Atherosclerotic Plaque Morphology
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Questions and Answers

What is the result of endothelial cell injury and dysfunction in atherosclerosis?

  • Increased vascular permeability (correct)
  • Smooth muscle cell recruitment
  • Decreased vascular permeability
  • T-cell activation

    • What is the composition of fatty streaks in atherosclerosis?

  • Platelets and lipoproteins
  • Foam cells and collagen
  • Lipid-filled foamy macrophages (correct)
  • Lipid-filled smooth muscle cells

    • What is the role of PDGF in atherosclerosis?

  • Activate T-cells
  • Induce smooth muscle cell death
  • Inhibit smooth muscle cell proliferation
  • Induce smooth muscle cell recruitment and proliferation (correct)

    • What is a complication of atherosclerosis?

    <p>All of the above</p> Signup and view all the answers

    What is a characteristic of atherosclerotic plaques?

    <p>Composed of lipid-filled macrophages and extracellular matrix</p> Signup and view all the answers

    What is a risk factor for atherosclerosis?

    <p>All of the above</p> Signup and view all the answers

    What is the critical percentage of luminal cross-sectional area decrease that typically occurs in atherosclerotic stenosis?

    <p>70%</p> Signup and view all the answers

    Which cell type is a component of atherosclerotic plaques?

    <p>T cells</p> Signup and view all the answers

    What is the consequence of atherosclerotic plaque rupture?

    <p>Atheroembolism</p> Signup and view all the answers

    What is the main component of the extracellular matrix in atherosclerotic plaques?

    <p>Collagen</p> Signup and view all the answers

    What is the term for the formation of a new blood vessel within an atherosclerotic plaque?

    <p>Neovascularization</p> Signup and view all the answers

    What is the term for the accumulation of lipids within atherosclerotic plaques?

    <p>Atheroma</p> Signup and view all the answers

    What is the consequence of atherosclerosis-induced pressure or ischemic atrophy of the underlying media?

    <p>Aneurysm formation</p> Signup and view all the answers

    What is the term for the narrowing of the vessel lumen due to atherosclerotic plaques?

    <p>Atherosclerotic stenosis</p> Signup and view all the answers

    What is the term used to describe the hardening of the arteries?

    <p>Arteriosclerosis</p> Signup and view all the answers

    What is the characteristic of atherosclerotic plaques?

    <p>A soft core of lipid covered by a fibrous cap</p> Signup and view all the answers

    What is the result of the rupture of an atherosclerotic plaque?

    <p>Obstructive thrombosis</p> Signup and view all the answers

    What is the underlying condition of coronary, cerebral, and peripheral vascular disease?

    <p>Atherosclerosis</p> Signup and view all the answers

    What is the result of atherosclerotic plaques enlarging?

    <p>Stenosis</p> Signup and view all the answers

    What is the consequence of atherosclerotic plaques increasing the diffusion distance from the lumen to the media?

    <p>Ischemic injury and weakening of the vessel wall</p> Signup and view all the answers

    What is the term used to describe the lesions that impinge on the vascular lumen and can rupture to cause sudden occlusion?

    <p>Atheromas</p> Signup and view all the answers

    What is the location of the arteries affected by atherosclerosis?

    <p>Medium-sized to large arteries</p> Signup and view all the answers

    Study Notes

    Atherosclerosis

    • Atherosclerotic plaques have three components: cells (smooth muscle cells, macrophages, and T cells), extracellular matrix (including collagen), and intracellular and extracellular lipid.
    • Atherosclerotic plaques can gradually occlude vessel lumina, compromising blood flow and causing ischemic injury.

    Morphology

    • Atherosclerotic plaques consist of a central lipid core, a fibrous cap, and a residual lumen.
    • Inflammation, calcifications, and neovascularization are common features of atherosclerotic plaques.

    Atherosclerosis Consequences

    • Atherosclerotic stenosis: narrowing of the lumen, causing ischemic injury, typically occurs when the occlusion produces a 70% decrease in luminal cross-sectional area.
    • Rupture, ulceration, and erosions: exposing highly thrombogenic plaque constituents (collagen), which can lead to hemorrhage, atheroembolism, and aneurysm formation.
    • Atheroembolism: plaque rupture can discharge atherosclerotic debris into the bloodstream, producing microemboli that can block distant arteries.
    • Aneurysm formation: atherosclerosis-induced pressure or ischemic atrophy of the underlying media, with loss of elastic tissue, causes weakness and potential rupture.

    Pathogenesis

    • Endothelial cell injury and dysfunction cause increased vascular permeability, leukocyte and platelet adhesion, and inflammation.
    • Injured endothelial cells allow the accumulation of lipoproteins, leading to monocyte migration into the intima and transformation into macrophages and foam cells.
    • Smooth muscle cells produce extracellular matrix (collagen) and inflammatory cytokines, which activate T-cells.
    • PDGF (from activated platelets, macrophages, endothelial cells, and smooth muscle cells) induces smooth muscle cell recruitment and proliferation.

    Morphology – Fatty Streaks

    • Fatty streaks: composed of lipid-filled foamy macrophages, beginning as multiple minute flat yellow spots, eventually coalescing into elongated streaks 1 cm long or longer.

    Arteriolosclerosis

    • Arteriosclerosis: hardening of the arteries, a generic term reflecting arterial wall thickening and loss of elasticity, with distinct clinicopathologic conditions: atherosclerosis, arteriolosclerosis, and Mönckeberg medial sclerosis.

    Atherosclerosis

    • Characterized by intimal lesions called atheromas (or atheromatous or atherosclerotic plaques) that impinge on the vascular lumen and can rupture to cause sudden occlusion.
    • Involves medium-sized to large arteries and underlies the pathogenesis of coronary, cerebral, and peripheral vascular disease.

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    Atherosclerosis, Aneurysm, and Dissection PDF

    Description

    This quiz covers the components and morphology of atherosclerotic plaques, including cells, extracellular matrix, and lipid. It also touches on ulceration and thrombus in complicated lesions.

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