冠狀動(dòng)脈1心尖外形一底一尖、二面、三緣、四條溝、心尖切跡、房室交點(diǎn)心尖搏動(dòng)的位置在左側(cè)第五肋間隙鎖骨中線內(nèi)側(cè)1-2CM處心尖切跡2一底一尖二面三緣四條溝心尖切跡房室交點(diǎn)心底胸肋面膈面右緣左緣下緣3四條溝冠狀溝coronarysulcus

前室間溝anteriorinterventriculargroove

后室間溝posteriorinterventriculargroove

房間溝Interatrial

groove冠狀溝前室間溝后室間溝房間溝4房間溝、后室間溝與冠狀溝的相交處稱(chēng)房室交點(diǎn)。該點(diǎn)是心表面的一個(gè)重要標(biāo)志。5右冠狀動(dòng)脈右冠狀動(dòng)脈近端右冠狀動(dòng)脈中段右冠狀動(dòng)脈遠(yuǎn)端AV動(dòng)脈結(jié)后降支右心室支鈍緣支竇房結(jié)支6LeftCoronaryArtery左主干左前降支近端第一對(duì)角支回旋支近端鈍緣支7分支吻合左室后支動(dòng)脈圓錐支右緣支竇房結(jié)支房室結(jié)支心房支心室支①左室前支②右室前支③室間隔前支

后室間支旋支①左緣支②竇房結(jié)支③房室結(jié)支前室間支左冠狀動(dòng)脈

右冠狀動(dòng)脈心尖切跡Vieussens環(huán)8左冠狀動(dòng)脈右冠狀動(dòng)脈起點(diǎn)行程主A左竇左心耳與肺A間分布主A右竇右心耳與肺A間左半心右心室前壁室間隔前2/3部分傳導(dǎo)系右半心左心室后壁室間隔后1/3部分傳導(dǎo)系91011

冠狀動(dòng)脈的分布類(lèi)型65.7%28.7%5.6%125．心室壁內(nèi)血管構(gòu)筑心肌橋13AscendingAorta 升主動(dòng)脈DescendingAorta 降主動(dòng)脈PulmonaryArtery 肺動(dòng)脈SuperiorVenaCava 上腔靜脈LeftCoronaryArtery(LCA) 左冠狀動(dòng)脈LeftMainArtery(LMA) 左主干LeftAnteriorDescending(LAD)左前降支LeftMarginalBranch(LMB) 左邊緣支LeftCircumflex(LCX) 左回旋支RightCoronaryArtery(RCA) 右冠狀動(dòng)脈PosteriorDescendingArtery(PDA)后降支ConusBranch動(dòng)脈圓錐支LeftAtrium 左心房RightAtrium 右心房LeftVentricle 左心室RightVentricle 右心室CardiacVein心臟靜脈MitralValv 二尖瓣CoronarySinus 冠狀竇CardiacAnatomy14升主動(dòng)脈肺動(dòng)脈降主動(dòng)脈AscendingAortaPulmonaryArtery降主動(dòng)脈CT平掃圖象 CT增強(qiáng)圖象CardiacAnatomy15AscendingAortaPulmonaryArteryDescendingAorta上腔靜脈AscendingAortaPulmonaryArteryDescendingAortaSuperiorVenaCavaCT平掃圖象 CT增強(qiáng)圖象CardiacAnatomy16上腔靜脈上腔靜脈左主干左主干

升主動(dòng)脈升主動(dòng)脈降主動(dòng)脈降主動(dòng)脈左前降支左邊緣支左前降支左邊緣支CT平掃圖象 CT增強(qiáng)圖象CardiacAnatomy17上腔靜脈升主動(dòng)脈降主動(dòng)脈左前降支左邊緣支左主干左回旋支SuperiorVenaCavaAscendingAortaDescendingAortaLADLeftMarginalBranch

LMA

LCX

肺動(dòng)脈PulmonaryArteryCT平掃圖象 CT增強(qiáng)圖象CardiacAnatomy18SuperiorVenaCavaSuperiorVenaCavaDescendingAortaDescendingAortaPulmonaryArteryPulmonaryArteryLAD

LCx

左回旋支LMB

左邊緣支左前降支

LeftAtrium左心房CT平掃圖象 CT增強(qiáng)圖象CardiacAnatomy19SuperiorVenaCavaSuperiorVenaCavaDescending

AortaDescendingAortaPulmonaryArteryPulmonaryArteryLAD

LCx

LCxLMB左邊緣支

LADLeftAtrium左心房CT平掃圖象 CT增強(qiáng)圖象CardiacAnatomy20DescendingAortaLCx左邊緣支

LADLeftAtriumDescendingAortaLCx

LMB

LAD

LeftAtrium右心房左心室LeftVentricle升主動(dòng)脈AscendingAortaRightAtriumCT平掃圖象 CT增強(qiáng)圖象CardiacAnatomy21右冠狀動(dòng)脈RCA

