text:
Anterior interventricular branch of left coronary artery
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Anterior interventricular branch of left coronary artery
Sternocostal surface of heart. Anterior descending branch labeled at upper right
Details
Source
left coronary artery
Branches
septals, diagonals
Supplies
anterolateral myocardium, apex, interventricular septum, 45-55% of the left ventricle (LV)
Identifiers
Latin
ramus interventricularis anterior arteriae coronariae sinistrae
TA
A12.2.03.202
FMA
3862
Anatomical terminology
[edit on Wikidata]
The anterior interventricular branch of left coronary artery, (also left anterior descending artery (LAD), or anterior descending branch) is a branch of the left coronary artery. Occlusion of this artery is often called the widow-maker infarction due to a high death risk.[1]
Contents
[hide]
1 Structure
1.1 Branches
2 Function
3 Widow maker
4 Additional images
5 References
6 External links
Structure[edit]
It passes at first behind the pulmonary artery and then comes forward between that vessel and the left atrium to reach the anterior interventricular sulcus, along which it descends to the notch of cardiac apex.
Although rare, multiple anomalous courses of the LAD have been described. These include the origin of the artery from the right aortic sinus.[2]
In 78% of cases, it reaches the apex of the heart.
Branches[edit]
The LAD gives off two types of branches: septals and diagonals.
Septals originate from the LAD at 90 degrees to the surface of the heart, perforating and supplying the anterior 2/3rds of the interventricular septum.
Diagonals run along the surface of the heart and supply the lateral wall of the left ventricle and the anterolateral papillary muscle.
Function[edit]
The artery supplies the anterolateral myocardium, apex, and interventricular septum. The LAD typically supplies 45-55% of the left ventricle (LV) and is therefore considered the most critical vessel in terms of myocardial blood supply.
Tight, critical stenosis (95%) of the proximal LAD in a patient with Wellens' Warning
Widow maker[edit]
Further information: Wellens' sign
The widow maker is an alternate name for the anterior interventricular branch of the left coronary artery.[3][1] The name widow maker may also apply to the left coronary artery[4] or severe occlusions to that artery.[5][6]
This term is used because the left main coronary and/or the left anterior descending supply blood to large areas of the heart. This means that if these arteries are abruptly and completely occluded it will cause a massive heart attack that will likely lead to sudden death. The blockage that kills is made up of platelets streaming to the site of a ruptured cholesterol plaque. Even a small amount of plaque in this area can (for a variety of poorly understood reasons) rupture and cause death; bypassing chronic blockages or trying to open them up with angioplasty does not prevent heart attack but it can restore blood flow in case of a sudden blockage or heart attack and if performed within a rapid time period can minimize the damage done. An example of the devastating results of a complete occlusion of the LAD artery was the sudden death of former NBC News Washington Bureau Chief Tim Russert.[7]
From the minute a widow maker heart attack hits, survival time ranges from minutes to several hours. Rapidly progressing symptoms should signal the need for immediate attention. Symptoms of initial onset may include nausea, shortness of breath, pain in the head, jaw, arms or chest, numbness in fingers, often of a novel but imprecise sensation which builds with irregular heart beat. Early symptoms may be mistaken for food poisoning, flu or general malaise until they intensify. A widow maker cannot kill instantly but induces cardiac arrest which may do so within 10 to 20 minutes of no circulation. A victim with no pulse or breath is still alive, living off oxygen stored in the blood and may be able to be rescued if treatment is begun promptly within this window.[8]
Additional images[edit]
Coronary arteries (labeled in red text)
The arch of the aorta, and its branches.
Heart attack
Cardiac vessels
Human heart with coronary arteries
Heart coronary territories
References[edit]
This article incorporates text in the public domain from page 547 of the 20th edition of Gray's Anatomy (1918)
^ Jump up to: a b Topol, Eric J.; Califf, Robert M. (2007). Textbook of Cardiovascular Medicine. Lippincott Williams & Wilkins. p. 283. ISBN 9780781770125. Retrieved 6 November 2014. The most worrisome type is the proximal left anterior descending (LAD) MI, often referred to as the widow-maker infarction, which carries a high mortality and is attributed to an occlusion of the LAD before or at the first septal perforator.
