Term
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Definition
is a type of inflammation or cell injury process
1. stimuli causing cell injury can induce a complex rxn. in the vascularized connective tissue
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Term
| What are the characteristic of the heart? |
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Definition
size of the fist
weighs 1 lb
located slightly to the left of the breastbone
pumps 5 quarts |
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Term
| What is the function of the heart? what removes CO2? where is oxgenated blood is pumped to? what are coronary arteries? |
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Definition
to circulate blood thru the body
pumping blood thru the lungs and refreshes the blood with oxygen
to the body to provide oxygen and nutrients and to remove waste products
the blood vessels that supply blood and oxyen to the heart muscle |
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Term
| What are the signs and symptoms where you dont get blood to the coronary arteries? |
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Definition
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Term
| What 3 types of problems can you get with coronary arteries? |
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Definition
spasm- narrowing of vessels
atherosclerosis- plaque buildup
atherosclerosis with blood clot-- narrowing of lumen |
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Term
| What is the purpose of stenting? |
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Definition
it holds the vessel open and improving the flow of blood |
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Term
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Definition
a balloon catheter is passed thru the guiding catheter to the area near the narrowing.
compressing the plaque
easily to have stroke |
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Term
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Definition
| blood vessel is used to create new blood flow path in your heart |
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Term
| What is aorta? characteristics? |
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Definition
coronary arteries branch from it
carry about 130 gallons of blood thru the heart muscle daily |
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Term
| What is the coronary artery DZ? |
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Definition
is one of the most common and serious effects of aging
fatty deposits build up in blood vessel walls and narrow the passageway for the moviment of blood
leads to artherosclerosis |
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Term
what percentage of stroke? ischemic stroke? |
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Definition
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Term
What is the common disorder of the arteries?
larger accumulations? |
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Definition
Fat ,cholesterol, and other substances collect in the walls of arteries
atheromas or plaques |
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Term
| What is arteriosclerosis? |
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Definition
hardening of the arteries frequently accompanies atherosclerosis
involves deposits along the arteries which often contain calcium |
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Term
| What age group does arteriosclerotic affect?ASHD |
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Definition
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Term
| What are the 3 main risk factors? |
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Definition
smoking
high bp
high cholesterol |
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Term
| What is intermittent claudication? |
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Definition
pain in calf or leg brought on by exercise and relieved by rest
is most common early sign of ateriosclerosis |
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Term
| Lack of hair on legs and feet is a sign of heart DZ. T/F |
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Definition
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Term
| What is raynaund phenomenon? symptoms? tx it with? |
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Definition
episodes of arterial spasm- usually in hands
in women 20-40
cold
numbness
paleness and pain in one or more fingers or toes
it's bilateral
smoking and cold makes it worse
Calcium Blockers |
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Term
what is the drug of choice of angina |
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Definition
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Term
what does nitroglycerin cause? |
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Definition
1. relaxes smooth muscle tissue of the vascular system
2. acts to dilate coronary arteries
3. increases blood flow to cardiac tissue
4. increases oxygenation of cardiac muscle |
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Term
What are the common side effect? |
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Definition
| headaches, dizziness, hypotension |
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Term
which of the following is a non-modified risk factor for ASHD?
a. smoking
b. obesity
c. family hx
d. hypertension |
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Definition
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Term
| What type of disease cause thickening and loss of elasticity of aterial walls, hardening of the arteries? |
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Definition
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Term
| What are the non modifiable risk factors? |
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Definition
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Term
| What are the modifiable risk factors? |
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Definition
hyperlipidemia
HTN
smoking
DM
elevated homocysteine
affect hemostasis and thrombosis
infection
obesity
stress
sedentary lifestyle |
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Term
What is the pathophysiology of atherosclerosis? 4 stages |
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Definition
endothelial dysfunction
initial lesion (fatty streak)
characteristic lesion (atheroma)
complicated lesion: lesion becomes unstable, plaque ruptures, thromboembolism, results in MI
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Term
What are the response to injury hypothesis? |
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Definition
injury to the endothelium
chronic inflammation response
migration of SMC from media to iniima
proliferation of SMC in intima
excess production of ECM
Enhanced lipid acculumation |
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Term
| What are the causes of chronic endothelial injury? |
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Definition
hyperlipidemia
HTN
smoking
homocysteine
hemodynamic factors
toxins
viruses
immune rxns |
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Term
What causes endothelial Dysfunction? |
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Definition
increased permeability
leukocyte adhesion
monocyte adhesion
emigration |
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Term
| What causes initiation of Fatty Streak? |
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Definition
Smooth muscle emigration from media to intima.
