Podcast
Questions and Answers
What characterizes atherosclerosis?
What characterizes atherosclerosis?
Which factor is not considered a non-modifiable risk factor for atherosclerosis?
Which factor is not considered a non-modifiable risk factor for atherosclerosis?
At which point does the incidence of atherosclerosis between genders change?
At which point does the incidence of atherosclerosis between genders change?
Which of the following organs is least likely to be affected by atherosclerosis?
Which of the following organs is least likely to be affected by atherosclerosis?
Signup and view all the answers
What initiates the development of atherosclerosis in blood vessels?
What initiates the development of atherosclerosis in blood vessels?
Signup and view all the answers
Which lipoproteins are involved in the entry into the intima during atherosclerosis development?
Which lipoproteins are involved in the entry into the intima during atherosclerosis development?
Signup and view all the answers
What is the end result of the lipid accumulation in atherosclerosis?
What is the end result of the lipid accumulation in atherosclerosis?
Signup and view all the answers
What role do monocytes play in the development of atherosclerosis?
What role do monocytes play in the development of atherosclerosis?
Signup and view all the answers
What characterizes a fatty streak in terms of its gross appearance?
What characterizes a fatty streak in terms of its gross appearance?
Signup and view all the answers
What components are found in the central core of an uncomplicated atheroma?
What components are found in the central core of an uncomplicated atheroma?
Signup and view all the answers
Which of the following is NOT a characteristic of complicated atheroma?
Which of the following is NOT a characteristic of complicated atheroma?
Signup and view all the answers
What pathological change is associated with chronic ischemia due to atherosclerosis?
What pathological change is associated with chronic ischemia due to atherosclerosis?
Signup and view all the answers
What is a potential consequence of ulceration of an atheroma?
What is a potential consequence of ulceration of an atheroma?
Signup and view all the answers
Which of the following findings is characteristic of a microscopic examination of a fatty streak?
Which of the following findings is characteristic of a microscopic examination of a fatty streak?
Signup and view all the answers
What impact does thrombosis have in the context of atherosclerosis?
What impact does thrombosis have in the context of atherosclerosis?
Signup and view all the answers
What is the role of neovascularization in the context of uncomplicated atheroma?
What is the role of neovascularization in the context of uncomplicated atheroma?
Signup and view all the answers
What is the major characteristic of atherosclerosis?
What is the major characteristic of atherosclerosis?
Signup and view all the answers
Which of the following is NOT a common modifiable risk factor for atherosclerosis?
Which of the following is NOT a common modifiable risk factor for atherosclerosis?
Signup and view all the answers
What initiates the migration of smooth muscle cells in atherosclerosis?
What initiates the migration of smooth muscle cells in atherosclerosis?
Signup and view all the answers
Which of these areas is least commonly affected by atherosclerosis?
Which of these areas is least commonly affected by atherosclerosis?
Signup and view all the answers
What happens to monocytes during the development of atherosclerosis?
What happens to monocytes during the development of atherosclerosis?
Signup and view all the answers
Which of the following is a symptom of severe atherosclerosis?
Which of the following is a symptom of severe atherosclerosis?
Signup and view all the answers
In which scenario is the incidence of atherosclerosis among genders equal?
In which scenario is the incidence of atherosclerosis among genders equal?
Signup and view all the answers
Which type of lipoproteins are involved in the entry into the intima during the process of atherosclerosis?
Which type of lipoproteins are involved in the entry into the intima during the process of atherosclerosis?
Signup and view all the answers
What is a key feature of a complicated atheroma?
What is a key feature of a complicated atheroma?
Signup and view all the answers
Which of the following best describes the gross appearance of an uncomplicated atheroma?
Which of the following best describes the gross appearance of an uncomplicated atheroma?
Signup and view all the answers
Which pathological change is associated with atherosclerosis and contributes to vascular lumen narrowing?
Which pathological change is associated with atherosclerosis and contributes to vascular lumen narrowing?
Signup and view all the answers
What type of infiltrate is typically found in the microscopic examination of a fatty streak?
What type of infiltrate is typically found in the microscopic examination of a fatty streak?
