Disorders of Veins and Arteries

orthostatic hypotension

A drop in blood pressure when changing position, for example, from lying down to sitting-up; caused by lack of normal BP compensation in response to gravitational changes on the circulation

HDLs

good cholesterol; made in the liver; remove excess cholesterol from body cells and blood; deliver to liver for metabolism/elimination

myocardial infarction

heart attack; caused by prolonged, unrelieved ischemia that interrupts blood supply to the myocardium; thrombus occludes vessel if greater than 20 min; myocyte dies; irreversible hypoxic injury causes cellular death and tissue necrosis; plasma enzyme levels are used to diagnose this

hypertension

high blood pressure; resulting from increases in cardiac output (blood volume), total peripheral resistance, or both; leading risk factor for cardiovascular disorders; can be primary (without a known cause) or secondary (caused by underlying disease)

tunica interna

inntermost layer of a vessel; has direct contact with the blood and is continuous with the endocardium; endothelium and basement membrane; creates growth factors that can stimulate smooth muscle; creates compounds to promote clot formation in injured areas

ulcers

venous stasis _____ follow the development of chronic venous insufficiency and probably develop as a result of borderline metabolic state of the cells in the affected extremities

VLDLs

very low density lipoproteins that form in hepatocytes; transport endogenous lipids to adipocytes

varicosities

Areas of veins in which blood has pooled, usually in the saphenous veins. Varicosities may be caused by damaged valves as a result of trauma to the valve or by chronic venous distention involving gravity and venous constriction.

pulmonary embolism

Blocking of a pulmonary artery due to a blood clot; causes sudden death

arteries

Blood vessels that carry blood away from the heart

veins

Blood vessels that carry blood back to the heart; have valves

deep vein thrombosis

DVT; results from stasis of blood flow, endothelial damage or hyper-coagulability; the most serious complication is pulmonary embolism

venous

embolus that originates in venous circulation; travels to right side of heart and pulmonary circulation; eventually lodges in pulmonary vessel

transmural infarction

ST elevated MI; clot permanently lodged in vessel and cells in all 3 layers of heart wall die; occur when there is an obstruction of a single artery; elevation of ST segments = STEMI; T wave inversion and abnormal Q wave; cells swell and burst; cardiac enzymes released; contractile function lost within 60 sec

capillaries

Smallest blood vessels; sites of exchange of substances between the blood and the body cells; cannot constrict/dilate

hypercholesterolemia

excessive cholesterol in the blood; more than 240 mg/dL; could contribute to heart attack, stroke, or other CV event associated with atherosclerosis

altered perfusion

The inability to adequately oxygenate tissues at the capillary level; could be the result of low oxygen presence or poor utilization of of oxygen; impaired circulation usually causes this

tunica media

The middle and thickest layer of tissue of a blood vessel wall, composed of elastic tissue and smooth muscle cells that allow the vessel to expand or contract in response to changes in blood pressure and tissue demand

Lipids

fats and oils; non-polar, hydrophobic, do not dissolve in watery blood; transported in the blood in combination with proteins as lipoproteins

ischemic

______ heart disease is most commonly the result of coronary artery disease and the ensuing decrease in myocardial blood supply

dehydration

_______ is the main cause of a thrombus forming

cholesterol

_______ plaques build up between the tunica interna and media

chronic venous

_________ _________ insufficiency is inadequate venous return over a long period of time that causes pathologic ischemic changes in the vasculature, skin, and supporting tissues; can be due to varicose veins or valvular incompetence

atherosclerotic plaque

____________ __________ formation weakens the vessel wall and is the most common cause of an aneurysm; loss of elastin and collagen in vessel wall

thrombus

a clot that remains attached to a vascular wall; consists of platelets, fibrin, RBCs, and WBCs; forms anywhere within vascular system; can be caused by endothelial injury, sluggish blood flow, or increased coagulability

Atherosclerosis

a form of arteriosclerosis and is the leading contributor to coronary artery disease and cerebrovascular disease; an inflammatory disease that begins with endothelial injury; results from injury to tunica intima

embolus

a mobile aggregate of a variety of substances that occludes the vasculature; moving clot; can cause ischemia and necrosis when a vessel is blocked; can be venous or arteriole

arteriosclerosis

abnormal thickening and hardening of the vessel walls; chronic disease of the arterial system; narrowing lumen; results in increased systolic BP; most common form is atherosclerosis

varicose veins

abnormally swollen, twisted veins with defective valves; most often seen in the legs

infarct

an area of necrosis resulting from a sudden insufficiency of arterial or venous blood supply; vessel is obstructed; results in loss of blood supply

