Module 13: Blood Vessel Disorders Flashcards

Comprehensive vocabulary terms based on Lecture Module 13 regarding blood vessel disorders, including arterial and venous diseases and hypertension.

Arteriosclerosis

A general term meaning "hardening of the arteries" where arterial walls become thickened, stiff, and less elastic, resulting in decreased blood flow and increased vascular resistance.

Atherosclerosis

The most common form of arteriosclerosis involving the formation of lipid-rich plaques called atheromas within the tunica intima.

Monckeberg's sclerosis

Characterized by calcium deposition in the tunica media of small and medium-sized arteries; it typically does not obstruct blood flow but causes loss of arterial elasticity.

Hyperlipidemia

An elevation of plasma lipids or lipoproteins, where elevated LDL cholesterol and triglycerides promote lipid deposition within arterial walls.

Vasculitis

Inflammation and destruction of blood vessel walls that can affect arteries or veins of any size, often caused by autoimmune disorders.

Aneurysm

A localized dilation of a blood vessel caused by weakness of the vessel wall, with the greatest complication being rupture and hemorrhage.

Response-to-injury theory

The most widely accepted explanation for the development of an atherosclerotic plaque, initiated by endothelial injury.

Foam cells

Macrophages that have engulfed oxidized LDL cholesterol within the damaged vessel wall during the formation of atherosclerosis.

Chylomicrons

The largest lipoproteins produced by the small intestine that transport dietary triglycerides to adipose and muscle tissue.

VLDL (Very Low Density Lipoproteins)

Lipoproteins produced by the liver responsible for transporting triglycerides and cholesterol to peripheral tissues.

LDL (Low Density Lipoproteins)

Known as "bad cholesterol," it transports cholesterol to tissues and promotes cholesterol deposition in vessel walls.

HDL (High Density Lipoproteins)

Known as "good cholesterol," it removes cholesterol from peripheral tissues and transports it to the liver for metabolism and excretion.

Vasculitides

Disorders involving inflammation and destruction of blood vessel walls, frequently involving autoimmune mechanisms.

Thromboangiitis Obliterans (Buerger Disease)

A chronic inflammatory disorder affecting small and medium arteries and veins, primarily in the extremities, strongly associated with tobacco use.

Raynaud Disease

Characterized by episodic vasospasm of digital arteries, usually triggered by cold exposure or emotional stress, manifesting as pallor, cyanosis, and rubor.

Embolism

The obstruction of a vessel by a detached intravascular mass called an embolus.

Peripheral arterial disease (PAD)

A disorder involving reduced blood flow through peripheral arteries, most commonly due to atherosclerosis.

Intermittent claudication

Exercise-induced muscle pain caused by inadequate oxygen delivery to working muscles, which is relieved by rest.

Acute arterial occlusion

A sudden interruption of blood flow caused by a thrombus, embolus, trauma, arterial spasm, or aortic dissection, characterized by the 7 P's.

Abdominal Aortic Aneurysm (AAA)

A localized dilation of the abdominal aorta often manifesting as a pulsatile abdominal mass, back pain, or flank pain.

Aortic Dissection

A life-threatening condition involving sudden tearing chest pain or severe back pain where blood enters the wall of the aorta.

Type A Aortic Dissection

A classification of aortic dissection that involves the ascending aorta and may affect the coronary arteries and aortic valve.

Type B Aortic Dissection

A classification of aortic dissection that involves the descending thoracic aorta distal to the left subclavian artery.

Varicose veins

Enlarged, elongated, tortuous superficial veins resulting from incompetent venous valves that allow blood to pool.

Chronic venous insufficiency

Occurs when venous return is impaired because of incompetent valves or venous obstruction, leading to chronic venous hypertension and edema.

Venous thrombus

A blood clot that forms within a vein, usually in the deep veins of the legs, often associated with Virchow's Triad.

Virchow's Triad

The three risk factors for venous thrombus: venous stasis, endothelial injury, and hypercoagulability.

Primary (Essential) Hypertension

Chronic elevation of blood pressure accounting for $90-95\%$ of cases, linked to genetics, obesity, and high sodium intake.

