CORONARY VASCULATURE DR. NIVIN SHARAF MD LMCC. OBJECTIVES This lecture covers the ILO titled: Enlist...
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Transcript of CORONARY VASCULATURE DR. NIVIN SHARAF MD LMCC. OBJECTIVES This lecture covers the ILO titled: Enlist...
CORONARY VA
SCULATU
RE
DR
. NI V
I N S
HA
RA
F M
D
LM
CC
OBJECTIVES
This 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 arteries
Define the origins of coronary arteries
Recognize innervation of the heart
ORIGIN
ORIGIN CONT.
RIGHT CORONARY ARTERY (RCA)
Supplies:
Right atrium
Most of right ventricle
Diaphragmatic surface of left ventricle
Post 1/3 of iv septum
SA node 60% of people
AV node 80% of people
LEFT CORONARY ARTERY
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%)
VENOUS DRAINAGE
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 heart
Runs left to right in the coronary groove
CORONARY SINUS
Tributaries:
Great Cardiac Vein= Anterior interventricular vein, runs with LAD
Drains most of the area supplied by the left coronary artery
Middle Cardiac Vein and small cardiac veins:
Drains most of the area supplied by the right coronary artery
Middle Cardiac vein runs in the posterior intervenricular groove
INNERVATION OF THE HEART
Autonomic nervous system from superficial and deep Cardiac plexuses
Nerve networks lie anterior to the bifurcation of the trachea, posterior to ascending aorta
Superior to bifurcation of Pulmonary trunk
INNERVATION OF THE HEART
Parasympathetic supply:
Presynaptic fibers of the vagus nerves
Post 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 rate
Reduce the force of heart beats
Constrics cornoray arteries
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)
LYMPHATIC TRAINAGE
Subepicardial lymphatic plexus
Pass to the coronary groove, and follow the coronary arterie
End in the inferior tracheobronchial lymphnodes, usually on the right side
REFERENCES
http://www.youtube.com/watch?v=Rcn3ZV-Iy6o
Myocardial blood supply
http://www.youtube.com/watch?v=tBQa8IBzP6I
Anatomy of the heart
http://www.youtube.com/watch?v=960_mAShiXQ
Part II
http://www.youtube.com/watch?v=Vr-DAhgq75w&feature=relmfu
CLINICALLY ORIENTED ANATOMY FOURTH EDITION/ KEITH L. MOORE
RECOMMENDED READING PAGES 132-139