PAEA Surgery End Of Rotation (EOR) Practice Exam

At which anatomical sites are arterial plaques commonly observed?

1. Distal arteries and capillaries

2. Branch points and tethered sites

3. Veins and small venules

4. Only the aorta

The correct answer is: Branch points and tethered sites

Arterial plaques are most commonly observed at branch points and tethered sites due to the unique hemodynamic conditions that exist in these areas. These locations typically experience turbulent blood flow, which can lead to endothelial injury and subsequent atherosclerosis. The shear stress at these sites is not uniform, creating an environment conducive to the development of plaques as lipids, inflammatory cells, and other materials accumulate in the arterial wall. Tethered sites, such as where arteries change direction or divide, are particularly prone to plaque formation because they are subject to disturbed flow patterns. The turbulence can cause damage to the endothelium, leading to the inflammatory responses that promote the development of atherosclerotic plaques. In contrast, distal arteries and capillaries do not typically show the same level of plaque accumulation, as the flow in these regions is more laminar and less prone to the disturbances that promote plaque formation. Veins and small venules are generally not sites for arterial plaque development, as atherosclerosis primarily affects arteries rather than veins. While the aorta can certainly develop plaques, it is not the only site where they can form, which makes the statement about the aorta too exclusive in comparison to the more commonly affected branch points and tethered