Download - Coronary Vasculature
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CORONARY VA
SCULATURE
DR . N
I V I N S H A R A F MD
L MC C
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OBJECTIVESThis lecture covers the ILO titled: Enlist the arteries, veins and
nerves supplying the heart.By the end of this lecture we will be able to:Define Right/ left or Coronary co dominance Enlist areas of the heart supplied by the right andd left
coronary arteriesDefine the origins of coronary arteriesRecognize innervation of the heart
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ORIGIN
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ORIGIN CONT.
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RIGHT CORONARY ARTERY (RCA)Supplies:Right atriumMost of right ventricleDiaphragmatic surface of left ventriclePost 1/3 of iv septumSA node 60% of peopleAV node 80% of people
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LEFT CORONARY ARTERY
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LEFT CORONARY ARTERY (LCA)Supplies- Left atrium- - Most of lt ventricle- Part of right ventricle- Most of the interventricular septum 2/3 rds- SAN (40%)- AVN( 20%)
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VENOUS DRAINAGE
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VENOUS DRAINAGE CONT.The heart is drained by veins that empty in the coronary sinus,
partly by small veins that empty in the right atrium
Coronary sinus:Main vein of the heartRuns left to right in the coronary groove
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CORONARY SINUSTributaries:Great Cardiac Vein= Anterior interventricular vein, runs with
LADDrains most of the area supplied by the left coronary arteryMiddle Cardiac Vein and small cardiac veins:Drains most of the area supplied by the right coronary arteryMiddle Cardiac vein runs in the posterior intervenricular groove
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INNERVATION OF THE HEARTAutonomic nervous system from superficial and deep Cardiac
plexusesNerve networks lie anterior to the bifurcation of the trachea,
posterior to ascending aortaSuperior to bifurcation of Pulmonary trunk
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INNERVATION OF THE HEARTParasympathetic supply:Presynaptic fibers of the vagus nervesPost synaptic fibers also end in the SA,& AV nodes, and directly on the coronary arteries
Stimulation results in Saving energy between periods of increased demands)Decreased heart rateReduce the force of heart beatsConstrics cornoray arteries
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INNERVATION OF THE HEART CON.Sympathetic stimulationIncreases heart rate, and the force of
contraction, and inhibits contraction of the coronary arteries”Passively dilates “
Presynaptic fibers with cell bodies in the lateral horn of T1-6 segments of spinal cord
Postsynaptic: cervical, and superior thoracic prevertebral ganglia of the sympathetic trunk( end in SA, and AV nodal tissue)
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LYMPHATIC TRAINAGESubepicardial lymphatic plexusPass to the coronary groove, and follow the coronary arterieEnd in the inferior tracheobronchial lymphnodes, usually on the
right side
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REFERENCEShttp://www.youtube.com/watch?v=Rcn3ZV-Iy6oMyocardial blood supplyhttp://www.youtube.com/watch?v=tBQa8IBzP6I
Anatomy of the hearthttp://www.youtube.com/watch?v=960_mAShiXQPart IIhttp://www.youtube.com/watch?v=Vr-DAhgq75w&feature=relmfu
CLINICALLY ORIENTED ANATOMY FOURTH EDITION/ KEITH L. MOORE RECOMMENDED READING PAGES 132-139