Coronary Circulation & innervation of the heart Flashcards

1
Q

what groove encircles the heart and separates the atria and ventricles?

A

atrioventricular groove

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2
Q

what are the components that form the interventricular groove?

A

anterior and posterior

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3
Q

where do arteries of the heart lie? what does it enable to do?

A

• Arteries lie on the external surface of the heart along the grooves which also enables to separate the chambers

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4
Q

what are the main arteries of the heart?

A

right/left coronary a

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5
Q

Where does the R coronary A travel?

A

Travels within the atrioventricular valve on the right side of the heart

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6
Q

what branches generally arise from the RCA?

A

marginal A
posterior interventricular A
sinoatrial nodal A

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7
Q

What A. travels along the margin of the right ventricle

A

marginal A

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8
Q

how does the posterior interventricular A travel?

A

curls around the back and dives 90 degrees into the interventricular groove (posterior)

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9
Q

Where does the L coronary A travel?

A

Travels within the atrioventricular groove on the left side of the heart

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10
Q

what branches does the LCA give rise to?

A

anterior ventricular A

circumflex A

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11
Q

where does the anterior ventricular A travel?

A

travels within the interventricular groove

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12
Q

relative to the heart, how is the circumflex A positioned?

A

it wraps around the back and does down to travel in the atrioventricular groove to the posterior surface of the heart

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13
Q

where do the main A. of the heart originate from?

A

ascending aorta

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14
Q

where do the main A. of the heart branch off of?

A

• They branch directly on the openings of the aortic valves found within the aortic sinuses

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15
Q

what acts as a valve to open and close the orifice of the coronary A?

A

cusps of the aortic valve

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16
Q

what happens when the aortic valve is open?

A

the coronary opening is closed

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17
Q

what are the different types of vascular variations of the heart?

A
  • right dominant equal
  • right dominant unequal
  • left dominant unequal
  • single coronary supply
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18
Q

which dominancy is seen is the majority of the population

A

right dominance

equal

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19
Q

how is vascular dominancy defined?

A

defined by which main coronary A gives rise to the posterior interventricular A

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20
Q

during right dominant unequal vascularity, which side supplies the majority of the blood?

A

right side

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21
Q

what is a coronary bypass used for?

A

Treatment for blockage of coronary A.

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22
Q

what procedure can be used during coronary bypass?

A

venous or arterial grafts

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23
Q

what does a venous graft involve?

A

o Venous grafts involve taking a vein and bypassing blocked A by grafting it directly to the aorta

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24
Q

what vein is generally taken for bypass surgery?

A

greater saphenous vein from ankle

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25
Q

what are some disadvantages of venous grafts?

A

grafted above the valves causes for the vein to be under constant hight pressures thus more prone to damage

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26
Q

what A. are generally used for Arterial grafts?

A

internal thoracic A

radial A from anatomical snuff box

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27
Q

why can the internal thoracic A be used for grafts?

A

because the thoracic wall is completed anastomosed by the anterior and posterior vessels hence its removal will not block circulation

28
Q

which method of grafting is preferred? why?

A

Arterial

more rigid than veins

29
Q

what are the 3 main veins responsible of the venous drainage of the heart?

A
  • greater
  • middle
  • small cardiac veins
30
Q

where does the Great cardiac vein travel? with what A?

A

travels in the anterior interventricular groove along with the anterior interventricular A.

31
Q

where does the middle cardiac vein travel? with what A?

A

travels in the posterior interventricular groove with the posterior interventricular A

32
Q

where does the small cardiac vein travel? with what A?

A

travels along the margin of the right ventricle with the marginal A.

33
Q

what do the cardiac veins drain into?

A

coronary sinus

34
Q

where is the coronary sinus found?

A

on the posterior surface of the heart in the atrioventricular groove

35
Q

into what is the blood from the coronary sinus emptied into?

A

in the RA

36
Q

what are the components of the aorta?

A

ascending
descending
arch

37
Q

what does the aorta loop around?

A

the left pulmonary A, V & the left primary bronchus

38
Q

what does the descending aorta travel along?

A

posterior to the the left pulmonary A, V & the left primary bronchus

39
Q

what branches arise from the branch of the aorta?

A

Brachiocephalic trunk A
Left common carotid A.
Left subclavian A

40
Q

what are the branches of the brachiocephalic trunk?

A

Right Subclavian A

Right common carotid A

41
Q

what forms the SVC

A

formed by the convergence both brachiocephalic veins which are formed on either side by the convergence of the
Subclavian V
Internal jugular V

42
Q

what vein drains blood from the UL?

A

subclavian

43
Q

what vein drains blood from the head and neck?

A

Internal jugular V

44
Q

where is the SA node located

A

in the atria, generally in RA

45
Q

what is the SA more prone to when located in the LA?

A

pinching due to its location behind the aorta

46
Q

what happens when the SA is stimulated?

A

atrial contraction

47
Q

what allows the SA node to travel and stimulate the AV node?

A

internodal branch

48
Q

what does the AV node pass its stimulus to via what?

A

muscles of the ventricles via the bundle of HIS

49
Q

where is the bundle of HIS located?

A

interventricular septum

50
Q

what does the bundle of his split into?

A

right/left bundle branches

51
Q

where do the right/left bundle branches go to?

A

they descend through the interventricular spetum and give branches to the walls and the papillary muscles of the ventricles

52
Q

what is the name of the branches that the right/left bundle branches give out to?

A

purkinje fibers

53
Q

what type of innervation does the heart receive?

A

ANS

54
Q

what type of innervation causes for increased heart rate?

A

sympathetic

55
Q

what spinal segments are involved if the heart receive sympathetic innervation?

A

T2-T4

56
Q

what forms the thoracic cardiacnerves

A

Information that exits the paravertebral ganglia of the sympathetic chain

57
Q

what gives rise to the cervical cardiac nerves

A

Some information ascends through the sympathetic chain to the cervical ganglia (superior, middle, inferior)

58
Q

what NS causes for a decreased HR?

A

parasympathetic NS

59
Q

what nerve innervate the parasympathetic NS?

A

vagus nerves

60
Q

how is the cardiac plexus formed?

A

Combination of parasympathetic/sympathetic NS together

61
Q

what happens for pain to be referred?

A

Visceral and somatic afferents travel along the same pathway as the CNS.
Along the way, info from the viscera is misinterpreted as if it came from a somatic area

62
Q

where is pain referred to during heart attacks?

A

neck and left UL

63
Q

what is the function of a pacemaker?

A

regulates HR

64
Q

where can the leads of the pacemaker be inserted?

A

inserted through subclavian or brachiocephalic veins

65
Q

how are the leads of pace makers generally placed?

A

it will vary between

  • Single atrial/ventricular
  • Atrial & ventricular leads
  • Biventricular leads