Heart-arterial supply, nerve supply, veins of heart

HEART-ARTERIAL SUPPLY, NERVE SUPPLY, VEINS OF HEART

Q. 1

Anterior cardiac veins open into:

 A

Right atrium

 B

Great cardiac vein

 C

Coronary sinus

 D

Marginal vein

Q. 1

Anterior cardiac veins open into:

 A

Right atrium

 B

Great cardiac vein

 C

Coronary sinus

 D

Marginal vein

Ans. A

Explanation:

Right atrium


Q. 2

In which of the following cardiac structure is middle cardiac vein located?

 A

Anterior AV groove

 B

Posterior AV groove

 C

Anterior interventricular sulcus

 D

Posterior interventricular sulcus

Q. 2

In which of the following cardiac structure is middle cardiac vein located?

 A

Anterior AV groove

 B

Posterior AV groove

 C

Anterior interventricular sulcus

 D

Posterior interventricular sulcus

Ans. D

Explanation:

Posterior interventricular vein or middle cardiac vein runs in the posterior interventricular sulcus and may drain into the right atrium or into the coronary sinus.

Q. 3

The middle cardiac vein is located in the?

 A

Anterior interventricular sulcus.

 B

Posterior interventricular sulcus.

 C

Posterior AV groove.

 D

Anterior AV groove.

Q. 3

The middle cardiac vein is located in the?

 A

Anterior interventricular sulcus.

 B

Posterior interventricular sulcus.

 C

Posterior AV groove.

 D

Anterior AV groove.

Ans. B

Explanation:

The middle cardiac vein commences at the apex of the heart; ascends in the posterior longitudinal sulcus, and ends in the coronary sinus near its right extremity.


Q. 4

Anterior cardiac vein open into ?

 A

Right atrium

 B

Great cardiac vein

 C

Coronary sinus

 D

Marginal vein

Q. 4

Anterior cardiac vein open into ?

 A

Right atrium

 B

Great cardiac vein

 C

Coronary sinus

 D

Marginal vein

Ans. A

Explanation:

The anterior cardiac veins drain the anterior portion of the right ventricle, cross the coronary groove, and empty directly into the right atrium. Anterior cardiac veins do not drain into the coronary sinus.
 Also Know:

The coronary sinus is the largest vein draining the heart muscle and lies in the coronary sulcus. The coronary sinus collects most of the venous return from the great, middle, and small cardiac veins and returns the venous blood to the right atrium. The coronary sinus opening in the right atrium is superior to the septal leaflet of the tricuspid valve.


Q. 5

Branches of R.C.A. (Rt. Coronary artery):

 A

Obtuse marginal

 B

Acute marginal

 C

Diagonal

 D

All

Q. 5

Branches of R.C.A. (Rt. Coronary artery):

 A

Obtuse marginal

 B

Acute marginal

 C

Diagonal

 D

All

Ans. B

Explanation:

B. i.e. Acute marginal


Q. 6

The right coronary artery supplies all of the following parts of the conducting system in the heart except: 

 A

SA Node

 B

AV Node

 C

AV Bundle

 D

Right Bundle branch

Q. 6

The right coronary artery supplies all of the following parts of the conducting system in the heart except: 

 A

SA Node

 B

AV Node

 C

AV Bundle

 D

Right Bundle branch

Ans. D

Explanation:

D i.e. Right bundle branch 

Right coronary artery supply SA node (in 65% cases), AV node, AV bundle or Bundle of His and part of LBB (left bundle branch Q); where as Left coronary artery supply SA node (in 35% cases), RBB (right bundle branch) & part of LBB Q


Q. 7

The middle cardiac vein is located at the:

 A

Anterior interventricular sulcus

 B

Posterior interventricular sulcus

 C

Posterior AV groove

 D

Anterior AV groove

Q. 7

The middle cardiac vein is located at the:

 A

Anterior interventricular sulcus

 B

Posterior interventricular sulcus

 C

Posterior AV groove

 D

Anterior AV groove

Ans. B

Explanation:

B i.e. Posterior interventricular sulcus 

  • vein & posterior interventricular br. of right coronary artery is located in poster inter ventricular sulcus Q

Q. 8

True statement about Rt coronary artery (RCA)

 A

Diameter less than LCA

 B

RCA arises from anterior aortic sinus

 C

RCA supplies major part of right atrium and right ventricle

 D

All

Q. 8

True statement about Rt coronary artery (RCA)

