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Anatomy > Heart Vasculature and Innervation > Flashcards

Heart Vasculature and Innervation Flashcards

1
Q

what do the coronary arteries supply?

A

the myocardium and epicardium (visceral layer or the serous pericardium)

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2
Q

how many coronary arteries are there?

A

2, left and right

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3
Q

where do the right and left coronary arteries arise from?

A

the right and left aortic sinuses, respectively

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4
Q

right coronary artery (2)

A

right marginal artery

posterior inter ventricular artery (posterior descending artery)

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5
Q

posterior inter ventricular artery gives rise to the

A

AV nodal artery

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6
Q

left coronary artery

A

circumflex artery

anterior inter ventricular artery (left anterior descending artery or LAD)

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7
Q

the coronary arteries are — end arteries

A

functionally

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8
Q

end artery (terminal artery)

A

an artery that is the only supply of oxygenated blood to a portion of tissue

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9
Q

do end arteries anastomose with other arteries or arterial branches of the same artery?

A

no

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10
Q

why aren’t the branches of the coronary arteries true end arteries?

A

because numerous anastomoses take place between the left and right coronary arteries (inter coronary anastomoses) and between branches of the same artery (inter coronary anastomoses)

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11
Q

where do the coronary arteries send branches to heart muscle?

A

on either side of their path and to any portion of septum deep to their path

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12
Q

blood supply is easy to deduce with the exception of (2)

A

the SA and AV nodes

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13
Q

4 branches of the right coronary artery

A

SA nodal (60%)
right marginal
AV nodal
posterior interventricular

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14
Q

what does the RCA supply? (4)

A

right atrium
right ventricle
posterior 1/3 interventricular septum
SA and AV nodes

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15
Q

2 branches of the left coronary artery

A 
anterior interventricular (LAD (left anterior descending))
circumflex
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16
Q

anterior interventricular

A

diagonal branch

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17
Q

circumflex

A

left marginal

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18
Q

what does the LCA supply? (6)

A 
left atrium
left ventricle 
portion of right ventricle 
interventricular septum (ant, 2/3) 
AV node 
SA node in 40% of the population
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19
Q

circumflex (6)

A 
left atrium
lateral- left ventricle 
inferior- left ventricle (15%)
posterior-left ventricle 
SA node (40%)
AV node (10-15%)
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20
Q

where does the right coronary artery run?

A

the coronary sulcus

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21
Q

what does the SA nodal artery supply?

A

the SA node

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22
Q

what does the right marginal artery supply?

A

the right ventricle

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23
Q

does the right marginal artery reach the apex?

A

no

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24
Q

what is dominance of the coronary arterial system defined by?

A

the artery that gives rise to the posterior interventricular artery

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25
Q

dominance of the — — — is typical (67%)

A

right coronary artery

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26
Q

how does blood supply to the heart from the RCA and LCA compare?

A

they are about equal

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27
Q

how often does dominance of the left coronary artery occur?

A

about 15% of hearts

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28
Q

codominance

A

both the RCA and LCA give rise to branches that course in or near the posterior interventricular groove

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29
Q

how often does codominance occur?

A

about 18% of hearts

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30
Q

can you have only one coronary artery?

A

yes, a few people have only one coronary artery

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31
Q

what is coronary atherosclerosis?

A

lipid deposits in the intimate (lining) of coronary arteries

32
Q

treatment of. coronary artery disease (CAD)

A

surgical therapy with coronary revascularization

33
Q

surgical therapy: coronary revascularization with coronary artery bypass graft (CABG) surgery is recommended for patients who (2)

A

fail medical management

have left main coronary artery or three vessel disease

34
Q

treatments of CAD include (4)

A

lifestyle changes
medications
angioplasty
surgery

35
Q

myocardial infarction (MI)

A

suffer occlusion of a major artery (by an embolus)

36
Q

in MI, a region of the heart supplied by occluded vessels becomes infarcted, and becomes

A

necrotic

37
Q

infarcted

A

rendered bloodless

38
Q

necrosis

A

tissue death

39
Q

what is the most common cause of MI?