macrophage activation |
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Term
| What causes Fatty Streak? |
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Definition
| macrophages and smooth muscle cells engulf lipid |
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Term
| What causes fibro fatty atheroma? |
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Definition
| Smooth muscle proliferation, collagen , and other ECM deposition, EC lipids |
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Term
| What is the first step in atherosclerosis? |
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Definition
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Term
| What are the steps of pathophysiology of atherosclerosis? |
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Definition
endotheial dysfunction
initial lesion ( fatty streak)
characteristic lesion ( atheroma)
complicated lesion (unstable plaque) |
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Term
What does injured endothelial consists? |
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Definition
decrease vasodilatory substances
decrease amounts of antithrombotic and anti-adhension
increase adhesion molecules |
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Term
| What does the initial lesion ( fatty streak ) consist of ? |
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Definition
foam cells
macrophage
lipids in macrophage become oxidized forming = fatty streak |
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Term
What does fatty streak produce? |
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Definition
| free radicals and inflammatory cytokines |
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Term
What does atheroma consist? |
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Definition
fibrous cap
the plaque may have a thick fibrous cap and may be stable |
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Term
| What does complicated lesion (unstable plaque)? |
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Definition
| fibrous cap may becomes thin and weak, forming a vulnerable plaque |
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Term
What is the earliest recognizable lesion of atherosclerosis? |
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Definition
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Term
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Definition
aggregation of lipid-rich macrophages
T lymphocytes
precedes the development of intermediate lesions which are composed of layers of macrophages and smooth muscle cells |
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Term
| What are the sudden deaths from MI are due to? |
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Definition
Ruptures or fissure :
results in hemorrhage into the plaque, thrombosis, and occlusion of the artery |
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Term
| What are the three processes involved in the formation of atherosclerotic lesion? |
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Definition
proliferation of smooth muscle cells and macrophages
formation by smooth muscle cells of connective tissue matrix
accumulation of lipid and mostly free and esterified cholesterol in the surrounding matrix
Progression = accumulation of alternating layers of SMC and lipid-laden macrophage |
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Term
All of the following are steps in the pathophysiology of atherosclerosis EXCEPT:
a. endothelial dysfxn
b. stable plaque
c. fatty streak
d. atheroma |
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Definition
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Term
| What role does oxidized LDL play? |
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Definition
directly injure the endothelium and increases adherence and migration of monocytes and T lymphocytes
once monocytes and lymphocytes enter into the intima of the artery,
uptake of oxLDL by the macrophages will lead to foam cell formation |
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Term
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Definition
when the macrophage become engorged with lipid
acccumulation of these foam cells in the subendothelial space of blood vessels forms the earliest gross evidence of a developing atherosclerotic plaque known as a FATTY STREAK |
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Term
| What is the early response? late respone |
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Definition
neutrophils--acute inflammation
lymphocytes and macrophages |
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Term
Can atherosclerosis be considered a form of chronic inflammation of arterial walls. T/F |
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Definition
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Term
| What does inflammation results in ? |
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Definition
lipid filled plaques
plaque rupture and thrombosis caused MI and strokes |
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Term
| What does oxidized LDL trigger? |
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Definition
| promote platelet aggregation |
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Term
| What are some key roles of Vascular Endothelium? |
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Definition
controls vascular tone
NO important
provides nonthrombogenic surface
acts as permability barrier |
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Term
What processes does endothelial injury promote atherosclerosis? |
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Definition
migration of monocytes thru endothelium
proliferation of macrophages and SMC
formation of Connective tissue matrix
accumulation of free and esterified cholesterol in macrophages and in surrounding tissue spaces upon cell death |
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Term
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Definition
thick fibrous cap
smaller lipid pool
few inflammatory cells
dense extracellar matrix |
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Term
What is vulnerable plaque (stable plaque)? |
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Definition
thin fibrous cap
large lipid pool
many inflammatory cells
few SMC |
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Term
Is insulin resistance and atherosclerosis are related. T/F |
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Definition
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Term
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Definition
bad cholesterol
major cholesterol carrier in the blood
increases the risk of heart DZ |
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Term
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Definition
good cholesterol
high level of HDL reduces the risk of heart DZ
it removes excess cholesterol from arterial plaques and carriers it back to the liver |
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Term
| Does adipose tissue make hormones. T/F |
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Definition
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Term
| What is made in fat cells that is a hormone? |
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Definition
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Term
| What is desirable blood lipid profile? total Cholesteral, LDL, HDL, TG |
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Definition
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Term
| What is produced in intestinal epithelium from dietary fat and carries TG in the blood? |
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Definition
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Term
What is produced in liver mainly from dietary Carbs
and carries TG in blood ? |
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Definition
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Term
| WHat is produced in blood (remains of VLDL TG digestion) and endocytosed by liver or converted to LDL? |
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Definition
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Term
| What is produced in blood and high cholesterol? |
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Definition
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Term
| What is produced in liver and intestine and exchange of proteins and lipids with lipoproteins? |
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Definition
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Term
| High levels of LDL reduce the risk of Heart DZ. T/F |
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Definition
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Term
What is the major blood supply is in contact with only what? |
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Definition
| Endothelial cells in the intima |
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Term
What is insulin resistance? |
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Definition
| the decreased responsiveness of tissues to insulin |
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Term
| How much blockage is needed to cause symptoms? |
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Definition
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Term
All of the following are cells within a plaque except:
a. T lymphocytes
b. macrophage
c. RBC |
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Definition
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