LDLs

bad cholesterol; carry 75% of total cholesterol in blood; deliver fat to body cells and liver for repair and synthesis; can deposit cholesterol in fatty plaques; these receptors are necessary for the liver to take them up

unstable angina

chest pain at rest or chest pain of increasing frequency; results in reversible myocardial ischemia; plaque has ruptured; transient episodes of thrombotic vessel occlusion and vasoconstriction at site of plaque damage; less than 20 min; 20% will progress to MI

angina

chest pain; means to choke; classic symptom of myocardial ischemia

Atherosclerosis

condition in which fatty deposits called plaque build up on the inner walls of the arteries; causes disturbance in blood flow

thiazides

diuretic that blocks sodium reabsorption

myocardial infarction

dysrhythmias and cardiac failure are the most common complications of acute _________ __________

myocardial ischemia

local, temporary deprivation of the coronary blood supply; cell injury is reversible; mot commonly a result of coronary artery disease; can be asymptomatic, and is a risk factor for the development of the acute coronary syndromes

aneurysm

localized dilation or outpouching of a vessel wall or cardiac chamber, to which the aorta is particularly susceptible; wall of artery weakens and stretches; risk of rupture/hemorrhage; risk of clot formation

kidneys

long term regulation of BP is largely regulated by the _____; regulation of EC fluid volume

subendocardial infarction

non-ST elevated MI; involve the inner 1/3 of the ventricular wall; occur more frequently in the presence of severely narrowed but still patent arteries; clot breaks up before complete distal tissue necrosis occurs; pain is persistent and severe, gets worse each time; outcome generally good; no T segment elevation = NSTEMI

tunica externa

outer layer of a blood vessel which connects it to surrounding tissues; protective layer; consisting of collagen and elastic fibers

intermittent claudication

pain in legs when walking

peripheral artery disease

result of atherosclerotic plaque formation in the arteries that supply the extremities; causes pain and ischemic changes in the nerves, muscles, and skin of the affected limb; intermittent claudication is the main S/S

venules

small veins receive blood from capillaries

arterioles

small vessels that receive blood from the arteries and carry blood to the capillaries

acute coronary syndromes

sudden coronary obstruction due to thrombus formation causes these; includes unstable angina, non-ST elevation myocardial infarction, and STEMI

chylomicrons

the class of lipoproteins that transport dietary lipids to adipose tissue; remnants are intermediate-density lipoproteins (IDLs); IDLs become LDLs

coronary heart disease

the clogging of the vessels that nourish the heart muscle; result of an atherosclerotic plaque that gradually narrows the coronary arteries or that ruptures and causes sudden thrombus formation; atherosclerosis is the main cause

blood pressure

the pressure that is exerted by the blood against the walls of blood vessels; cardiac output x peripheral resistance = _________

acute arterial occlusion

the sudden occlusion of arterial blood flow; thrombi or emboli, especially at branching/curve sites

fusiform

type of aneurysm larger than 25mm in diameter and occur as a result of arteriosclerotic changes; most often found in thoracic and abdominal aorta; characterized by gradual and progressive enlargement of the aorta

berry

type of aneurysm most often found in the circle of willis in the brain circulation; consists of a small, spherical vessel dilation; usually from congenital abnormalities in media of arterial wall

coronary

type of circulation; blood flow to the heart muscle cells supports the heart's work in pumping blood through the body

pulmonary

type of circulation; deoxygenated blood from the right side of the heart is carried to the lungs to get rid of CO2 and pick up oxygen; oxygenated blood returns to left side of heart

systemic

type of circulation; oxygenated blood from the left side of the heart is carried to tissue cells in the rest of the body where gas exchange occurs and deoxygenated blood that is high in co2 is returned to the right side of the heart

arteriole

type of embolus; most common source is the left side of the heart as a result of mitral and aortic valvular disease and atrial fibrillation; tissues affected include the lower extremities, brain, kidneys, and heart