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Heart (Coronary arteries (Both left and right coronary arteries arise from…
Heart
Coronary arteries
- Both left and right coronary arteries arise from left and tight aortic sinuses
- Left aortic sinus lies on left side of ascending aorta, right aortic sinus lies posteriorly
- Coronary sinus: venous vessel that is derived from the confluence of four coronary veins
- Receives venous blood from great, middle, small and posterior cardiac veins
- Descending aorta is a continuation of aortic arch
- Runs through chest and abdomen before bifurcating into left and right common iliac arteries
- Pulmonary veins carry oxygenated blood from lungs to left atrium. No branches
- Pulmonary artery carries deoxygenated blood from right ventricle to lungs, bifurcates to form left and right, travel to left and right lungs
Anatomy
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Relations
- Heart and roots of great vessels within pericardial sac related anteriorly to sternum
- Medial ends of 3rd to 5th ribs on left and their associated costal cartilages
- Heart and pericardial sac are situated obliquely two thirds to left and one third to right of median plane
- Pulmonary valve: lies level of the left third costal cartilage
- Mitral valve lies level of fourth costal cartilage
Coronary sinus
- Posterior part of coronary groove
- Receives blood from cardiac veins
- Great cardiac vein lies at its left
- Middle and small lies on its right
- Smallest cardiac vein (anterior cardiac vein) drains into right atrium directly
Aortic sinus
- Right coronary artery arises from right aortic sinus
- Left is derived from left aortic sinus, lies posteriorly
Valves
Aortic
- 3 cusps
- 2nd heart sound
- 2 anterior cusps
- No chordae
Pulmonary
- 3 cusps
- 2nd heart sound
- 2 anterior cusps
- No chordae
Mitral
- 2 Cusps
- First heart sound
- 1 anterior cusp
- Attached to choardae tendiane
Tricuspid
- 3 cusps
- 1st heart sound
- 2 anterior cusps
- Attached to chordae tendinae
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Superior vena cava
Drainage
- Head and neck
- Upper limbs
- Thorax
- Part of abdominal walls
Formation
- Subclavian and internal jugular veins unite to form right and left brachiocephalic veins
- Unite to form SVC
- Azygos vein joins SVC before it enters right atrium
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Coronary arteries
RCA
Supplies:
- Right atrium
- Diaphragmatic part of left ventricle
- Usually posterior third of interventricular septum
- Sino atrial node (60%)
- AV node (20%)
LCA
Supplies:
- Left atrium
- Most of left ventricle
- Part of right ventricle
- Anterior two thirds of interventricular septum
- Sino atrial node (40%)
Scalene muscles
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table
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Relations
- Brachial pleux and subclavian artery pass between anterior and middle scalenes (scalene hiatus)
- Subclavian vein and phrenic nerve pass anteriorly to anterior scalene as it crosses over first rib
Innervation
- Autonomic nerve fibers from superficial and deep plexus
- Lie anterior to bifurcation of trachea , posterior to ascending aorta and superior to bifurcation of pulmonary trunk
- Parasymphathetic supply to heart is from presynaptic fibers of vagus nerve