Lecture 6: Angiology Flashcards
What is the ascending aorta?
Ascending aorta comes off of the L ventricle and is the origin of our coronary arteries.
Ascending aorta splits into what?
- Left coronary artery 2. Right coronary artery`
Branches of the R coronary artery
- Sinuatrial nodal A 2. Conus branch of the right coronary A. 3. Atrial branch of the right coronary A. 4. Right marginal A. —Loops around to the back in the atrioventricular groove, stopping at the posterior interventricular groove 5. Posterior interventricular A. 6. Right posterolateral A. 6. Atrioventricular nodal A.
Conus branch of the right coronary artery supplies blood to what?
Conus arteriosus
Atrial branch of the right coronary A supplies blood to what?
RIGHT atrium
Atrioventricular nodal A supplies blood to what?
AV node
Where does the psoterior interventricular artery travel?
Posterior aspect of the heart. Between the R and L ventricles.
What does the right posterolateral A supply?
L ventricle
What are the branches of the L coronary artery and what do they supply blood to?
- Circumflex A. Gives rise to:
- L marginal A
- Posterior left ventricular A–> [left ventricle]
- Anterior interventricular A. –> [atrioventricular bundle as it passes through the interventricular septum]
- Diagonal A
- Conus branch of the L coronary A. [conus arteriosus]
What does the posterior interventricular artery give rise to?
Septal arteries, which go into the septum and supply the atrioventricular bundle (bundle of Hiss)
What gives rise to more septal arteries: Anterior interventricular A of the LCA or posterior interventricular A of the RCA?
Anterior interventricular A of the LCA
What is more damaging to the conducing system of the heart?
L or R coronary artery?
Left.
Because Anterior interventricular A of the LCA gives rise to more septal arteries that go to the septum and supply the atrioventricular bundle (bundle of Hiss)
What is a coronary angioplasty?
Stick a balloon inside a coronary artery and inflate it. It flattens the plaque against the wall, increasing the size of the lumen and making blood flow better.
What comes off of the arch of the aorta?
BCS
- Brachiocephalic trunk
- Left common carotid a.
- Left subclavian a.
Important branch of the subclavian A
1. Internal thoracic A.
A. Pericardiacophrenic A–> [Pericardium* and thoracic diaphragm]
B. Anterior intercostal A,
C. Superior epigastric A–> [rectus abdominis]
D. Musculophrenic A–> laterally: 7-9th costal cartliages and intercostal space
What is the medial and lateral terminal branch of the internal thoracic A.
Medial- superior epigastric A [rectus abdominus m.]
Lateral- musculophrenic A [[7-9th costal cartliages and intercostal space]
What does the brachiocephalic trunk branch into?
- R common carotid A
- R subclavian A.
What runs with the phrenic nerve?
Pericardiacophrenic A.
What supplies our mammary glands?
- Internal thoracic artery send perforating branches that become our medial mammary A.
- Lateral thoracic A of the axillary A branches into the lateral mammary A.
What are the branches of the axillary artery?
- Superior thoracic A.
- Lateral thoracic A.
What are the three types of branches that come off of the descending thoracic aorta?
- Unpaired visceral branches –> go to an organ, but unpaired
- Paired lateral visceral branches- go to pairs to a organ
- Paired segmental parietal branches (posterior intercostal A)- all correstpond to a single vertebrae.
Unpaired visceral branches of the thoracic (descending aorta)
- Mediastinal A.
- Esophageal A.
- Pericardial A
Paired lateral visceral branches of the thoracic (descending) aorta
Left and right bronchial A–> supply the bronchi.
Paired segmental parietal branches of the of the thoracic aorta
- Posterior intercostal A.
- Subcostal A. (goes into the abdomen below the 12th rib with the subcostal N)
Posterior intercostal arteries
PIA- paired segmental parietal branch.
