Pericardium & Heart Anatomy 2 (Megan) Flashcards

1
Q
A
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2
Q

The heart and pericardial sac are situated ______, approximately 2/3 to the left and 1/3 to the right of the median plane.

A

obliquely

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3
Q

Externally, the atria are demarcated from the ventricles by the coronary or atrioventricular ______ (sulcus)

A

groove

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4
Q

The right and left ventricles are demarcated from each other by anterior and posterior ______ grooves

A

interventricular (IV)

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5
Q

The heart is shaped like a tilted pyramid with an _____ (directed anteriorly and to the left), a _____ (opposite the apex, facing mostly posteriorly), _______ and _________.

A

apex, base, four surfaces and four borders

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6
Q

Formed by the inferolateral part of the left ventricle.

A

Apex

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7
Q

The apex lies posterior to the left ______ intercostal space in adults

A

5th

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8
Q

The apex is where the sounds of _____ closure are maximal (apex beat)

A

mitral valve

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9
Q

The apex underlies the site where the heartbeat may be ____ on the thoracic wall.

A

auscultated

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10
Q

The heart’s posterior aspect (opposite the apex).

A

base

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11
Q

The base is formed mainly by the ___, with a lesser contribution by the right atrium.

A

left atrium

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12
Q

The base of the heart faces posteriorly toward the bodies of vertebrae ______ and is separated from them by the pericardium, oblique pericardial sinus, esophagus, and aorta

A

T6 - T9

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13
Q

The _____ of the heart extends superiorly to the bifurcation of the pulmonary trunk and inferiorly to the coronary groove.

A

base

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14
Q

The base of the heart receives the pulmonary veins on the right and left sides of its left atrial portion and the superior and inferior ____ at the superior and inferior ends of its right atrial portion.

A

venae cavae

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15
Q

This surface of the heart is formed mainly by the right ventricle.

A

Anterior (sternocostal) surface

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16
Q

This surface is formed mainly by the left ventricle and partly by the right ventricle; it is related mainly to the central tendon of the diaphragm.

A

Diaphragmatic (inferior) surface

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17
Q

This surface is formed mainly by the right atrium.

A

Right pulmonary surface

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18
Q

This surface is formed mainly by the left ventricle; it forms the cardiac impression of the left lung.

A

Left pulmonary surface.

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19
Q

Right border (slightly convex), formed by the _____ and extending between the superior vena cava and the inferior vena cava

A

right atrium

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20
Q

Inferior border (oblique, nearly vertical), formed mainly by the ____ and slightly by the left ventricle.

A

right ventricle

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21
Q

Left border (nearly horizontal), formed mainly by the ______

A

left ventricle and slightly by the left auricle.

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22
Q

This border is formed by the right and left atria and auricles in an anterior view; the ascending aorta and pulmonary trunk emerge from this border and the superior vena cava enters its right side.

A

Superior border

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23
Q

The superior border is posterior to the aorta and pulmonary trunk, and forms the inferior boundary of the _____

A

transverse pericardial sinus

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24
Q

Dextrocardia is abnormal folding of the embryonic heart that may cause the position of the heart to be completely reversed so that the ___ is directed to the right instead of the left.

A

Apex

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25
Q

This congenital anomaly is the most common positional abnormality of the heart, but it is still relatively uncommon

A

Dextrocardia

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26
Q

Dextrocardia is associated with _____ positioning of the great vessels and the arch of the aorta.

A

mirror image

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27
Q

general transposition of the thoracic and abdominal viscera

A

situs inversus

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28
Q

transposition may affect only the heart

A

isolated dextrocardia

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29
Q

In _____ with situs inversus, the incidence of accompanying cardiac defects is low, and the heart usually functions normally.

A

dextrocardia

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30
Q

In isolated dextrocardia, however, the congenital anomaly is complicated by severe cardiac anomalies, such as transposition of the ______

A

great arteries.

