动脉粥样硬化和冠心病.ppt

* * * * * * * * * * * * This is an acute renal infarction. Note the wedge shape of this zone of coagulative necrosis resulting from loss of blood supply with resultant tissue ischemia that produces the pale infarct. The small amount of blood supply from the capsule supplies the immediate subcortical zone. The remaining cortex is congested, as is the medulla. * Hemorrhages involving the basal ganglia area (the putamen in particular) tend to be non-traumatic and caused by hypertension, which damages and weakens the small penetrating arteries. A mass effect with midline shift, often with secondary edema, may lead to herniation. * This is a computed tomographic (CT) scan demonstrating a hypertensive hemorrhage in the right thalamus that has extended into the ventricular system. Hemorrhages in this location are not amenable to surgical intervention with removal of the blood. * The large hemorrhage in this adult brain arose in the basal ganglia region of a patient with hypertension. This is one cause for a stroke. * These three aortas demonstrate mild, moderate, and severe atherosclerosis from bottom to top. At the bottom, the mild atherosclerosis shows only scattered lipid plaques. The aorta in the middle shows many more larger plaques. The severe atherosclerosis in the aorta at the top shows extensive ulceration in the plaques. * Here is an example of an atherosclerotic aneurysm of the aorta in which a large bulge appears just above the aortic bifurcation.Such aneurysms are prone to rupture when they reach about 6 to 7 cm in size. They may be felt on physical examination as a pulsatile mass in the abdomen.Most such aneurysms are conveniently located below the renal arteries so that surgical resection can be performed with placement of a dacron graft. * At high magnification, the dark red thrombus is apparent in the lumen of the coronary. The yellow tan plaques of atheroma narrow this coronary significantly, and the thrombus occludes it completely * * * * * * * * *