Coronary arteries
Posterior descending artery (PDA) (posterior interventricular septum)
Found on posterior surface of the heart descends I'm the back of the heart coming off the RCA
Coronary arterys functions what
Supply myocardium and epicardium of the heart (myo-muscle tissue)
LCX (left circumflex artery)
(Goes around coronary sulcus all the way to back siide)Branches into left marginal artery
What are LAD major branches
.LAD and CLx • LAD feeds anterior surface, part of lateral surface, IVS
coronary arteries are considered
End arteries meaning they supply myocardium without sufficient overlap ananastomoses from other coronary artery meaning there end artery
Right ventricle papillary muscles Anterior, posterior, septal
Anterior papillary muscle Largest and most consistent papillary muscle, arises from anterior RV wall Posterior papillary muscle May consist of 1, 2, or 3 structures, with some chordae arising from RV wall Septal Usually the smallest and most inconsistent, may be absent. Chordae arise from septal wall.
RCA
Arises from aorta (the right cups has the opening for right coronary artery-where it flows in the coronary sulcus along the top of the heart
LCA
Arises from aorta very short arter-courses along the coronary sulcus. Comes out of the left cusp of the aortic valve them bifurcated into the LAD AND LCX
great cardiac vein
Arises from apex coursing up anterior surface for the interventricular septum, Courses around coronary sulcus from front and back and dumps blood into the coronary sinus Drains the same cardiac territory supplied by the LCA
Small cardiac vien
Arises from tissue along right margin of heart and along the coronary sulcus to dump into the coronary sinus
coronary circulation
Blood pumps blood from the heart to the heart back to the heart Pumps blood from left ventricle through the aorta to first branches of the aorta which is the r and l coronary arteries that supply the heart (myocardium and epicardium) Then the co2 is brought back to the heart through cardiac veins into the right atrium
right marginal artery comes from and is located
Comes from right coronary heart on the right side of the heart(marginal because it courses all along the right margin of the heart)
External sulci Coronary sulcus: Anterior interventricular sulci Posterior interventricular sulci
Coronary sulcus: circles heart, separates atria from ventricles, contains RCA, small cardiac vein, coronary sinus, and left lateral circumflex a. • Anterior interventricular sulci: Separates two ventricles. Contains anterior interventricular artery, great cardiac vein. • Posterior interventricular sulci: Separates two ventricles on diaphragmatic surface. Contains posterior interventricular artery, middle cardiac vein.
Middle cardiac veins
Courses up the posterior surface of the interventricular septum and drains into coronary sinus
Middle and cardiac veins
Drain the same cardiac vein Territory supplies by the RCA
If one of the coronary arteries doesn't receive oxygen or has a blockage what happens
Heart attack
acute marginal artery
If you look at the angle between the coronary sulcus and that border of the heart it forms an acute less the 90 degree angle_the artery is synonymous (same meaning as marginal artery)
Left anterior descending artery (LAD) / anterior interventricular a.
Lays in the anterior interventricular groove Supplies -Interventricular septum (bindle of his- in 60% of individuals , (Bundle branches (85-90% of individuals) -L ventricle, anterior surface -L ventricle, lateral surface
circumflex artery
Lays in the left atrioventricular groove Supplies -L atrium ( SA node (in 60% of individuals) (AV node (in 85-90% individuals) -L ventricle, high later wall -L ventricle, inferior surface (in 15% individuals) -L ventricle, posterior surface (in 15% of individuals
Coronary means
Like a crown(around the head). Coronary arteries courses In the coronary sulcus along crown of heart
crux of the heart
Makes a t with the coronary sulcus and interventricular septum . A little artery comes off that and it is the AV node
Av nodal artery
Nervous tissue of the conduction system, that takes The depolarization of the heart muscles from atria down to the ventricles
Coronary circulation in a nut shell PDA
O2 blood of the LV goes into the aorta, then out to the aorta in the RCA supplying the right side of the heart supplying the tissue , the. Once the right side of the hearts co2 blood is brought back to the coronary sinus via the middle and small cardiac vein , then, the left coronary arteries is gonna supply the left side of the heart , and the great cardiac vein that parallels the LAD will bring the co2 blood back to the coronary sinus and into the right atrium
Coronary sinus
Opening in the right atrium that drains blood into right atrium
left coronary artery (LCA)
Originates from aortic Has two branches -circumflex artery -Left anterior descending artery
Right Coronary Artery (RCA)
Originates from aortic root, Lays in atrioventricular groove on the right Supplies ~Right atrium -SA node ( in 60% individuals) -Av node (in 85-90% individuals) ~R ventricle ~L ventricle, inferior surface (in 85% of individuals) ~L verntricle, posterior surface (in 85% of individuals)
SA nodal artery arises from and courses where?
