الثالثة أناتومي CVS (قبل التعديل)
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Questions and Answers

What percentage of cases does the artery to the SA node occur?

  • 40% (correct)
  • 30%
  • 20%
  • 10%

    • Which artery supplies the left margin of the heart?

  • Left marginal artery (correct)
  • Posterior interventricular artery
  • Circumflex artery
  • Right coronary artery

    • Which type of coronary dominance is present in 90% of individuals?

  • Right coronary dominance (correct)
  • Balanced dominance
  • Left coronary dominance
  • Alternate dominance

    • The coronary sinus is defined as what?

    <p>The largest vein draining the heart</p> Signup and view all the answers

    Where does the posterior interventricular artery arise in left coronary dominance?

    <p>From the circumflex branch of the left coronary artery</p> Signup and view all the answers

    What is the termination site of the anterior cardiac veins?

    <p>Directly into the anterior wall of right atrium</p> Signup and view all the answers

    Which of the following statements about the vascular supply of the heart is true?

    <p>Venae cordis minimi open directly into the four chambers, mostly into the atria</p> Signup and view all the answers

    What is the primary function of the coronary sinus?

    <p>To collect blood from cardiac veins and return it to the right atrium</p> Signup and view all the answers

    What is the origin of the Right Coronary Artery?

    <p>Right aortic sinus of the ascending aorta</p> Signup and view all the answers

    Which artery is associated with the left border of the heart?

    <p>Circumflex artery</p> Signup and view all the answers

    Which of the following supplies the right atrium?

    <p>Right atrial branches</p> Signup and view all the answers

    Which branch supplies the posterior part of the interventricular septum?

    <p>Posterior interventricular branch</p> Signup and view all the answers

    What does the Anterior interventricular artery supply?

    <p>Both ventricles</p> Signup and view all the answers

    What structure is supplied by the right conus artery?

    <p>Infundibulum</p> Signup and view all the answers

    Which artery typically supplies the SA node?

    <p>Right Coronary Artery</p> Signup and view all the answers

    Where does the Circumflex artery continue after segmenting along the left border?

    <p>Posterior part of the coronary groove</p> Signup and view all the answers

    Where does the termination of the coronary sinus occur?

    <p>In the right atrium between the IVC opening and the tricuspid orifice</p> Signup and view all the answers

    Which vein ascends in the anterior interventricular groove?

    <p>Great Cardiac Vein</p> Signup and view all the answers

    What type of nerve fibers originate from the vagus nerve?

    <p>Parasympathetic fibers</p> Signup and view all the answers

    Which vein runs in the posterior interventricular groove along with the posterior interventricular artery?

    <p>Middle Cardiac Vein</p> Signup and view all the answers

    The pain from myocardial ischemia is primarily interpreted in which dermatomes?

    <p>T1 to T5</p> Signup and view all the answers

    Which cardiac structure is accompanied by the circumflex artery?

    <p>Great Cardiac Vein</p> Signup and view all the answers

    Which area of the heart does the Posterior Vein of the Left Ventricle primarily supply?

    <p>Diaphragmatic surface of the left ventricle</p> Signup and view all the answers

    What causes angina pectoris?

    <p>Narrowing of the coronary arteries</p> Signup and view all the answers

    Which artery supplies the anterior 2/3 of the interventricular septum?

    <p>Septal branches</p> Signup and view all the answers

    What is the course of the left coronary artery?

    <p>Runs between the pulmonary trunk and the left auricle</p> Signup and view all the answers

    Which artery typically supplies the AV node in most cases?

    <p>Circumflex artery</p> Signup and view all the answers

    What does the posterior interventricular branch supply?

    <p>Posterior surface of both ventricles</p> Signup and view all the answers

    Which of the following branches belongs to the left coronary artery?

    <p>Anterior interventricular artery</p> Signup and view all the answers

    Where does the right coronary artery end?

    <p>In the posterior part of the coronary groove</p> Signup and view all the answers

    Which artery supplies the anterior surface of the right ventricle?

    <p>Right ventricular branches</p> Signup and view all the answers

    Which artery supplies the left atrium and continues as the circumflex branch?

    <p>Left coronary artery</p> Signup and view all the answers

    Which statement correctly describes the left marginal artery?

