B4.074 Prework 1: Coronary Arteries

Question 1

origin of RCA

Answer 1

right aortic sinus

Question 2

distribution of RCA

Answer 2

RA, SA and AV nodes, posterior portion of IV septum

Question 3

origin of right marginal

Answer 3

RCA

Question 4

distribution of right marginal

Answer 4

RV and apex

Question 5

origin of posterior descending

Answer 5

RCA

Question 6

distribution of posterior descending

Answer 6

RV, LV and IV septum

Question 7

origin of LCA

Answer 7

left aortic sinus

Question 8

distribution of LCA

Answer 8

LA, LV, IV septum, AV bundle

Question 9

origin of LAD

Answer 9

LCA

Question 10

distribution of LAD

Answer 10

RV, LV, IV septum

Question 11

origin of circumflex

Answer 11

LCA

Question 12

distribution of circumflex

Answer 12

LA, LV

Question 13

lateral diagonal branch

Answer 13

off LAD

supply LV

Question 14

origin of left marginal

Answer 14

circumflex

Question 15

distribution of left marginal

Answer 15

L border of LV

Question 16

septal branches

Answer 16

off LAD or posterior descending

serve IV septum

Question 17

ramus intermedius

Answer 17

3rd branch off of LCA

between LAD and circumflex

Question 18

right dominant distribution

Answer 18

80% of pop

posterior descending arises from RCA

Question 19

left dominant distribution

Answer 19

10% of pop

posterior descending arises from circumflex

Question 20

balanced distribution

Answer 20

10% of pop

both RCA and LCA supply posterior descending

Question 21

RCA supplies:

Answer 21

RA
most of RV
diaphragmatic surface of LV
posterior 1/3 of IV septum
SA node in 60% of people
AV node in 80% of people

Question 22

what are right sided blockages associated with

Answer 22

abnormal pacing

right sided heart failure

Question 23

LCA supplies:

Answer 23

LA
most of LV
anterior 2/3 of IV septum
SA node in 40% of people
AV node in 20% of people

Question 24

what are left sided blockages associated with

Answer 24

poor CO

pulm edema

Question 25

most common places for occulsion

Answer 25

1. LAD
2. proximal PCA
3. circumflex
4. LCA

Question 26

what might right sided heart failure patients benefit from that is not typically given w a heart attack

Answer 26

fluids

pacemaker placement

Question 27

when do you do functional stress testing

Answer 27

symptomatic stable CAD

Question 28

stress echocardiography

Answer 28

looks at cardiac wall movement
indirect indication of blood flow
lack of wall movement = lack of adequate blood flow to that region of the heart

Question 29

stress-cardiac MRI

Answer 29

recommended in intermediate to high risk patients
in presence of preceding discordant or a non interpretable stress test
yields perfusion and wall movement

Question 30

coronary artery calcium scoring

Answer 30

quantification of calcium in coronary arteries
marker for atherosclerosis
risk stratify asymptomatic patients

Question 31

treatment for coronary artery occlusion

Answer 31

diet, exercise
pharm
balloon angioplasty
PCI
CABG

Question 32

describe a PCI

Answer 32

catheter threaded through femoral or radial artery to aortic root
guide wire is inserted into coronary artery and advanced past the area of stenosis

Question 33

describe a CABG

Answer 33

distal end of left internal thoracic (mammary) artery is attached to coronary artery, distal to the blockage
additional arteries/veins commonly used: right internal mammary, radial, gastroepiploic, great saphenous vein (one side to aorta, one distal of blockage)