Vascular Disorders Exam Three

What are examples of arterial disorders?

hyperlipidemia, atherosclerosis, arterial disease of extremities, aneurysms and dissections

How are types of lipoproteins categorized?

by density (amount of protein and fat)

What is considered "good" cholesterol?

High-density lipoprotein (HDL)

Why do we want high HDL?

because these lipoproteins help clear out extra fat and prevent arterial damage

What affects lipoprotein levels?

diet, activity level, and liver function

Can you raise HDL through physical activity?

yes

Where are lipoproteins created?

in the liver

Dyslipidemia can also be referred to as what?

hyperlipidemia

What is dyslipidemia?

a condition of imbalance of the lipid components of the blood

What levels are elevated in dyslipidemia?

TC, LDL, and/or triglycerides

What levels are decreased in dyslipidemia?

HDL cholesterol

Primary (familial) dyslipidemia is caused by what?

genetic disorders causing issues with liver

Secondary dyslipidemia is caused by what?

modifiable lifestyle changes

Is primary or secondary dyslipidemia more common?

secondary dyslipidemia

How is dyslipidemia measured/diagnosed?

with a fasting lipid profile/panel

How long do you have to fast before a blood draw for dyslipidemia?

eight hours

What is the treatment for dyslipidemia?

diet, exercise, then medications

What can make dyslipidemia more aggressive?

other cardiovascular disease risk factors

What are the goal levels for LDL?

What are the goal levels for TC?

What are the goal levels for HDL?

>60 mg/dL

Severe elevations of lipid components may cause what?

xanthomas or acute arterial blockages

What are xanthomas?

skin blemishes due to cholesterol deposits under the skin

What is atherosclerosis?

the development of fibrous, fatty lesions in the intima (inside) of large and medium-sized arteries

What kind of process is atherosclerosis?

a slow process within arteries, a gradual and chronic condition

What are examples of medium-sized arteries?

aorta, coronary arteries, cerebral arteries, peripheral arteries

What is the most common cause of coronary heart disease?

atherosclerosis

What happens to the vessels and blood flow during atherosclerosis and what does it lead to?

vessels become narrowed, blood flow decreases, leads to ischemia

How long does ischemia take to occur in atherosclerosis?

years

What is the most significant complication of atherosclerosis?

thrombosis

Where can thrombosis occur as a complication of atherosclerosis?

in central or peripheral arteries

What are the risk factors of atherosclerosis?

family history, hyperlipidemia, increasing age, male gender, cigarette smoking, obesity/diabetes, and emerging role of inflammation

What atherosclerosis risk factors are biological?

family history, increasing age, male gender, emerging role of inflammation

What atherosclerosis risk factors are modifiable?

hyperlipidemia, cigarette smoking, and obesity/diabetes

Study the atherosclerosis pathogenesis! The answer to this card is STUDY!

STUDY

What do the manifestations of atherosclerosis depend on?

the vessel affected and the extent of narrowing

Chest pain and discomfort with exertion is caused when atherosclerosis occurs where?

coronary arteries

Where might atherosclerosis occur affecting the legs?

peripheral arteries

Where might atherosclerosis occur increasing risk for ischemic strokes?

cerebral arteries

What is peripheral arterial disease?

atherosclerosis of peripheral arteries

Atherosclerosis of peripheral arteries are often what?

superficial femoral and popliteal

Blood flow to the extremities is ______________ in peripheral arterial disease.

reduced

Symptoms of peripheral arterial disease are ____________ to where the blockage is.

distal

What is the main symptom of peripheral arterial disease?

intermittent claudication

What is intermittent claudication?

aching deep pain that happens when the muscle is active and is relieved by rest

How is peripheral arterial disease diagnosed?

by ultrasound and/or signs of chronic hypoxia in limb

What are the signs of chronic hypoxia in limbs?

weak/absence pedal pulses, cool skin, pallor, and hair loss

How do ultrasounds diagnose peripheral arterial disease?

ultrasounds listen to blood flow or doppler imaging

Reduced blood flow due to peripheral arterial disease can cause what?