    <p>It is located on the left margin of the heart.</p> Signup and view all the answers

    What is the primary role of the coronary sinus?

    <p>To drain blood from the heart muscle into the right atrium.</p> Signup and view all the answers

    In which percentage of individuals is right coronary dominance found?

    <p>90%</p> Signup and view all the answers

    Which artery is responsible for supplying the anterior surfaces of the left ventricle?

    <p>Ventricular branches.</p> Signup and view all the answers

    Which of the following statements accurately represents left coronary dominance?

    <p>The posterior interventricular artery arises from the circumflex branch.</p> Signup and view all the answers

    What type of veins predominantly open directly into the atria from the heart wall?

    <p>Venae cordis minimi.</p> Signup and view all the answers

    Which artery supplies the posterior part of the interventricular septum in right coronary dominance?

    <p>Posterior interventricular artery.</p> Signup and view all the answers

    Which of the following correctly describes the anterior cardiac veins?

    <p>They lie on the sternocostal surface of the right ventricle.</p> Signup and view all the answers

    What is the primary function of the great cardiac vein?

    <p>To transport blood from the anterior interventricular groove</p> Signup and view all the answers

    Which vein runs with the right coronary artery?

    <p>Small cardiac vein</p> Signup and view all the answers

    Where do the sympathetic nerve fibers supplying the heart originate?

    <p>From the upper 5 thoracic segments of the spinal cord</p> Signup and view all the answers

    Which structure is responsible for the drainage of the left ventricle?

    <p>Posterior vein of the left ventricle</p> Signup and view all the answers

    What is a common symptom associated with myocardial ischemia?

    <p>Pain in the left side of the chest</p> Signup and view all the answers

    Which nerve fibers are involved in the formation of cardiac plexuses?

    <p>Sympathetic and parasympathetic fibers</p> Signup and view all the answers

    What anatomical feature marks the termination of the coronary sinus?

    <p>Between the IVC opening and the tricuspid orifice</p> Signup and view all the answers

    What condition is characterized by a reduced blood supply due to narrowing of the coronary arteries?

    <p>Angina pectoris</p> Signup and view all the answers

    Study Notes

    Blood Supply of the Heart

    • The heart is supplied by the right and left coronary arteries.
    • The right coronary artery originates from the right aortic sinus and runs in the coronary groove between the right atrium and ventricle.
    • The left coronary artery originates from the left aortic sinus and divides into the anterior interventricular artery and the circumflex artery.
    • The anterior interventricular artery supplies both ventricles and the anterior 2/3 of the interventricular septum.
    • The circumflex artery supplies the left ventricle and the left atrium.
    • Right coronary dominance occurs when the posterior interventricular artery originates from the right coronary artery.
    • Left coronary dominance occurs when the posterior interventricular artery arises from the circumflex artery.
    • Right coronary dominance is found in 90% of individuals, whereas Left coronary dominance is found in 10%.

    Veins of the Heart

    • Venae cordis minimi are small veins that drain the heart and open into the chambers, mostly into the atria.
    • Anterior cardiac veins are 3-4 veins that lie on the sternocostal surface of the right ventricle and drain directly into the anterior wall of the right atrium.
    • The coronary sinus is the largest vein draining the heart and lies in the posterior part of the coronary groove between the back of the left atrium and the diaphragmatic surface of the left ventricle.
    • The coronary sinus ends in the right atrium between the IVC opening and the tricuspid orifice.
    • The great cardiac vein ascends in the anterior interventricular groove, curves, and ends in the posterior part of the coronary groove.
    • The middle cardiac vein runs in the posterior interventricular groove.
    • The small cardiac vein runs in the right posterior part of the coronary groove.
    • The posterior vein of the left ventricle runs on the diaphragmatic surface of the left ventricle.
    • The oblique vein of the left atrium descends obliquely on the back of the left atrium.

    Nerve Supply of the Heart

    • The heart is supplied by parasympathetic fibers from the vagus nerve and sympathetic fibers from the upper 5 thoracic segments of the spinal cord.
    • These nerve fibers form the superficial and deep cardiac plexuses.

