P. 1
Pathology of Blood Vessels

Pathology of Blood Vessels

|Views: 1,451|Likes:
Published by dhainey

More info:

Published by: dhainey on Oct 31, 2008
Copyright:Attribution Non-commercial

Availability:

Read on Scribd mobile: iPhone, iPad and Android.
download as PPT, PDF, TXT or read online from Scribd
See more
See less

04/23/2013

pdf

text

original

•PA THOLO GY of BLO OD VESSELS

By: DR. ANTOINETTE T. LEUTERIO

ARTERIES
• • • • • ARTERIOSCLEROSIS ARTERITIS ANEURYSM KAWASAKI DISEASE RAYNAUD’S PHENOMENON

ARTERIOSCLEROSIS
• ATHEROSCLEROSIS
• MONKEBERG ‘S ARTERIOSCLEROSIS • ARTERIOLOSCLEROSIS

ATHEROSCLEROSIS
• RISK FACTORS
– hyperlipidemia – hypertension

• VLDL , HDL • TYPE IV • PATHOGENESIS
– Lipid infiltration theory

ARTERIOLOSCLEROSIS
• Hyaline arteriolosclerosis (nephrosclerosis of kidneys) • Hyperplastic arteriolosclerosis
– malignant hypertension

• MONKEBERG’S ARTERIOSCLEROSIS
(medial calcific sclerosis)

ARTERITIS
• • • • Polyarteritis nodusa Giant cell arteritidis Thromboangiitis obliterans Wegener’s granulomatosis

GIANT CELL ARTERITIDIS
• Temporal arteritis (skip areas) • Takayasu’s arteritis (pulseless
disease)
• multinucleate giant cells

POLYARTERITIS NODUSA
group of systemic necrotizing vasculitides

THROMBOANGIITIS OBLITERANS ( BUERGER’S DISEASE ) - thrombosis of medium-sized
vessels (fibrous encasement of artery, vein & nerve)

WEGENER’S GRANULOMATOSIS
- necrotizing vasculitis of small arteries and witn granulomatous inflammation

RAYNAUD DISEASE
- paroxysmal pallor or cyanosis of the digits of hands or feet

RAYNAUD PHENOMENON - arterial insufficiency of the
extremities

• CONGENITAL ANOMALIES: - ARTERIOVENOUS FISTULA
abnormal communication between artery and vein

ANEURYSMS
ETIOLOGIC CLASSIFICATION
– Atherosclerotic aneurysm ( most common) – Syphilitic aneurysm ( thoracic aorta) – Dissecting aneurysm (hypertension)

ANATOMIC CLASSIFICATION
– Saccular aneurysm (balloon like-arterial dilatations) – Fusiform aneurysm ( spindle- shaped dilatations) – Berry aneurysm ( Circle of Willis)

VEINS
• VENOUS THROMBOSIS
– Thrombophlebitis – Phlebothrombosis – Deep venous thrombosis – Predisposing conditions venous stasis / hypercoagulable state ( embolization to pulmonary arteries)

• VARICOSE VEINS
– (superficial veins of lower extremities)

LYMPHATICS
PRIMARY DISORDERS
– Simple congenital lymphedema – Heredofamilial lymphedema ( Milroy’s disease ) – Lymphedema praecox

SECONDARY DISORDERS
– Filariasis - (Elephantiasis)

TUMORS of ARTERIES VEINS
& LYMPHATICS
• BENIGN TUMORS
– ANGIOMAS
• Cavernous hemangiomas ( Von Hippel - Lindau disease) • Capillary hemangiomas (bleeding)

– GLIOMANGIOMAS (Glomus tumor) – VASCULAR ECTASIAS (spider telengiectasia)
• OSLER RENDU- WEBER DISEASE

LOW GRADE MALIGNANT TUMOR
– KAPOSI SARCOMA (AIDS)

• MALIGNANT TUMORS
– ANGIOSARCOMA (RARE)