LeftVentricleLeftVentricle右心室RightVentricle左心房LeftAtrium右心房RightAtrium左回旋支左邊緣支LCx

LMB

CT平掃圖象 CT增強(qiáng)圖象CardiacAnatomy22RCALeftVentricleRightVentricleLeftAtriumRightAtriumLCxLMBRCA

LeftVentricleRightVentricleLeftAtriumRightAtriumLCx

LMB

DescendingAortaDescendingAortaCT平掃圖象 CT增強(qiáng)圖象CardiacAnatomy23RCARCA

LeftVentricleLeftVentricleRightVentricleRightVentricleLeftAtriumLeftAtriumRightAtriumRightAtriumLCxLMBLCx

心臟靜脈LMBCardiacVein

CT平掃圖象 CT增強(qiáng)圖象CardiacAnatomy24RCALeftVentricleRightVentricleLeftAtriumRightAtriumLCxLMBRCA

LeftVentricleRightVentricleLeftAtriumRightAtriumLCx

LMB

主動(dòng)脈瓣膜DescendingAortaDescendingAortaCT平掃圖象 CT增強(qiáng)圖象CardiacAnatomy25RCALeftVentricleRightVentricleLeftAtriumRightAtriumLCxLMB

RCALeftVentricleRightVentricleLeftAtriumRightAtriumLCxLMBAorticValveCardiacVeinCardiacVein

CT平掃圖象 CT增強(qiáng)圖象CardiacAnatomy26RCALeftVentricleRightVentricleLeftAtriumRightAtriumLCxLMB

RCALeftVentricleRightVentricleLeftAtriumRightAtriumLMBDescendingAortaDescendingAortaCT平掃圖象 CT增強(qiáng)圖象CardiacAnatomy27動(dòng)脈圓錐支ConusBranch二尖瓣RCALeftVentricleRightVentricleLeftAtriumRightAtriumLMB

RCALeftVentricleRightVentricleLeftAtriumRightAtriumLMBCardiacVein

心臟靜脈CT平掃圖象 CT增強(qiáng)圖象CardiacAnatomy28RCALeftVentricleRightVentricleLeftAtriumRightAtriumLMB

RCARightVentricleLeftAtriumRightAtriumLeftVentricleMitral

ValveDescendingAortaDescendingAortaCardiacVein

CardiacVeinCT平掃圖象 CT增強(qiáng)圖象CardiacAnatomy29RCALeftVentricleRightVentricleLeftAtriumRightAtriumRCALeftVentricleRightVentricleLeftAtriumRightAtriumDescendingAortaDescendingAortaCT平掃圖象 CT增強(qiáng)圖象CardiacAnatomy30RCA

LeftVentricleRightVentricleRightAtriumRCALeftVentricleRightVentricleRightAtriumDescendingAortaDescendingAorta冠狀竇CoronarySinusCT平掃圖象 CT增強(qiáng)圖象CardiacAnatomy31RCA

LeftVentricleRightVentricleRightAtriumRCA左心室RightVentricleRightAtriumDescendingAortaDescendingAortaCT平掃圖象 CT增強(qiáng)圖象CardiacAnatomy32RCALeftVentricleRightVentricleRCALeftVentricleRightVentricleDescendingAortaDescendingAortaCT平掃圖象 CT增強(qiáng)圖象CardiacAnatomy33RCA

LeftVentricleRightVentricleRCALeftVentricleRightVentricleDescendingAortaDescendingAortaCT平掃圖象 CT增強(qiáng)圖象CardiacAnatomy34RCA

LeftVentricleRightVentricleRCALeftVentricleRightVentricleDescendingAortaDescendingAortaCT平掃圖象 CT增強(qiáng)圖象CardiacAnatomy35PDALeftVentricleRightVentricle后降支

RightVentricleLiverStomachLiverStomachCT平掃圖象 CT增強(qiáng)圖象CardiacAnatomy36前降支右冠狀動(dòng)脈對(duì)角支3738回旋支3940左冠：左前斜位加頭位用以區(qū)分前降支和對(duì)角支，觀察LAD中遠(yuǎn)端的狹窄41右前斜+足位（Cau）20°（肝位）觀察LAD、LCX開(kāi)口、近端、LCX體部和OM開(kāi)口42LAO45°+Cau20°（蜘蛛位）觀察近段血管特別是左主干，近段前降支，中部和近段回旋支，顯示LAD、L