Secondary Hypertension

Hypertension that occurs because of an identifiable disorder such as renal disease, endocrine disorders, or medications.

Preeclampsia

Hypertension associated with proteinuria, headache, and visual disturbances occurring after $20$ weeks of gestation.

Eclampsia

A severe progression of preeclampsia that includes the onset of seizures.

Orthostatic hypotension

A significant decrease in blood pressure occurring when a person stands from a sitting or lying position, leading to dizziness or syncope.

arteriosclerosis

is a general term meaning "hardening of the arteries." It occurs when arterial walls become thickened, stiff, and less elastic, resulting in decreased blood flow and increased vascular resistance. it is is often asymptomatic until significant narrowing or occlusion develops.

atherosclerosis

is the most common form of arteriosclerosis and involves the formation of lipid-rich plaques called atheromas within the tunica intima. These plaques contain cholesterol, inflammatory cells, smooth muscle cells, calcium, and connective tissue. As plaques enlarge, they narrow the vessel lumen and reduce blood flow. Plaque rupture may cause thrombosis, embolism, myocardial infarction, stroke, or peripheral artery disease.

monckebergs sclerosis

is characterized by calcium deposition in the tunica media of small and medium-sized arteries. Unlike atherosclerosis, it does not typically obstruct blood flow because it does not significantly narrow the lumen. However, it causes loss of arterial elasticity and increased vascular stiffness, particularly in elderly individuals.

hyperlipidemia

is an elevation of plasma lipids or lipoproteins. Elevated LDL cholesterol and triglycerides promote lipid deposition within arterial walls, leading to atherosclerosis. Hyperlipidemia is a major risk factor for coronary artery disease, peripheral artery disease, stroke, and aneurysm formation.

atherosclerosis

is a chronic inflammatory disease involving plaque formation within arterial walls. Progressive plaque growth narrows the lumen and decreases tissue perfusion. Plaque rupture may trigger thrombosis and acute ischemic events.

vasculitis

is inflammation and destruction of blood vessel walls. It may affect arteries or veins of any size. Autoimmune disorders are a major cause. Vessel inflammation can lead to stenosis, thrombosis, aneurysm formation, and tissue ischemia.

aneurysum

is a localized dilation of a blood vessel caused by weakness of the vessel wall. The greatest complication is rupture with life-threatening hemorrhage. Atherosclerosis and hypertension are major contributing factors.

causes of atherosclerosis

Genetic predisposition, Familial hypercholesterolemia, Elevated LDL cholesterol, Elevated triglycerides, Diabetes mellitus, Hyperglycemia, Elevated homocysteine levels, Hypertension, Smoking, Obesity, Sedentary lifestyle, Chronic stress, Inflammation, Postmenopausal estrogen deficiency, Possible infectious factors such as Chlamydia pneumoniae

diagonses of atherosclerosis

Total cholesterol levels, LDL cholesterol levels, HDL cholesterol levels, Triglyceride levels, Blood glucose testing, Homocysteine levels, C-reactive protein (CRP), Erythrocyte sedimentation rate (ESR), Stress testing, Doppler studies, CT angiography, MRI angiography, Coronary angiography, Ankle-Brachial Index (ABI) for PAD assessment

theory of the development of an atherosclerotic plaque

1. Endothelial injury occurs from smoking, hypertension, diabetes, or hyperlipidemia.

2. LDL cholesterol enters the damaged vessel wall and becomes oxidized.

3. Monocytes migrate into the intima and become macrophages.

4. Macrophages engulf oxidized LDL and become foam cells.

5. Foam cells accumulate to form fatty streaks.

6. Smooth muscle cells migrate into the intima and proliferate.

7. Fibrous tissue forms a cap over the lipid core.

8. Calcium, connective tissue, and cellular debris accumulate.

9. The plaque enlarges and narrows the vessel lumen.

10. Plaque rupture can trigger thrombosis, embolization, myocardial infarction, stroke, or aneurysm formation.

chlyomicrons

Largest lipoproteins produced by the small intestine. They transport dietary triglycerides to adipose and muscle tissue. Their remnants are used by the liver for VLDL production.