wounds to heal slower

How should you treat peripheral arterial disease?

address risk factors, avoid injury, and use medications to maintain blood flow

What is a treatment option for peripheral arterial disease?

stent placement

What is acute arterial occlusion?

sudden blockage of an artery that completely blocks blood flow distal to the blockage

What are the common causes of acute arterial occlusion?

emboli from the heart, fat emboli from broken bones, air emboli

What are the manifestations of acute arterial occlusion?

the 7 Ps- pistol shot, pallor, polar, pulselessness, pain, paraesthesia, paralysis

What is paraethesia?

nerve related pain (pins and needles)

What does a pistol shot describe?

the suddenness of the pain

What is pallor?

paleness of the skin

What is polar?

skin is cold to the touch

What treatment is essential in acute arterial occlusion?

quick restoration of blood flow

What are the possible treatments for acute arterial occlusion other than restoration of blood flow?

removal of clot (surgical) and possibly amputation

What is an aneursym?

an abnormal localized dilatation of an artery

What cause an aneurysm?

atrophy (thinning) or weakness of the medial layer of the vessel wall causes a dilation of the artery

Although aneurysms can occur in any artery where do they most commonly occur?

the abdominal aorta or cerebral arteries

What allows arteries to constrict or dilate?

the smooth muscle layer within arteries

What may cause the degeneration that causes aneurysms?

atherosclerosis, connective tissue disorders, or increased blood pressure around a stenotic area

What does the word stenotic mean?

narrowed

Arteries are considered ____________ pressure vessels.

high

What does the law of LaPlace describe?

increasing radius at the weakened spot increases tension inside wall of the artery.

Who do we usually see with abdominal aortic aneurysm?

usually men >50, smoker or past smoker

The incidence of abdominal aortic aneurysm increases with what?

age

What is abdominal aortic aneurysm characterized by?

often asymptomatic, pulsating mass midline (possible sign)

It is hard to catch a growing aneurysm before it _______________.

burst

What is aortic dissection?

a unique, more dangerous type of aneurysm

What is the most common site of aortic dissection?

the ascending aorta

What is the highest pressure artery coming off the heart?

the ascending aorta

What can aortic dissection be characterized by?

abrupt, intense pain, BP quickly falls (usually fatal)

Pain associated with the dissection of the ascending aorta is usually felt where?

anterior chest

What does aortic dissection involve?

rupture, hemorrhage into vessel wall

Where is blood pressure measured?

in an artery, usually the branchial

What is BP measured in?

mmHg (millimeters of mercury)

What is blood pressure?

the pressure inside an artery caused by the movement of blood through it

What is the equation for blood pressure?

BP = CO x PVR

cardiac output x peripheral vascular resistance

What does MAP stand for?

mean arterial pressure

What neural mechanisms do our bodies have to short-term regulate BP?

baroreceptors and chemoreceptors

What are baroreceptors?

pressure receptors in carotids and aortic arch

What are chemoreceptors?

chemical receptors in carotids and aortic arch

What are chemoreceptors primarily sensitive to?

decrease in oxygen

What humoral mechanisms do our bodies have?

RAA system and vasopressin/ADH

What organ releases renin?

the kidneys

What is vasopressin/ADH released in response to?

decreased BP or increased osmolality of blood

What is renin release stimulated by?

increased SNS activity, decreased BP, ECF volume, or ECF Na concentration

Renin converts _________________ to ________________ in the blood.

angiotensinogen to angiotensin I

Renin converts angiotensin I to what in the lungs?

angiotensin II

Angiotensin II cause what?

vasoconstriction of arterioles (short-term control) and stimulates aldosterone release, causing Na and water retention (longer-term control)

What organ mainly takes care of long-term regulation of BP?

the kidneys via their control of ECF volume

What does excess ECF cause?

higher rates of Na and H2O excretion

What does deficient ECF cause?

lower rates of Na and H2O excretion

What does increased fluid volume do to BP?

increases BP

Approximately how many US adults have hypertension?

fifty million

Hypertension is more common in what individuals?

older individuals and African Americans