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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

Coronary Vasculature

Dr. Nivin Sharaf MD

LMCC

objectives
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 artery
  • Recognize innervation of the heart
venous drainage cont
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
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
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 heart1
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

innervation of the heart con
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)
lymphatic trainage
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
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