 A

Diameter less than LCA

 B

RCA arises from anterior aortic sinus

 C

RCA supplies major part of right atrium and right ventricle

 D

All

Ans. A

Explanation:

A i.e. Diameter less than LCA; B i.e. RCA arises from anterior aortic sinus


Q. 9

Branch of Rt. Coronary artery:

 A

Obtuse marginal

 B

Acute marginal

 C

Posterior interventricular

 D

b & c

Q. 9

Branch of Rt. Coronary artery:

 A

Obtuse marginal

 B

Acute marginal

 C

Posterior interventricular

 D

b & c

Ans. D

Explanation:

B. i.e. Acute marginal; C. i.e. Posterior interventricular


Q. 10

The right coronary artery supplies all of the following parts of the conducting system in the heart except:

 A

SA Node

 B

AV Node

 C

AV Bundle

 D

Right Bundle branch

Q. 10

The right coronary artery supplies all of the following parts of the conducting system in the heart except:

 A

SA Node

 B

AV Node

 C

AV Bundle

 D

Right Bundle branch

Ans. D

Explanation:

Answer is D (Right bundle branch)

Right bundle is supplied by the Left coronary artery.

Right coronary artery supplies the SA node (in 65% cases), AV node, AV bundle or Bundle of His and part of left bundle branch(LBB)

Left cronoary artery supplies the right bundle branch (RBB, part of LBB and sometimes the SA node (in 35% cases),


Q. 11

Branches of left coronary artery are all of the following except:   

 A

Anterior interventricular branch

 B

Left diagonal artery

 C

Left atrial artery

 D

Posterior interventricular branch

 

Q. 11

Branches of left coronary artery are all of the following except:   

 A

Anterior interventricular branch

 B

Left diagonal artery

 C

Left atrial artery

 D

Posterior interventricular branch

 

Ans. D

Explanation:

The left coronary artery, which is usually larger than the right coronary artery, supplies the major part of the heart, including the greater part of the left atrium, left ventricle, and ventricular septum.

  • It arises from the left posterior aortic sinus of the ascending aorta.
  • It then enters the atrioventricular groove and divides into an anterior interventricular branch and a circumflex branch. Branches
  • The anterior interventricular (descending) branch /left anterior descending (LAD) runs downward in the anterior interventricular groove to the apex of the heart.
  • The anterior interventricular branch supplies the right and left ventricles with numerous branches that also supply the anterior part of the ventricular septum. One of these ventricular branches (left diagonal artery) may arise directly from the trunk of the left coronary artery.
  • The left circumflex artery (LCX) is the same size as the anterior interventricular artery. It winds around the left margin of the heart in the atrioventricular groove. A left marginal artery is a large branch that supplies the left margin of the left ventricle down to the apex. Anterior ventricular and posterior ventricular branches supply the left ventricle. Atrial branches supply the left atrium.

Posterior interventricular branch: It is typically a branch of the right coronary artery (80%, known as right dominance). Alternately, the Posterior interventricular branch can be a branch of the left circumflex coronary artery (20%, known as left dominance) which itself is a branch of the left coronary artery


Q. 12

Arterial supply to SA node is by:       

 A

Left anterior descending coronary artery

 B

Posterior interventricular (descending) artery

 C

Left coronary artery

 D

Right coronary artery

Q. 12

Arterial supply to SA node is by:       

 A

Left anterior descending coronary artery

 B

Posterior interventricular (descending) artery

 C

Left coronary artery

 D

Right coronary artery

Ans. D

Explanation:

The right coronary artery arises from the anterior aortic sinus of the ascending aorta and runs forward between the pulmonary trunk and the right auricle.

The artery of the sinuatrial node (branch of right coronary artery) supplies the SA node and the right and left atria; in 40% of individuals it arises from the left coronary artery.


Q. 13

Cardiac dominance is determined by coronary artery:

 A

Supplying circulation to the SA node

 B

Supplying circulation to the inferior portion of the interventricular septum

 C

Supplying circulation to the interatrial septum

 D

Supplying circulation to the anterior portion of the interventricular septum

Q. 13

Cardiac dominance is determined by coronary artery:

 A

Supplying circulation to the SA node

 B

Supplying circulation to the inferior portion of the interventricular septum

 C

Supplying circulation to the interatrial septum

 D

Supplying circulation to the anterior portion of the interventricular septum

Ans. B

Explanation:

In 85% of patients the right coronary artery (RCA) is said to be “dominant” because it supplies circulation to the inferior portion of the interventricular septum via the right posterior descending coronary artery/posterior interventricular artery.

