blood vessels of heart

• Blood supply of the heart

  • Right coronary artery
  • Left coronary artery

  
• Arterial supply


  • Right coronary artery
  • Left coronary artery

  
• Venous drainage


  • Coronary venous sinus
  • Anterior cardiac veins
  • Venae cordis minimi

  
• Origin of coronary arteries

  • Aortic valve
  • Aortic sinuses

  
• Course of right coronary artery

  1. Between pulmonary trunk and right auricle

  2. Anterior part of coronary groove

  3. Posterior part of coronary groove

  
• Course of left coronary artery

  1. Between pulmonary trunk and left auricle

  2. On reaching coronary groove, it divides into circumflex and anterior interventricular arteries

  
• Branches of right coronary artery

  • Right marginal A.
  • Posterior interventricular A.
  • Anterior interventricular A.

  
• Branches of left coronary artery

  • Left marginal A.
  • Anterior interventricular A.

  
• Gradual occlusion of coronary arteries

  Angina pectoris. There is time for healthy anastomosis to open up.
• Sudden occlusion of coronary arteries

  Myocardial infarction (Necrosis of cardiac muscle)
• Coronary venous sinus


  Site: in the posterior part of coronary groove between left atrium and left ventricle. It opens in the right atrium.

  
• Tributaries of coronary venous sinus

  • Great cardiac vein
  • Middle cardiac vein
  • Small cardiac vein
  • Oblique vein of left atrium
  • Posterior vein of left ventricle

  
• Anterior cardiac veins


  1. 5 cardiac veins that receive venous drainage of right ventricle. They open in the right atrium.
• The inferior surface and base of the heart

  
• Pulmonary trunk


  • Begins at pulmonary orifice of the right ventricle opposite the left 3rd costal cartilage
  • 5 cm long
  • Runs upwards & backward in front of the ascending aorta then on its left side
  • Completely covered with the pericardium
  • Divides into right and left pulmonary arteries below the arch of aorta at the level of T4
• Aorta


  Divided into 3 parts: Ascending, Arch and descending aorta
• Ascending aorta


  • Begins at the aortic orifice of left ventricle opposite left 3rd intercostal space
  • Lies in the middle mediastinum
  • 5 cm long
  • Ascends upwards, forwards & to the right behind the body of the sternum
  • Runs at first behind the pulmonary trunk, then on its right side
  • Completely covered with the pericardium
  • Continues as arch of aorta opposite the right 2nd costal cartilage
• Arch of aorta


  • Continuation of the ascending aorta opposite the right 2nd costal cartilage
  • Lies in the superior mediastinum
  • Passes upwards, backwards & to the left in front of the trachea
  • Curves backward above the root of left lung
  • Curves downwards to the lower border of the body of T4
  • Continues as descending thoracic aorta opposite T4
  • Branches: Brachiocephalic artery, Left common carotid artery, Left subclavian artery, Thyroidea ima artery (occasional)
  • Radiological appearance: Aortic knuckle on X-ray chest
• Descending thoracic aorta


  • Continuation of arch of aorta opposite T4
  • Lies in posterior mediastinum
  • Descends in the posterior mediastinum toward the median plane in front of the vertebral column
  • Esophagus crosses in front from right to left at level of 7th thoracic vertebra
  • Branches: Posterior intercostal arteries, Subcostal artery, Superior phrenic artery, Two left bronchial arteries, Oesophageal branches, Pericardial branches, Mediastinal branches
• Ligamentum arteriosum


  • Connects the left pulmonary artery to the arch of aorta distal to the origin of the left subclavian artery
  • Was the ductus arteriosus in fetus
• Abdominal aorta


  • Continuation of descending thoracic aorta after passing through aortic opening of diaphragm opposite T12
  • Divides into right and left common iliac arteries opposite L4
  • Branches: Celiac trunk, Superior mesenteric artery, Inferior mesenteric artery, Median sacral artery, Inferior phrenic arteries, Middle suprarenal arteries, Renal arteries, Gonadal arteries, Lumbar arteries
• Internal iliac artery


  • One of the two terminal branches of common iliac artery at sacro-iliac joint
  • Divides into anterior and posterior divisions at the upper border of greater sciatic notch
  • Posterior division gives: Iliolumbar artery, Lateral sacral arteries, Superior gluteal artery
  • Anterior division gives: Inferior gluteal artery, Internal pudendal artery, Obturator artery, Umbilical artery, Inferior vesical artery, Middle rectal artery, Uterine artery
• Abnormal obturator artery


