Stages of individual work in class Study and describe the macrospecimens
Arherosclerosis of the aorta. Pay attention to the thickness, relief, colour of the aortic intima, the condition of
the lumen, the elasticity of the vascular wall. Name visual manifestations of atherosclerosis.
Atherosclerotic aortic aneurysm with thrombus. Pay attention to the form of aneurysm, the condition of the intima of the adjacent parts. Name the causes of thrombogenesis and possible complications in this case.
Dissecting aortic aneurysm. What is the danger of this pathology? Name the mechanism of complications.
Atherocalcinosis of the aortic arch. How can we diagnose this pathology intravitally (during the patient's life)? Name the possible clinical signs.
Atherosclerosis of the arteries of the brain base. Pay attention to the thickness of the walls, condition of the lumen, winding pathways of vessels. What is the cause? Name the main clinical manifestations of these changes.
Stenosing atherosclerosis of the coronary artery with thrombosis, acute myocardial infarction complicated by development of acute mural aneurysm and its rupture. Pay attention to the condition of the myocardium in the infarction zone. What is the name of this disease and its lethal complications.
Chronic aneurysm of the heart with parietal thrombus. How can we call the basic disease? What are the causes and role of thrombogenesis in this case.
Gangrene of the foot. Pay attention to the color of the soft tissues. What is the cause of the gangrene and what is the cause of darkness of the soft tissues?
Study, draw and describe the slides
JNs 184 — necrotic stage of myocardial infarction (stained with hematoxylin and eosin). Pay attention to the structureless part nuclearless muscular fibers with rough basophilia of the
stroma and massive leukocytic infiltration. Name possible outcomes of these changes in the heart.
N° 185 — atherosclerosis of the coronary artery (stained according to Van-Gieson). Using low magnification find the plaque with lipoprotein detritus, covered with connective tissue in the center. Evaluate the state of the lumen. How is it connected with the clinical state of the patient?
N° 186 — aortic lipoidosis (stained with Sudan III). Pay attention to the infiltration of the intima with lipids. Find the accumulation of xantomatous cells.
Study the electronogram
Myocardial infarction, stage of ischemia, x 22 000. Pay attention to the rough swelling and vacuolisation of mitochondria with destruction of the crusts.
Test
1. Name the main types of atherosclerosis: a)..., b)..., c)...,d)...,e)...,f)...,g)...,h)....
2. Name all stages of atherosclerosis morphogenesis: a)...,b)...,c)...,d)...,e)...,f)...,g)....
3. Name the clinical periods (A)..., B)...) and stages of atherosclerosis: a)..., b)..., c)... .
4. Name the complications of aortic atherosclerosis: a)..., b)...,c)...,d)...,e)...,f)....
5. The patient aged 58, smoker for many years with 5-year history of angina pectoris died during the attack. The autopsy has demonstrated atherosclerosis of the coronary arteries, uneven color of anterior wall of the left ventricle and flabbiness of the myocardium. What is the diagnosis?
Answers: 1) a) atherosclerosis, b) arteriosclerosis, c) toxic, d) inflammatory, e) allergic, f) primary calcinosis of the artery tunic media, g) age-related. 2) a) pre-lipid stage, b) lipoidoses, c) liposclerosis, d) atheromatosis, e) ulceration (anabrosis), f) atherocalcinosis. 3) A: pre-clinic period, B: period of clinic manifestations; a) ischemic, b) necrotic, sclerotic. 4) a) thrombosis, b) thromboembolism, c) embolism with atheromatous masses, d) renal infarctions, e) gangrene of low extremities, intestine, f) aortic aneurysm. 5) acute IHD, ischemic stage of myocardial infarction.
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