Lecture 6 Pathophysiology

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Questions and Answers

Which type of blood vessel primarily allows for expansion and recoiling?

Capillaries

Arterioles

Medium-sized veins

Elastic arteries (correct)

Endothelial activation results in the formation of anti-inflammatory surfaces.

False

What is the primary function of vascular smooth muscle cells (SMCs)?

Produce red blood cells

Regulate blood volume

Mediate vasoconstriction and vasodilation (correct)

Transport oxygen

What is the primary function of arterioles in the circulatory system?

Regulation of blood flow resistance Signup and view all the answers

The disease characterized by thickening and hardening of the arterial walls is called ________.

arteriosclerosis Signup and view all the answers

Atherosclerosis is considered the least clinically important type of arteriosclerosis.

False Signup and view all the answers

Match the following terms with their correct descriptions:

Hypertensive Vascular Disease = Pathological condition resulting from high blood pressure Monckeberg Medial Sclerosis = Calcification of the medial layer of arteries Atherosclerosis = Buildup of plaques within arteries Endothelial Cells = Cells lining blood vessels involved in vascular regulation Signup and view all the answers

What are two types of arteriolosclerosis associated with hypertension?

Hyaline and hyperplastic arteriolosclerosis Signup and view all the answers

Which factor is increased when endothelial cells are activated?

Procoagulant surfaces Signup and view all the answers

Arteriosclerosis refers to the _____________ of the arteries.

hardening Signup and view all the answers

Match the type of arteriosclerosis with its description:

Hypertensive arteriosclerosis = Affects small arteries and may cause ischemic injury Atherosclerosis = Most frequent and clinically important pattern Mönckeberg medial calcific sclerosis = Characterized by calcific deposits without lumen encroachment Signup and view all the answers

Only arteries can undergo vasoconstriction and vasodilation.

False Signup and view all the answers

What is a common response of the vessel wall to injury?

Intimal thickening Signup and view all the answers

What vascular pathology is characterized by plaque formation and can lead to cardiovascular diseases?

atherosclerosis Signup and view all the answers

Neointimal smooth muscle cells have the same capacity to contract as medial smooth muscle cells.

False Signup and view all the answers

The _____ is the largest elastic artery in the human body.

aorta Signup and view all the answers

Which growth factors are upregulated by vascular smooth muscle cells when stimulated?

Collagen, elastin, and proteoglycans Signup and view all the answers

Which characteristic is NOT associated with endothelial cells during injury?

Vasodilation Signup and view all the answers

Infection, inflammation, and physical trauma can induce ____________ in blood vessels.

intimal thickening Signup and view all the answers

At what age is Mönckeberg medial calcific sclerosis typically observed?

Over 50 Signup and view all the answers

Study Notes

Blood Vessel Diseases

This lecture covers blood vessel diseases, focusing on atherosclerosis, hypertensive vascular disease, and Mönckeberg medial sclerosis.

Structure and Function of Blood Vessels

Blood vessels have regional specializations in structure and function.
Different types of blood vessels (e.g., arteries, veins, arterioles, venules) have unique layers (intima, media, adventitia; elastic lamina).
Arteries are responsible for high-pressure blood flow, characterized by muscular layers mediating vasoconstriction/dilation.
Veins transport low-pressure blood back to the heart, with larger lumens for easier flow.
Arterioles regulate blood flow to capillary beds.

Vascular Wall Response to Injury

Intimal thickening is a common response to vessel wall injury, regardless of specific cause.
Injury prompts smooth muscle cell proliferation, extracellular matrix production, and inflammation.
Smooth muscle cells migrate from the outer layer of the vessel into the inner tunic (intima), causing thickening and potentially disrupting normal blood flow.
Multiple causes of injury include infection, inflammation, immune responses, and exposure to toxic substances.

Arteriosclerosis

Arteriosclerosis refers to hardening of the arteries, a general term for thickening of arterial walls and loss of elasticity.
Three types are commonly recognized: hypertensive arteriosclerosis, atherosclerosis, and Mönckeberg medial calcific sclerosis.
Hypertensive arteriosclerosis affects small arteries and arterioles and may cause downstream ischemic injury. It is associated with hypertension and includes variants like hyaline and hyperplastic arteriolosclerosis.
Atherosclerosis is the most frequent and clinically significant type of arteriosclerosis.
- Characterized by the formation of atherosclerotic plaques within the vessel intima.
Mönckeberg medial calcific sclerosis involves calcification of the media of medium and small muscular arteries, typically in older adults, but is usually not clinically significant.

Hypertensive Vascular Disease

Essential/primary hypertension (95%): Causes are generally unknown, with genetic predispositions and environmental factors contributing.
Genetic polymorphisms and environmental factors interact in blood pressure regulation.
Blood volume, hormonal factors (e.g., angiotensin II, natriuretic peptides), cardiac output, peripheral resistance, and neural/local factors influence blood pressure.
Secondary hypertension arises due to specific medical conditions, including chronic renal disease, renal artery stenosis, adrenal disorders, and renin-secreting tumors,
Hypertensive vascular disease is characterized by changes in smaller blood vessels, like hyalinoic arteriolosclerosis or hyperplastic arteriolosclerosis.

Atherosclerosis

Atherosclerosis is the presence of atheromatous/atherosclerotic plaques in the arterial intima.
The plaques feature a fibrous cap, necrotic center, and lipid components (both intracellular and extracellular).
Atherosclerosis epidemiology shows higher prevalence in developed nations and is a significant cause of death globally, particularly due to ischemic heart disease (IHD).
Risk factors include nonmodifiable factors like genetics and age, and modifiable ones such as hypertension, hyperlipidemia, smoking, diabetes and inflammation.
Risk factors can interact multiplicatively such that possessing multiple factors elevates the risk even more than simply adding the risks together.
Pathogenesis follows the response-to-injury hypothesis, characterized by endothelial injury, intimal cellular proliferation, repeated thrombus formation, and various risk factors.
Clinical consequences include a diverse array of complications, such as angina, myocardial infarction, stroke, peripheral artery disease, and aneurysms.
Stable versus unstable plaques differentiate the severity of consequences, where unstable plaque tends to rupture more readily.

Competencies

Pharmacy students should understand the pathophysiological mechanisms of blood vessel diseases, use relevant medical terminology, integrate fundamental science concepts with clinical manifestations, comprehend the role of physicians within a comprehensive healthcare team, and link disease characteristics to appropriate drug treatment strategies.

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Description

This quiz covers essential aspects of blood vessel diseases, including conditions like atherosclerosis and hypertensive vascular disease. Additionally, it explores the structure and function of different types of blood vessels, and their response to injury. Test your knowledge on the vascular system and its complexities.