1. Mechanisms of production of atheroma
Mechanisms of production of atheroma. A: Structure of normal muscular artery. The adventitia, or outermost layer of the artery, consists principally of recognizable fibroblasts intermixed with smooth muscle cells loosely arranged between bundles of collagen and surrounded by proteoglycans. It is usually separated from the media by a discontinuous sheet of elastic tissue, the external elastic lamina. B: Platelet aggregates, or microthrombi, form as a result of adherence of the platelets to the exposed subendothelial connective tissue. Platelets that adhere to the connective tissue release granules whose constituents may gain entry into the arterial wall. Platelet factors thus interact with plasma constituents in the artery wall and may stimulate events shown in the next illustration. C: Smooth muscle cells migrate from the media into the intima through fenestrae in the internal elastic lamina and actively multiply within the intima. Endothelial cells regenerate in an attempt to re-cover the exposed intima, which thickens rapidly owing to smooth muscle proliferation and formation of new connective tissue. (Redrawn, with permission, from Ross R et al. The pathogenesis of atherosclerosis. [Part 1.] N Engl J Med. 1976;295:369.)
Source: Cardiovascular Disorders: Heart Disease, Pathophysiology of Disease: An Introduction to Clinical Medicine, 7e
Citation: Hammer GD, McPhee SJ. Pathophysiology of Disease: An Introduction to Clinical Medicine, 7e; 2013 Available at: Accessed: October 15, 2017
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