Manual of Surgery Volume First: General Surgery. Sixth Edition.Thomson, Alexis
Science
Manual of Surgery Volume First: General Surgery. Sixth Edition.
Thomson, Alexis
Surgery
#Arterio-sclerosis# or #Chronic Arteritis#.--These terms are applied to
certain changes which result in narrowing of the lumen and loss of
elasticity in the arteries. The condition may affect the whole vascular
system or may be confined to particular areas. In the smaller arteries
there is more or less uniform thickening of the tunica intima from
proliferation of the endothelium and increase in the connective tissue
in the elastic lamina--a form of obliterative endarteritis. The
narrowing of the vessels may be sufficient to determine gangrene in the
extremities. In course of time, particularly in the larger arteries,
this new tissue undergoes degeneration, at first of a fatty nature, but
progressing in the direction of calcification, and this is followed by
the deposit of lime salts in the young connective tissue and the
formation of calcareous plates or rings over a considerable area of the
vessel wall. To this stage in the process the term _atheroma_ is
applied. The endothelium over these plates often disappears, leaving
them exposed to the blood-stream.
Changes of a similar kind sometimes occur in the middle coat, the lime
salts being deposited among the muscle fibres in concentric rings.
The primary cause of arterio-sclerosis is not definitely known, but its
almost constant occurrence, to a greater or less degree, in the aged
suggests that it is of the nature of a senile degeneration. It is
favoured by anything which throws excessive strain on the vessel walls,
such as heavy muscular work; by chronic alcoholism and syphilis; or by
such general diseases as tend to raise the blood-pressure--for example,
chronic Bright's disease or gout. It occurs with greater frequency and
with greater severity in men than in women.
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