Ch11-Vessels

Ch11-Vessels - Diseases of BLOOD VESSELS COMPONENTS Intima,...

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Unformatted text preview: Diseases of BLOOD VESSELS COMPONENTS Intima, Media, Adventitia, M>A or A>M ENDOTHELIUM INTERNAL ELASTIC LAMINA ECM: Elastin (~aging), collagen, mucopolysaccharides Smooth Muscle Connective Tissue Fat 1) Blockage (preceded by narrowing) 2) Rupture Preceded by weakening) TOPICS Vascular wall responses Congenital Anomalies Atherosclerosis Arteriosclerosis Hypertension Aneurysms Vasculitides Raynaud phenomenon Veins Lymphatics Tumors Interventions DEFINITIONS ARTERIO-sclerosis ATHERO-sclerosis Aneurysm Dissection Thrombus Hypertension Vasculitis/Vasculitides, infectious/NON- infectious (often-autoimmune) Varicosity DVT/Thrombo-phlebitis/Phlebo-thrombosis DEFINITIONS Lymphangitis Lymphedema Angioma/Hemangioma (generic) Lymphangioma Angiosarcoma (generic) Lymphangiosarcoma NON-Specific Vascular Wall Response to Injury Endothelial activation Smooth Muscle cell roles Development, Growth, Remodeling Intimal thickening ENDOTHELIAL CELLS Recall Jeckyl/Hyde concept: maintain hemostasis/cause thrombosis Maintenance of Permeability Barrier Elaboration of Anticoagulant, Antithrombotic, Fibrinolytic Regulators Elaboration of Prothrombotic Molecules Extracellular Matrix Production (collagen, proteoglycans) Modulation of Blood Flow and Vascular Reactivity Regulation of Inflammation and Immunity Regulation of Cell Growth Oxidation of LDL ENDOTHELIAL CELL ACTIVATORS (?) Cytokines Bacterial Products Hemodynamic Forces Lipid Products Viruses Complement Hypoxia VASCULAR SMOOTH MUSCLE Vasoconstriction Vasodilatation Make ECM: Collagen Elastin Proteoglycans Regulated by: PROMOTORS: PDGF, endothelin, thrombin, etc. INHIBITORS: Heparan SO4, NO, TGF- Vessel Growth & Remodeling The sum total of all the factors and processes involved in tissue injury and the bodys ability to grow vessels, develop new pathways, and re-perfuse areas in response to tissue and/or blood vessel injury. CONGENITAL ANOMALIES Arteriovenous fistulas Also called A rterio V enous M alformation (AVM) Common factor is abnormal communication between high pressure arteries and low pressure veins Usually congenital (malformation), but can be acquired by trauma or inflammation Most often described in the brain as an AVM Often asymptomatic or with hemorrhage or pressure effects ARTERIO-SCLEROSIS GENERIC term for ANYTHING which HARDENS arteries Atherosclerosis (99%) Mnckeberg medial calcific sclerosis (1%) Arterio lo sclerosis, involving small arteries and arterioles, generally regarded as NOT strictly being part of atherosclerosis, but more related to hypertension and/or diabetes ATHEROSCLEROSIS (classical) Etiology/Risk Factors Pathogenesis Morphology Clinical Expression ATHEROSCLEROSIS...
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Ch11-Vessels - Diseases of BLOOD VESSELS COMPONENTS Intima,...

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