November 17, 2011 | POSTED BY | Clinical Pearls

Sheathing and widening of the vessel “light reflex” due to a deposition of hyaline and inflammatory cell debris within blood vessels walls.

This is a body mechanism to keep lumens of arteries constricted (reducing blood flow) so that capillary beds don’t explode. If you’re body can’t hold this increased pressure anymore you will leak out of your arteries (exudation) or have an out-pouched vessel (aneurysm) but still protect the capillary beds (preventing ischemia to tissues).

Chronic hypertension thickens the arterioles and narrows the lumen, giving the red reflection from the blood columns a shiny appearance (due to the increased light reflection). At first, the light reflection has a bronze sheen and is called “copper-wiring.” With continued hypertension, it develops a whitish glint and is called “silver-wiring”.

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