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31
Q

when patient has inverted internal organs, bronchi is not working properly (cilia of bronchi not removing dust, mucus from bronchi). As a result, patients will suffer from chronic inflammation in bronchi, lungs, pneumonia, and other lung problems. What is this syndrome called?

A

Kartagener syndrome

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32
Q

The _______ receives blood from the superior vena cava, inferior vena cava, and coronary sinus

A

right atrium

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33
Q

The ear-like right _____ is a conical muscular pouch that projects from the right atrium

A

auricle

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34
Q

Posterior wall of the right atrium formed by superior vena cava and inferior vena cava and coronary sinus opening, it has smooth surface and called _____

A

sinus venarum

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35
Q

Anterior wall of right atrium composed of _____ and has rough surface.

A

pectinate muscles

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36
Q

The smooth and rough parts of the atrial wall are separated externally by a shallow terminal groove, and internally by a vertical ridge, the ______

A

crista terminalis

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37
Q

The _________ separating the atria has an oval, thumbprint-size depression, the oval fossa (fossa ovalis), which is a remnant of the oval foramen (foramen ovale) and its valve in the fetus.

A

interatrial septum

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38
Q

Specialized cardiac muscle cells that carry impulses throughout the heart musculature, signaling the chambers to contract in the proper sequence

A

Electrical conduction system (in Right atrium)

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39
Q

Main parts of conduction system:

A

Sinoatrial node Atrioventricular Node Bundle of His Left/Right Branches of the bundle of His Purkinje fibers

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40
Q

In the conduction system, the ___ node is located in wall of right atrium, sets basic heart rate 70-80 bpm, and is the normal pacemaker.

A

SA (sinoatrial)

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41
Q

Impulse from SA to atria Impulse also to AV node via _______ pathway

A

internodal

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42
Q

In the conduction system of the right atrium, which node is in the interatrial septum?

A

AV node

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43
Q

SA node through AV bundle (also known as the…?)

A

bundle of His

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44
Q

SA node through AV bundle, into interventricular septum. Divides R and L _______.

A

bundle branches

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45
Q

The R and L bundle branches in conduction become subendocardial branches, or ______.

A

Purkinje fibers

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46
Q

Contraction of ventricles begins at _______

A

apex

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47
Q

Recording of electric activity of the heart

A

ECG

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48
Q

In ECG, this pattern is an impulse that spreads across atria, triggering atrial contractions

A

P wave

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49
Q

In ECG, this pattern is an impulse that spreads to the ventricles, triggering ventricular contractions.

A

QRS complex

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50
Q

In ECG, this pattern consists of ventricles returning to resting state.

A

T wave

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51
Q

Damage to the conducting system causes a ______, which interferes with the ability of the ventricles to receive the atrial impulses.

A

heart block

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52
Q

A ______ of the electrical signals produces an irregular and slower heartbeat, reducing the heart’s efficiency in maintaining adequate circulation.

A

delay or disruption

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53
Q

Heart block requires a ______ to be implanted.

A

pacemaker

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54
Q

_____ is a cardiac arrhythmia resulting from rapid irregular uncoordinated contractions of the atrial or ventricular muscle due to fast repetitive excitation of myocardial fibers, causing palpitations, shortness of breath, angina, fatigue, congestive heart failure, and sudden cardiac death.

A

Atrial or ventricular fibrillation

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55
Q

This chamber of the heart Is smaller and has thicker walls than the right atrium, but its walls are smooth, except for a few pectinate muscles in the auricle.

A

left atrium

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56
Q

Is the most posterior of the four chambers lying posterior to the right atrium but anterior to the esophagus

A

Left atrium

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57
Q

The left atrium shows no _____ on a posteroanterior radiograph.

A

structural borders

58
Q

The _______atrium receives oxygenated blood through four pulmonary veins.

A

left

59
Q

This chamber of the heart Makes up the major portion of the anterior (sternocostal) surface of the heart.

A

Right ventricle

60
Q

Structure in right ventricle that are anastomosing muscular ridges of myocardium in the ventricles.

