KNES260 - Vasculature of the heart

When looking at a heart, which 3 clues can tell you that it is in anatomical position?

1. From right to left : SVC → Aorta → pulmonary trunk

2. SVC and IVC will align in the sagittal plane

3. The apex of the heart is directed anteriorly and to the left

(reminder: right side of the heart will be on my left side if I look at it from the front)

What are those structures, and what do they do?

1. Right auricle

2. Left auricle

They serve as landmarks for the vasculature of the heart, and they allow for more blood to be collected (increases space in atria)

What layer(s) would we have to remove to clearly identify the grooves of the heart?

Adipose tissue + visceral layer of serous pericardium

Name the 2 grooves of the heart. Describe them slightly (their positions)

1. Atrioventricular (AV) groove → between the atrium and the ventricles, wraps all the way around the heart

2. Interventricular (IV) groove → between the two ventricles (stops when reaching the atrium)

Her are the grooves in pictures. From an anterior view

From a posterior view

Which 2 vessels rise from the ascending aorta, just distal to the aortic valve?

Right and left coronary arteries (RCA and LCA)

Compared to the left, the right coronary artery is (shorter or longer) ?

Longer

The left coronary artery is _________ to the pulmonary trunk

Posterior

The RCA and LCA travel in the ______________

AV groove (also known as the coronary sulcus)

Anteriorly, the RCA will branch off into two other arteries (two = that I need to know). What are they? How can I recognize each one?

1. Sinoatrial nodal artery : proximal branch of the RCA, travels to SVC deep to the right auricle *sometimes arise from LCA

2. Right marginal artery : travels towards the apex of the heart, supplies the right ventricle

Posteriorly, the RCA branches off into the…

Posterior interventricular artery: located in IV groove, connects with the anterior interventricular artery

The LCA bifurcates into two branches (just before the right auricle): first, the ___________________ (deep to left auricle) travels in the ________, with the ___________ on the __________ aspect of the heart. This branch branches further into the ____________, which supplies the ____________.

Circumflex branch of the LCA, AV groove, coronary sinus, posterior, left marginal artery, left ventricle

The LCA bifurcates into two branches (just before the right auricle): the second branch is called the _________________, located in the _________; it connects with the __________________

Anterior interventricular artery, IV groove, posterior interventricular artery

What and where is the coronary sinus ?

A big vessel located within the AV groove on the posterior aspect (only!) of the heart → receives venous blood from most veins of the heart and brings it to the right atrium

The ______________ is the main tributary of the coronary sinus, and it conveys venous blood to the _____ side of the coronary sinus

Great cardiac vein, left

The ______________ travels with the posterior interventricular artery; the ___________ travels with the right coronary artery and right marginal artery

Middle cardiac vein, small cardiac vein

T/F: the middle cardiac vein starts on the anterior aspect of the heart and then “becomes” the coronary sinus as it travels posteriorly

False, it’s the great cardiac vein

Match the arteries with their venous travel buddies

1. Circumflex branch of LCA

2. Posterior interventricular artery

3. Right coronary artery

4. Right marginal artery

A. Middle cardiac vein

B. Small cardiac vein (use 2x)

C. Coronary sinus

1. C

2. A

3. B

4. B

The anterior cardiac veins are _________ and ____________ to the RCA and AV groove; and they bring venous blood directly into the __________

Perpendicular, superficial, R atrium

Identify

1. LCA

2. Pulmonary trunk

3. RCA

Identify

1. Sinoatrial nodal artery

2. RCA

3. Right marginal artery

Identify

1. RCA

2. Posterior IV artery

Identify

1. LCA

2. Left auricle

3. Pulmonary trunk

Identify

1. LCA

2. Circumflex branch of the LCA

3. Left marginal artery

4. Anterior IV artery

Which 2 vessels are encircled there ?

The circumflex branch of the LCA and the coronary sinus

What is this?

The opening for the coronary sinus in the R atrium

Identify

1. Small cardiac vein

2. Great cardiac vein

Identify

1. Great cardiac vein

2. Middle cardiac vein

3. Small cardiac vein

Identify the pairs of vessels travelling together (either one within the pairs is interchangeable)

1. Circumflex branch of the LCA

2. Coronary sinus

3. Posterior IV artery

4. Middle cardiac vein

5. RCA

6. Small cardiac vein

7. Right marginal artery

8. Small cardiac vein

9. Anterior IV artery

10. Great cardiac vein

Identify

1. Anterior cardiac veins

2. RCA

Identify the structures. Orienting yourself correctly first is the key here

1. LCA

2. Anterior interventricular artery

3. Circumflex branch of the LCA

4. Coronary sinus

5. RCA