Signup and view all the answers
Which of the following factors is NOT typically associated with the formation of an atheroma?
Which of the following factors is NOT typically associated with the formation of an atheroma?
Signup and view all the answers
Which component of the atheroma's structure is formed from proliferated smooth muscle cells?
Which component of the atheroma's structure is formed from proliferated smooth muscle cells?
Signup and view all the answers
What is the consequence of neovascularization in atheromatous plaques?
What is the consequence of neovascularization in atheromatous plaques?
Signup and view all the answers
What is a likely consequence of significant media atrophy associated with atherosclerosis?
What is a likely consequence of significant media atrophy associated with atherosclerosis?
Signup and view all the answers
Study Notes
Atherosclerosis - Definition and Incidence
- Atherosclerosis is a chronic progressive multifocal disease of the vessel wall that is characterized by the formation of fibro-fatty plaques.
- It is more prevalent in males than females before menopause, but after menopause, the incidence rate equalizes.
- Atherosclerosis is more common in developed countries.
Atherosclerosis - Risk Factors
-
Non-Modifiable:
- Increasing age
- Male gender
- Family history
- Genetic abnormalities
-
Modifiable:
- High carbohydrate intake
- Obesity
- Physical inactivity
- Stress
- Postmenopausal
- Alcohol
- Lipoprotein Lp(a)
- Unsaturated fat intake
- Hyperlipidemia
- Hypertension
- Cigarette smoking
- Diabetes
Atherosclerosis - Common Sites
- Aorta, especially descending
- Coronary arteries
- Cerebral and internal carotids
- Femoral, renal, and superior mesenteric arteries
Atherosclerosis - Pathogenesis
- The development of atherosclerosis begins with focal chronic endothelial cell injury caused by factors such as endotoxins, hypoxia, cigarettes, viruses, and stress.
- This injury allows lipoproteins, such as LDL and VLDL, to enter the intima of the vessel.
- Monocytes migrate into the intima and transform into macrophages, engulfing lipids and becoming foam cells.
- Platelets adhere to the injured endothelium and release platelet-derived growth factor (PDGF).
- Activated platelets, macrophages, and endothelial cells also release mitogenic factors that stimulate smooth muscle cell migration.
- Smooth muscle cells proliferate in the intima, depositing extracellular matrix, collagen, and proteoglycans.
- Lipid accumulates, both extra- and intra-cellularly, within macrophages and smooth muscle cells, further contributing to foam cell formation.
- A fibrous cap forms, separating the lesion from the lumen.
Atherosclerosis - Gross Appearance
-
Fatty Streak:
- Multiple, smooth, yellowish fatty dots that are not raised above the endothelial surface
- Coalesce to form larger units
-
Uncomplicated ATHEROMA:
- Disc-like patches
- Color ranges from yellow to white depending on the relative amounts of fat and fibrous tissue
- Covered by a glistening intima
- More common around the mouths of branches
- Grayish white and firm
-
Complicated ATHEROMA:
- Cut surface reveals a fibrous coat and a yellow soft center
- May exhibit calcification, ulceration, and thrombosis
Atherosclerosis - Microscopic Appearance
-
Fatty Streak:
- Exhibits cholesterol clefts, lipid-laden foam cells, extracellular lipid, and lymphoplasmacytic infiltrate
-
Uncomplicated ATHEROMA:
- A subendothelial fibrous cap is observed, composed of proliferated smooth muscle cells, foam cells, and extracellular matrix
- A central core is present, containing cholesterol and cholesterol esters, lipid-laden macrophages (foam cells), necrotic debris, and calcification
- Neovascularization is observed around the periphery
- The media exhibits disruption of the elastic lamina and atrophy deep to the plaque
Atherosclerosis - Complications
- Narrowing of the vascular lumen leads to chronic ischemia
- Superimposed thrombosis can result in acute ischemia and infarction
- Ulceration with liberation of the fatty core can cause acute ischemia, fat emboli, and infarction
- Pressure atrophy of the media with fibrosis weakens the wall, increasing the risk of aneurysm
- Dystrophic calcification can occur
Atherosclerosis - Illustrations
- Images depict a normal coronary artery and a coronary artery affected by atherosclerosis (uncomplicated atheroma)
Atherosclerosis
- Chronic, progressive, multifocal disease affecting vessel walls.