A

coronary artery insufficiency from atherosclerosis

40
Q

the heart is drained mainly by veins that empty into the

A

coronary sinus

41
Q

small anterior cardiac veins drain directly into the

A

right atrium

42
Q

the coronary sinus runs toward the right side of the heart and drains in the

A

right atrium

43
Q

what are the 5 cardiac veins?

A 
great cardiac v
middle cardiac v
small cardiac v 
anterior cardiac 
coronary sinus
44
Q

where is the SA node located?

A

in the wall of the right atrium near the opening of the superior vena cava and the superior end of the crista terminalis

45
Q

function of the SA node (2)

A

initiates cardiac muscle contraction and determines heart rate

46
Q

where is the AV node located?

A

in the intertribal septum just superior to the opening of the coronary sinus

47
Q

where does the AV bundle pass from?

A

the AV node in the membranous part of the interventricular septum

48
Q

what does the AV bundle divide into?

A

the right and left bundle branches

49
Q

function of the conducting system?

A

network of specialized tissue that stimulates contraction

50
Q

what does the conducting system contain?

A

modified cardiac myocytes

51
Q

the heart can contract with any

A

innervation

52
Q

where do purkinje fibers carry their signal?

A

into papillary muscles to coordinate their contraction with systole

53
Q

where are preganglionic sympathetic neuron cell bodies located?

A

in the lateral horns of the spinal cord segments T1-T5

54
Q

where are postganglionic cells located?

A

in the cervical and superior thoracic paravertebral ganglia

55
Q

the postsynaptic fibers are carried in to the

A

splanchnic nerves, contributing to the cardiac plexus and ending in the SA and AV nodes and in relation to the termination of parasympathetic fibers on the coronary arteries

56
Q

what is sympathetic innervation responsible for?

A

increase heart rate, impulse conduction, force of heart beat, and blood flow in coronary arteries

57
Q

what does the vagus nerve do

A

parasympathetic, decreases heart rate

58
Q

what do the sympathetic cardiac nerves do?

A

increase heart rate and force of contraction

59
Q

parasympathetic innervation is via

A

preganglionic fibers located in the vagus nerve

60
Q

what do presympathetic fibers contribute to?

A

the cardiac plexuses

61
Q

where are postganglionic cells of the parasympathetic system located?

A

in the cardiac tissue (atrial wall and intertribal septum near the SA and AV nodes and along coronary arteries)

62
Q

where do postsynaptic fibers end?

A

in the SA and AV nodes and directly on the coronary arteries

63
Q

what is parasympathetic stimulation is responsible for? (3)

A

decreasing heart rate, force of contraction, and contracting coronary arteries

64
Q

what do visceral pain pathways for the heart follow?

A

the path of the sympathetic backward

65
Q

visceral sensory pathways that participate in reflex actions that lower blood pressure and slow the heart rate are carried in the

A

vagus nerve (CN 10)

66
Q

the vagus nerve does not. transmit any visceral pain fibers originating in

A

the heart

67
Q

how many blood vessels are in the umbilical cord?

A

3

68
Q

ideally, the umbilical cord contains which 3 vessels?

A

2 umbilical arteries

1 umbilical vein

69
Q

what do the two umbilical arteries become?

A

the medial umbilical ligaments of the anterior abdominal wall

70
Q

the 2 umbilical arteries are branches of the internal iliac arteries which carry unoxygenated blood

A

away from the fetus

71
Q

what does the umbilical vein drain into

A

ivc and bypasses the liver the ductus venous which drains into the

72
Q

this vein carries oxygenated blood from the

A

placenta to fetus

73
Q

blood from the inferior vena cava flows into the right atrium, toward the

A

foramen ovale and into the left atrium

74
Q

this blood is ultimately circulated to the fetus’ (3)

A

head
neck
upper extremities

75
Q

blood from the superior vena cava flows into the right atrium, toward the

A

tricuspid valve and into the right ventricle and pulmonary trunk

76
Q

blood in the pulmonary trunk is shunted to the

A

aorta (distal to the brachiocephalic, L common carotid, and L subclavian branches) via the ductus arteriosus

77
Q

this blood is ultimately circulated to the fetus’ (4)

A

thorax, abdomen, pelvis, and lower extremities

Anatomy (29 decks)

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