Coronary circulation

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Coronary circulation

General CV system

General CV system

Introduction to the cardiovascular system
Anatomy of the heart
Anatomy of the coronary circulation
Anatomy clinical correlates: Heart
Anatomy of the superior mediastinum
Anatomy of the inferior mediastinum
Anatomy clinical correlates: Mediastinum
Development of the cardiovascular system
Fetal circulation
Cardiac muscle histology
Artery and vein histology
Arteriole, venule and capillary histology
Cardiovascular system anatomy and physiology
Lymphatic system anatomy and physiology
Coronary circulation
Blood pressure, blood flow, and resistance
Pressures in the cardiovascular system
Laminar flow and Reynolds number
Resistance to blood flow
Compliance of blood vessels
Control of blood flow circulation
Microcirculation and Starling forces
Measuring cardiac output (Fick principle)
Stroke volume, ejection fraction, and cardiac output
Cardiac contractility
Frank-Starling relationship
Cardiac preload
Cardiac afterload
Law of Laplace
Cardiac and vascular function curves
Altering cardiac and vascular function curves
Cardiac cycle
Cardiac work
Pressure-volume loops
Changes in pressure-volume loops
Physiological changes during exercise
Cardiovascular changes during hemorrhage
Cardiovascular changes during postural change
Normal heart sounds
Abnormal heart sounds
Action potentials in myocytes
Action potentials in pacemaker cells
Excitability and refractory periods
Cardiac excitation-contraction coupling
Electrical conduction in the heart
Cardiac conduction velocity
ECG basics
ECG rate and rhythm
ECG intervals
ECG QRS transition
ECG axis
ECG normal sinus rhythm
ECG cardiac infarction and ischemia
ECG cardiac hypertrophy and enlargement
Baroreceptors
Chemoreceptors
Renin-angiotensin-aldosterone system
Arterial disease
Angina pectoris
Stable angina
Unstable angina
Myocardial infarction
Prinzmetal angina
Coronary steal syndrome
Peripheral artery disease
Subclavian steal syndrome
Aneurysms
Aortic dissection
Vasculitis
Behcet's disease
Kawasaki disease
Hypertension
Hypertensive emergency
Renal artery stenosis
Coarctation of the aorta
Cushing syndrome
Conn syndrome
Pheochromocytoma
Polycystic kidney disease
Hypotension
Orthostatic hypotension
Abetalipoproteinemia
Familial hypercholesterolemia
Hypertriglyceridemia
Hyperlipidemia
Chronic venous insufficiency
Thrombophlebitis
Deep vein thrombosis
Lymphedema
Lymphangioma
Shock
Vascular tumors
Human herpesvirus 8 (Kaposi sarcoma)
Angiosarcomas
Truncus arteriosus
Transposition of the great vessels
Total anomalous pulmonary venous return
Tetralogy of Fallot
Hypoplastic left heart syndrome
Patent ductus arteriosus
Ventricular septal defect
Atrial septal defect
Atrial flutter
Atrial fibrillation
Premature atrial contraction
Atrioventricular nodal reentrant tachycardia (AVNRT)
Wolff-Parkinson-White syndrome
Ventricular tachycardia
Brugada syndrome
Premature ventricular contraction
Long QT syndrome and Torsade de pointes
Ventricular fibrillation
Atrioventricular block
Bundle branch block
Pulseless electrical activity
Tricuspid valve disease
Pulmonary valve disease
Mitral valve disease
Aortic valve disease
Dilated cardiomyopathy
Restrictive cardiomyopathy
Hypertrophic cardiomyopathy
Heart failure
Cor pulmonale
Endocarditis
Myocarditis
Rheumatic heart disease
Pericarditis and pericardial effusion
Cardiac tamponade
Dressler syndrome
Cardiac tumors
Acyanotic congenital heart defects: Pathology review
Cyanotic congenital heart defects: Pathology review
Atherosclerosis and arteriosclerosis: Pathology review
Coronary artery disease: Pathology review
Peripheral artery disease: Pathology review
Valvular heart disease: Pathology review
Cardiomyopathies: Pathology review
Heart failure: Pathology review
Supraventricular arrhythmias: Pathology review
Ventricular arrhythmias: Pathology review
Heart blocks: Pathology review
Aortic dissections and aneurysms: Pathology review
Pericardial disease: Pathology review
Endocarditis: Pathology review
Hypertension: Pathology review
Shock: Pathology review
Vasculitis: Pathology review
Cardiac and vascular tumors: Pathology review
Dyslipidemias: Pathology review
Sympatholytics: Alpha-2 agonists
Adrenergic antagonists: Presynaptic
Adrenergic antagonists: Alpha blockers
Adrenergic antagonists: Beta blockers
ACE inhibitors, ARBs and direct renin inhibitors
Thiazide and thiazide-like diuretics
Calcium channel blockers
cGMP mediated smooth muscle vasodilators
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
Lipid-lowering medications: Statins
Lipid-lowering medications: Fibrates
Miscellaneous lipid-lowering medications
Positive inotropic medications
Cardiomyopathies: Clinical
Congenital heart defects: Clinical
Valvular heart disease: Clinical
Infective endocarditis: Clinical
Pericardial disease: Clinical
Chest trauma: Clinical
Hypertension: Clinical
Pulmonary hypertension
Aortic aneurysms and dissections: Clinical
Raynaud phenomenon
Peripheral vascular disease: Clinical
Heart failure: Clinical
Coronary artery disease: Clinical
Deep vein thrombosis and pulmonary embolism: Pathology review
Fascia, vessels and nerves of the upper limb
Vessels and nerves of the forearm
Vessels and nerves of the hand
Anatomy of the abdominal viscera: Blood supply of the foregut, midgut and hindgut
Fascia, vessels, and nerves of the lower limb
Vessels and nerves of the gluteal region and posterior thigh
Anatomy of the popliteal fossa
Ventilation
Ventilation-perfusion ratios and V/Q mismatch
Gas exchange in the lungs, blood and tissues
Oxygen binding capacity and oxygen content
Oxygen-hemoglobin dissociation curve
Carbon dioxide transport in blood
Trypanosoma cruzi (Chagas disease)
Yellow fever virus
Rickettsia rickettsii (Rocky Mountain spotted fever) and other Rickettsia species
Arteriovenous malformation
Cerebral circulation

Assessments

Flashcards

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USMLE® Step 1 questions

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High Yield Notes

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Flashcards

Coronary circulation

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Questions

USMLE® Step 1 style questions USMLE

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A 65-year-old man presents to the emergency department because of episodic, burning substernal chest pain. According to past medical records, the patient has a right-dominant circulation. A myocardial perfusion scan reveals inducible ischemia in the posteroinferior surface of the heart. This region of the heart is supplied by which of the following vessels?  

External References

First Aid

2024

2023

2022

2021

Codominant coronary circulation p. 288

Coronary arteries

anatomy of p. 289

atherosclerosis in p. 305

occlusion of p. 289

Coronary artery

atherosclerosis in p. 731

Left anterior descending artery

coronary circulation p. 288

Left-dominant coronary circulation p. 288

Right coronary artery (RCA)

coronary circulation p. 289

Right-dominant coronary circulation p. 288

Transcript

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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.