Cardiovascular

and Lymphoid
Systems

Kelompok 4

March
2024
 Ischemia, Infarction, and Necrosis in Arteriosclerosis
Arteriosclerosis =
Arteries carrying oxygen become clogged
and damaged, causing lack of oxygen
supply and tissue damage
Causing :
• Coronary artery disease (CAD) - a
buildup of plaque inside a coronary artery
• Peripheral artery disease (PAD) -
narrowing of the arteries in the legs, arms or
pelvis
• Carotid artery disease (CAD) -
narrowing of the carotid arteries, which carry
blood to the head and aorta
• Aortic aneurysm - an abnormal
enlargement in the aorta (the body’s largest
blood vessel)
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Ischemia, Infarction, and Necrosis in Arteriosclerosis

Location :
• Coronary artery disease (CAD) - a
buildup of plaque inside a coronary artery
• Peripheral artery disease (PAD) -
narrowing of the arteries in the legs, arms or
pelvis
• Carotid artery disease (CAD) -
narrowing of the carotid arteries, which carry
blood to the head and aorta
• Aortic aneurysm - an abnormal
enlargement in the aorta (the body’s largest
blood vessel)

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Ischemia, Infarction, and Necrosis in Arteriosclerosis

Ischemia =
Diminished blood flow to a
tissue, a common cause of
acute cell injury underlying
human disease

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 Ischemia, Infarction, and Necrosis in Arteriosclerosis

Infarct = Factors that influence

Area of ischemic necrosis caused by
occlusion of the vascular supply
infarct development:
• Anatomy of the vascular supply.
• Rate of occlusion.
• Tissue vulnerability to ischemia.
• Hypoxemia.

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Ischemia, Infarction, and Necrosis in Arteriosclerosis

Necrosis =
cell death that is associated with
loss of membrane integrity and
leakage of cellular contents →
dissolution of cells, resulting from
the degradative action of enzymes
on lethally injured cells

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Incompetent Valves in Varicose
Vein

● Veins = Blood vessels that carry low-

oxygen blood back to the right atrium.
● Low venous pressure ➝ vein walls are
thinner
● Venous valves ➝ muscle contraction ➝
squeeze the blood ➝ blood flow towards
the heart ➝ blood pulled downward by
gravity ➝ valves prevent backflows

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Incompetent Valves in Varicose
Vein

● Deep veins and superficial veins are connected by

perforator vessels ➝ allow blood flow from the
superficial veins to the deep veins ➝ not vice
versa
● Incompetent perforator vessel valves ➝ blood
flows back into the superficial veins ➝ overload
➝ enlargement and swelling of the superficial
veins ➝ varicose veins
● Varicose veins ➝ enlarged veins diameter ➝
worsen

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Lymphagenous Cancer Spread

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 Lymphagenous Cancer Spread

• Lymphogenous -> most

common route
• Physicians must know
the drainage
(forward/backward)

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 Lymphangitis, Lymphadenitis, and Lymphedema

Lymphangitis Lymphadenitis Lymphedema

Acute inflammation of lymphatic vessels due to bacterial Lymph node enlargement due to Swelling due to blocked lymph fluid
infection commonly ß hemolytic streptococci infection Primary : Congenital defect
Red streak Secondary : Cancer, radiation, surgery, Filariasis
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HOMEWORK

Kelompok 4

March
2024
Differences Between Arteries and Veins
List of Valveless Veins
• Brachiocephalic veins
• Dural venous sinuses
• Portal venous system
• Superior vena cava (SVC)
• Inferior vena cava (IVC)
• Thebesian veins
• Vertebral venous plexuses
• Common iliac veins
• External iliac veins
Source : Bell D, Valveless vein. Reference article, Radiopaedia.org (Accessed on 06 Mar 2024) https://doi.org/10.53347/rID-73032 14
Impact of Jugular Vein Valve Function on Cerebral Venous Haemodynamics

