Coronary arteries Flashcards

1
Q

Which two of the three layers of the heart do the coronary arteries supply?

A

Epicardium & myocardium

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2
Q

Where do the coronary arteries arise from?

A

The right and left aortic sinuses of the ascending aorta just above the aortic valve

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3
Q

Where does the left coronary artery lie?

A

In the left atrioventricular groove between the pulmonary trunk and left auricle.

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4
Q

What does the left anterior descending artery run along?

A

Anterior interventricular septum

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5
Q

Where does the circumflex artery originate from and where does it run?

A

Left coronary artery

Runs laterally & onto the posterior surface of the heart

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6
Q

Where does the right coronary artery lie?

A

In the coronary/right atrioventricular groove

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7
Q

What is the coronary sinus?

A

A short venous conduit which receives the deoxygenated blood from the cardiac vessels

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8
Q

Where does the coronary sinus drain into?

A

Right atrium

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9
Q

What does the right coronary artery become when it reaches the posterior surface of the heart?

A

Right posterior atrioventricular artery and then the posterior interventricular artery

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10
Q

What are the two most common sites of narrowing/occlusion within the coronary arteries?

A

LAD or right coronary artery

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11
Q

What coronary artery supplies the SA node?

A

SA nodal branch of the RCA

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12
Q

What coronary artery supplies the AV node?

A

AV nodal branch of the RCA, near the origin of the posterior interventricular artery

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13
Q

Which coronary artery supplies the interventricular septum?

A

Left anterior descending

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14
Q

What is the significance of the high oxygen extraction of the heart under resting conditions?

A

Myocardial oxygen perfusion cannot be increased by increasing the oxygen extraction - can only be increased by increasing coronary blood flow

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15
Q

What are the intrinsic mechanisms of coronary blood flow?

A

Decreased Po2 causes vasodilatation of the coronary arterioles
Metabolic hyperaemia matches flow to demand
Adenosine (from ATP) is a potent vasodilator

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16
Q

What are the extrinsic mechanisms of coronary blood flow?

A

Coronary arterioles supplied by sympathetic vasoconstrictor nerves, but:
Over-ridden by metabolic hyperaemia as a result of increased heart rate and stroke volume
So sympathetic stimulation of the heart results in coronary vasodilatation despite direct vasoconstrictor effect (functional sympatholysis)
Circulating adrenaline activates beta 2 adrenergic receptors, which cause vasodilatation