Session 1.2j - Gray's Anatomy for Students - Thorax - Regional anatomy - Mediastinum (Part III) Flashcards
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Where does the left coronary artery originate from?
The left aortic sinus of the ascending aorta
Where does the left coronary artery pass?
Between the pulmonary trunk and the left auricle before entering the coronary sulcus
Where does the left coronary artery enter?
The coronary sulcus
Where does the left coronary artery emerge?
From behind the pulmonary trunk
What does the left coronary artery divide into?
Its two terminal branches
What are the two terminal branches of the left coronary artery?
- ANTERIOR INTERVENTRICULAR branch
- CIRCUMFLEX branch (Fig. 3.71A)
What is the anterior interventricular branch also known as?
LEFT ANTERIOR DESCENDING ARTERY - LAD
What is the left anterior descending artery also known as?
(LAD) ANTERIOR INTERVENTRICULAR BRANCH
Where does the left anterior descending travel?
It continues around the left side of the pulmonary trunk and descends obliquely toward the apex of the heart (Fig. 3.71A,C).
Where does the left anterior descending artery lie?
In the anterior interventricular sulcus (Fig. 3.71A,C).
What does LAD divide into?
During its course, one or two large DIAGONAL BRANCHES may arise
Where are the diagonal branches of LAD?
These arise from LAD and descend diagonally across the anterior surface of the left ventricle.
Where does the circumflex branch of the left coronary artery course?
The CIRCUMFLEX BRANCH (Fig. 3.71A,C) courses towards the left of it, in the coronary sulcus and onto the base/diaphragmatic surface of the heart, and usually ends before reaching the posterior interventricular sulcus.
Where does the circumflex branch of the left coronary artery sit?
In the coronary sulcus
What is one of the large branches of the left circumflex branch of the coronary artery?
The LEFT MARGINAL ARTERY (Fig. 3.71A,C)
Where does the left marginal artery arise from?
The left circumflex branch of the left coronary artery
Where does the left marginal artery travel, after emerging from the left circumflex branch?
It continues across the rounded obtuse margin of the heart.
What does the left coronary artery supply?
The distribution pattern of the left coronary artery enables it to supply most of the:
- left atrium
- left ventricle
- interventricular septum, including the atrioventricular bundle and its branches
Is the distribution pattern of the coronary arteries consistent?
No, several major variations in the basic distribution patterns of the coronary arteries occur.
What is the most common distribution pattern for the coronary arteries?
The distribution pattern described above for both right and left coronary arteries is the most common and consists of a right dominant coronary artery.
Which is more common, a right or left dominant coronary artery?
Right dominant coronary artery.
What does a right dominant coronary artery mean?
That the posterior interventricular branch arises from the right coronary artery.
In a right dominant coronary artery, what does the right coronary artery supply a large portion of?
The posterior wall of the left ventricle
How does the circumflex branch of the left coronary artery appear in a right dominant coronary artery?
The cirumcflex branch of the left coronary artery is relatively small.
Which artery appears relatively small in people with right dominant coronary arteries?
The circumflex branch of the left coronary artery.
What is different in left and right dominant coronary arteries?
Right
- posterior interventricular branch arises from right coronary artery
- left circumflex branch is relatively small
Left
- posterior interventricular branch arises from an enlarged circumflex branch
Where does the posterior interventricular branch arise from in a left dominant coronary artery?
An enlarged circumflex branch
Which artery is enlarged in a left dominant coronary artery?
The circumflex branch of the left coronary artery
What supplies most of the posterior wall of the left ventricle in a left dominant coronary artery?
The posterior interventricular branch from the circumflex branch of the left coronary artery (Fig. 3.72)
What supplies the posterior wall of the left ventricle?
Posterior interventricular branch
Where does the posterior interventricular branch arise?
Right dominant - right coronary artery
Left dominant - enlarged circumflex branch of left coronary artery
What other anatomical variation is there in terms of cardiac vasculature, as well as right and left dominant coronary arteries?
Arterial supply to the sinu-atrial and atrioventricular nodes (SAN and AVN).
What most commonly supplies the SAN and AVN?
In most cases, these two structures are supplied by the right coronary artery.
What sometimes supplies the SAN and AVN?
Vessels from the circumflex branch of the left coronary artery
What does the coronary sinus receive?
Four major tributaries: the - great, - middle, - small, and - posterior cardiac veins
Which four major tributaries does the coronary sinus receive?
Great Middle Small Posterior cardiac veins
What do the great, middle, small and posterior cardiac veins feed into?
The CORONARY SINUS
Where does the great cardiac vein begin?
At the apex of the heart (Fig. 3.75A).
Where does the great cardiac vein ascend?
In the anterior interventricular sulcus
What is the great cardiac vein related to?
The anterior interventricular artery
What is the great cardiac vein often termed as?
The anterior interventricular vein.
What happens to the great cardiac vein when it reaches the coronary sulcus?
It turns to the left and continues onto the base/diaphragmatic surface of the heart.
Once the great cardiac vein has reached the coronary sulcus, which vessel is it then associated with?
The circumflex branch of the left coronary artery.
When and what does the great cardiac vein eventually form?
Continuing along its path in the coronary sulcus, the great cardiac vein gradually enlarges to form the coronary sinus
What does the great cardiac vein form part of?
The coronary sinus
Where does the coronary sinus enter?
The right atrium (Fig. 3.75B).
Describe the course of the great cardiac vein
- Begins at the apex of the heart
- Ascends in the anterior interventricular sulcus
- Reaches the coronary sulcus
- Turns left and continues onto the base/diaphragmatic surface of the heart
- Continues in the coronary sulcus
- Gradually enlarges to form the coronary sinus (right atrium)
Which arteries is the great cardiac vein associated with?
- Anterior interventricular artery (in anterior interventricular sulcus)
- Circumflex branch of left coronary artery (in coronary sulcus)
What is the middle cardiac vein sometimes known as?
Posterior interventricular vein
What is the posterior interventricular vein also known as?
Middle cardiac vein
Where does the middle cardiac vein begin?
Near the apex of the heart
Where does the middle cardiac vein ascend?
In the posterior interventricular sulcus
What is the route of the middle cardiac vein?
- Begins at the apex of the heart
- Ascends in the posterior interventricular sulcus
- Ends at the coronary sinus (Fig. 3.75B)
What is the middle cardiac vein assocaited with?
The posterior interventricular branch of the right or left coronary artery throughout its course.
Where does the small cardiac vein begin?
In the lower anterior section of the coronary sulcus between the right atrium and right ventricle (Fig. 3.75A).
