Coronary Arteries, Great Vessels, and Posterior Mediastinum (Part 4) Flashcards
Arise from the ascending aorta and are filled with blood during the ventricular diastole.
Coronary Arteries
When is coronary artery usually filled with blood?
During ventricular diastolic phase
When does heart have minimal blood flow?
during systole
Why is there minimal blood flow during systole?
because of compression of the arterial branches in the myocardium
When does the heart relaxes hence the maximum blood flow?
During ventricular diastolic
Arises from the anterior (right) aortic sinus of the ascending aorta, runs between the root of the pulmonary trunk and the right auricle, and then descends in the right coronary sulcus, and generally supplies the right atrium and ventricle
Right Coronary Artery
Passes between the right atrium and the root of the ascending aorta, encircles the base of the SVC, and supplies the SA node and the right atrium.
SA Nodal Artery
Runs along the inferior border toward the apex and supplies the inferior margin of the right ventricle.
Marginal Artery
Arises opposite the origin of its posterior IV artery and supplies the AV node.
AV Nodal Artery
Is a larger terminal branch and supplies a part of the IV septum and left ventricle and the AV node.
Posterior IV (Posterior Descending) Artery
Arises from the left aortic sinus of the ascending aorta, just above the aortic semilunar valve.
Left Coronary Artery
Is shorter than the right coronary artery and usually is distributed to more of the myocardium.
Left Coronary Artery
Generally supplies anterior aspects of the right and left ventricles and is the chief source of blood to the IV septum and the apex.
Anterior IV (Left Anterior Descending) Artery
Runs in the coronary sulcus, gives off the left marginal artery, supplies the left atrium and left ventricle, and anastomoses with the terminal branch of the right coronary artery.
Circumflex Artery
Is the largest vein draining the heart and lies in the coronary sulcus, which separates the atria from the ventricles.
Coronary Sinus
Opens into the right atrium between the opening of the IVC and the AV opening.
Coronary Sinus
Has a one-cusp valve at the right margin of its aperture.
Coronary Sinus
Receives the great, middle, and small cardiac veins; the oblique vein of the left atrium; and the posterior vein of the left ventricle.
Coronary Sinus
Begins at the apex of the heart and ascends along with the IV branch of the left coronary artery.
Great Cardiac Vein
together with LADA, this is also located in anterior interventricular groove
Great Cardiac Vein
Turns to the left to lie in the coronary sulcus and continues as the coronary sinus.
Great Cardiac Vein
Begins at the apex of the heart and ascends in the posterior IV groove, accompanying the posterior IV branch of the right coronary artery, draining to the coronary sulcus
Middle Cardiac Vein
Runs along the right margin of the heart in company with the marginal artery and then posteriorly in the coronary sulcus to end in the right end of the coronary sinus.
Small Cardiac Vein
Descends to empty into the coronary sinus, near its left end.
Oblique Vein of the Left Atrium
Drains the anterior right ventricle, crosses the coronary groove, and ends directly in the right atrium.
Anterior Cardiac Vein
What other structures drain into the right atrium?
SVC, IVC, Anterior Cardiac Vein, Coronary sinus
Begin in the wall of the heart and empty directly into its chambers.
Smallest Cardiac Veins (Venae Cordis Minimae)
Receive lymph from the myocardium and epicardium.
Lymphatic Vessels of the Heart
Where does right coronary artery empty?
anterior mediastinal nodes
Where does left coronary artery empty?
tracheobronchial node
Receives the superior, middle, and inferior cervical and thoracic cardiac nerves from the sympathetic trunks and vagus nerves
Cardiac Plexus
Division of cardiac plexus which lies beneath the arch of the aorta in front of the pulmonary artery
superficial cardiac plexus
Division of cardiac plexus which lies posterior to the arch of the aorta in front of the bifurcation of the trachea.
deep cardiac plexus
the right sympathetic and parasympathetic branches terminate chiefly in the region of the?
SA node
the left sympathetic and parasympathetic branches end chiefly in the region of the?
AV node
What are devoid in the cardiac muscle fibers and are activated by the conducting system?
motor endings
Supplies the heart with sympathetic fibers, which increase the heart rate and the force of the heartbeat and cause dilation of the coronary arteries, and parasympathetic fibers, which decrease the heart rate and constrict the coronary arteries.
Cardiac Plexus
Takes its origin from the left ventricle within the pericardial sac and ascends behind the sternum to end at the level of the sternal angle.
Ascending Aorta
Lies in the middle mediastinum, has three aortic sinuses located immediately above the cusps of the aortic valve, and gives off the right and left coronary artery.
Ascending Aorta
Found within the superior mediastinum, begins as a continuation of the ascending aorta, and arches over the right pulmonary artery and the left main bronchus.
Arch of the Aorta
Forms a prominence that is visible on the radiograph as the aortic knob.
Arch of the Aorta
Gives rise to the brachiocephalic, left common carotid, and left subclavian arteries.
Arch of the Aorta
Formed by the union of the right and left brachiocephalic veins and returns blood from all structures superior to the diaphragm, except the lungs and heart.
Superior Vena Cava
Descends on the right side of the ascending aorta, receives the azygos vein, and enters the right atrium.
Superior Vena Cava
What are the tributaries of SVC?
right and left brachiocephalic veins
azygos vein
Where is the upper half and lower half of SVC located?
up: superior mediastinum
down: middle mediastinum
Arises from the conus arteriosus of the right ventricle, passes obliquely upward and backward across the origin and on the left side of the ascending aorta within the fibrous pericardium, and bifurcates into the right and left pulmonary arteries in the concavity of the aortic arch.