• Unlike veins in other parts of the body, cerebral veins do not have valves.
Thus, bidirectional flow is possible in cerebral veins
• The IJV valve functions as a buffer that can prevent sustained retrograde
transmitted venous blood and pressure into the cranium.
1. Inferior petrosal sinus
2. Pharyngeal veins
3. Common facial vein
4. Lingual vein
5. Superior thyroid vein
6. Kocher vein
7. Occipital vein
8. Thoracic duct (left)
9. lymphatic duct (right)
Anastomosis of Facial Vein
Cerebral
Venous
Anatomy
Cerebral
Venous
Anatomy
Differences Between Ischemia, Infarction and Necrosis
Terminology
• Ischemia Reduction of blood supply to an area of the heart and may be gradual complete or sudden
incomplete. Gradual complete ischaemia leads to degenerative changes, namely atrophy and fibrosis, and
this is the phenomenon that we as pathologists recognize as ischaemic fibrosis. Sudden incomplete
ischaemia usually results in necrosis but this tends to be patchy and although an area of infarction may be
produced it is more likely to be a multifocal necrosis not showing the necessary localization to fall within
the definition of an infarct.

• Infarction May be defined as a localized area of necrosis resulting from some form of circulatory
insufficiency. For most purposes an infarct occurs when a vessel is acutely occluded and, therefore, rt is
unusual to find an area of infarction where no acute vascular occlusion can be discovered. However, there
are now several reports in the literature of infarction in the absence of coronary thrombosis , and associated
with prolonged coronary artery spasm

• Necrosis The death of a tissue occurring in a living body and it is irre- versible. Microscopically the
changes will be recognized by evidence of coag- ulative change affecting the myofibrils in the cytoplasm of
the cell and there will be degenerative changes occurring in the nucleus. Under the electron microscope
some of the earliest changes are swelling of the cell, swelling of the mitochondria with distortion of the
cristae and peripheral clumping of nuclear chromatin
Ferris J, Friesen J. Definitions Of Ischemia, Infarction and Necrosis. Forensic science International. 1979;13:253-259.
Lymph nodes dissection in cancer
Lymph nodes are often dissected in cancer patients for several reasons:
1.Staging : determine the staging
2.Treatment Planning : if cancer has spread to nearby lymph nodes, more aggressive
treatment may be recommended (additional surgery, radiation therapy, or systemic
treatments like chemotherapy)
3.Prognosis : cancer that has spread to lymph nodes generally has a higher risk of
recurrence and may be associated with a poorer prognosis.
4.Monitoring Response to Treatment: assess the effectiveness of cancer treatment. If
cancer cells are still present in the dissected nodes after treatment, adjustments to the
treatment plan may be necessary.
5.Research and Clinical Trials
6.Prevent spreading to to other distant organs
ADD A FOOTER 22
 Sources
• Szuba, Andrzej & Shin, William & Strauss, H & Rockson, Stanley. (2003). The third circulation: Radionuclide
lymphoscintigraphy in the evaluation of lymphedema. Journal of nuclear medicine : official publication,
Society of Nuclear Medicine. 44. 43-57.
• Mohseni, S., Shojaiefard, A., Khorgami, Z., Alinejad, S., Ghorbani, A., & Ghafouri, A. (2014). Peripheral
lymphadenopathy: approach and diagnostic tools. Iranian journal of medical sciences, 39(2 Suppl), 158–170.
• Clinically Oriented Anatomy, Moore, 8ed, page 164-182
• Greenberg, M.S., 2023. Handbook Of Neurosurgery 10th Edition, New York: Thieme.
• Ferris J, Friesen J. Definitions Of Ischemia, Infarction and Necrosis. Forensic science International.
1979;13:253-259.
• Bell D, Valveless vein. Reference article, Radiopaedia.org (Accessed on 06 Mar 2024)
https://doi.org/10.53347/rID-73032

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THANK YOU 24