  A large pubic branch of inferior epigastric artery that replaces an absent obturator artery in 30% of individuals
• External iliac artery


  • Origin: one of the two terminal branches of common iliac artery at sacro-iliac joint
  • Termination: it continues as femoral artery at midinguinal point
  • Branches: inferior epigastric and deep circumflex iliac arteries
• Femoral artery


  • Origin: It is the continuation of external iliac artery at midinguinal point
  • Termination: it continues as popliteal artery at adductor hiatus
  • Course: Its proximal part in femoral triangle, its distal part in adductor canal, its proximal 4 cm is enclosed by femoral sheath
  • Branches: 3 Superficial (Superficial external pudendal, Superficial epigastric, Superficial circumflex iliac) and 3 Deep (Deep external pudendal, Profunda femoris, Descending genicular)
• Presence of tendinous arches in adductor magnus to prevent compression of perforating branches of profunda femoris during contraction of adductor magnus
• Profunda femoris artery


  • Origin: from femoral artery 4cm below inguinal ligament
  • Termination: by becoming 4th perforating artery
  • Course: It leaves femoral triangle by passing between pectineus and adductor longus. It descends on adductor magnus piercing it as 4th perforating
  • Branches: Medial circumflex femoral, Lateral circumflex femoral, Four perforating arteries
• Femoral pulse


  It can be felt in the femoral triangle just below the midinguinal point
• Retrograde catheterization


  Femoral artery is a favored vessel for coronary angiography, in which after entering the femoral artery, the catheter passes in external iliac artery, common iliac artery, abdominal aorta, descending thoracic aorta, arch of aorta and ascending aorta to reach the coronary arteries
• Popliteal artery


  • Origin: it is the continuation of femoral artery at adductor hiatus
  • Termination: it divides into anterior and posterior tibial arteries at lower border of popliteus
  • Branches: Cutaneous (sural artery), Muscular (to muscles of the fossa), Genicular (Superior medial and superior lateral, Inferior medial and inferior lateral, Middle genicular)
• Popliteal artery pulsation is difficult to be felt because it is the deepest structure in popliteal fossa and surrounded by strong muscles
• Anterior tibial artery


  • Origin: one of two terminal branches of popliteal A. at lower border of popliteus
  • Termination: it continues as dorsalis pedis artery in front of ankle joint
  • Branches: Anterior & posterior tibial recurrent, Anterior medial & anterior lateral malleolar, Muscular (to muscles of anterior compartment of the leg)
• Dorsalis pedis artery


  • Origin: it is the continuation of anterior tibial artery in front of ankle joint
  • Termination: it passes between two heads of 1st dorsal interosseous muscle to reach the sole where it anastomoses with plantar arch
  • Branches: Medial tarsal, Lateral tarsal, Arcuate (gives 2nd, 3rd, 4th dorsal metatarsal arteries), 1st dorsal metatarsal
• The neck of fibula is related laterally to common peroneal N. and circumflex fibular A., and Medially to the anterior tibial A.
• Posterior tibial artery


  • Origin: one of two terminal branches of popliteal artery at lower border of popliteus
  • Termination: deep to flexor retinaculum by dividing into medial and lateral plantar arteries
  • Branches: Circumflex fibular, Peroneal (Muscular, Nutrient, Communicating, Perforating, Lateral calcanean), Muscular, Nutrient, Communicating, Malleolar, Medial calcanean
• Medial plantar artery


  • Origin: one of two terminal branches of posterior tibial artery deep to flexor retinaculum
• Lateral plantar artery


  • Origin: one of two terminal branches of posterior tibial artery deep to flexor retinaculum
• Brachiocephalic artery


  • Origin: From the arch of the aorta opposite the center of the manubrium sterni
  • Termination: Opposite the right sternoclavicular joint by dividing into right common carotid & right subclavian arteries
  • Branches: Right common carotid artery, Right subclavian artery, Sometimes, the thyroid ima artery for the thyroid gland
• Left common carotid artery


  • Origin: From the arch of the aorta close to the left side of the brachiocephalic artery
  • Course: Passes behind the left sternoclavicular joint to enter the neck
  • Branches: No branches in the thorax, Divided in the neck opposite upper border of thyroid cartilage into external carotid artery and internal carotid artery
• Subclavian artery


  • Origin: Right artery from the brachiocephalic artery, Left one from the aortic arch
  • Course: divided by scalenus anterior muscle into 3 parts
  • Termination: Continues as axillary artery at the outer border of the 1st rib
  • Branches: Vertebral artery, Thyrocervical trunk, Internal thoracic artery, Costocervical trunk, Dorsal scapular artery