Coronary Vasculature

"Coronary Arteries in 3D"

Coronary artery in 3D from 3D vascular atlas image using volume rendering techniques (3D CT):  courtesy of Elliot Fishman, MD, (c) 2000, Department of Radiology, Johns Hopkins University, used with permission.

• Circumflex branch

  •  Follows atrioventricular groove

  •  One branch: obtuse marginal

  •  Perfuses

    • All the posterior left ventricular

    • Part of the right ventricular wall

  •  Electrocardiographic changes associate with circumflex coronary artery disease observed in: leads I and aV_L

• Sinus node and atrioventricular (AV node) nodal arteries: originates from the right coronary artery

• Sinus nodal artery: supplies the right atrial myocardium.

• Blood supply to the AV node and Bundle of His: 

  1. Right coronary artery atrioventricular branch  (90% of hearts)

  2. Septal perforating branches of the left anterior descending vessel (10% of hearts) are

• Blood supply to the right bundle branch:

  • Branches of the left anterior descending coronary vessel

•  Electrocardiographic changes associated with right coronary artery occlusion:

  • ECG changes in leads II, III, and aV_F

  • Aberrant conduction

   

•   Coronary Artery Perfusion Patterns

  • Left Coronary Artery

    • Anterolateral left ventricle

    • Anterior descending branch

    • Right bundle branch

    • Left bundle branch

    • Anterior and posterior papillary muscles (mitral)

  • Right Coronary Artery

    • Sinoatrial (SA) and Atrioventricular (AV) nodes

    • Right atrium and ventricle

    • Posterior interventricular septum

    • Posterial fascicle of left bundle branch (LBB)

    • Interatrial septrum

  • Circumflex Artery Branch

    • Lateral left ventricle

• Cerebral Circulation: Components

  • Circle of Willis

    1. Anterior communicating arteries

    2. Internal carotid arteries

    3. Posterior communicating arteries

    4. Vertebral arteries

       1. Circle of Willis

          courtesy of vesalius (http://www.vesalius.com), used with permission

 

• Internal carotid artery Horizontal (A1) segment of anterior cerebral artery (ACA) Anterior communicating artery (ACOM) Posterior communicating artery (PCOM) P1 segment of posterior cerebral artery Basilar artery bifurcation Middle cerebral artery (MCA) Vertebral arteries image: William G. Staten, R.T. (R) (ARRT), copyright November 1996

• External carotid supply:

  • Face

  • Neck (not brain)

•  Clinical Note:

  • During carotid artery surgery, a pressure transducer inserted into the internal carotid artery {during clamping of external and common carotid arteries} allow measurement of arterial pressure occurring as a result the blood flow through the circle of Willis

• Bronchial Circulation

  • Origination of bronchial arteries: from the thoracic aorta at T5 and  T6 or intercostal arteries

  • Three bronchial arteries (to for the left lung; one for the right lung)

  • Clinical factors which may change bronchial circulation

    •  Inadequate pulmonary flow -- e.g. in congenital heart disease-- causes an increase in blood flow

    •  Tumor (increase flow)

    •  Injury (increase flow)

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