Anatomy: Central Chest Pain Flashcards
What sympathetic nerves supply the heart and the lungs?
cardiopulmonary splanchnic nerves
At what spinal level do sympathetic nerves leave supplying the thorax leave the spine?
thoracolumbar, T1-L3
Cranial Nerve X, (CN X)?
vagus nerve
It supplies parasympathetic innervation of the thorax.
What is the action of the vagus nerve on the heart?
Vagal tone - background action potentials which continually slow the heart rate down.
Effects of the cardiopulmonary splanchnic nerve?
Carries sympathetic efferents, which innervate the SA and myocardium, increasing heart rate and contractility.
Two sources of (chest) pain?
Somatic (muscle, joints, bones, pericardium, nerve)
Visceral (heart, vessels, trachea, oesophagus)
What is referred pain?
It is felt only at a site remote from that being damaged.
What region of the cerebral cortex receives the APs from somatic /body wall sensations (somatosensory)?
the poscentral gyrus of the parietal lobe
Where in the cerebral cortex do somatosensor APs that stimulate contraction of skeletal muscle originate?
The precentral gyrus of the frontal lobe
What are the sources of sharp / somatic central chest pain?
- Muscle, joint and bone
- Parietal pleura and fibrous pericardium
- herpes zoster (if shingles develop in the T4/5 dermatome)
Sources of visceral / dull central chest pain?
trachea aorta oesophagus heart abdominal viscerae
Describe radiating pain?
If originating in the heart, pain radiates to the dermatome entering the spinal cord at the same level.
Visceral radiating pain is dull, aching and poorly localised.
What are the most commonly occluded coronary arteries?
- LAD artery
- Right coronary artery
- Circumflex (branch of LCA)
- left coronary artery
What are commonly used grafts for CABG?
radial artery
great saphenous vein
internal thoracic artery
Blood supply of the SA node?
From a branch of the Right Coronary Artery
