Thorax 3 - Coronary Circulation (arterial & venous) Flashcards
what vessels (one vein, one artery) run through the anterior interventricular groove?
left anterior descending (LAD) or anterior interventricular artery
great cardiac vein
what vessels (one vein, one artery) run through the posterior interventricular sulcus?
posterior interventricular artery (posterior descending artery)
middle cardiac vein
where does the right coronary artery arise form?
arises from the right coronary sinus from the ascending aorta
what is the first branch of the right coronary artery? what does it supply?
sinoatrial nodal branch - runs between the aorta & right auricle
supplies the right atrium & sinoatrial node
what are the 4 branches of the right coronary artery in order?
sinoatrial nodal branch
right anterior ventricular branches
right marginal artery
posterior interventricular/ descending artery
what do the right anterior ventricular branches supply?
have 2-3 smaller branches that supply the anterior wall of the right ventricle
where does the right marginal artery travel? what does it supply?
travels along the acute margin of the right side of the heart (along the right border)
supplies the right ventricle
within what sulcus/ groove does the right coronary artery travel within?
right atrioventricular groove/ coronary sulcus
what is the terminal branch of the RCA? where does it travel & what structures does it supply?
terminal branch - posterior interventricular (descending) artery
travels within the posterior interventricular sulcus with the middle cardiac vein
supplies the posterior 1/3 of the interventricular septum
describe the course of travel of the right coronary artery
arises form the right coronary sinus of the aorta - gives off the sinoatrial nodal branch
travels within the right atrioventricular groove/ coronary sulcus - gives off right anterior ventricular branches
descends vertically down between the pulmonary trunk and right auricle
goes around the inferior border of the heart’s posterior surface - gives off right marginal artery
terminates with the posterior descending artery in the posterior interventricular sulcus (anastomoses with the left anterior descending artery of the LCA) at the heart’s apex
what is the anastomosis formed between the RCA & LCA?
posterior interventricular artery (RCA branch) anastomoses with left anterior descending artery (LCA branch) at apex of the heart
what vessel does the posterior interventricular artery run with?
middle cardiac vein
what artery is commonly named the widow-maker? why?
left anterior interventricular (descending) artery - branch of LCA
occlusion of this artery can lead to a massive anterior wall myocardial infarction; it’s the most commonly involved artery in coronary artery disease
what are the branches of the left coronary artery?
left anterior interventricular/descending artery
left circumflex artery
how does left anterior interventricular artery travel?
branches from LCA - travels along anterior interventricular groove to apex of heart; anastomoses with posterior interventricular artery at apex
what does the left anterior descending artery supply?
anterior 2/3 of the interventricular septum (& AV node)
anterior walls of both ventricles - mainly LV
apex of heart
how does the left circumflex artery travel? what does it supply?
travels within coronary sulcus from the anterior to posterior aspect of the heart
supplies: left atrium, (posterior part of) left ventricle
what determines the dominance of the heart?
the artery that gives off the posterior interventricular artery (PDA)
what is the majority case/scenario with heart dominance?
right sided dominance in 67-85% of cases = RCA gives off the posterior interventricular artery
in left dominant hearts (10-15%), which artery supplies the posterior interventricular artery?
left coronary artery via the left circumflex artery
why is left dominance more clinically significant?
blockage in the LCA can compromise blood flow to the entire interventricular septum - can lead to severe heart issues
in left dominant hearts, the posterior interventricular artery and left anterior descending artery (PDA & LDA) are both supplying the septum
what is co-dominance in coronary circulation?
occurs in 5-10% of cases = both the RCA and LCA contribute to the posterior interventricular artery
what coronary artery is most likely to be blocked in a myocardial infarction?
left coronary artery
what is the main venous sinus the majority of the cardiac veins drain into?
coronary sinus (cardiac veins carry deoxygenated blood & drain into the coronary sinus)
what are the 4 major tributaries that drain into the venous sinus of the heart?
great cardiac vein
middle cardiac vein
small cardiac vein
posterior cardiac vein
drain into coronary sinus
which cardiac veins drain directly into the right atrium, bypassing the coronary sinus?
anterior cardiac veins - into right atrium
smallest cardiac veins (Thebesian veins) 0 into right atrium & ventricle
which cardiac vein runs alongside the anterior interventricular artery?
great cardiac vein (within the anterior interventricular sulcus)
which vein runs alongside the posterior interventricular artery?
middle cardiac vein (within the posterior interventricular sulcus)
function of the coronary sinus?
collects deoxygenated blood from the heart’s veins and empties it into the right atrium
what happens when a coronary artery becomes completely blocked?
leads to a myocardial infarction - cuts off blood supply to the affected area of the heart, causes ischaemia
if blood flow isn’t restored - the heart muscle suffers tissue damage or death