Pulmonary Trunk
a sac formed by dilation of the aortic arch that compresses the left recurrent laryngeal nerve
Aneurysm of the aortic arch
is an inheritable disorder of connective tissue that affects the skeleton (causing long limbs), eyes (dislocated lens), lungs (pneumothorax), and heart and blood vessels (aortic root dilation, aortic aneurysm, aortic regurgitation, and mitral valve prolapse).
Marfan syndrome
It may be treated with B-blocker medications that reduce aortic root dilation
Marfan syndrome
a muscular tube (approximately 10 in. long) that extends from the pharynx to the stomach, descending behind the trachea.
Esophagus
What are the three constrictions of esophagus?
upper or pharyngoesophageal constriction
middle or thoracic constriction
inferior or diaphragmatic constriction
At what level is upper or pharyngoesophageal constriction?
cricoid cartilage (C6) (lumen narrows)
What causes upper or pharyngoesophageal constriction?
cricopharyngeus muscle
it is crossed by the aortic arch and then left main bronchus
middle or thoracic constriction
Where is inferior or diaphragmatic constriction?
at the esophageal hiatus of the diaphragm (T10).
Esophagus has a physiologic sphincter, which is the circular layer of smooth muscle at the gastroesophageal junction. What is it called?
inferior esophageal sphincter
Where does esophagus receive blood?
inferior thyroid artery in the neck
Receives blood from the inferior thyroid artery in the neck and branches of the aorta (bronchial and esophageal arteries) and from the left gastric and left inferior phrenic arteries in the thorax.
Esophagus
is a condition of impaired esophageal contractions because of failure of relaxation of the inferior esophageal sphincter, resulting from degeneration of myenteric (Auerbach) plexus (parasympathetic nerves) in the esophagus.
Achalasia of esophagus
is a systemic collagen vascular disease and has clinical features of dysphagia for solids and liquids, severe heartburn, and esophageal stricture
Systemic sclerosis (scleroderma)
Where does thoracic aorta begin?
T4 vertebra
Where will thoracic aorta pass to become abdominal aorta?
aortic hiatus of the diaphragm
What thoracic level will thoracic aorta pierce the diaphragm?
T12
It descends on the left side of the vertebral column and then approaches the median plane to end in front of the vertebral column by passing through the aortic hiatus of the diaphragm.
Thoracic Aorta
What does Thoracic Aorta give rise to?
nine pairs of posterior intercostal arteries
one pair of subcostal arteries
Also gives rise to pericardial, bronchial (one right and two left), esophageal, mediastinal, and superior phrenic branches
Thoracic Aorta
- Congenital condition wherein the arch of aorta is constricted
Coarctation of the aorta
Where is blood pressure higher and lower in Coarctation of the aorta?
higher in upper extremity
lower in lower extremity
Where will blood go in Coarctation of the aorta to go to lower extremities?
Blood will go to anastomosing areas (posterior intercostal artery) to connect to descending aorta
Where does posterior intercostal arteries arise?
1st and 2nd from superior intercostal artery of costovertical trunk of 2nd part of subclavian artery
lower 9 arteries from descending aorta
Where does subcostal artery arise?
from the descending aorta
Is formed by the union of the right ascending lumbar and right subcostal veins. Its lower end is connected to the IVC.
Azygos (Unpaired) Vein
Arches over the root of the right lung and empties into the SVC, of which it is the first tributary
Azygos (Unpaired) Vein
Receives the right intercostal veins, the right superior intercostal vein, and the hemiazygos and accessory hemiazygos veins.
Azygos (Unpaired) Vein
How does Azygos (Unpaired) Vein enter the thorax?
through the aortic opening of the diaphragm
Is formed by the union of the left subcostal and ascending lumbar veins. Its lower end is connected to the left renal vein.
Hemiazygos Vein
What does Hemiazygos Vein
receive?
9th, 10th, and 11th posterior intercostal veins.
Begins at the fourth or fifth intercostal space; descends, receiving the fourth or fifth to eighth intercostal veins; turns to the right; passes behind the aorta; and terminates in the azygos vein.
Accessory Hemiazygos Vein
Is formed by a union of the second, third, and fourth posterior intercostal veins and drains into the azygos vein on the right and the brachiocephalic vein on the left.
Superior Intercostal Vein
The second, third, and often the fourth intercostal veins join to form the?
Superior Intercostal Vein
Where does the first intercostal vein on each side drains into?
into the corresponding brachiocephalic vein
Begins in the abdomen at the cisterna chyli, which is the dilated junction of the intestinal, lumbar, and descending intercostal trunks.
Thoracic Duct
usually beaded because of its numerous valves and often forms double or triple ducts.
Thoracic Duct
Drains the lower limbs, pelvis, abdomen, left thorax, left upper limb, and left side of the head and neck.
Thoracic Duct
Passes through the aortic opening of the diaphragm and ascends through the posterior mediastinum between the aorta and the azygos vein.
Thoracic Duct
Where does thoracic duct drain?
into the junction of the left internal jugular and subclavian veins
Drains the right sides of the thorax, upper limb, head, and neck.
Right Lymphatic Duct
Where does Right Lymphatic Duct drain into?
into the junction of the right internal jugular and subclavian veins
What is the diaphragmatic opening at T8-T9?
Caval opening?
What structures are found in Caval opening?
IVC, and some branches of right phrenic nerve
What is the diaphragmatic opening at T10?
Esophageal hiatus
What structures are found in Esophageal hiatus?
Esophagus
Anterior and posterior vagal trunks
Small esophageal arteries
What is the diaphragmatic opening at T12?
Aortic hiatus
What structures are found in Aortic hiatus?
Aorta
Azygos vein
Thoracic duct