VLDL

Produced by the liver and responsible for transporting triglycerides and cholesterol to peripheral tissues. VLDL remnants are converted into LDL.

LDL

Known as "bad cholesterol." LDL transports cholesterol to tissues. Elevated LDL promotes cholesterol deposition in vessel walls and contributes to atherosclerosis.

HDL

Known as "good cholesterol." HDL removes cholesterol from peripheral tissues and transports it to the liver for metabolism and excretion. HDL also has anti-inflammatory properties and inhibits LDL uptake.

vasculitides

are disorders involving inflammation and destruction of blood vessel walls. Autoimmune mechanisms are frequently involved. Vessel inflammation causes narrowing, thrombosis, ischemia, and tissue injury.

thromboangitis obliterans (buerger disease)

A chronic inflammatory disorder affecting small and medium arteries and veins, primarily in the extremities. Strongly associated with tobacco use.

manifestations of thromboangitis obliterans (buerger disease)

Intermittent claudication, Rest pain, Cold sensitivity, Thin shiny skin, Nail deformities, Ulcers, Gangrene

raynauds disease

Characterized by episodic vasospasm of digital arteries, usually triggered by cold exposure or emotional stress.

manifestations of raynauds disease

Pallor, Cyanosis, Rubor (redness after reperfusion), Pain, Numbness, Tingling

May occur as a primary disorder or secondary to autoimmune diseases such as lupus or scleroderma.

embolism

 is obstruction of a vessel by a detached intravascular mass called an embolus.

types of embolism

Thromboembolism, Cholesterol embolism, Fat embolism, Tissue embolism, Air embolism, Gas embolism, Amniotic fluid embolism, Septic embolism

Peripheral arterial disease (PAD)

is a disorder involving reduced blood flow through peripheral arteries, most commonly due to atherosclerosis.

Intermittent claudication is exercise-induced muscle pain caused by inadequate oxygen delivery to working muscles. The pain is relieved by rest.

signs and symptoms of PAD

Diminished pulses, Cool extremities, Thin shiny skin, Delayed wound healing, Ulceration, Gangrene

DX of PAD

ABI, Doppler ultrasound, Angiography, CT angiography, MRI angiography

Acute arterial occlusion is sudden interruption of blood flow caused by a thrombus, embolus, trauma, arterial spasm, or aortic dissection.

Manifestations are the 7 P's:

Pain, Pallor, Pulselessness, Polar (coldness), Paresthesia, Paralysis, Pistol-shot onset

Aneurysm

is a localized dilation of a blood vessel caused by weakening of the vessel wall. The vessel enlarges because the wall can no longer withstand the pressure exerted by blood flow. most commonly occur in the aorta. Rupture can result in life-threatening hemorrhage.

types of aneurysms

Fusiform aneurysm, Saccular aneurysm, Berry aneurysm, Dissecting aneurysm, False aneurysm (pseudoaneurysm)

manifestations Abdominal Aortic Aneurysm (AAA)

Pulsatile abdominal mass, Back pain, Abdominal pain, Flank pain, Digestive upset, Signs of rupture include shock and severe pain

manifestations of aortic dissection

Sudden tearing chest pain, Severe back pain, Pulse deficits, Unequal blood pressures, Syncope, Organ ischemia, Cardiovascular collapse

etiologies of aneurysm

Atherosclerosis, Hypertension, Aging, Smoking, Connective tissue disorders, Marfan syndrome, Ehlers-Danlos syndrome, Trauma, infection, Inflammation, Diabetes, Alcoholism, Copper deficiency

type A aortic dissections classified

Involves the ascending aorta. More serious because coronary arteries and the aortic valve may be affected.

type B aortic dissections classified

Involves the descending thoracic aorta distal to the left subclavian artery.It is typically less serious than type A, but can still lead to complications such as organ ischemia.

aneurysms DX

Ultrasound, CT scan, MRI, Echocardiography, Angiography

aneurysms treatment

Blood pressure management, Smoking cessation, Risk factor reduction, Surgical repair, Endovascular stent graft placement, Ongoing monitoring for smaller aneurysms

