BLOOD SUPPLY OF

HEART
Arterial Supply of Heart
Right Coronary Artery

Left Coronary Artery

 Heart (sternocostal surface)
Ascending aorta

Right auricle
Left coronary artery

Right
coronary
artery Circumflex artery

Anterior
interventricular
artery

Right marginal Great cardiac

artery vein
Pulmonary trunk
 Heart (base and diaphragmatic surface)
Left atrium

Right atrium
Circumflex
artery

Right coronary
artery

Left ventricle Right ventricle

Right Coronary Artery
Origin:
Branch of ascending aorta
Begins from the anterior aortic (right coronary)
sinus
Course:
Runs between the right auricle and pulmonary
trunk, enters the anterior part of coronary sulcus
Runs to the right in the anterior part of coronary
sulcus
Winds around the right margin of heart
Then runs to the left in the posterior part of
coronary sulcus
Termination:
Anastomoses with circumflex branch of left
coronary artery
Branches
of Right
Coronary
Artery Atrial
branch
Right
marginal Right
artery conus Ventricular
artery branch
Branches:

Right conus branch supplies lower part of

pulmonary trunk and upper part of right
ventricle

Atrial branches supply right atrium, one of

them supply SA node (artery of SA node)

Ventricular branches supply right ventricle

 Right marginal artery is one of the
ventricular branch, runs along the inferior
margin of heart

Posterior inter-ventricular branch (posterior

descending) runs in the posterior inter-
ventricular groove, terminates by
anastomosing with anterior inter-ventricular
artery, supplies posterior part of inter-
ventricular septum and adjoining part of right
and left ventricles
 Area of distribution of right coronary
artery:

Right atrium
Right ventricle except a part on the sternocostal
surface near the anterior inter-ventricular
groove
Part of the left ventricle on the inferior surface
near the posterior inter-ventricular groove
Posterior part of inter-ventricular septum
Most of the conducting system of heart (SA
node, AV node, right AV bundle) except left AV
bundle
Left Coronary Artery
Origin:
Branch of ascending aorta
Arises from the left posterior aortic sinus

Course:
Runs between the left auricle and pulmonary trunk
Reaches the anterior part of coronary sulcus
As it enters the coronary sulcus it terminates by
dividing to 2 branches

Termination:
Divides into anterior inter-ventricular and circumflex
branches
Heart (sternocostal surface)
Ascending aorta

Left coronary artery

Right
coronary Circumflex artery
artery
Anterior
interventricular
artery

Great cardiac
vein
Pulmonary trunk
Heart (base and diaphragmatic surface)
Left atrium

Right atrium
Circumflex
artery

Right coronary
artery
Posterior inter-
ventricular artery
Left ventricle Right ventricle
 Anterior interventricular artery (anterior
descending):
Branch of left coronary artery
Runs on the sternocostal surface in the anterior inter-
ventricular groove with the great cardiac vein
Terminates by anastomosing with posterior inter-
ventricular artery

Branches:
Left conus artery supplies upper part of right
ventricle and lower part of pulmonary trunk
Ventricular branches supply the left ventricle and
part of right ventricle near the anterior inter-
ventricular groove. One of the ventricular branch is
large and is known as left diagonal artery
Septal branches supply anterior part of inter-
ventricular septum
 Circumflex artery:

Branch of left coronary artery

Curves around the left margin of heart in the
coronary sulcus
Enters the posterior part of coronary sulcus
Terminates by anastomosing with right coronary
artery

Branches:

Atrial branches supply left atrium

Ventricular branches supply left ventricle
Left marginal artery runs along the left margin
of heart, supplies left ventricle
Area of distribution of left coronary
artery:

Left atrium
Left ventricle except a part on the
diaphragmatic surface near the posterior
interventricular groove
Part right ventricle on the anterior surface
near the anterior interventricular groove
Anterior part of interventricular septum
Left AV bundle
Venous Drainage of Heart
Coronary sinus and its
tributaries
Anterior cardiac veins
Thebesian veins
 Coronary Sinus
Largest vein of heart, about 3 cm long
Situated in the posterior part of coronary
sulcus between the left atrium and left
ventricle
Terminates by opening into the smooth
part of right atrium
Opening is guarded by valve of coronary
sinus (Thebasian valve)
Receives most of the veins of heart
 Coronary sinus and its tributaries
Left atrium

Oblique vein
of left atrium
Right atrium

Great cardiac vein

Coronary sinus

Small cardiac vein

Posterior vein of
left ventricle

Left ventricle Right ventricle Middle cardiac vein

 Tributaries of Coronary Sinus
Great cardiac vein

Small cardiac vein

Middle cardiac vein

Posterior vein of left ventricle

Oblique vein of left atrium

Great cardiac vein:
Situated in the anterior
interventricular
groove and anterior part of coronary sulcus

Small cardiac vein:

Situated in the posterior
part of coronary
sulcus between right atrium and right ventricle

Middle cardiac vein:

Situated in the posterior inter-ventricular
groove
 Posterior vein of left ventricle:
Situated on the diaphragmatic surface of left
ventricle

Oblique vein of left atrium (of Marshall):

Situated on the posterior surface of left atrium

Anterior cardiac veins:

3 to 4 veins situated on the sternocostal surface
of right ventricle
Terminate by opening into the right atrium
 Thebasian Veins (Venae Cordis
Minmae)

Small veins situated in the myocardium of all

the chambers

Terminate by opening into all chambers

NERVE SUPPLY OF
HEART
 Through the cardiac muscle contracts
rhythmically and automatically, the nerves
supplying the heart alter the cardiac rate.

