Coronary vessels, nerves and Pericardium Flashcards
Describe the path of the right coronary artery and its branches
- Long artery which extends down the right anterior and travels to the posterior to become the posterior interventricular artery
- Gives off marginal artery on the anterior
Where do the right and left coronary arteries originate from?
-The right and left aortic sinuses
Describe the path of the left coronary artery and its branches
-The left coronary artery is short as it branches early dividing into the circumflex artery and the left anterior descending (anterior interventricular artery)
What nerve lays most lateral to the heart and is anterior to the pericardium?
-Phrenic nerves (left and right)
What nerve lies directly at either side of the trachea?
-Recurrent pharangeal nerves (left and right)
Recurrent pharangeal nerves branch off…
-the vagus nerve
What structure does the left recurrent pharangeal nerve loop around?
-The aorta
What structure does the right recurrent pharangeal nerve loop around?
-Right subclavian artery
Which nerve lies posterior to the heart and passes through the diaphragm to supply the gut?
-The left and right vagus nerves
What happens to the phrenic nerves?
-They merge with the diaphragm
What does the arch of the aorta branch into?
- Brachiocephalic trunk
- Left common carotid
- Left subclavian
What does the brachiocephalic trunk branch into?
- Right common carotid
- Right subclavian
What does the right coronary artery become on the posterior of the heart?
-Posterior interventricular artery
What two veins are on the anterior of the heart?
- Anterior cardiac vein
- Great cardiac vein
What is the function of the pulmonary arteries?
-Carry deoxygenated blood from the RV to the lungs
What is the function of the pulmonary veins?
-Carry oxygenated blood from the lungs to the LA
What are the flaps called on the atria?
-Right and left auricles
What veins lie on the posterior of the heart?
- Left marginal vein
- Left posterior interventricular vein
- Middle cardiac vein
- Small cardiac vein
What do all the coronary veins drain into?
-Coronary sinus
Whee does the coronary sinus drain into?
-Right atrium
What drains into the right atrium?
- Superior vena cava
- Inferior vena cava
- Coronary sinus
- Small tributary veins
What is the first branch off the superior vena cava?
-Left brachiocephalic vein
What is he pericardium?
-Fibrous sac which encloses the heart and the roots of the great vessels
What are the main functions of the pericardium?
- Protection from infection
- Prevent overfilling and excessive movement
- Lubrication
What are the two layers of the pericardium?
- Fibous
- Serous
Which layer of the pericardium is the outermost layer?
-Fibrous
Describe the fibrous pericardial layer
- Tough and strong
- Blends with sternum and diaphragm
- Fuses with tunica adventitia of great vessels
What cell type makes up the serous layer of the pericardium?
-Mesothelium
How thick is the serous layer of the pericardium?
-1 cell thick
What are the two layers of the serous layer of the pericardium?
- Parietal
- Visceral
Where is the parietal layer of pericardium?
-Lining the fibrous layer
Are the parietal and visceral layers of the serous pericardium connected?
-Yes they are continuous, the serous membrane is reflected by the roots and viscera
Where is the visceral layer of pericardium?
-Closely applied to the heart
What is another name for the visceral layer of serous pericardium?
-Epicardium
What is the pericardial cavity?
-The space between the two layers of the serous pericardium
What is the purpose of the pericardial cavity?
-Filled with pericardial fluid to promote friction free movement
What is a pericardial effusion?
-Increase in fluid within the pericardial cavity
When can a pericardial effusion be less dangerous?
-When the build up of fluid has been gradual so the heart has been able to compensate
When is a pericardial effusion most dangerous?
-When the build up of fluid is sudden as it can lead to cardiac tamponade
What is cardiac tamponade?
- Build up of fluid or blood around the heart within the pericardial sac
- Causes compression of heart which leads to inadequate filling and inadequate pumping
What are the potential outcomes of cardiac tamponade?
- Heart failure
- Drop in blood pressure
- Cardiac arrest
What are the classical diagnostic features of a cardiac tamponade?
Beck’s triad
- Dilated neck veins
- Fall in blood pressure
- Muffled heart sounds
Where does the right coronary artery serve?
-Right anterior surface
What does the posterior interventricular artery serve?
- Posterior ventricles
- Septum
- AVN
How can the left coronary artery be identified on a prosection?
-Passes between the pulmonary trunk and the left auricle
What do the left coronary artery and its branches serve?
- Left atrium
- Left ventricle
- Septum
What happens to the anterior interventricular artery?
-Continues to the apex of the heart where it travels to the posterior and anastomoses with the posterior interventricular artery
What is meant by left handed-dominance when talking about coronary arteries?
-The posterior interventricular artery arises from the circumflex artery of the left coronary artery
What is meant by co-dominance when discussing coronary arteries?
-Both the left and the right coronary arteries contribute to the posterior interventricular artery
