Pathology
__________ __________________ is responsible for more morbidity andmortality
than any other category of human disease
Vascular pathology
Weakening of vessel walls leads to
dilation or rupture
stenosis
Narrowing or complete obstruction of vessel lumens
The general architecture and cellular composition of blood vessels (are/are not)
similar throughout the cardiovascular system
are
what do structural specilizations in the cardiovascular system reflect?
distinct functional roles characterize specific kinds of vessels
All vessels except capillaries share a three-layered architecture consisting of?
endothelium lined intima, a surrounding smooth muscle media, and supportive
adventitia, admixed with extracellular matrix.
Intima
endothelial cells, basal lamina, pericytes, subendothelial connective tissue, and the
internal elastic lamina; in the heart
Media
smooth muscle cells and elastic laminas including the external elastic lamina
Adventitia
collagenous connective tissue; in the heart called epicardium
what two factors influence the sequential differentiation of the blood vessels?
- Mechanical factors or hemodynamic forces (esp., blood pressure)
- metabolic factors or tissue requirements
veins are (low/high) pressure
low
arteries are (low/high) pressure
high
The smooth muscle cell and matrix content of arteries, veins, and capillaries vary
according to what?
hemodynamic demands (e.g., pressure, pulsatility) and functional requirements
The specific composition of the vessel wall at any given site within the vascular
tree influences what about pathologic injuries?
the nature and consequences
Vasculogenesis
De novo formation of blood vessels during embryogenesis
Angiogenesis
• The process of new vessel formation in the mature organism.
• Neovascularization
Arteriogenesis
Remodeling of existing arteries in response to chronic changes in pressure or flow.
Endothelial cells Inflammatory Response
, - capture and Rolling (E-selectin)
- Adhesion and Arrest 9ICAM-1, VCAM-1, PECAM-1)
- Diapedesis
Endothelial cells Vessel Remodeling (wall Growth, development and
differentiation)
- vasculogenesis
- angiogenesis
- arteriogenesis
Endothelial cells Barrier/Endocrine/Paracrine/Autocrine Functions
- solute flux & fluid permeability (barrier)
- EC derived NO, PGI2 (autocrine and paracrine)
- EC derivedd CNP and ET-1 (Endocrine)
Endothelial cells Regulation of Blood Homeostasis
- Blood homeostasis
- blood fluidity
- fibrinolysis (tPA, PAI-1)
what is critical for maintaining vessel wall homeostasis and circulatory function?
endothelial cells
what are the functions of endothelial cells?
- Maintenance of permeability barrier
- Elaboration of anticoagulant, antithrombotic, fibrinolytic regulators
- Elaboration of prothrombotic molecules
- Extracellular matrix production
- Modulation of blood flow and vascular reactivity
- Regulation of inflammation and immunity
- Regulation of cell growth
- Oxidation of LDL
what causes endothelial activation in vascular endothelial cells?
- Normotension
-Laminar flow
-Growth factors (e.g., VEGF)
-Cytokines
-Hypoxia, acidosis
what is the result of endothelial activation in vascular endothelial cells?
- Growth factors
- Vasoactive mediators
- Adhesion molecules
- Anti-coagulants
what causes endothelial dysfunction in vascular endothelial cells?
Turbulent flow, Hypertension, Cytokines, Complement, Bacterial products, Lipid
products, Advanced glycation end-products, Hypoxia, acidosis, Viruses, Cigarette
smoke
what is the result of endothelial dysfunction in vascular endothelial cells?
Growth factors, Chemokines, Cytokines, Pro-coagulants proteins, Adhesion molecules,
Vasoactive mediators
what is the predominant cellular element in the vascular media?