RCA and courses along the top of the heart then it's artery is deep inside the tissue supplying the SA node located between SVC and the RA and the SA node/ pacemaker initiates conduction system of the heart
Coronary circulation
Right coronary artery, left coronary artery,circumflex artery , left anterior descending artery (anterior interventricular artery)
Conduction system of the heart: The autorhythmic cells are located in these areas:
Sinoatrial node (SA), or sinus node, Atrioventricular (AV) node, Atrioventricular (AV) Bundle (=bundle of his), Right and left bundle branches, Purkinje fibers
venous return
The amount of blood returned to the heart by the veins, • Cardiac veins collect deoxygenated blood from the capillaries of the myocardium • Join together to form a large vessel, the coronary sinus
Aortic valve
The aortic valve consists of three valve cusps • Distal to the left and right cusps are pocket-like sinuses that contain orifices of left and right coronary arteries • Third cusp is non-coronary cusp
What is the valve annulus
The attachment line of the valve leaflets to the valve support ring. • There is no distinct tissue characteristic of this attachment zone.
RCA arises from the aorta and course
The coronary sulcus in front and the back
Lunule
Thin lateral portion
Coronary dominance is determined by ?
Which artery gives rise to PDA -most of the time the PDA arises (connected) from the RCA meaning it's a right dominant heart happens 60-80% of the time. Small percent of the to,e the PDA arises from (connected to) the LCA meaning left dominant heart. Very very small % of the time the PDA arises from both LCA and RCA meaning co-dominant heart
Nodule
a small lump, free superior edge of each cusp has middle, thickened portion
Cardiac veins
coronary sinus Great cardiac vein Middle cardiac vein Small cardiac vein
posterior cardiac vein drains
drains the area supplied by the circumflex artery; drains into coronary sinus, Lies on posterior surface of LV, just left of middle cardiac vein • Enters CS directly or joins great cardiac vein
anterior cardiac veins empty
empty directly into right atrium anteriorly • Small, arise on anterior surface of RV • Drain directly into anterior wall of RA • May include right marginal vein if it does not enter small cardiac vein
coronary sulcus
groove that marks border between atria and ventricles gives blood passive through coronary sinus coronary veins and coronary arteries
Coronary dominance
is determined by the coronary artery supplying the posterior descending artery (PDA), which also supplies blood to the AV node via the AV nodal artery. The PDA usually originates form the right coronary artery (70%), but also from both (20%) and the left circumflex artery: 10% (left dominant circulation)
LAD (left anterior descending artery) anterior interventricular artery
left anterior descending (coronary artery) comes off left coronary artery and is on the anterior surface.
Valve sinuses
• Sinuses contain origins of coronary arteries • Provide reservoir for diastolic blood to the coronaries • During systole, the open AV leaflets shield the ostia from the main force of ejected blood • Separation of the leaflets from the ostia prevents coronary occlusion by not coming into direct contact with the coronary orifice
Pathway of blood through the heart and lungs
right atrium, tricuspid valve, right ventricle, pulmonary semilunar valve, pulmonary arteries, lungs, pulmonary veins, left atrium, bicuspid valve, left ventricle, aortic semilunar valve, aorta, systemic circulation
Rv Carries portion of conduction system
right bundle of atrioventricular bundle to anterior wall of RV
Coronary dominance RCA
right dominant system (85% of people) • RCA supplies posterior wall of LV and LCx is relatively small
RV moderator band
single trabeculum extending from base of anterior pap muscle to interventricular septum
middle cardiac vein
• AKA posterior interventricular vein • Begins near apex, ascends in posterior interventricular sulcus toward CS. • Associated with posterior interventricular a.