A

Trabecular Carneae Cordis

61
Q

Structure in right ventricle that are cone-shaped muscles enveloped by endocardium.

A

Papillary muscles

62
Q

Papillary muscles of the right ventricle extend from the anterior and posterior ventricular walls and the septum, and their _____ are attached to the chordae tendineae.

A

apices

63
Q

The papillary muscles of the right ventricle contract to tighten the chordae tendineae, preventing the cusps of the tricuspid valve from being everted into the atrium by the _____developed by the pumping action of the heart. This prevents regurgitation of ventricular blood into the right atrium

A

pressure

64
Q

Structure of right ventricle that: -Extend from one papillary muscle to more than one cusp of the tricuspid valve. -Prevent eversion of the valve cusps into the atrium during ventricular contractions.

A

Chordae Tendineae

65
Q

the upper smooth-walled portion of the right ventricle, which leads to the pulmonary trunk.

A

Conus Arteriosus (Infundibulum)

66
Q

an isolated band of trabeculae carneae that forms a bridge between the intraventricular (IV) septum and the base of the anterior papillary muscle of the anterior wall of the right ventricle.

A

Septomarginal Trabecula (Moderator Band)

67
Q

The Septomarginal Trabecula is called the _____ band for its ability to prevent overdistention of the ventricle and carries the right limb (Purkinje fibers) of the atrioventricular (AV) bundle from the septum to the sternocostal wall of the ventricle

A

moderator band

68
Q

the place of origin of the septal papillary muscle.

A

IV Septum

69
Q

The IV Septum is mostly muscular but has a small membranous upper part, which is a common site of ________.

A

ventricular septal defects (VSDs).

70
Q

This chamber of the heart lies at the back of the heart, and its apex is directed downward, forward, and to the left.

A

Left ventricle

71
Q

The left ventricle is divided into the left ventricle proper and the ______, which is the upper anterior part of the left ventricle and leads into the aorta.

A

aortic vestibule

72
Q

The left ventricle contains two ____ (anterior and posterior) with their chordae tendineae and a meshwork of muscular ridges, the trabeculae carneae cordis.

A

papillary muscles

73
Q

This ventricle of the heart performs harder work, has a thicker (two to three times as thick) wall, and is longer, narrower, and more conical-shaped than the right ventricle.

A

Left

74
Q

Lies behind the medial end of the left third costal cartilage and adjoining part of the sternum.

A

Pulmonary valve

75
Q

The pulmonary valve of the heart is most audible over the ________ intercostal space just lateral to the sternum.

A

left second

76
Q

The pulmonary valve of the heart is opened by ______ and shut slightly after closure of the aortic valve.

A

ventricular systole

77
Q

Lies behind the left half of the sternum opposite the third intercostal space.

A

Aortic Valves

78
Q

The aortic valve is closed during ventricular diastole; its closure at the beginning of ventricular diastole causes the second (_____) heart sound.

A

“dub”

79
Q

The aortic valve of the heart is most audible over the _______ intercostal space just lateral to the sternum.

A

right second

80
Q

Lies between the right atrium and ventricle, behind the right half of the sternum opposite the fourth intercostal space, and is covered by endocardium.

A

Tricuspid (Right AV) valve

81
Q

Is most audible over the right (or left for some people) lower part of the body of the sternum.

A

Tricuspid (Right AV) valve

82
Q

The Tricuspid (Right AV) valve has anterior, posterior, and septal ______, which are attached by the chordae tendineae to three papillary muscles that keep the valve closed against the pressure developed by the pumping action of the heart.

A

cusps

83
Q

The tricuspid (Right AV) valve is closed during the ventricular systole (contraction); its closure CONTRIBUTES TO the first (____) heart sound.

A

“lub”

84
Q

The bicuspid (Left AV valve) is called the _____ valve because it is shaped like a bishop’s miter.

A

mitral

85
Q

Lies between the left atrium and ventricle, behind the left half of the sternum at the fourth costal cartilage, and has two cusps: a larger anterior and a smaller posterior.

