Intro To Cardiology

Front 1

List the major branches of the Coronary arteries

Back 1

1. Left main coronary artery:
--> Left anterior descending gives rise to septal perforators (penetrates IV septum) and diagonal branches (along surface of heart)
--> Circumflex Artery gives rise to obtuse marginal branches (provide flow to lateral wall, or obtuse margin of heart)

2. Right coronary artery gives rise to posterior descending artery (90% dominant) (runs along posterior aspect of IV septum, feeding posterolateral wall of LV)

Front 2

What does the LAD Artery supply?

Back 2

LAD: runs along front of heart, wraps around the apex

Supplies the entire anterior and apex of the LV
--danger of rupture in transmural MI
--prone to mural thrombosis in anterior MI

Supplies anterior IV septum
--Danger of permanent BBB in anterior MI
--Permanent pacemaker is often required

Front 3

What does the RCA supply?

Back 3

RCA: leaves the aorta anteriorly, runs down anterior atrioventricular groowve giving rise to RV branches

Supplies the entire posterior and inferior part of the left ventricle, including posterior 1/3 of IVS (if R-dominant coronary circ): responsible for epigastric pain in MI

Supplies the entire right ventricle: right ventricular infarction

Supplies the posteromedial papillary muscle: danger of papillary muscle rupture and mitral regurgitation in MI

Supplies most of the blood to the AV node: danger of sinus bradycardia

Front 4

What does the Left circumflex supply?

Back 4

Left Circumflex: runs posteriorly in atrioventricular groove

Supplies lateral wall of left ventricle

Can also supply posterior wall if Left dominant coronary circulation

Front 5

What artery is affected in an ANTERIOR infarct?

Back 5

Left Anterior Descending Artery

Front 6

What artery is affected in an ANTEROLATERAL infarct?

Back 6

Occlusion of Left circumflex, marginal branch of left circumflex, or diagonal branch of Left anterior descending

Front 7

What artery is affected in a DIAPHRAGMATIC or INFERIOR infarct?

Back 7

Occlusion of right coronary artery

Front 8

What artery is affected in a TRUE POSTERIOR infarct?

Back 8

Occlusion of posterior descending of distal right coronary artery

Occlusion of distal circumflex art

Front 9

In Right Heart Dominance, which vessels provides a majority of the flow to the inferior and posterior walls of the left ventricle?

Back 9

90% of the time RCA s dominant, supplying the majority of the flow to the inferior and posterior walls of the LV

Front 10

In Left Heart Dominance, which vessels provides a majority of the flow to the inferior and posterior walls of the left ventricle?

Back 10

About 10% of the time, RCA is very small, and LCX which runs posteriorly in the atrioventricular groove, continues in the groove all the way to the back of the heart

In this case: Left Coronary artery is dominant
--> Occlusion of LCX will have much more serious consequences b/c you'll knock out:
1) majority of the flow to the inferior and posterior walls
2) the lateral wall, or obtuse margin of the heart(obtuse marginal branch of LCX)

Front 11

Who provides bloodflow to the Sinus node?

Back 11

SA Node blood flow:

RCA: 55% of the time
LCA: 45% of the time

Front 12

Who provides bloodflow to the AV node?

Back 12

AV Node blood flow:

RCA: 90% of the time
LCA: 10% of the time

Front 13

Where is the sinus node located?

Back 13

SA node is located at the junction of the SVC and right atrium

Front 14

Explain the functional divide of the AV node

Back 14

AV node has a slow and fast pathway - these are anatomically unique structures with different electrical properties

Fast pathway conducts quickly and repolerizes slowly and v/v

This provides substrate for abnormal cardiac rhythms

Front 15

What is the role of the Papillary muscles?

Back 15

The papillary muscles shorten to help adjust the valve leaflet position to accomodate and seal off a smaller sized atrioventricular orifice and ventricular chamber length during systole

Papillary muscle defects can lead to regurgitation at the AV valves

Front 16

Tricuspid Leaflets

Back 16

Anterior Cusp
Posterior Cusp
Septal Cusp

Front 17

Mitral Leaflets

Back 17

Anterior Cusp
Posterior Cusp

Front 18

Pulmonic leaflets

Back 18

Anterior semilunar Cusp
Right semilunar Cusp
Left semilunar Cusp

Front 19

Aortic Leaflets

Back 19

Left semilunar Cusp
Right semilunar Cusp
Posterior semilunar Cusp

Front 20

Inter-valve/ Cusp Relationships

Back 20

Tricuspid septal cusp shares fibrous trigone with anterior cusp of mitral valve

Mitral valve anterior cusp also shares fibrous trigone with posterior aortive semilunar cusp

Left Pulmonic cusp next to left aortic

Right pulmonic cusp next to right aortic