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Coronary Vasculature

Coronary Vasculature. Dr. Nivin Sharaf MD LMCC. 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

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Coronary Vasculature

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  1. Coronary Vasculature Dr. Nivin Sharaf MD LMCC

  2. 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

  3. Origin

  4. Origin Cont.

  5. 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

  6. Left Coronary Artery

  7. 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%)

  8. Venous drainage

  9. 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

  10. 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

  11. 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

  12. 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 Constricscornoray arteries

  13. Innervation of the Heart Con. • Sympathetic stimulationIncreases 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)

  14. 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

  15. 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

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