Right Coronary Artery (RCA) arises from what , and turns posterior around what
• Arises from aortic sinus and passes down coronary sulcus between RA and RV • Turns posteriorly around inferior margin of heart
left coronary artery (LCA) (Left main) arises from, passes betweeen and bifurcates into what
• Arises from left aortic sinus and runs a short distance to the left • Passes between pulmonary trunk and left auricle before entering coronary sulcus • Bifurcates into left anterior descending artery (LAD) and circumflex (LCx) arteries
Heart valves diastole
• Atrioventricular valve leaflets are open and opposed to ventricle walls • High aortic pressure causes blood to pool in aortic valve sinuses, forcing them together
small cardiac vein begins
• Begins in lower anterior coronary sulcus between RA and RV • Continues along diaphragmatic surface, enters CS at atrial end • Companion to RCA • May receive right marginal vein which accompanies the RCA marginal branch a. • If RMV doesn't join small cardiac vein, it will enter RA directly
Right Coronary Artery (RCA) branches are
• Branches: • Sinu-atrial a - passes posterioly around SVC to supply sinu-atrial node • Right marginal a - branches as RCA travels by inferior margin of heart, continues to apex Posterior descending a (posterior interventricular a) - lies in posterior interventricular sulci RCA forms PDA in 85% of people
Right ventricular outflow tract(RVOT)
• Channel of blood flow out of right ventricle to pulmonary trunk • Conus- arteriosus/infundibulum (derived from embryonic bulbus cordis to be discussed later). • Contains annulus of semilunar pulmonic valve
Left ventricular outflow tract (LVOT)
• Channel of blood flow out of left ventricle • Contains the annulus of the semilunar aortic valve
Coronary circulation circles the heart in what?
• Circle the heart in the coronary sulcus with marginal and interventricular branches, in the interventricular sulci, converge at apex
Cardiac Skeleton is what
• Dense, fibrous connective tissue that surround MV, TV, aorta, and pulmonary trunks. Interconnecting areas are: • Right fibrous trigonebetween aortic ring and right atrioventricular ring • Left fibrous trigonebetween aortic ring and left atrioventricular ring
Coronary sinus collects from
• Great, middle, and small cardiac veins • Posterior vein of LV • Other cardiac veins
Heart valves Systole
• Increasing ventricle pressure pushes blood against atrioventricular valve cusps, forcing them closed • Blood ejected from ventricle force aortic valve leaflets against the walls of the aortic root, opening LVOT
LCx ( circumflex artery supplies blood to)
• LA • Lateral surface • Inferior & posterior surface • SA node (45% of people) • AV node (10-15% of people)
LAD passes down where?
• LAD passes down toward the apex of heart in anterior interventricular sulcus •AKA anterior interventricular a. • Usually travels to LV apex & terminates on LV's inferior surface (75% of people)
Coronary Dominance (LCx)
• LCx: left dominant system (15% of people) • LCx supplies posterior wall of LV
coronary sinus is located and empties where
• Located in coronary sulcus on posterior surface between LA and LV • Empties into RA between opening of IVC and TV
circumflex artery passes, circles, and usually ends where?
• Passes toward the left in the coronary sulcus and onto diaphragmatic surface • Circles to the posterior aspect of the heart • Usually ends before reaching posterior interventricular sulcus
Cardiac skeleton provides, separates and electrically isolates what?
• Provides points of attachment for cusps • Separates atrial/ventricular musculature • Electrically isolates atria from vents • Atrioventricular bundle is single connection between two groups of myocardium
Right coronary artery supplies
• SA node supply (50% of people) • AV node supply (80-90% of people) • Inferior & Posterior surfaces
Coronary circulation is what? what are the primary muscles
• Vessels on epicardial surface; branches penetrate the myocardium (subendocardium) • Primary vessels: • Right coronary artery • Left coronary artery • Circumflex coronary artery
