Thorax 4 - The Heart, Coronary Circulation, Conducting System Flashcards
What is another name for the left coronary artery?
Left Main Stem
What two arteries does the left main stem divide into?
Circumflex artery
Left anterior descending artery/anterior intraventricular artery
What is the marginal artery a branch of?
The right coronary artery
What are the SAN and AVN supplied by?
Right coronary artery
What is the name given to obstruction of the right coronary artery?
Inferior infarct
What is the name given to obstruction of the left anterior descending?
Anterior infarct
What is the name given to obstruction of the circumflex artery?
Lateral infarct
Why is an obstruction of the left anterior descending so dangerous?
Causes an anterior infarct which may cause catastrophic loss of left ventricular function and cardiac arrest
Where do the coronary arteries originate?
Just superior to the aortic valve
What is the order from most common to least common, of infarcts due to obstruction of coronary arteries?
Anterior
Inferior
Lateral
What is the name given to the vein that lies parallel to the left anterior descending artery?
Great cardiac vein
Where do the anterior cardiac veins drain to?
Atria
What is the function of the Purkinje Fibres?
To spread the signal to the ventricles
What is the proximal part of the bundles of His supplied by?
Right coronary artery
Where is cardiac pain referred to?
Anterior chest wall and possibly medial aspect of left arm
What does the left coronary artery divide into?
LAD (anterior interventricular)
Circumflex
In which groove does the RCA run in?
AV groove / Coronary sulcus
List the branches of the RCA.
SA nodal branch (1st) Right marginal (2nd) Posterior interventricular (3rd)
What does the RCA supply (inc. its branches)?
- Walls of RA & RV
- SA & AV nodes
- Posterior part of interventricular septum (proximal portion of AV bundle of His - arrhythmia)
- Small areas of the walls of LA & LV
What is obstruction of the RCA known as?
Inferior infarct
What is Bundle of His ischaemia likely to cause?
Arrhythmias
Which groove does the LAD follow?
Anterior interventricular groove
What does the LCA supply (inc. its branches)?
- Walls of LA & LV
- Most of the interventricular septum including part of the AV bundle of His
- Left anterior descending LAD
Which coronary artery is most commonly affected by atherosclerosis?
LAD
What is obstruction of the LAD known as?
Anterior infarct
What is obstruction of the circumflex known as?
Lateral infarct
What can anterior infarct lead to?
Ventricular fibrillation
In right cardiac dominance, what extra branch does the RCA give?
Right circumflex
What are the two most common vessels used in a coronary artery bypass graft?
Left internal thoracic / Left internal mammary artery (LIMA)
Great saphenous vein
In a percutaneous transluminal coronary angioplasty, where is the catheter inserted?
Femoral artery
Name the 3 cardiac veins and state which coronary artery they run alongside.
Small - with Marginal
Middle - with Posterior Interventricular
Great - with LAD
Which of the cardiac veins becomes the coronary sinus?
Great cardiac vein
How do anterior cardiac veins and venae cordis minimi drain to the RA?
Directly through cardiac muscle
Between which two chambers does the coronary sinus lie?
LA & LV
From where is sympathetic innervation of the heart?
Both left and right sympathetic trunks
From where is parasympathetic innervation of the heart?
Left and right vagus nerves
In relation to the arch of aorta, where does the cardiac plexus lie?
Inferior
Which spinal nerves form the origin of the cardiac plexus?
T1 - T4
