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Blood Vessels

Vascular Disorders

1. Narrowing vessels Ischemia


Endothelial Cells

- Semipermeable: - transfer of small & large mol


- junction EC >: - BP
- Vasoact agent: Histamine

Vascular Smooth Muscle Cells

Functions: - Cons/ Dil


Arteriosclerosis: -> thick, inelastic

1. Atherosclerosis (athera = gruel / porride)


Atherosclerosis

- Intimal plaques (atheroma)

- Loc: aorta, a. cor, a. cer


Risk Factors

Age: 40-60: 5x incidence MI


Major Acq Risk Factors

Hyperlipidemia: Hypercholesterolemia
Hypertriglyceridemia VLDL
HDL exercice
smoking, obesity

HT: 160/95 > 5x 140/90

Smoking: 1 a 2 pack/day: several yrs death rate IHD: 200%


Role of Endothelial Injury

- Early lesion at intact end dysfunction & activation: important


- end permeability
Role of Lipid (hyperlipidemia/hyperchol)

- superoxide & oxy free rad nitric oxide


(endo relaxing fac) end gene expr
- lipopro acc within the intima (site: end permeability)
Role of macrophage
Role of smooth muscle proliferation
Progression of lesion

- fibrous cap
- fibrous plaque
Cell Injury, Adaptation, & Death
Pathologic Calcification

= Abn deposition of ca salt + Fe, Mg

- 2 forms: - metastatic: in vital tissues,


- disturbance of ca met hypercalc

- dystrophic: - locally in nonviable / dying tissue


Metastatic calcification

- In normal hypercalcemia exacerbates dystrophic calc

- 4 causes: - secr of parathyroid hormon tumor


- destruction of bone : - Paget dis
- immoblization
Dystrophic calcification

- In: - areas of necrosis (coagulative, caseous, liquefactive)


- foci of enzymatic necrosis of fat
- advanced atherosclerosis
- aging / damaged heart valves
Pathogenesis

- final: cryst ca phosphate mineral in form of an apatite

2 mayor phases: - initiation (nucleation)


- propagation

- Initiation of intracell calc in mitochondriaof dead / dying cells


Crystal formation depends on

- Concentration of Ca2+ & PO4


- Inhibitors & other protein in extracell space: matrix protein

1. Osteopontin: acidic ca-binding phosphoprot w. high affinity


to hydroxiapatit
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Complicated plaques
I

American Heart Association


Complications

Ulceration, thrombosis, intraplaque hemorrhage


Advice

* Cigarette smoking <


Hypertension: D > 90, S > 140 mm Hg

Risk fac: CHD, CVA, CHF, Aortic dis, Renal Failure


Course

- Benign: modest, stable ove years


Role of kidney: PR & Na homeostasis
Hyaline Arteriolosclerosis
E
C
Vasculitis
Polyarteritis Nodosa

- Medium to small a.
- Transmural acute necrotizing inflammation
Microscopic Poliangiitis (Poliarteritis)

- Necr vas, smaller ves than PAN


- >< PAN: all lesions: same age
Temporal (Giant Cell, Cranial) Ateritis
Takayasus Arteritis (Pulseless Dis)
Kawasakis Dis (Mucocutanoeus Lymph Node Synd)
Clinic
Raynaud Disease

- Paroxysmal pallor or cyanosis: - digit: hand, feet


Topik Sebelum Sekarang PA Ket

Ssd Anatomi,
PA-1 2 3 3 Histologi,
Fisiologi

PA-2 3 4 4

PA-3 4 4 5

PJ-1 4 4 5 Ssd PA-2



Nama Terkait dengan masalah kuliah dan praktikum Patologi yang
berkembang akhir-akhir ini, dan setelah saya pertimbangkan
denganmatangmakasaya
N.I.M.
1.Setuju,-kuliahPA-2ditempatkanpadaSemester-4
-kuliahPA-3danPraktikumPJ-1padaSemester5

TandaTangan
2.Setuju,ketiga(kuliahPA-2,PA-3danPraktikumPJ-1)di-
tempatkanpadaSemester-4

*PILIHsatu,diantarakeduanyadenganmelingkarinomor
Aneurysms & Dissection

= Loc, abn, dilatation blo ves most common: aorta, heart


Mac
Abdominal Aortic Aneurysms
Syphilis
Clinical
Aortic Dissection (Dissecting Hematoma)

Blood: laminar planes o/t media rupture massive hem


1.

Vein & Lymphatis


Varicose veins

Def: dilated, turtous

Cause
1. prolonged intraluminal pressure
Clinic

Venous stasis, conestion, edema, thrombosis


Superior Vena Cava Syndrome
Lymphangitis & Lymphedema
Primary lymphedema
Tumors

Spectrum: Benign hemangioma,


2. Cavernous Hemangioma

- arge, dilated vascular channels


3. Nodule
Hemangioendothelioma
Lymphangiosarcoma
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