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CORE Anatomy > Cardiac anatomy > Flashcards

Cardiac anatomy Flashcards

1
Q

left coronary artery arises from:

A

left sinus of Valsalva near the sinotubular ridge

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2
Q

what is the difference between the septal branches and diagonal branches of the LAD?

A

septal branches quickly reach and penetrate the myocardium. the diagonal branches course laterally to the LV free wall

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3
Q

left main coronary artery branches into:

A

the left circumflex and LAD

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4
Q

what is the course of the LCx?

A

courses in the left AV groove, giving rise to obtuse marginal branches

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5
Q

what does the LCx supply?

A

LV free wall and a variable portion of the anterolateral papillary muscle

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6
Q

What is the ramus intermedius?

A

variant anatomy. in about 15% of people the left main trifurcates and the ramus intermedius courses laterally to supply the LV free wall

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7
Q

where does the RCA normally arise?

A

right coronary sinus

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8
Q

what is the “conus artery”

A

supplies the RVOT (conus arteriosis) and forms the circle of Vieussens - an anastomosis with the LAD circulation origin: 50-60% from RCA 30-40% directly from aorta

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9
Q

what i the circle of Vieussens?

A

anastomosis of RCA with LAD circulation. conus artery –> LAD

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10
Q

LCx branches

A

obtuse marginal

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11
Q

SA node artery supply:

A

60% of the time from RCA 40% from LCx

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12
Q

largest ventricular branch from RCA

A

acute marginal branch

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13
Q

what determines “dominance”

A

the coronary artery that gives rise to the posterior descending artery (PDA) determines dominance

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14
Q

% RCA is dominant

A

70%

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15
Q

proximal LAD

A

left main bifurcation to the first septal branch

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16
Q

average coronary artery diameter in men and women

A

men - 4mm women - 3mm

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17
Q

definition of a coronary artery aneurysm

A

1.5 times the diameter of an adjacent normal coronary artery

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18
Q

what is the Thebesian valve?

A

valve from coronary sinus to RA

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19
Q

what is the crista terminalis?

A

muscular ridge that separates the smooth muscle fibers of the posterior RA from the trabeculated muscle fibers anteriorly runs from entrance of SVC to IVC (will see this on sagittal)

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20
Q

what is the eustachian valve?

A

(also known as the “valve of the inferior vena cava”) is a ridge of variable thickness in the inferior right atrium. It is a remnant of a fetal structure that directed incoming oxygenated blood to the foramen ovale and away from the right atrium. Incomplete regression of this structure results in a thickened ridge at the IVC/RA junction, which can occasionally be thick enough to mimic thrombus or a right atrial mass on echocardiography, cardiac CT, or cardiac MRI.

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21
Q

what is the moderator band?

A

only in the RV (distinguishes RV from LV in congenital heart disease) muscular band extending from the interventricular septum to the base of the anterior papillary muscle. part of the right bundle branch conduction system

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22
Q

what variant pulmonary vein anatomy has a high association with atrial fibrillation

A

right middle PV

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23
Q
A

moderator band

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24
Q
A

fossa ovalis

this is spared in lipomatous hypertrophy

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25
Q
A

moderator band

26
Q
A

crista terminalis

27
Q
A

eustachian valve

28
Q
A

thesbian valve

29
Q
A

right atrial appendage

30
Q
A

crista terminalis

31
Q
A

right atrial appendage

32
Q
A

normal coronary sinus

33
Q
A

coronary sinus

34
Q
A

cor triatrium

35
Q
A

cor triatrium

36
Q
A

crista supraventricularis

The pulmonary valve has three cusps, and is separated from the tricuspid valve by a thick muscle known as the crista supraventricularis.

This differs from the left ventricular outflow tract, where the mitral and aortic valves lie side by side.

37
Q
A

left atrial appendage

38
Q
A
39
Q
A
40
Q
A
41
Q
A
42
Q

How many patients have a ramus intermedius?

A

In approximately 15% of patients, a third branch, the ramus intermedius (RI) branch, arises at the division of the LCA, resulting in a trifurcation (Fig 5) (4). When present, the RI branch courses laterally toward the LV free wall. Its course is similar to that of a diagonal branch of the LAD artery.

43
Q
A

Sinoatrial nodal branch

44
Q
A
45
Q
A
46
Q
A
47
Q
A
48
Q
A
49
Q

likely dominance?

A

Coronal MPR image shows a left-dominant system, with the RCA being smaller than normal

The RCA is typically diminutive compared with the LCx artery in patients with left-dominant systems

The LCA is dominant in approximately 10% of cases, supplying the entire LV, accompanied by the PDA and posterolateral branches from the LCx artery

50
Q

dominance?

A

co-dominant

VR image shows a codominant system, with the inferior myocardial surface supplied equally by the RCA and the LCx artery.

51
Q

dominance?

A

right dominant.

VR image shows the inferior surface of the heart. A right-dominant system is depicted, with the PDA (white arrowhead) arising from the RCA (black arrowhead). A posterolateral branch (arrow) is also seen.

52
Q
A

left ventricular papillary muscles

53
Q
A
54
Q
A
55
Q
A

vertical long axis MPR of the left atrial appendage

56
Q
A

Right top pulmonary vein (least common supernumerary pulmonary vein)

= Supernumerary pulmonary veins, also known as accessory pulmonary veins

most common supernumerary pulmonary vein is the right middle lobe vein

important to identify these for ablation and surgical planning

57
Q
A

normal pericardial recess. do not mistake this for a mass or lymph node

58
Q

this anomaly is associated with:

A

this is PAPVR, which is associated with a sinus venosus type ASD

59
Q
A

superior sinous venosis ASD

60
Q
A

CORE Anatomy (9 decks)

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