A

Bicuspid (Left AV) Valve

86
Q

The bicuspid Left AV valve is closed slightly before the tricuspid valve by the ventricular contraction (systole); its closure at the onset of ventricular systole CAUSES the first (_____) heart sound.

A

“lub”

87
Q

The bicuspid left AV valve is most audible over the apical region of the heart in the left __ intercostal space at the midclavicular line.

A

fifth

88
Q

If a patient has a problem with their tricuspid wall - although it could be congenital patholigies or cancers - it most likely is because they are ___.

A

drug abusers

89
Q

A necrosis of the myocardium because of local ischemia resulting from vasospasm or obstruction of the blood supply, most commonly by a thrombus or embolus in the coronary arteries.

A

Myocardial infarction (MI)

90
Q

Myocardial infarctions symptoms include: severe ____ pain or pressure for a prolonged period (more than 30 minutes), congestive heart failure, and murmur of mitral regurgitation.

A

chest

91
Q

Myocardial infarctions can be treated with:

A

nitroglycerin, morphine, lidocaine, or atrophine.

92
Q

Medication that prevents coronary spasm and reduces myocardial oxygen demand

A

nitroglycerin

93
Q

Medication that relieves pain and anxiety

A

Morphine

94
Q

Medication that reduces ventricular arrhythmias

A

Lidocaine

95
Q

Medication that restores conduction and increases heart rate

A

Atrophine

96
Q

Characterized by attacks of chest pain originating in the heart and felt beneath the sternum, in many cases radiating to the left shoulder and down the arm.

A

Angina pectoris

97
Q

Angina pectoris is caused by an insufficient supply of _____ to the heart muscle because of coronary artery disease or exertion (e.g., exercise, excitement) or emotion (e.g., stress, anger, frustration).

A

oxygen

98
Q

Symptoms and treatment of angina pectoris are very similar to MI, but the only thing to differentiate the two is _____

A

EKG (ECG)

99
Q

Condition in which the valve everts into the left atrium and thus fails to close properly when the left ventricle contracts

A

Mitral valve prolapse

100
Q

Mitral valve prolapse may produce ___(these four symtoms). In most cases, no treatment is needed.

A

chest pain, shortness of breath, palpitations, and cardiac arrhythmia

101
Q

an infection of the endocardium of the heart, most commonly involving the heart valves and is caused by a cluster of bacteria on the valves.

A

Endocarditis

102
Q

Endocarditis: the valves do not receive any blood supply and ______ cannot enter, and thus they have no defense mechanisms. Symptoms include fatigue, weakness, fever, night sweats, anorexia, heart murmur, and shortness of breath.

A

white blood cells

103
Q

Risk factors of endocarditis include a damaged abnormal heart valve, ______, and certain congenital heart defects.

A

mitral valve prolapse

104
Q

_______ is a characteristic sound of endocarditis generated by turbulence of blood flow through an orifice of the heart.

A

Cardiac murmur

105
Q

10% of the population have _______

A

mitral valve prolapse.

106
Q

It is very common for patients with mitral valve prolapse to have _____

A

tachycardia.

107
Q

Arise from the ascending aorta and are filled with blood during the ventricular diastole.

A

Coronary arteries

108
Q

Coronary arteries have maximal blood flow during diastole and minimal blood flow during systole because of compression of the arterial branches in the ______ during systole.

A

myocardium

109
Q

The #1 cause of death in the U.S.

A

blockage of coronary arteries

110
Q

Blockage of the R coronary artery can cause

A

bradycardia

111
Q

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.

A

Right coronary artery

112
Q

The right coronary artery gives rise to the following four branches:

A

SA Nodal Artery Marginal Artery Posterior IV (Posterior Descending) Artery AV Nodal Artery

113
Q

Which right coronary artery branch 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?

A

SA Nodal Artery

114
Q

Which right coronary artery branch runs along the inferior border toward the apex and supplies the inferior margin of the right ventricle?