It makes several branches
- Dorsal branch
- Collateral branches which can be damaged in thoracentesis
- Lateral cutaneous branch- third and final contributer to the mammary gland
What is the third and final contributer to the mammary gland ?
Lateral cutaneous branch of the posterior intercostal A.
contributes to the lateral mammary branch (as well as the lateral thoracic a.)
Medial mammary branch comes from _____
internal thoracic A.
Lateral mammary branch comes from ____
- Lateral thoracic A.
- Lateral cutaneous branch of the posterior intercostal A
CN: CABG
What is it and what is used in a CABG?
CABG is a procedure that is used to bypass a blocked section of a coronary artery and delivery O2 to the heart.
One end of the BV will be attached to the aorta and another part is attached to the coronary artery at the point BELOW the blockage.
-SOMETIMES THE GREAT SAPHENOUS VEIN IS USED or the INTERNAL THORACIC A.
What are the phrenic arteries?
- Musculophrenic artery- comes off of the internal thoracic A.
- Pericardiacophrenic A- from the internal thoracic A
- Superior phrenic A- from the descending aorta (located below the diaphragm)
What comes off the pulmonary trunk?
R pulmonary A
- Superior lobar A–> supplies the superior lobe of the lung
- Middle lobar A–> middle lobe
- Inferior lobar A–> inferior lobe of the
L pulmonary A
- Superior lobar A- to superior lobe
- Inferior lobar A- to inferior lobe
CN: pulmonary embolism
When the pulmonary A is blocked (often in the lobar or segmental branch) due to an embolism, such as a blood cot, fat, air bubble.
The embolus usually passes from a vein–> right side of the heart–> pulmonary artery.
It stops deoxygenated blood from getting oxygenated
Pulmonary veins
Empty into the L atrium.
There are 4 of them.
- Right superior/inferior pulmonary vein
- Left superior/inferior pulmonary vein
Role of the coronary sinus
Drains the GREAT, MIDDLE and SMALL CARDIAC VEINS
and empties into the right atrium
Where does the anterior cardiac vein empty into?
DIRECTLY INTO
the Right atrium
Where does the small cardiac vein drain into?
Coronary sinus
Where does the coronary sinus lay? and what does it drain into?
Left atrioventriventricular groove.
Drains into the right atrium
Where does the small cardiac vein run?
Inferior border of the heart (right margin) and travels with the R marginal A.
What is the largest diameter vein on the heart?
Middle cardiac vein
What does the great cardiac vein run with?
- Anterior interventricular artery
- Circumflex artery ( on the posterior surface)
What is the role of the azygous vein complex?
It drains the posterior intercostal veins.
What is the role of the azygous vein?
- Drains the right posterior intercostal veins DIRECTLY.
- Receives blood from the hemiazygous vein and the accessory hemiazygous vein, which drain the LEFT POSTERIOR INTERCOSTAL VEINS.
–> SVC
Thoracic duct
-originates as the chyle cistern in the abdomen and drains lymph from the LE, pelvis, abdomen, left half of the thorax, Left UE, left side of the head and neck superiorly and emptiies into the venous system near –> L internal jugular vein and L subclavian vein
in the thorax, it drains the [L subclavian lymphatic trunk] and [L broncomediastinal trunk]
Thymus
A lymphoid organ located on the superior mediastinum and is replaced by fat after puberty.
Subclavian trunk
What does it drain?
UE
Axilla
via the axillary lymphatic plexus
Jugular trunk
What does it drain?
1. Cranial LN
2. Cervical LN
Bronchomediastinal trunk
drains
1. Parasternal,
2. Paratracheal,
3. Paraesophageal,
4. Superior Phrenic
5. Brachiocephalic Lymph Nodes
Right lymphatic duct
What does it drain?
1. R subclavian trunk
2. R jugular trunk
3. R bronchomediastinal trunk
Thoracic LN on the right side
Drain lymph from the R lymphatic duct–> venous circulation
Thoracic LN on the L side
drrain lymph from the thoracic duct–> venous circulation
