NURSING 3PA2 Study Guide - Final Guide: Central Venous Pressure, Adrenergic, Digoxin
23 Apr 2017
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Document Summary
Endothelium is smooth with tight junctions between cells. It can be injured due to factors such as smoking, mechanical stress due to htn, elevated ldl levels or mechanisms of the immune system. Endothelium suffers an injury or high cholesterol levels monocytes become sticky and attach themselves to the endothelium in response to expression of adhesion molecules. The endothelium then loses some of its ability to produce antithrombotic and vasodilating cytokines. Endothelial injury monocytes move into intimal layer of endothelium, squeezing through cell junctions. Monocytes are then transformed into macrophages and free radicals are released. Macrophages consume any oxidized ldls that are present, transitioning them into foam cells. Foam cells release growth factors and inflammatory cytokines that worsen endothelial injury. Ldls make their way through the intact endothelium and are oxidized into proinflammatory lipids. Oxidized ldls serve as an attractant to monocytes in the endothelium, causing further migration of monocytes into the subendothelium.
