Coronary circulation

28,818views

Coronary circulation

Cardiothoracic Disease

Cardiothoracic Disease

Respiratory system anatomy and physiology
Lung volumes and capacities
Anatomic and physiologic dead space
Ventilation
Alveolar gas equation
Compliance of lungs and chest wall
Combined pressure-volume curves for the lung and chest wall
Alveolar surface tension and surfactant
Airflow, pressure, and resistance
Breathing cycle
Breathing control
Pulmonary chemoreceptors and mechanoreceptors
Ideal (general) gas law
Boyle's law
Dalton's law
Henry's law
Fick's laws of diffusion
Graham's law
Diffusion-limited and perfusion-limited gas exchange
Hypoxia
Oxygen binding capacity and oxygen content
Oxygen-hemoglobin dissociation curve
Erythropoietin
Carbon dioxide transport in blood
Regulation of pulmonary blood flow
Zones of pulmonary blood flow
Pulmonary shunts
Ventilation-perfusion ratios and V/Q mismatch
Pulmonary changes during exercise
Pulmonary changes at high altitude and altitude sickness
Diffuse parenchymal lung disease: Clinical
Restrictive lung diseases: Pathology review
Restrictive lung diseases
Idiopathic pulmonary fibrosis
Sarcoidosis
Lung cancer: Clinical
Lung cancer and mesothelioma: Pathology review
Mesothelioma
Cardiovascular system anatomy and physiology
Lymphatic system anatomy and physiology
Cardiac cycle
Normal heart sounds
Abnormal heart sounds
Blood pressure, blood flow, and resistance
Resistance to blood flow
Laminar flow and Reynolds number
Compliance of blood vessels
Pressures in the cardiovascular system
Physiological changes during exercise
Cardiovascular changes during hemorrhage
Cardiovascular changes during postural change
Measuring cardiac output (Fick principle)
Cardiac and vascular function curves
Altering cardiac and vascular function curves
Stroke volume, ejection fraction, and cardiac output
Frank-Starling relationship
Pressure-volume loops
Changes in pressure-volume loops
Cardiac work
Cardiac preload
Cardiac afterload
Law of Laplace
Baroreceptors
Renin-angiotensin-aldosterone system
Chemoreceptors
Cardiac conduction system
Action potentials in pacemaker cells
Action potentials in myocytes
Cardiac conduction velocity
Excitability and refractory periods
Cardiac excitation-contraction coupling
Cardiac contractility
Cerebral circulation
Coronary circulation
Control of blood flow circulation
Microcirculation and Starling forces
Cardiomyopathies: Clinical
Cardiomyopathies: Pathology review
Hypertrophic cardiomyopathy
Dilated cardiomyopathy
Restrictive cardiomyopathy
Sleep apnea
Apnea of prematurity
Aortic aneurysms and dissections: Clinical
Aortic dissections and aneurysms: Pathology review
Aortic dissection
Aneurysms
Marfan syndrome
Peripheral vascular disease: Clinical
Peripheral artery disease: Pathology review
Peripheral artery disease
Arterial disease
Deep vein thrombosis
Leg ulcers: Clinical
Chronic venous insufficiency
Thrombophlebitis
Vasculitis: Pathology review
Vasculitis
Kawasaki disease
Behcet's disease
Nutcracker syndrome
Superior mesenteric artery syndrome
Subclavian steal syndrome
Coronary steal syndrome
Lymphedema
ECG basics
ECG normal sinus rhythm
ECG rate and rhythm
ECG intervals
ECG axis
ECG QRS transition
ECG cardiac hypertrophy and enlargement
ECG cardiac infarction and ischemia
Heart blocks: Pathology review
Premature ventricular contraction
Premature atrial contraction
Atrial fibrillation
Atrial flutter
Atrioventricular nodal reentrant tachycardia (AVNRT)
Wolff-Parkinson-White syndrome
Atrioventricular block
Bundle branch block
Long QT syndrome and Torsade de pointes
Ventricular tachycardia
Brugada syndrome
Ventricular fibrillation
Pulseless electrical activity
Class I antiarrhythmics: Sodium channel blockers
Class II antiarrhythmics: Beta blockers
Class III antiarrhythmics: Potassium channel blockers
Class IV antiarrhythmics: Calcium channel blockers and others
Positive inotropic medications
Sympatholytics: Alpha-2 agonists
Adrenergic antagonists: Alpha blockers
Adrenergic antagonists: Beta blockers
Adrenergic antagonists: Presynaptic
cGMP mediated smooth muscle vasodilators
Calcium channel blockers
Heart failure: Clinical
Heart failure: Pathology review
Heart failure
Cor pulmonale
Pulmonary hypertension
Pulmonary edema
Anatomy of the coronary circulation
Asthma: Clinical
Obstructive lung diseases: Pathology review
Asthma
Chronic obstructive pulmonary disease (COPD): Clinical
Chronic bronchitis
Emphysema
Alpha 1-antitrypsin deficiency
Bronchodilators: Beta 2-agonists and muscarinic antagonists
Bronchodilators: Leukotriene antagonists and methylxanthines
Pulmonary corticosteroids and mast cell inhibitors
Non-corticosteroid immunosuppressants and immunotherapies
Cystic fibrosis: Pathology review
Cystic fibrosis
Bronchiectasis
Anatomy of the heart
Anatomy clinical correlates: Heart
Cardiac muscle histology
Marfan syndrome
Ehlers-Danlos syndrome
Arteriole, venule and capillary histology
Cardiac muscle histology
Artery and vein histology
Trachea and bronchi histology
Bronchioles and alveoli histology
Nasal cavity and larynx histology
Coarctation of the aorta
Mitral valve disease
Pulmonary valve disease
Tricuspid valve disease
Aortic valve disease
Ventricular arrhythmias: Pathology review
Supraventricular arrhythmias: Pathology review
Coronary artery disease: Clinical
Atherosclerosis and arteriosclerosis: Pathology review
Coronary artery disease: Pathology review
Arterial disease
Angina pectoris
Unstable angina
Myocardial infarction
Prinzmetal angina
Coronary steal syndrome

