Disorders of Arterial

Circulation
Pathophysiology 2020-2021
Ms. Cres P. Quinzon RN MAN
OBJECTIVE
S
1 3
Describe the Differentiate
etiology and between a true
pathogenesis of and false
hyperlipidemia aneurysm.
2
Describe the
etiology and
pathogenesis of
artherosclerosis
OBJECTIVE
S
4
Differentiate
berry and
saccular 5
aneurysms
Describe the
etiology and
pathogenesis of
aortic,
abdominal and
dissecting
aneurysms
Hyperlipidemia

isan excess of lipids in the blood

Lipids are classified as triglycerides or
neutral fat, phospholipids, and
cholesterol.
 Hyperlipidemia

1. Triglycerides
are fatty acids that are used
in energy metabolism.

2.Phospholipids are important structural

constituents of lipoproteins, blood clotting
components, the myelin sheath, and cell
membranes.
 Hyperlipidemia

3.Cholesterol, its chemical and physical

activity is similar to that of other lipid
substances.
Hyperlipidemia

Etiology and Pathogenesis

Serum cholesterol levels may be

elevated as a result of an increase in
any of the lipoproteins—the
chylomicrons, VLDL, IDL, LDL, or
HDL
 Hyperlipidemia

 Etiology and Pathogensis: cont

 Nutrition
 Genetics
 Medications (beta-blockers, estrogens and protease
inhibitors)
 Comorbid conditions (additional disorders occurring
with the primary disease)
 Metabolic diseases ( diabetes, hyper/hypothyroidism)
 Hyperlipidemia

 Etiology and Pathogenesis (cont)

 Hypercholesterolemia (hyperlipoproteinemia) can be
classified as :

 Primary hypercholesterolemia describes elevated

cholesterol levels that develop independent of other
health problems or lifestyle behaviors
 Secondary hypercholesterolemia is associated with
other health problems and behaviors.
 Hyperlipidemia

Primary hypercholesterolemia Secondary

(Familial Hypercholesterolemia- FH)
hypercholesterolemia
ETIOLOGY and Pathogenesis
genetic basis (lack of LDL • obesity with high-calorie intake,
receptors, defective LDL diabetes mellitus, hypothyroidism,
nephrotic syndrome and obstructive
receptors, or defects in the liver disease;
handling of cholesterol in the • Medications such as beta-blockers,
cell) estrogens, and protease inhibitors
(used in the treatment of human
immunodeficiency virus [HIV]
Primary Hyperlipidemia Pathogenesis

Gene mutation for the LDL

receptors (mostly found in the liver)

LDL receptors in the blood

blood cholesterol levels in the

blood are markedly elevated
Secondary Hyperlipidemia Pathogenesis

increase the production of

High calorie diets, Diabetes VLDL
Mellitus (hyperliporoteinemia) and
triglycerides

Suppress LDL
receptor activity
Let’s Challenge Ourselves:

TRUE or FALSE:

Thetype of cholesterol
most harmful to health is
HDL.
Let’s Challenge Ourselves:

LDL is removed from the

circulation by
___________
Atherosclerosis
 Atherosclerosis

 Atherosclerosis is a type of arteriosclerosis

( hardening of the arteries )

 formation of fibrofatty lesions in the intimal lining

of the large- and medium-sized arteries such as the
aorta and its branches, the coronary arteries, and the
large vessels that supply the brain, thereby,
obstructing blood flow.
 Atherosclerosis

 Etiology and Risk Factors:

Hypercholesterolemia, increasing age, family
history of premature CHD, male sex, cigarette
smoking, obesity and visceral fat, hypertension,
diabetes mellitus, cigarette smoking, hypertension
 The role of inflammation in the etiology of
atherosclerosis has emerged over the last few years.
 Atherosclerosis

 Etiology and Risk Factors: cont

 Non-traditional Risk Factors:
 C-reactiveprotein (CRP)- serum marker for systemic
inflammation
 Homocysteine- an amino acid in animal protein
 Associated with endothelial damage
 Infectious Agents- (e.g., Chlamydia pneumoniae, herpesvirus,
cytomegalovirus)
The organisms may play a role in atherosclerotic
development and initiating and enhancing the
inflammatory response
 Atherosclerosis

 Pathogenesis
 The lesions associated with atherosclerosis
are of three types :
- fatty streak
- fibrous atheromatous plaque,
- complicated lesion
Atherosclerosis
Lesions Associated with Atherosclerosis

• thin, flat, yellow intimal discolorations that progressively enlarge by becoming thicker
and slightly elevated as they grow in length.
Fatty • consist of macrophages that have become distended with lipid to form foam cells.
Streaks

• gray to pearly white appearance due to the macrophages that ingest

Fibrous and oxidize accumulated lipoproteins and form a visible fatty steak
atheromatous
plaque

• contain hemorrhage, ulceration, and scar tissue deposits.

Complicated
lesions
Atherosclerosis
Lesions Associated with Atherosclerosis

Fatty streaks
Atherosclerosis
Lesions Associated with Atherosclerosis
Atherosclerosis
Lesions Associated with Atherosclerosis
Let’s Challenge Ourselves:

What is this?

C-Reactive protein, homocysteine

levels, infectious agents
Let’s Challenge Ourselves:

Describe the progression of

lesions in atherosclerosis.
 Aneurysm

 An aneurysm is an abnormal
localized dilation of a blood
vessel.

 Aneurysms can occur in arteries

and veins, but they are most
common in the aorta.
Aneurysm

 Classification of Aneurysm:
 according to their cause, location,
and anatomic features
Aneurysm

 Etiology: weakness of the vessel

wall caused by:

 congenital defects,
 trauma,
 infections, and
 atherosclerosis
Aneurysm
True Aneurysm False Aneurysm
• aneurysm is • or pseudoaneurysm
bounded by a presence of a
complete vessel localized tear in the
inner wall of the
wall artery with formation
of a hematoma that
• blood remains causes vessel
within the vascular enlargement
compartment
Aneurysm
Aneurysm
 TRUE ANEURYSM

Berry aneurysm Saccular aneurysm

true aneurysm that consists of a true aneurysm that extends over

small, spherical dilation of the part of the circumference of the
vessel at a bifurcation. (circle of vessel and appears saclike.
Willis)
 Aortic Aneurysm

 may involve any part of the aorta—the

ascending aorta, descending aorta,
thoracoabdominal aorta, or abdominal
aorta.

 Multiple aneurysms may be present.

m
ys
eur
An
rtic
Ao
Ascending aorta

Descending aorta

Thoracic aorta
 Etiology and Pathogenesis
Abdominal Aortic Aneurysm
• Located below the kidney
• most common causes of aortic
aneurysm- Atherosclerosis,
degeneration of the vessel
• Degeneration of the vessel
media
• Hypertension, more in men,
after 50 years
• Smoking
Aortic Dissection (dissecting
aneurysm)
• hemorrhage and tearing anywhere in
the aorta and its branches into the
vessel wall to form a blood-filled
channel
• is an acute, life threatening
condition
• 40-60 years age group, men
• Hypertension
• Pregnancy
• Congenital defects of aorta
(structural)
• Potential complication of cardiac
surgery and catheterization
Aortic Dissection Aneurysm
Let’s Challenge Ourselves:

What are these:

 Varicose veins

 Chronic venous insufficiency

 Venous thrombosis
Let’s Challenge Ourselves:

Abnormal localized dilatation of an

artery due to a weakness in the vessel
wall.
Let’s Challenge Ourselves:

Most often found in the circle of Willis

in the brain
THANK
YOU