Ch11-Vessels

Ch11-Vessels - Diseases of BLOOD VESSELS COMPONENTS •...

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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” (Δ?) • 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-β Vessel Growth & Remodeling • The sum total of all the factors and processes involved in tissue injury and the body’s 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%) – Mönckeberg 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 •...

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