

hyperlipidemia

What are the 3 causes of hyperlipidemia

hereditary

nutrition

secondary dyslipidemia (metabolic)

What is an example of hereditary hyperlipidemia

familial hypercholesterolemia

Familial hypercholesterolemia causes

defective LDL receptors

What is example of nutrition of hyperlipidemia

high saturated fat intake; obesity

high saturated fat or obesity causes

reduced number of activity of HDL receptors

What is an example of hypercholesterolemia secondary dyslipidemia?

diabetes mellitus

In hypercholesterolemia dibetes mellitus causes

increased lipoprotein levels

What are 3 manifestations of hypercholesterolemia (what we see)

CAD (coronary artery disease)

PAD (peripheral artery disease)

Xanthomas

What manifests at extremely high levels of hypercholesterolemia

paresthesia

dyspnea

confusion

paresthesia

numbness

dyspnea

shortness of breath

This photo is an example of what?

xanthomas

hardening of the arteries

atherosclerosis

atherosclerosis is a formation of ______ in the intimal lining of large medium sized arteries

fibrofatty lesions

What are 3 non modifiable risk factors for atherosclerosis

age

genetics

gender

What are 3 modifiable risk factors for atherosclerosis

cigarette smoking

obesity

hypertension

What are 2 non traditional risk factors for atherosclerosis

increased lipoprotein levels

inflammation marked by elevated C reactive proteins levels

What are the 3 types of lesions associated with atherosclerosis plaque

fatty streaks

fibrous atheromatous plaque

Complicated lesions

This atherosclerosis plaque is most common in children in their first year of life

fatty streaks

This atherosclerosis plaque is the most basic definition of lesion of clinical atherosclerosis

fibrous atheromatous plaque

This atherosclerosis plaque when the size of the lesion increases it begins to occlude the vessel and blood flow is reduced

fibrous atheromatous plaque

This atherosclerosis plaque is a thrombus clot the develops due to slowing of blood flow

complicated lesions

Complicated lesions are

more advanced

What are 3 major risk factors for atherosclerosis

cigarette smoking

hypertension

family history (genetics)

Which vessel has the important complications that are those of thrombus formation and weakening of the vessel wall?

larger vessels

In which artery has ischemia and infarction? Vessel occlusion are also more common

Medium sized arteries

Inflammation of the blood vessel wall resulting in vascular injury and necrosis

vasculitis

With vasculitis what may be affected?

arteries, capillaries and veins

With vasculitis the inflammatory process may be initiated by what 3 things?

direct injury

infectious agents

immun processes

What are the 4 other flow issues?

acute arterial occlusion

atherosclerotic occlusive disease

thromboangiitis obliterans (burger’s disease)

raynaud’s disease

Which flow is a disruption of blood flow caused by thrombus, embolus, and trauma?

Acute arterial occlusion

Which flow is the MOST common in arteries of LOWER legs and feet for 60-70 yr old men

atherosclerotic occlusive disease

Which flow is in the lower leg, feet, arm and hand; mostly men 25-40 and is caused by heavy cigarette smokers?

thromboangiitis obliterans (Burger's disease)

Which flow has intense vasospasm of arteries is in the fingers, toes and is in young women?

Raynaud's disease

This disease is often precipitated by cold or strong emotions; ischemia causes finger pallor to cyanosis

Raynaud’s disease

Abnormal localized dilation of a blood vessel; occurs in veins and arteries and can cause out pouching

Aneurysms

What are the 4 aneurysms?

Berry aneurysms

Fusiform aneurysms

Saccular aneurysms

dissecting aneurysms (false)

This type of aneurysms is found in the BRAIN specifically the circle of willis in the brain circulation; consists of a small spherical vessel dilation

Berry aneurysms

This type of aneurysms is found in the thoracic characterized by gradual and progressive enlargement of the aorta

fusiform aneurysm

This type of aneurysms is found in the abdominal aorta characterized by gradual and progessive enlargement of the aorta

saccular aneurysm

This type of aneurysms is an acute life threatening condition that involves hemorrhage into the vessel wall with longitudinal tearing (dissection) of the vessel wall to form a blood filled channel

dissecting aneurysms (false)

What are the 3 disorders of venous circulation?

