4. Neurovasculature of Heart Flashcards
Identify the various grooves and neurovasculature structures.
atrioventricular groove: between atrium and ventricles
interventricular groove: between ventricule
coronary arteries run w cardiac veins which start anterior and run posterior (travels along atrioventricular groove)
What can be found in the aortic valve?
aortic valve have sinus in their valve cusps: aortic sinus (space) in which there are openings for coronary arteries
- when valve opens: coronary arteries close to prevent the high pressure from exploding the arteries
- when valve closes: due to (-) P, pulls blood into coronary ateries
Describe the right coronary artery and its branches.
right coronary artery divides into: posterior interventricular a (post) and right marginal a (ant)
identify the 2 structures.
top arrow: right coronary artery
bottom: right marginal artery (because anterior view)
Identify the various structures.
top arrow: right coronary artery
middle arrow: right marginal artery
bottom arrow: posterior interventricular a
Describe the left coronary artery and its branches.
left coronary artery (more post, originates posterior of pulmonary trunk): divides into
- left marginal artery (on left more post side of heart)
- anterior interventricular a (runs anterior)
- continues as circumflex a (runs more post and to the left)
What are the various anastomosis of the heart (arteries)
anterior and posterior interventricular arteries
circumflex a and posterior interventricular a
Identify the various structures.
A: Left coronary artery
B: circumflex a
C: left marginal a
D: anterior interventricular a
Explain coronary dominance. (4) What determines dominance?
What determines dominance is which coronary artery gives off the posterior interventricular artery.
- normal: right dominant (right coronary artery gives off posterior interventricular a => equal sharing of blood on left and right side => if blockage on left heart, only impacts left side of heart.
- Very left dominant: all arteries come from left coronary artery
- left dominant
- right dominant
What is a myocardial infarction? What are the solution? Which solution is preferred? Why?
myocardial infarction: blocked lumen of an arterial branch of coronary arteries
solutions:
- coronary venous bypass: taking great saphenous vein and connect it from past the blockage to aorta
- coronary artery bypass using the internal thoracic a
coronary a bypass is preferred due to arteries being able to handle the P whilst a vein cannot
normal
Explain the cardiac vein and its branches.
- small cardiac v (post, atriovent groove)
- middle cardiac v (post, intervent groove)
- great cardiac v (anterior torwards left)
1,2,3 drain into coronary sinus which then drains into right atrium
EXCEPT: anterior cardiac v (ant) dumps directly into right atrium
Identify each artery each vein runs with.
small cardia v + right coronary a
middle cardiac v + posterior interventricular a
great cardiac v + anterior interventricular a + circumflex a
What four neurovascular structure drain back into the right atrium?
SVC, IVC, coronary sinus and anterior cardiac v
Identify all the great vessels of the heart.
- veinous blood:
left subclavian v (from arm) + left jugular v (from head and neck) -> left brachiocephalic v + right brachiocephalic v (@veinous angle) + azygous v + SVC
- O2 blood:
ascending aorta -> arch of aorta (@ venous angle) -> descending aorta (@ venous angle)
arch of aorta -> left carotid a
- > left subclavian a
- > brachiocephalic trunk -> right subclavian a + right carotid a
What occurs at the veinous angle? (4)
- Trachea bifricate
- pulmonary trunk divides
- ascending => arch => descending aorta
- azygous v +aorta arch are over the bronchi
d
Describe the electrical current of the heart.
Identify the structure. (arrow)
SINOATRIAL nodal artery: can come from either the left or right coronary artery (most commonly the first branch off of the right coronary artery to supply blood to the SA node which wraps around SVC)
(if comes off from the left: goes behind aorta and svc)
Identify this structure and its function.
Moderator band = septomarginal band
- found only in the right ventricule bc the right ventricule is thinner than the left ventricule
- connects from the septum the anterior wall of the heart and carries the perkinje fibers from the base of the anterior wall to the papillary muscles => speeds signals in the right ventricule and ensure timing of heart beat (left is thicker => more space for fibers giving it a shorter distance)
When the ventricule contracts, what muscle mainly contracts?
the myocardium (papilarry muscles will contract to prevent prolapse)
Describe the innervation of the heart.
Why does the sympathetic innervation of the heart ascends to join the cervical ganglia to only redescend down to the heart?
embryology: heart starts forming in the pharyngeal areas then starts to lower as fetus grows
Describe the cardiac plexus and its components.
autonomic and consists of the parasympathetic and sympathetic nervous system
What is a pacemaker and its function?
battery w leads that go into the subclavian or brachiocephalic vein which joinds into the SVC which go to our nodes to stimulate the heart and ensure it beats
Explain why referred heart pain may occur.
if you have a blockage in the right coronary artery (infarction), it sends a pain signal via the visceral afferent which then travels through the posterior root and rootles (same as somatic sensory does) to our brain
=> looking at T2 dermatome: pain in higher chest area, armpit
D) both a and c are right
pain in left cervical region
- cannot be b) bc cannot be intercostal pleural space as that is inn by the intercostal nerves
- may be a) and c) bc diaphragmatic surface is inn by phrenic n (C3,C4,C5) and myocardial space can be referred anywhere in the upper chest armpit region