- Characterized by fibro-fatty plaques.
- Males are at a greater risk before menopause, while females are more at risk after menopause.
- Found more often in developed countries.
Atherosclerosis - Risk Factors
-
Non-Modifiable Risk Factors:
- Increasing age
- Male gender
- Family history
- Genetic abnormalities
-
Modifiable Risk Factors:
- Hyperlipidemia
- Hypertension
- Cigarette smoking
- Diabetes
- High carbohydrate intake
- Obesity
- Physical inactivity
- Stress (Type A personality)
- Postmenopausal
- Alcohol
- Lipoprotein Lp(a)
- Unsaturated fat intake
Atherosclerosis - Locations
- Aorta, especially the descending aorta.
- Coronary arteries
- Cerebral and internal carotid arteries
- Femoral, renal, and superior mesenteric arteries
Atherosclerosis - Development
-
Focal chronic endothelial cell injury:
- Caused by endotoxins, hypoxia, cigarette smoke, viruses, or stress
-
Entry of lipoproteins into the intima of the vessel:
- LDL (low-density lipoprotein) and VLDL (very low-density lipoprotein) are the main contributors
-
Migration of monocytes into the intima:
- Monocytes differentiate into macrophages and foam cells by engulfing lipids, leading to lipoprotein oxidation.
-
Platelet adhesion:
- Platelets adhere and release platelet-derived growth factor (PDGF).
-
Smooth muscle migration:
- Mitogenic factors released by activated platelets, macrophages, and endothelial cells lead to smooth muscle migration.
-
Proliferation of smooth muscle cells:
- Smooth muscle cells proliferate in the intima, depositing extracellular matrix, collagen, and proteoglycans.
-
Lipid accumulation:
- Lipids accumulate both intracellularly and extracellularly in macrophages and smooth muscle cells, forming foam cells.
-
Formation of a fibrous cap:
- A fibrous cap separates the lesion from the lumen.
Atherosclerosis - Gross Morphology
-
Fatty Streak:
- Multiple, smooth, yellowish fatty dots.
- Not raised above the endothelial surface (flat).
- Coalesce to form larger streaks.
-
Uncomplicated ATHEROMA:
- Disc-like patches.
- Color ranges from yellow to white due to the relative amount of fat and fibrous tissue.
- Covered by glistening intima.
- More frequently found around the mouths of branches.
- Grayish-white and firm.
- On cut surface, shows a fibrous coat and a yellow soft center.
- May contain calcification.
-
Complicated ATHEROMA:
- Ulcerated.
- May have superimposed thrombosis.
Atherosclerosis - Microscopic Morphology
-
Fatty Streak:
- Cholesterol clefts
- Lipid-laden foam cells
- Extracellular lipid
- Lymphoplasmacytic infiltrate
-
Uncomplicated ATHEROMA:
- Subendothelial fibrous cap: formed of proliferated smooth muscle cells, foam cells, and extracellular matrix.
- Central core: composed of cholesterol, cholesterol esters, lipid-laden macrophages (foam cells), necrotic debris, and calcification.
- Neovascularization: occurs around the periphery of the plaque.
-
Media:
- Disrupted elastic lamina
- Atrophy of the media deep to the plaque
Atherosclerosis - Complications
-
Narrowing of the vascular lumen:
- Leads to chronic ischemia.
-
Superimposed thrombosis:
- Leads to acute ischemia and infarction.
-
Ulceration:
- Liberation of fatty core leads to acute ischemia, fat emboli, and infarction.
-
Pressure atrophy of the media with fibrosis:
- Weakening of the vessel wall, leading to aneurysm formation.
-
Dystrophic calcification:
- May occur.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
Explore the multifaceted disease of atherosclerosis in this quiz, covering its definition, incidence, risk factors, and common sites affected. Delve into both modifiable and non-modifiable factors that contribute to this chronic condition, making it vital for understanding cardiovascular health.