Varicose veins

Chronic Venous insufficiency

Venous thrombosis

What are the two types of varicose veins?

superficial vein

deep vein

This is a disorder of venous circulation due to pressure on the valves, venous system in the leg it can be caused by excessive standing, obesity, pregnancy

varicose veins

This is a disorder of venous circulation that is caused by deep vein thrombosis or bad valves

chronic venous insufficiency

This is a disorder of venous circulation is the worst, DVT associated inflammation response; blood stasis + blood coagulability + vessel wall injury

Venous Thrombosis

What are 7 risk factors associated with venous thrombosis?

bad rest

immobility

spinal cord injury

surgery

fractured hip

pregnancy

genetic factors

sustained condition of elevation of the blood pressure within the arterial circuit

hypertension (high BP)

What are the 2 types of hypertension

Essential/ primary

Idiopathic

This type of hypertension is chronic elevation in blood pressure

essential/ primary hypertension

This type of hypertension occurs without evidence of other disease basically IDK

Idiopathic (IDK cause ID)

When systolic BP is 120-129 and diastolic BP is <80 what is the classification?

elevated blood pressure

When systolic BP is 130-139 and diastolic BP is 80-89 what is the classification?

Stage 1 hypertension

When systolic BP is >140 and diastolic BP is >90 what is the classification?

Stage 2 hypertension

Elevated BP #’s

systolic BP of 120-129

diastolic BP under 80.

Stage 1 hypertension #’s

systolic BP of 130-139

diastolic BP of 80-89.

Stage 2 hypertension #’s

systolic BP of 140 or higher

diastolic BP of 90 or higher.

Essential hypertension 4 risk factors

genetics

race

diabetes

age

Essential hypertension 5 lifestyle risk factors

salt

obesity

inactivity

alchohol

contraceptives

What are the consequences of essential hypertension

left ventricular hypertrophy which is caused by an increased workload on the LEFT side of the heart and this can lead to renal insufficiency and accelerate other types of kidney diseases

What are the major risk factors for essential hypertension? (3)

ischemic heart disease, CHF, dysrhythmias

What are the 4 risk factors for hypertension

age

tobacco

obesity

family history and genetics

secondary hypertension can develop into an accelerated potentially fatal form; Usually in younger people, African American men and women who a are pregnant that is suddenly increased in BP; diastole > 120;

malignant hypertension

Why is malignant hypertension dangerous?

Cause of vascular changes and retinopathy

Elevation of BP that results from some other disorder and can be corrected by surgery or specific medical treatment

secondary hypertension

This hypertension is the largest single cause in renal disease renal hypertension

Secondary hypertension

Secondary hypertension causes what 4 things

renal

adrenocoricosteroid disorders

pheochromocytoma

coarctation of the aorta

This increases in renal blood blow then increases in renin

Renal

This undergoes hyperplasia or hyperaldosterone; excessive glucocorticoid hormone

Adrenocoricosteroid disorders

This is a tumor in adrenal medulla causes excessive epinephrine and nonrephinephrine

Pheochromocytoma

This is narrowing of aortic arch increases resistance to LV pumping

Coarctation of the aorta

Abnormal drop in blood pressure on assumption of the standing position

Orthostatic Hypotension (postural hypotension)

This is caused by a drop in BP because of posture

Orthostatic hypotension

What are the 4 causes of Orthostatic (postural) hypotension

reduced blood volume

drug induced hypotension

aging

extensive bed rest

What are the autonomic nervous dysfunctions caused by orthostatic hypotension (4)

neuropathies of diabetes mellitus

CVAs

spinal cord injury

Parkinson’s