Transcript

Watch video only

Introduction

With coronary circulation, coronary comes from the Latin word “coronarius,” meaning "crown." This is because the coronary blood vessels surrounding the heart resembles a little crown! And circulation refers to “the flow of blood.” So, coronary circulation is the movement of blood throughout the vessels that supply the myocardium also known as the heart muscle.

Now, the heart is a pump, primarily made up of cardiac muscle cells known as cardiomyocytes. And like any other cell, they require a steady supply of oxygen, nutrients, and a way to eliminate wastes. And although the heart is continually pumping blood throughout its chambers, the myocardium is too thick for the diffusion of blood to happen effectively. So, instead, the coronary circulation provides an efficient way for the exchange of substances to occur.

Coronary Circulation

Okay, the coronary circulation system is mainly made up of arteries and veins. To begin, the arterial supply of the heart starts with the branching out of the left and right coronary arteries from the base of the aorta. It’s like a superhighway that carries oxygenated blood from the heart to the rest of the body.

Left Coronary Artery

Now, the left coronary artery heads along the left coronary sulcus, a groove on the outer surface of the heart that marks the point of division between the ventricles and the atria. Not too far along the sulcus, the left coronary artery divides into two major branches. The first is the left anterior descending artery or LAD. It travels down the anterior interventricular sulcus, and it supplies the anterior 2/3 of the interventricular septum, the anterolateral papillary muscle, and the anterior surface of the left ventricle. The second branch is the left circumflex artery or LCX. It goes along the coronary sulcus, around the left side of the heart and supplies the left atrium and the posterior walls of the left ventricle.

Right Coronary Artery

Alternatively, the right coronary artery heads in the opposite direction, following the coronary sulcus, and along the way it supplies the SA node It later divides into two branches. The first is the right marginal artery, which stretches along the margins of the bottom right side of the heart, supplying the right ventricle. The second branch is the posterior descending artery or PDA, sometimes called the posterior interventricular artery. It goes down the posterior interventricular sulcus towards the heart’s apex while supplying the posterior 1/3 of the interventricular septum the posterior 2/3 of the ventricular walls, and the posteromedial papillary muscle. At the apex, the posterior descending artery merges with its anterior counterpart, through interconnected arterial branches called anastomoses. Together, they supply the right atrium and nearly all of the right ventricle.