1. Ch 13.6: Blood Vessels 13.7: Athrosclerosis and Cardiac Arrhythmias
Transportation
Respiratory gases, nutrients, and wastes
Regulation
Hormonal and temperature
Protection
Clotting and immunity

2. SLOs Compare the structure and function of arteries and veins
Explain venous return and what happens when valves become incompetent
Explain Angiogenesis and why understanting of it is relevant to medicine
Review the structures and functions of different types of capillaries
Describe how atherosclerosis develops and how it contribute to disease and death

3. Blood Vessel Structure Review
Exchange Takes Place in the Capillaries
Compare to Figs & 27

4. Clinical Application: Aneurism
Arteries
Vasoconstriction and Vasodilation influence resistance
Clinical Application: Aneurism
Weakening of arterial walls  Risk: May lead to _______________________
Causes?
Where is this?

5. Clinical Application cont.
Cerebral aneurisms that rupture lead to _________________________

6. Capillaries Capillary types Tight leaky
Diameter of these smallest blood vessels: ____________
Structure?
Function?
Regulation of Blood flow to capillaries:
Vasoconstriction and vasodilation of arterioles
Precapillary sphincters
Capillary types
Tight leaky
Skin
Muscle
Lung
CNS
Exocrine glands
Kidneys
GI tract
Liver
Spleen BM

8. Clinical Application: Angiogenesis
Growth of new blood vessels – occurs during
Normal body maturation and growth
Monthly re-growth of functional endometrium
Wound healing
Endurance training
Cancer growth
Macular Degeneration
Clinical implications: Promote or inhibit angiogenesis with relevant cytokines

9. Veins Most of the total blood volume is in veins
Lower pressure (2 mmHg compared to 100 mmHg average arterial pressure)
Thinner walls than arteries, larger lumen; collapse when cut
help return blood to heart
Compare to Fig 13-29

10. Clinical Application: Varicose Veins
Other vein pathologies: Deep vein thrombosis, leading to thrombo____________

11. Atherosclerosis
Most common form of arteriosclerosis (hardening of the arteries) Contributes to 50% of deaths due to MI and stroke Plaque form in response to damage to endothelium of blood vessel. Caused by smoking, high blood pressure, diabetes, high cholesterol

13. Steps of Atherosclerosis
LDLs vs. HDLs People who consume or produce a lot of cholesterol have more LDLs When endothelial cells engulf LDLs, they become oxidized LDLs that damage the endothelium Macrophages ingests LDL-cholesterol just under intima  Foam cells Macrophage paracrines cause smooth muscle cell proliferation  Fatty streaks  Plaques Cap of connective tissue covers layers of smooth muscle, lipids, and cellular debris.

15. Atherosclerosis is Inflammatory Process
C-reactive protein (CRP): Produced by liver, increased in the presence of inflammation
Blood tests can detect elevated C-reactive protein levels  considered non-specific “marker” for disease
C-reactive protein is better predictor for athero- sclerosis than LDL levels
Atherosclerosis is promoted by inflammation, Many cytokines and other paracrine regulators are involved

16. Inflammation converts stable plaques to vulnerable plaques Cerebral and coronary thrombi and emboli  ? Plaques can also weaken artery walls  ?
Fig 13-31

17. Cardiovascular Disease (CVD)
Not in book!
Cardiovascular Disease (CVD)
 1/2 of deaths in US – most common: CAD or CHD
Uncontrollable vs. controllable risk factors
Gender, age, genetics
Cigarette smoking, obesity,
Both: DM, high BP, high cholesterol

18. Cigarette Smoking Not in book!
Nicotinic cholinergic receptors stimulate sympathetic neurons where?
Vasoconstriction  BP ?  Risk for atherosclerosis 
Carbon monoxide (myocardium extracts most of O2 brought to it under resting conditions)

19. Ischemic Heart Disease
Ischemia means? Atherosclerosis most common cause Associated with increased production of lactic acid and resulting pain  angina pectoris (= type of ________ _____) Consequence of sustained ischemia? Nitroglycerin produces vasodilation

20. Detecting Ischemia
Depression of the S-T segment of an electrocardiogram
Plasma concentration of blood enzymes
CPK – 3-6 hours, return to normal in 3 days
LD – hours, elevated about 11 days
Troponin I – today’s most sensitive test

21. Heart Arrhythmias Detected by ECG see lab!
The End