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MD3001 - Cardiology Anatomy > Coronary Circulation and Conduction System > Flashcards

Coronary Circulation and Conduction System Flashcards

(64 cards)

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1
Q

What are the 2 main arteries that supply the heart?

A
  • Right Coronary Artery
  • Left Coronary Artery
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2
Q

Where does the endocardium recieve nutrients from?

A

directly from the chambers of the heart

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3
Q

Where do coronary arteries branch from and where do they emerge?

A
  • Ascending Aorta
  • Aortic sinus
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4
Q

When do the coronary arteries fill?

A

During diastole

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5
Q

Where does the RCA arise from?

A

right aortic sinus

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6
Q

Where does the RCA pass between?

A

right auricle and pulmonary trunk

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7
Q

What branch does the RCA give before entering the coronary sulcus?

A

SA nodal branch

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8
Q

What does the SA nodal branch supply?

A

SA node of the conduction system

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9
Q

What branch of the RCA supplies the right atrium?

A

atrial branches

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10
Q

What branch does the RCA give off before turing onto the inferior surface?

A

right (acute) marginal branch

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11
Q

What additional bracnh does the RCA usually give off?

A

Posterior interventricular branch (posterior descending artery)

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12
Q

Where does the RCA anastomose with the LCA

A

In the coronary sulcus and at the apex of the heart

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13
Q

What do the RCA and its branches supply?

A
  • Walls of RA and RV
  • SA and AV nodes
  • Posterior part of IV septum (proximal portion of AV bundle of His)
  • Small areas of the walls of the LA and LV
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14
Q

In what % of people is the RCA dominant?

A

80%

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15
Q

Obstruction of the RCA can lead to ?

A

Inferior infarct

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16
Q

Mild cases of obstruction of the RCA are likely to cause

A

Arrhythmias

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17
Q

Where does the LCA arise from?

A

left aortic sinus between the left auricle and pulmonary trunk

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18
Q

How does the LCA differ from the RCA?

A

Shorts but thicker

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19
Q

What does the LCA divide into when it enters the coronary sulcus?

A
  • Circumflex branch
  • ANterior IV branches
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20
Q

What is the course of the anterior IV branch of the LCA (left anterior descending)?

A

in the anterior IV sulcus

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21
Q

What does the anterior IV branch supply?

A

sternocostal surface

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22
Q

What does the LAD (left anterior descending) anastomose with?

A

Posterior IV branch of RCA at the apex

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23
Q

What coronary artery is most commonly affected by atherosclerosis?

A

Left anterior descending

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24
Q

What branch comes off the circumflex branch of the LCA

A

left marginal branch

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25
Where does the circumflex branch travel?
posteriorly along coronal sulcus
26
What does the circumflex branch anastomose with?
Branches of the RCa in the coronary sulcus posteriorly
27
What does the LCA and its branches supply?
* Walls of LA and LV * Most of the IV septum inclusing part of the AV bundle
28
Obstruction of the left anterior descending artery causes?
Anterior infarct
29
Obstruction of the circumflex artery causes?
Lateral infarct
30
Anterior infarct causes
Loss of LV function and Ventricular fibrillation
31
What is the left ventricle and septum mostly supplied by?
left coronary artery
32
What is the right ventricle and the part of the septum containing the bundle of HIs mistly supplied by?
Right coronary artery
33
What is coronary dominance determined by?
The artery that gives off the posterior IV/ posterior descending artery
34
What is atheroslcerosis?
Condition in which arteries become clogged with fatty substances called plaques and atheroma
35
Sites of coronary artery occlusion due to atherosclerosis in order of frequency
1. LAD of LCA 2. RCA 3. Circumflex of LCA
36
Occlusion of coronary arteries may...
damage the conducting system
37
How does occlusion of coronary arteries damage the conducting system?
* LAD to septal branches supplying AV bundles * RCA supplies both SA and AV nodes * Heart block Symptom = bradycardia
38
What is bundle branch block?
* Ischaemic bundle branch ceases to conduct impulses appropriately * USes altered pathways for depolarisation * Impulse travels through myocytes (slower speed) = producing a prolonged QRS complex * Loss of ventricular function
39
What ECG leads correspond to the lateral portion of the heart?
* I * aVL * V5 * V6
40
What ECG leads correspond to the inferior portion of the heart?
* II * III * aVL
41
What ECG leads correspond to the septal portion of the heart?
* V1 * V2
42
What ECG leads correspond to the anterior portion of the heart?
* V3 * V4
43
What is coronary artery bypass grafting?
bypass of the occluded portion of the vessel?
44
Describe the path of cardiac veins
accompany coronary arteries and their branches
45
Great cardiac vein
(anterior IV vein) * accompanies LAD * Joins coronary sinus
46
What artery does the small cardiac vein accompany?
right marginal branch
47
Where do anterior cardiac veins drain into?
Independently into the RA
48
Where does the middle cardiac vein run?
with posterior interventricular artery and drains into the coronary sinus
49
Where do the majority of cardiac veins drain?
coronary sinus
50
Where is the coronary sinus?
Lies between LA and LV
51
What is the coronary sinus surrounded by?
muscle fibres from the LA
52
What is the function of the coronary sinus?
Drain approx 60% of the venous blood of the heart into the RA
53
Within the cardiac condution system there is a specialised group of modified muscle cells that can:
* generate electrical impulses without external stimuli * lie immediately beneath the endocardium * distribute electrical impulses through the myocardium * cause the heart to contract in a proper sequence
54
What are the components of the conduction system?
o Sino-atrial node (SAN) o Atrioventricular node (AVM) o Atrioventricular bundle (Bundle of His) § Left bundle branch § Right bundle branch o Purkinje fibres \*\*None of them are macroscopic
55
How does the autonomic nervous system affect the cardiac cycle?
shortens or prolongs the duration of the cycle
56
Sino-Atrial Node
* Pacemaker * The basic depolarisation rate of the SA node is 70 to 80 beats per minute * Located anterior to the opening of the SVC, upper end of crista terminalis * Usually supplied by branches of the RCA
57
AV Node
* Located at the poster-inferior part of IA septum, close to the opening of the coronary sinus * Usually supplied by AV nodal branch of the right coronary artery
58
Atrioventricular Bundle
Bundle of His o Continuation of AV node o Runs along the membranous part of the IV septum o Splits into right and left bundle branches o Both right and left split into Purkinje fibres * The AV bundle of His should be the only conductive route through the fibrous skeleton * This system ensures synchronous contraction, in the correct sequence, toward the outflow of each chamber
59
Right Bundle Branch
* Descends on the right side of the membranous part of the IV septum * Enters the septomarginal trabecula to reach the base of the anterior papillary muscles * Splits into Purkinje fibres which spread out into the ventricular walls
60
Left Bundle Branch
* Descends on the left side of the membranous part of the IV septum * Splits into Purkinje Fibres
61
Superifical and deep cardiac plexus
* Lies inferior to the aortic arch, adjacent to the bifurcation of both the pulmonary trunk and the trachea * Supply conduction system, coronary blood vessels, and myocardium
62
Presynpatic sympathetic fibres travel in T1-5(6) spinal nerves
* Increase the heartbeat and force of contraction * Dilate coronary arteries
63
Parasympathetic fibres reach in vagus
* Decrease the heart beat and force of contraction * Constrict coronary arteries
64
Nerve supply of the heart

MD3001 - Cardiology Anatomy (11 decks)

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