A

Marginal artery

115
Q

Which right coronary artery branch is a larger terminal branch and supplies a part of the IV septum and left ventricle and the AV node?

A

Posterior IV (Posterior Descending) Artery

116
Q

Arises from the left aortic sinus of the ascending aorta, just above the aortic semilunar valve.

A

Left coronary artery

117
Q

The left coronary artery is _____ than the right coronary artery and usually is distributed to more of the myocardium

A

shorter

118
Q

The left coronary artery gives rise to the following two branches:

A

Anterior IV (Left Anterior descending LAD)Artery Circumflex Artery

119
Q

The branch of the left coronary artery that supplies anterior aspects of the right and left ventricles and is the chief source of blood to the IV septum and the apex.

A

Anterior IV (Left Anterior descending LAD)Artery

120
Q

The branch of the left coronary artery that 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.

A

Circumflex artery

121
Q

This coronary artery is a chief source of blood to the IV septum and the apex (2/3)

A

Left coronary artery

122
Q

1 artery that is blocked in humans.

A

Left coronary artery

123
Q

The largest vein draining the heart and lies in the coronary sulcus, which separates the atria from the ventricles. Opens into the right atrium between the opening of the IVC and the AV opening

A

Coronary sinus

124
Q

The coronary sinus has a one-cusp valve at the _____ of its aperture.

A

right margin

125
Q

Receives the great, middle, and small cardiac veins; the oblique vein of the left atrium; and the posterior vein of the left ventricle.

A

Coronary sinus

126
Q

Begins at the apex of the heart and ascends along with the IV branch of the left coronary artery.

A

Great Cardiac vein

127
Q

The great cardiac vein turns to the left to lie in the coronary _______ and continues as the coronary ________

A

sulcus, sinus

128
Q

Begins at the apex of the heart and ascends in the posterior IV groove, accompanying the posterior IV branch of the right coronary artery.

A

Middle cardiac vein

129
Q

The middle cardiac vein drains into the right end of the coronary _____.

A

sinus

130
Q

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.

A

Small cardiac vein

131
Q

Descends to empty into the coronary sinus, near its left end.

A

oblique vein of the left atrium

132
Q

Drains the anterior right ventricle, crosses the coronary groove, and ends directly in the right atrium.

A

Anterior cardiac vein

133
Q

Begin in the wall of the heart and empty directly into its chambers.

A

Smallest cardiac veins (Venae Cardis Minimase)

134
Q

Receives the superior, middle, and inferior cervical and thoracic cardiac nerves from the sympathetic trunks and vagus nerves.

A

Cardiac plexus

135
Q

The cardiac plexus is divided into the superficial cardiac plexus, which lies beneath the arch of the aorta in front of the pulmonary artery, and the deep cardiac plexus, which lies posterior to the arch of the aorta in front of the bifurcation of the ___

A

trachea.

136
Q

_____ nerves give parasympathetic innervation of the heart, slowing the heart rate.

A

Vagus

137
Q

Increases rate and force of contractions of coronary arteries.

A

Sympathetic

138
Q

characterized by the presence of sclerotic plaques containing cholesterol and lipoid material that impair myocardial blood flow, leading to ischemia and myocardial infarction.

A

Coronary artherosclerosis

139
Q

an angiographic reconstruction (radiographic view of vessels after the injection of a radiopaque material) of a blood vessel made by enlarging a narrowed coronary arterial lumen. It is performed by peripheral introduction of a balloon-tip catheter and dilation of the lumen on withdrawal of the inflated catheter tip. A metal stent is often placed during angioplasty.

A

Coronary angioplasty

140
Q

involves a connection of a section of vessel usually the saphenous vein or of the internal thoracic artery or other conduit between the aorta and a coronary artery distal to an obstruction in the coronary artery, shunting blood from the aorta to the coronary arteries. Alternatively, the internal thoracic artery is connected to the coronary artery distal to the obstructive lesion.

A

Coronary bypass