increases resistance to flow, turbulence --> DAMAGE

decrease in production of nitric oxide (a vasodilator by endothelium

hyperglycemia

glycosylation of endothelial cells, LDL, and hemoglobin

decreased blood vessel flexbility, destabilization of LDL, decreased oxygen carrying capacity of hemoglobin

insulin is alo a growth factor for smooth muscle cells (insulin levels are hard to control)

system involved in regulation of Na+ levels and blood pressure in the body

can be activated by tissue injury

angiotensin II is potent VASOCONSTRICTOR and stimulates smooth muscle cell growth

HYPERTROPHY

-vascular and ventricular remodeling

-causes migration of smooth muscle cells into intimal layer of blood vessel

-increases platelet aggregation and thrombosis

-triggers further inflammatory response

homocysteine is toxic to endothelial cells, is PROTHROMBIC, increases collagen production and reduces availiablity of nitric oxide

high levels due to high consumption of cysteine of methionine or deficiency in folate, B12 or B6

defect in production or function of LDL RECEPTTORS

poor LDL clearing

impaired lipoprotein uptake

apolipoprotein E, a main apoprotein of chylomicron (and VLDL) binds ot specific receptor on liver cells and peripheral cells

chylomicron remnants and VLDL remnants are NORMALLY removed fromt he circulation by recpcetor mediated endocytosis in the liver

if defective---> lipoprotein stays in circulation

the enzyme that removes fatty acids from lipoprotein particles in blood

-note: insulin and thyroxin neccassry for function of enzyme

maybe a reason why diabetics and hypothyroid patients have hyperlipidemia and atherosclerosis

as plaque grows, DAMAGe and DEATh in cells

deposition of CA2+ in plaque... less flexible plaque

tears, bleeding into wall of vessel

decreasing flexibility of plaque.. blood flow puts pressure on leading edge and causes turbulent flow.. tear or damage to plaque... deposition of platelets... platelet thrombosis.. potential occlusion of lumen

if clot dislodges.. embolism

regulate excretion of water and salt (Na+, Cl-, HCO3-) by kidney

produced in cortex of adrenal gland

ex. aldosterone

regulate carbs, protein, and lipid metabolism (ie. gluconeogenesis) and reduce inflammatory response and influence stress responses

produced in cortex of adrenal gland

ex. cortisol

progesterone, estrogens, androgens

regulate sexual development and function

reproduction

secreted by LH, FSH (by cAMP system)

sertoli cells

-increase production of inhibin (has negative feedback effect on anterior pituatary... decreases FSH secretion)

-conversion of testosterone to 17 beta estradiol (needed for spermatogenesis)

impaired adrenocortical function (disease or truama)

((remember that cortisol and aldosterone are synthesized in cortex of adrenal glan, they regulate glucose metabolism and salt excretion)

Symptoms (hypoglycemia, muscle weakness, Na+ loss, K+ retention, increased susceptibility to stress (fatal w/o treatment)

TREATMENT: administer GLUCOCORTICOIDS and MINERALCORTICOIDS

adrenocortical hyperfunction (caused by tumor of the adrenal cortex)

SYMPTOMS: edema (water retention), round or puffy face (moon face), increased fat aroudn the neck and upper part of the back (buffalo hump) enlarged waistline, HYPERGLYCEMIA

TREATMENT: if due to tumour... surgery

lack of progesterone 21 hydroxylase in adrenal cortex

-lack of aldosterone and corticosteroids

-corticosteroids are invloved in the feedback loop with ACTH, so corticosteroid production decreases and ACTH increases

adrenal glands undergo HYPERPLASIA and since they cant make aldosterone and cortisol... androgens produced

SYMPTOMS: virilization of fetus (feale child appears male)

male child undergoes precocious puberty (2-3 yrs)

TREATMENT: cortisol and aldosterone

in its inactive form ... it is converted to 1,25 dihydroxycholecalciferol which is a hormone that regulates Ca 2+ uptake in the intestine and Ca2+ levels in the bone and kidney

DEFICIENCY can lead to RICKETS in children--- defective bone growth

derivative of Vit A

acts through receptor proteins in cell nucleus to regulate gene expression in development of epithelial tissue, including skin