Varicose Veins etiology

Prolonged standing, Pregnancy, Obesity, Genetics, Aging, Previous DVT

pathogenesis varicose veins

Valve dysfunction allows blood to flow backward and pool within the veins. Increased venous pressure causes vein dilation and tortuosity.

manifestations varicose veins

Visible dilated veins, Aching, Heaviness, Swelling, Fatigue, Cosmetic concerns

diagnosis varicose veins

Physical examination, Duplex ultrasound

treatment varicose veins

Compression stockings, Exercise, Weight loss, Leg elevation, Sclerotherapy, Laser therapy, Surgical removal

Chronic venous insufficiency

occurs when venous return is impaired because of incompetent valves or venous obstruction.

Chronic venous hypertension causes

Increased capillary pressure, Fluid leakage into tissues, Chronic inflammation, Poor oxygen delivery

chronic venous hypertension manifestations

Edema, Skin discoloration, Venous stasis dermatitis, Ulceration, Necrosis, Skin atrophy

Treatment focuses on improving venous return through compression therapy, exercise, leg elevation, and treatment of underlying venous disease.

venous thrombus

 is a blood clot that forms within a vein, usually in the deep veins of the legs.

Virchow's Triad

Venous stasis, Endothelial injury, Hypercoagulability

venous thrombus manifestations

Swelling, Warmth, Redness, Pain, Tenderness

venous thrombus

Forms in veins

Low-flow environment

Rich in fibrin and RBCs

Causes congestion and swelling

May cause pulmonary embolism

arterial thrombus

Forms in arteries

High-pressure environment

Rich in platelets

Causes ischemia and tissue death

May cause MI, stroke, or limb ischemia

Primary (Essential) Hypertension etiology

Genetics, Obesity, High sodium intake, Stress, Smoking, Physical inactivity

pathogenesis of primary hypertension

Increased sympathetic activity, activation of RAAS, sodium retention, endothelial dysfunction, and increased peripheral vascular resistance lead to chronic elevation of blood pressure.

secondary hypertension

Occurs because of an identifiable disorder.

secondary hypertension etiology

Renal disease, Endocrine disorders, Brain tumors, Head injuries, Pregnancy, Medications, Aortic narrowing (coarctation)

secondary hypertension complications

Left ventricular hypertrophy, Heart failure, Stroke, Myocardial infarction, Kidney failure, Retinopathy, Peripheral artery disease, Aneurysm formation

lifestyle modifications to help manage hypertension

Weight reduction, DASH diet, Reduced sodium intake, Increased physical activity, Smoking cessation, Limiting alcohol, Stress reduction, Improved sleep habits, Diabetes control, Cholesterol management

drugs treatment to stage of hypertension

Common antihypertensive medications include:

• Thiazide diuretics

• ACE inhibitors

• ARBs

• Calcium channel blockers

• Beta blockers

stage 1 hypertension

 often begins with lifestyle modifications and one medication.

stage 2 hypertension

commonly requires two medications from different drug classesto achieve blood pressure control.

gestational hypertension

Elevated blood pressure after 20 weeks of gestation without proteinuria.

preeclampsia

Hypertension associated with proteinuria, headache, elevated liver enzymes, visual disturbances, and endothelial dysfunction.

eclampsia

Preeclampsia that progresses to seizures.

chronic hypertension

Hypertension that existed before pregnancy and may worsen during pregnancy.

orthostatic hypotension

is a significant decrease in blood pressure that occurs when a person stands from a sitting or lying position. Blood pools in the lower extremities, reducing venous return, cardiac output, and cerebral perfusion.

orthostatic hypotension etiology

Hypovolemia, Medications, Aging, Prolonged bed rest, Autonomic dysfunction

orthostatic hypotension manifestations

Dizziness, fainting, blurred vision, lightheadedness, and weakness upon standing or during changes in position.

orthostatic hypotension management

Treatment includes increasing fluid intake, using compression stockings, and adjusting medications that may contribute to symptoms. In severe cases, medications like fludrocortisone may be prescribed to help manage blood pressure.