HYPERTENSION
• DEFINITION - sustained elevation - > 140/90 ; 160/ 95 - diastolic pressure • ETIOLOGY - Essential hypertension (after age 40)
primary phenomenon commonest type familial tendency due high dietary intake of sodium ( current theory)
– Secondary hypertension ( under age 40)

due preceding disease

HYPERTENSION
• MECHANISM of ESSENTIAL HPN (related) - Primary increase in cardiac output reduced sodium excretion - Increase in peripheral resistance increased vasoconstriction agents increased sensitivity of vascular smooth muscles behavioral or neurogenic factor - Multiple defects contribute

HYPERTENSION
• PATHOLOGY – Benign hypertension earliest phase, no change later, hyaline arteriolosclerosis – Malignant hypertension diastolic pressure > 110mm Hg fibrinoid necrosis of media w/ marked intimal fibrosis tissues with acute ischemia & microinfarcts elevated serum renin levels

HYPERTENSION
• CLINICAL FEATURES – Early hypertension asymptomatic – Hypertensive heart disease left ventricular hypertrophy increased risk of ischemic heart disease – Hypertensive renal disease decreased glomerular filtration progressive glomerular fibrosis elevation of serum creatinine & hematuria – Hypertensive cerebral disease cerebral thrombosis & hemorrhage hypertensive encephalopathy (headache) – Hypertensive retinal disease (“ cotton wool spots “ )

• THROMBOLYSIS - dissolution of a clot - plasminogen activators • BALLOON ANGIOPLASTY AND RELATED TECHNIQUES - dilatation of stenosed artery by balloon catheter - causes plaque fracture • VASCULAR REPLACEMENT - large diameter Dacron grafts perform well than small dia • CORONARY ARTERY BYPASS GRAFT SURGERY

PATHOLOGY OF THERAPEUTIC INTERVENTIONS IN VASCULAR DISEASE

Table 1

TYPES OF HYPERTENSION
• DISEASES – ESSENTIAL HYPERTENSION ( adult HPN) – familial – SECONDARY HPN ( children) – MALIGNANT HPN ( > 200/140 mm Hg) • Description • Causes • Pathology

Table 2 MOST COMMON CAUSES & TYPES
• DISORDER – Pulmonary embolism – HPN – Valvular lesion

VASCULAR DISEASES
• • • • • ANEURYSM ARTERIOSCLEROSIS HDL LDL VASCULITIS

Table 4

ARTERIOSCLEROTIC DISORDERS
• DISEASES
– MONCKEBERG DISEASE – ARTERIOSCLEROSIS – ATHEROSCLEROSIS
• Description • Risk factors • Pathology

Table 5 ANEURYSMS
• • • • TYPE ATHEROSCLEROTIC ANEURYSM SYPHILITIC BERRY DISSECTING
– Description – Predisposing factors – Pathology

Table 6 OTHER VASCULAR DISEASES
• VARICOSE VEINS • RAYNAUD DISEASE
– Description – Risk factors

Table 7 DISEASES BY VESSEL SIZE
• SMALL VESSELS • MEDIUM VESSELS • LARGE VESSELS

Table 8 TYPES OF VASCULITIS
• DISEASES
– – – – – – – POLYARTERITIS NODOSA Hypersensitivity Vasculitis Mixed Cryoglobulinemia Wegener Granulomatosis Buerger disease Giant cell Arteritidis Kawasaki disease • Description • Factors • Pathogenesis

Table 9 VASCULAR TUMORS
• BENIGN TUMORS
– HEMANGIOMA – TELENGIECTASIA – GLOMANGIOMA

• MALIGNANT TUMORS
– ANGIOSARCOMA – KAPOSI SARCOMA

CNS SMOKI NG ALCOHOL BURNS LEAD edema stroke dementia

CVS MI cardiomyopathy Hypo - Volemia anemia

RESP

RENAL

Nephritis

You're Reading a Free Preview

Download
scribd
/*********** DO NOT ALTER ANYTHING BELOW THIS LINE ! ************/ var s_code=s.t();if(s_code)document.write(s_code)//-->