    Clinical Correlation

    • Angina pectoris is a condition caused by reduced blood supply to the heart due to narrowing of the coronary arteries.
    • Myocardial infarction is a condition caused by the death of a part of the heart due to a cut off in blood supply.
    • Pain fibers accompany the sympathetic nervous system, leading to pain referred to the T1 to T5 dermatomes which cover the chest and medial upper arm and forearm.
    • This explains why myocardial ischemia (heart pain) is felt along the left side of the chest and inside of the left arm.

    Blood Supply of the Heart

    • Right Coronary Artery:
      • Originates from the right aortic sinus immediately above the aortic valve.
      • Courses in the coronary groove between the right atrium and ventricle.
      • Ends by anastomosing with the circumflex artery.
      • Supplies the:
        • Right conus artery: supplies the infundibulum.
        • Right atrial branches: right atrium.
        • Right ventricular branches: anterior and inferior surfaces of the right ventricle.
        • Marginal artery: inferior border of the heart, supplying both surfaces of the right ventricle.
        • Posterior interventricular branch (posterior descending): posterior surface of both ventricles and posterior 1/3 of the septum.
        • SA node in 60% of cases.
    • Left Coronary Artery:
      • Originates from the left aortic sinus of the ascending aorta.
      • Passes between the pulmonary trunk and the left auricle.
      • Divides into two terminal branches:
        • Anterior Interventricular Artery (Left Anterior Descending):
          • Supplies both ventricles (anterior surface).
          • Gives the following branches:
            • Ventricular branches: both ventricles (anterior surface).
            • Septal branches: anterior 2/3 of the interventricular septum.
            • AV bundle and its branches.
        • Circumflex Artery:
          • Curves on the left border of the heart, continuing in the posterior coronary groove.
          • AV node in most cases.
          • Gives the following branches:
            • Atrial branches: left atrium.
            • Ventricular branches: left ventricle (anterior and posterior surfaces).
            • Artery to SA node: 40% of cases.
            • Left marginal artery: on the left margin of the heart, supplying the left ventricle.
    • Coronary Dominance:
      • Right Coronary Dominance: posterior interventricular artery arises from the right coronary artery (90% of individuals).
      • Left Coronary Dominance: posterior interventricular artery arises from the circumflex branch of the left coronary artery (10% of individuals).

    Veins of the Heart

    • Venae Cordis Minimi:
      • Small veins from the wall of the heart opening directly into the four chambers, primarily the atria.
    • Anterior Cardiac Veins:
      • 3-4 veins located on the sternocostal surface of the right ventricle.
      • Drain directly into the anterior wall of the right atrium.
    • Coronary Sinus:
      • Largest vein draining the heart.
      • Located in the posterior coronary groove between the left atrium and the diaphragmatic surface of the left ventricle.
      • Ends in the right atrium between the IVC opening and the tricuspid orifice.
    • Tributaries of the Coronary Sinus:
      • Great Cardiac Vein:
        • Ascends in the anterior interventricular groove with the anterior interventricular artery.
        • Curves left in the left coronary groove to the back of the heart with the circumflex artery.
      • Middle Cardiac Vein:
        • Runs in the posterior interventricular groove with the posterior interventricular artery.
      • Small Cardiac Vein:
        • Runs in the right posterior coronary groove with the right coronary artery.
      • Posterior Vein of Left Ventricle:
        • Runs on the diaphragmatic surface of the left ventricle.
      • Oblique Vein of the Left Atrium:
        • Descends obliquely on the back of the left atrium.

    Nerve Supply of the Heart

    • Parasympathetic Fibers: from the vagus nerve.
    • Sympathetic Fibers: from the upper 5 thoracic segments of the spinal cord.
    • Both types of nerves contribute to the superficial and deep cardiac plexuses.

    Clinical Correlation

    • Angina Pectoris: reduced blood supply due to narrowing of the coronary arteries.
    • Myocardial Infarction: death of a portion of the heart due to complete blood supply blockage.
    • Pain fibers accompanying the sympathetic nervous system (upper 5 thoracic segments) relay to the dorsal root of the spinal cord. This pain is interpreted in the brain and referred to dermatomes T1 to T5, covering the chest, medial upper arm, and forearm. Therefore, myocardial ischemia (heart pain) is felt along the left side of the chest and inside of the left arm.

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