PATH 1016 Test 2 Review

Pathology & Therapeutics I (George Brown College)

Week 4: CARDIOVASCULAR - ATHEROSCLEROSIS, HYPERTENSION,
CORONARY ARTERY DISEASE (CAD)
STRUCTURE OF BLOOD VESSELS WALLS - 3 LAYERS
Inner Layer
Tunica interna
o Inner most layer
o Endothelium
o Simple squamous
Some larger vessels have sub endothelium
o Loose connective tissue
o Basement membrane
Middle Layer
Tunica media
o Middle layer
o Circularly arranged smooth muscle
o Chemical and nervous control of degree of contraction
Sympathetic Nervous System
o Change in diameter
o Vasoconstriction
o Vasodilation
Tunica externa
Made of collagen fibers
Function
o Protection
o Reinforcement
o Anchor to surrounding tissue
c. Accessory tissues
i. Nerve fibers
ii. Lymphatic vessels
iii. Elastic network
iv. Tiny blood vessels within layer-vasa vasorum
Endothelium cells
o Endothelial cells play an important role in controlling vascular function.
o Control transfer of molecules
o Regulating blood flow and vascular resistance
o Control platelet adhesion and blood clotting
o Metabolism of hormones
o Regulate immune and inflammatory reactions
o Growth factors that influence growth of other cells types like vascular smooth muscle cells
o Angiogenesis – What is this process? Angiogenesis is the growth of new blood vessels.
o Control of molecules - oxygen, Na, K, Cl, Glu
o Regulation of vascular resistance - signals outer muscular layers to relax - Nitrous
o Oxide
o Adhesion and blood clotting - endothelium should be “slick” like silicon - lets blood flow easily
o Metabolism - insulin production signalling when increasing glucose levels
DISORDERS OF ARTERIAL CIRCULATION
o Hyperlipidemia
o Atherosclerosis
o Occlusions/Obstructions Lipid pathways
Lipid pathways
Exogenous lipid pathway
o Absorption of fats from the digestive tract into the circulation
Endogenous lipid pathway
Transporting of fats synthesized in the liver between the liver and the peripheral tissues
HYPERLIPIDEMIA
o Cholesterol/triglycerides are fats (also called a lipid) that your body needs to work
properly.
o Cholesterol/triglycerides levels that are too high can increase your chance of getting heart disease, stroke,
and other problems.
o The medical term for high blood cholesterol is lipid disorder, or hyperlipidemia.
LIPOPROTEINS
Five types of lipoproteins
Classified according to their protein content (protein weighs more than fats):
o Chylomicrons
o Very-low density lipoprotein (VLDL)
o Intermediate-density lipoprotein (IDL)
o Low-density lipoprotein (LDL) – is what contributes to the formation of atherosclerosis and hyperlipidemia.
o High density lipoprotein (HDL) Lipoproteins - HDL & LDL
High-density lipoprotein
o “Good cholesterol” synthesized by the liver
o Transports cholesterol back to the liver from the periphery
Low-density lipoprotein
o Called “Bad cholesterol” because main carrier of cholesterol to the peripheral blood vessels.
It can then contribute to atherosclerotic lesions.
LDL - Role in Atherosclerosis Pathogenesis of LDL
o Too much fats = saturation of liver = too much in blood
o Excess LDL binds to endothelial cells
Phagocytic macrophages have receptors that bind to LDL
o Macrophages will oxidize LDL
o Oxidized LDL by macrophages is key component of atherosclerosis
HYPERCHOLESTEREMIA
o Increased levels of cholesterol in the blood
o Diagnosis through blood lipid studies
o Fasting serum lipoprotein levels such as;
o total serum cholesterol (sum of LDL, HDL and VLDL), LDL, HDL, Triglycerides
Relationship between the different lipid fractions used as indicator for risk of CAD or atherosclerosis
related diseases.