Blood supply of heart

BLOOD SUPPLY OF HEART
anatomy 1st year

1. BLOOD SUPPLY OF HEART

2. CONTENTS Heart Arterial supply Venous drainage

3. HEART The heart is a conical hollow muscular organ situated in the middle mediastinum . It is enclosed within the pericardium. It is placed obliquely behind the body of sternum and adjoining parts of costal cartilages.

4. FEATURES OF HEART The human heart has four chambers:

5. ARTERIAL SUPPLY OF HEART The heart is supplied by TWO arteries Left coronary is larger in calibre and supplies more myocardium. LEFT CORONARY ARTERY RIGHT CORONARY ARTERY

6. Right Coronary Artery It arises from the anterior aortic sinus of ascending aorta.

7. COURSE OF RIGHT CORONARY ARTERY

8. BETWEEN PULMONARY TRUNK AND RT. AURICLE PASSES FORWARD MOVES DOWNWARDS ATRIO-VENTRICULAR GROOVE WINDS AROUND INFERIOR BORDER PASSES UPWARDS ALONG ATRIO-VENTRICULAR GROOV CRUX OF THE HEART TERMINATES ANASTOMOSING WITH CIRCUMFLEX BRANCH OF LEFT. CORONARY ARTERY

9. CRUX OF THE HEART It is the meeting point of interatrial,posterior interventricular and posterior part of atrioventricular groove.

10. BRANCHES FROM ANTERIOR SEGMENT Ventricular rami Atrial Rami Right conus artery Right anterior ventricular rami BRANCHES FROM POSTERIOR SEGMENT RIGHT POSTERIOR VENTRICULAR RAMI POSTERIOR INTRANVENTRICULAR BRANCH RIGHT POSTERIOR ATERIAL RAMI ARISE FROM CRUX OF HEART AS A SINGLE A BRANCH IN 70% CASES

11. LEFT CORONARY ARTERY Left coronary artery is wider than right coronary artery. It arises from left posterior aortic sinus of ascending aorta.

12. COURSE OF LEFT CORONARY ARTERY

13. PASSES BEHIND THE PULMONARY TRUNK GOES ON BETWEEN PULMONARY TRUNK AND LEFT AURICLE DIVIDES INTO 2 BRANCHES ANTERIOR INTERVENTRICULAR CIRCUMFLEX DESCENDS ALONG STERNO-COSTAL SURFACE WINDS AROUND INCISURA APICIS CORDIS END PASSES ALONG THE LEFT OF AV GROOV WINDS AROUND LEFT BORDER POSTERIOR PART OF AV GROOVE ANATOMOSING WITH RIGHT CORONARY ARTERY

14. BRANCHES ANTERIOR INTERVENTRICULAR ARTERY CIRCUMFLEX ARTERY Anterior ventricular rami one of the right anterior ventricular rami forms the left conus artery which supplies the infundibulum of right ventricle. Septal rami Atrial and ventricular rami Sinu -atrial nodal artery (35% subjects arises from circumflex branch) Left marginal artery Posterior interventricular artery It extends as a continuation of circumflex branch in 10% to 20% individuals. An atrial branch of circumflex artery

15. CORONARY DISTRIBUTION Right coronary artery supplies whole of right atrium, most of the right ventricle except a strip along the anterior interventricular groove. Left coronary artery supplies most of the left atrium and left ventricle except a strip along the posterior and inferior surfaces of the heart.

16. Coronary Artery Dominance The artery that gives the posterior interventricular artery determines the coronary dominance. RCA (Right coronary artery) CX(Circumflex artery)

17. VENOUS DRAINAGE The venous drainage of the heart is by 3 ways 1.Coronary sinus 2.Anterior Cardiac Veins 3.Venae Cordis Minimae

18. CORONARY SINUS It is the largest vein of the heart situates in the left posterior coronary sulcus.It is about 3cm. long and ends by opening into the posterior wall of the right atrium.

19. Branches 1. Great cardiac vein -it enter the left end of the coronary sinus. 2. Middle cardiac veins -it accompanies the posterior interventricular artery and joins the right end of the coronary sinus. 3. Small cardiac veins -it accompanies the right coronary srtery and joins the right end of the coronary sinus. 4. Posterior veins of left ventricle -it runs on the diaphragmatic surface of the left ventricle and ends in the coronary sinus. 5. Oblique vein of the left atrium -it runs on the posterior surface of the left atrium,joins the left end of coronary sinus and develops from the left common cardinal veins. 6. The right marginal veins - it accompanies the marginal branch of the right coronary artery.

20. ANTERIOR CARDIAC VEINS The anterior cardiac veins are three or four small veins run on the anterior wall of the right ventricle,open directly into the right atrium.

21. VENAE CORDIS MINIMAE Numerous small veins present in all four chambers of the heart which opens directly into the cavities.