NURSING 2PF3 Study Guide - Final Guide: Hypertension, Amrinone, Intravenous Therapy
19 Apr 2018
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Document Summary
Atherosclerotic lesions tend to form where vessels branch or in areas of turbulent flow hemodynamic factors play a role in causing injury. When the endothelium is injured, or when ldl levels are high, the monocytes become sticky and attach themselves to the endothelium in response to expression of adhesion molecules. The endothelium loses its ability to produce antithrombotic and vasodilating cytokines. Endothelial injury can be caused by: ht, smoking, hyperlipidemia, hyperhomocystinemia, hemodynamic factors, toxins, viruses, and immune reactions. Ldl moves through intact endothelium and are oxidized into proinflammatory lipids. Foam cells release growth factors and inflammatory cytokines that worsen endothelial injury and progress atherogenesis. Early response to injury or elevated ldl"s: monocytes move into the intimal layer of the endothelium squeezing through cell junctions: monocyte emigration. Once past the endothelial layer and into the subendothelial space the monocytes are transformed into macrophages and free radicals are released.