The Sympathetic and Parasympathetic

fibres supplying the heart from two
cardiac plexuses : - Superficial and Deep
Supericial cardiac plexus:
Situated below the arch of aorta and infront of the
right pulmonary artery.
Fibres from the superficial cardiac plexus pass into
deep cardiac plexus and pulmonary plexus.

Formed by
Superior cervical cardiac branch of left
sympathetic chain
Inferior cervical cardiac branch of left vagus nerve
Deep cardiac plexus:
Situated in front of bifurcation of trachea and
behind the arch of aorta

Formed by
Cardiac branches of the both(right and left)
cervical sympathetic ganglia (excepts from left
superior)
Cardiac branches from the upper four or five
thoracic sympathetic ganglia
Cardiac branches of the both vagus (except lower
cervical cardiac branch of the left vagus)
Right superior
cervical sympathetic
ganglion
Left vagus nerve
Right sympathetic chain

Cardiac branch

Middle cervical
sympathetic ganglion

Inferior cervical
sympathetic ganglion

Cardiac plexus
of nerves
 Function
PARASYMPATHETIC NERVES [vagus nerve, 10th
cranial nerves]
Stimulation of parasympathetic nerves to the
heart causes the hormone acetylcholine to be
released at the vagal endings.
This hormone has two major effects on the heart
first, it decreases the rate of rhythm of the sinus
node second, it decreases the excitability of the A-
V junctional fibers between the atrial musculature
and the A-V node, there by slowing transmission
of the cardiac impulse in to the ventricles.
SYMPATHETIC NERVES [ T1 T4 thoracic
segments of spinal cord]
Stimulation of Sympathetic nerves releases the
hormone norepinephrine at the sympathetic
nerve endings
First, it increases the rate of sinus nodal
discharge.
Second, it increases the rate of conduction as
well as the level of excitability in all portions of
heart
Third, it increases greatly the force of
contraction of all the cardiac musculature.
 Conducting system of heart
Made of specialised myocardium
For initiation, conduction of cardiac impluse
SA node (Sinuatrial nodes, pace maker) situated in wall of right
atrium
AV (atrioventricular node) smaller than SA node , situated in lower
part of atrial septum.
AV bundle (atrioventricular bundle) BUNDLE OF HIS begins at the
AV node and divide into right & left bundles

Clinical Importance
Damage or defect to this system will result in cardiac arrythmias
Arrythmias means irregularity of heart beat.
Large Blood Vessels
Aorta

Superior Vena Cava

Inferior Vena Cava

AORTA

Aorta is the great arterial trunk which receives oxygenated

blood from the left ventricle.

It distributes blood to all parts of the body

It has three parts

i. Ascending aorta
ii. Arch of aorta
iii. Descending aorta
 ASCENDING AORTA

Arises from the upper end of left ventricle.

It is about 5 cm long.
It gives two branches Right and Left Coronary arteries.

ARCH OF AORTA

It is the continuation of ascending aorta .

It ends at the lower borer of T4 vertebra by becoming continuous with
the descending aorta.

Branches:
Three main branches
Brachiocephalic artery which divides into right common carotid and
right subclavian arteries
Left common carotid artery
Left subclavian artery
The coronary arteries supply the heart
 DESCENDING AORTA

It has two parts.

Thoracic aorta and abdominal aorta.

Thoracic Aorta

Begins at T 4 vertebra and continues as descending abdominal aorta at T 12

vertebra.

Branches :
Posterior intercostal arteries
Oesophegeal branches
Pericardial branches.
Mediastinal branches
Superior phrenic arteries
Subcostal arteries
 ABDOMINAL AORTA

Begins at T 12 vertebra at the aortic opening of diaphragm and terminates

at L 4 vertebra by dividing into two terminal branches right and left
common iliac arteries.

Branches
Ventral branches
Dorsal branches
Terminal branches

Ventral Branches

Coeliac trunk
Superior mesenteric artery
Inferior mesenteric artery
 Lateral Branches

Inferior phrenic
Middle suprarenal
Renal
Testicular / ovarian artery

Dorsal Branches

Lumbar
Median sacral branches.

Terminal Branches

Right and left common iliac arteries

They supply the pelvis and lower limbs
 GREAT VEINS

(Superior & Inferior vena cava)

Superior Vena Cava (S.V.C)

Length 7 cm
It is a great vein which collects venous blood from upper half of the body
and drains it into the right atrium.
It is formed by the union of two brachiocephalic (innominate) veins.
Each brachiocephalic vein is formed by the union of the internal jugular
vein (draining venous blood from head and neck region) and subclavian
vein (draining venous blood from upper limb region).
Superior vena cava opens into the right atrium.
 Inferior Vena Cava (I.V.C)

It is formed by the union of two common iliac

veins at L 5 vertebra.
It pierces the diaphragm at the level of T8
vertebra and opens in the right atrium
Tributaries:
Right and left common iliac veins, lumbar veins
(third & fourth) right testicular vein, right
suprarenal vein, renal veins & hepatic veins.
References
Manipal Manual of Anatomy by Sampath
Madhyastha
Anatomy and Physiology in Health and
Illness by Rose and Wilson
THANK YOU