Atherosclerosis
Terms
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- initial lesion could be either
- fatty streak or initimal cell mass
- contains only smooth muscle cells and connective tissue;
- intimal cell mass
- fibrous athermoatous plaque
- characteristic lesion
- 3 zones of fibrous athermatous plaque
-
fibrous cap
lipid
basal - location of fibrous cap
- directly under endothelial tissue, next to lumen
- consistency of fibrous cap
-
connective tissue - dense collagen
foam cells
scattered smooth muscle cells - description of lipid zone of FAP
-
atheroma, necrotic zone of lipid
foam cells
extracellular lipid and debris - consistency of basal zone of FAP
- smooth muscle and connective tissue
- complications of plaque
-
calcification
ulceration
vascularization
hemorrhage
aneurysms - frequency of lipid profile
- 6 months apart
- 3 types of arteriosclerosis
-
Atherosclerosis
Medial calcific
arteriolosclerosis - two types of arteriolosclerosis
-
hyaline
hyperplastic - disae of small arteries or arterioles with thickned vessels walls, lumen narrowing
- arteriosclerosis
- 4 cell types in lesion
-
vascular endothelion
arterial smooth muscle
mononuclear phagocytes
lymphocytes/neutrophils - purpose of vacular endothelium
- transports of lipid proteins (HDL, LDL)
- purpose of smooth muscle
-
control of vascular wall
maintenance/repair
lpid metabolism
secrete cytokines - purpose of mononuclear phagocytes
-
uptake of LDL
secrete cytokines - purpose of lymphocyte/nuetrophils
- respond to injury and infection
- risk factors (controllable)
-
smoking
hyperlipidemia
hypertension
diabetes - risk factors (uncontrollable)
-
age
male
menopause
hypercholesterolemia - muscular artieres in systemic atherosclerosis
-
coronary
popliteal
lower extremities - consequence of large, medium muscular artieres with atherosclerosis
-
occulude lumen
distal organs non-functioning - consequence of elastic arteries with atherosclerosis
-
aneurysm
embolization - elastic arteries involved with atherosclerossi
-
aorta
iliac artery
carotid artery - possible initiating injuries to vascular endothelium
-
smoking,
viruses
infection
blood borne toxins - conversion of fatty streak to lesion by 3 growth factors by prolieration of smooth muscle
-
PDGF
fibroblastic
transforming grwoth alpha - predictable atheromatic locations
-
abdominal aorta
caronary artery
popliteal
desc. thoracic aorta
internal carotid
circle of willis - symptoms of atherosclerosis
-
claudication
impotence
weak distal pulse
bruit
coolness, clammy skin - ocular symptoms of atherosclerosis
-
amaurosis fugax
visual field loss - ocular signs of atherosclerosis
-
arterial reflex
copper wire
AV ratio change
arcus
xanthelama
artery/vein occlusion - treatment of atherosclerosis
-
removal of lipid (diet/exercise)
medical management