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B Vascular Disorders uni malaya prof.pdf
- 1. Vascular Disorders Assoc ProfDr Azura Mansor Dept of Orthopaedic Surgery University of Malaya
- 2. Outline • Normal Vessels •Response to injury • Atherosclerosis • Hypertensive • Aneurysms & Dissection • Vasculitis • Venous Disesases
- 3. 3 types ofblood vessels 1. Artery 2. Vein 3. Capillary
- 4. Function General • Deliver oxygenand nutrients • Carry waste products • Part of maintaining blood pressure Specific • Artery: Carry oxygen rich blood AWAY from the heart. High pressure. • Capillary: Exchange place for gaseous, nutrients, waste and fluid. • Veins: Collect blood for RETURN to the heart. Low pressure.
- 5. Response to injury GeneralResponse: 1) Endothelial cells: loss or dysfunction 2) Smooth muscle cells: Proliferate 3) Intimal thickening 2° Extra cellular matrix synthesis
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- 7. Atherosclerosis A disease ofthe arteries characterized by the deposition of plaques of fatty material on their inner walls
- 8. Development of atherosclerosis •The key event – damage to the endothelium caused by excess of lipoproteins, hypertension, diabetes, components of cigarette smoke. • Endothelium becomes more permeable to lipoproteins. • Lipoproteins move below the endothelial layer (to intima). • Endothelium loses its cell-repelent quality. • Inflammatory cells move into the vascular wall.
- 9. Pathogenesis of atherosclerosis •You Tube VideosPathogenesis of Atherosclerosis.mp4
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- 11. Morphological changes thatare seen on macro and microscopic levels in atherosclerosis • Neovascularization (formation of new blood vessels) • Calcification • Hemorrhage • Fissure • Ulcer • Thrombosis • Cholesterol microemboli • Aneurysmal dilatation
- 12. Clinical Complications • Narrowing/Occlusion: • Stroke • Myocardial Infarction • Mesenteric Occulsion • Peripheral Vascular Disease • Weakening of Wall: • Aneurysm • Emboli: • Gangrene
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- 14. Classification • Primary (Essential)Hypertension • No clear cause. • Risk factors: • Old age • Obesity • Salt-heavy diet • Sedentary Lifestyle • Secondary Hypertension: • Renal • Endocrine • Nervous System
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- 17. Clinical complications ofhypertension
- 18. Aneurysm Aneurysm: Permanent, localizedand abnormal dilatation of blood vessels.
- 19. Classification of Aneurysm •Wall: • True • False (pseudo) • Shape: • Spherical • Fusiform • Cylindrical • Varicose/ tortuous • Pathogenetic: • Atherosclerosis • Syphilitic • Mycotic • Berry • Dissecting
- 21. Laplace’s Law: (T= pr x r)
- 22. Complications of Aneurysm •Rupture • Thrombosis • Embolism • Infection • Distal arterial occlusion • Pressure Effects: • Oesophagus: Dysphagia • Stomach: Erosion/ haematemesis • Nerve: Pain, paresthesia • Veins: Oedema • Bone: Erosion
- 23. Dissecting Aneurysm Dissection: Tearin vessel wall resulting in separation of vessel layers.
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- 27. Vasculitis Inflammation of theblood vessels
- 28. Causes • 1. Immunehypersensitivity • 2. Direct Invasion of Micro-organism
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- 34. Varicose Veins • Definition: •veins that have become distended over time. Long, tortuous and dilated veins of the superficial varicose system due to the pooling of blood in the lower extremities.
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- 36. In the leg InitialStage Chronic Venous Insufficiency
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- 39. Other Vascular Disorders Congenital •Berry Aneurysm • Arteriovenous Fistula • Fibromuscular Dysplasia Tumours
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- 41. Acknowledgement • Robbins: BasicPathology • Saunders Books • You Tube Interactive channels