In these cases the RCA travels to the cross-section of the AV groove and the posterior interventricular (IV groove). Here, it gives rise to the right posterior descending coronary artery (PDA) branch which travels in the posterior IV groove and gives off several septal perforator branches (SP). The SP supply blood to the lower portion of the IV septum. Generally, the dominant RCA also gives rise to the AV nodal branch which supplies blood to the AV node

The dominant RCA also provides the right postero-lateral (PLA) branch to the lower postero-lateral portion of the left ventricle.

The sinus or sino-atrial (SA) node branch originates in the proximal portion of the RCA in 60% of cases and as a left atrial branch of the Cx in the remaining 40% of cases. This is unrelated to whether the artery is “dominant” or not.


Q. 14

The Diagram repersents the blood supply of Heart. Identify the Vessel Marked B in the Diagram ?

 A

Left Coronary Artery

 B

Left Circumplex Artery

 C

Left Anterior Descending Branch  (LAD)

 D

Right Cornorary Artery

Q. 14

The Diagram repersents the blood supply of Heart. Identify the Vessel Marked B in the Diagram ?

 A

Left Coronary Artery

 B

Left Circumplex Artery

 C

Left Anterior Descending Branch  (LAD)

 D

Right Cornorary Artery

Ans. B

Explanation:


Q. 15

Right coronary artery supplies all, except‑

 A

Anterior 2/3 of ventricular septum

 B

SA node

 C

AV node

 D

LBB

Q. 15

Right coronary artery supplies all, except‑

 A

Anterior 2/3 of ventricular septum

 B

SA node

 C

AV node

 D

LBB

Ans. A

Explanation:

Right coronary artery supplies

(i) SA node (in 65%),

(ii) whole conducting system (AV bundle, bundle of his, part of left bundle branch) except RBB and part of left branch of AV bundle,

(iii) posterior part of ventricular septum,

(iv) most of right ventricle except small part adjoining anterior interventricular groove and small part of left ventricle adjoining posterior interventricular groove.

Left coronary artery supplies

(i) most of the left atrium,

(ii) most of the left ventricle including apex,

(iii) small part of right ventricle odjoining anterior interventricular septum,

(iv) anterior 2/3 of ventricular septum,

(v) RBB, LBB 

(vi) SA node in 35% of cases.


Q. 16

True about SA node are all except ‑

 A

Supplied by nodal artery

 B

Primary pacemaker

 C

Supplied by left vagus nerve

 D

Made up of nodal cells and connective tissue

Q. 16

True about SA node are all except ‑

 A

Supplied by nodal artery

 B

Primary pacemaker

 C

Supplied by left vagus nerve

 D

Made up of nodal cells and connective tissue

Ans. C

Explanation:

 

  • SA node is located in the upper part of crista terminalis at the junction of SVC and the right atrium.
  • It is the pacemaker of the heart and generates impulse at a rate of 70-100/min.
  • SA node is suplied by nodal artery, a branch of RCA in 65% cases and a branch of circumflex branch of LCA in 35% cases.
  • SA node is supplied by right vagus/parasympathetic (inhibitory) and right Sympathetic (excitatory) system as it develops from structures on the right side of embryo.
  • The SA node consists of connective tissue stroma containing an irregular whorled network of cardiac nodal cells, the SA nodal artery and numerous nerve endings (postganglionic parasympathetic and postganglionic sympathetic).

Q. 17

The artery represented below supplies all of the following parts of the conducting system in the heart except?

 A

SA Node

 B

AV Node

 C

AV Bundle

 D

Right Bundle branch

Q. 17

The artery represented below supplies all of the following parts of the conducting system in the heart except?

 A

SA Node

 B

AV Node

 C

AV Bundle

 D

Right Bundle branch

Ans. D

Explanation:

 

The arrow represents Right coronary artery.

D i.e. Right bundle branch 

Right coronary artery supply SA node (in 65% cases), AV node, AV bundle or Bundle of His and part of LBB (left bundle branch ); where as Left coronary artery supply SA node (in 35% cases), RBB (right bundle branch) & part of LBB.



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