Jump up ^ Ropers, D. (12 February 2002). "Anomalous Course of the Left Main or Left Anterior Descending Coronary Artery Originating From the Right Sinus of Valsalva: Identification of Four Common Variations by Electron Beam Tomography". Circulation. 105 (6): 42e–43. doi:10.1161/hc0602.102020.
Jump up ^ Lewis, Kathryn (1 December 2009). Multiple Lead ECGs: A Practical Analysis of Arrhythmias. Cengage Learning. p. 10. ISBN 9781435441248. Retrieved 6 November 2014. The LAD is frequently implicated in sudden cardiac death, predominantly in adult males. Clinicians often refer to the LAD as the widow maker because obstruction here predisposes to a high incidence of sudden death.
Jump up ^ Barbara J. Aehlert; Robert Vroman (2011). "22". Paramedic Practice Today: Above and Beyond (1st ed.). Jones & Bartlett Publishers. p. 819. ISBN 978-0-323-08535-9. Retrieved 2 March 2015.
Jump up ^ Richard Beebe; Jeff Myers (11 December 2009). "34". Professional Paramedic, Volume I: Foundations of Paramedic Care. Cengage Learning. p. 764. ISBN 1-4283-2345-7. Retrieved 2 March 2015.
Jump up ^ Carlos S Restrepo; Dianna M. E. Bardo (1 January 2011). Cardiac Imaging. Thieme. p. 188. ISBN 978-1-60406-186-4. Retrieved 2 March 2015.
Jump up ^ Morgan, David (June 13, 2008). "TV newsman Tim Russert dies of heart attack". Reuters. Archived from the original on June 24, 2008. Retrieved June 13, 2008.
Jump up ^ Kearl, Mary (June 2009). "Surviving a Widow-Maker Heart Attack". AOL Health. Retrieved June 2009. Check date values in: |access-date= (help)
External links[edit]
Anatomy photo:20:09-0102 at the SUNY Downstate Medical Center - "Heart: The Left Coronary Artery and its Branches"
Anatomy figure: 20:03-08 at Human Anatomy Online, SUNY Downstate Medical Center - "Anterior view of the heart."
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text:
Standard form contract
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This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (May 2010) (Learn how and when to remove this template message)
Contract law
Part of the common law series
Contract formation
Offer and acceptance
Posting rule
Mirror image rule
Invitation to treat
Firm offer
Consideration
Implication-in-fact
Collateral contract
Defenses against formation
Lack of capacity
Duress
Undue influence
Illusory promise
Statute of frauds
Non est factum
Contract interpretation
Parol evidence rule
Contract of adhesion
Integration clause
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Mistake
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Related areas of law
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v
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A standard form contract (sometimes referred to as a contract of adhesion, a leonine contract, a take-it-or-leave-it contract, or a boilerplate contract) is a contract between two parties, where the terms and conditions of the contract are set by one of the parties, and the other party has little or no ability to negotiate more favorable terms and is thus placed in a "take it or leave it" position.
While these types of contracts are not illegal per se, there exists a very real possibility for unconscionability. In addition, in the event of an ambiguity, such ambiguity will be resolved contra proferentem against the party drafting the contract language.
Contents
[hide]
1 Theoretical issues
2 Common law status
2.1 United States
2.1.1 Generally
2.1.2 Contracts of adhesion
2.1.3 Shrink wrap contracts
2.2 Canada
2.3 Australia
2.4 India
3 Legislation
3.1 United Kingdom
3.2 Israel
3.3 Lithuania
4 Civil law countries
4.1 Russia
5 See also
6 References
7 External links
Theoretical issues[edit]
There is much debate on a theoretical level whether, and to what extent, courts should enforce standard form contracts.
On one hand, they undeniably fulfill an important role of promoting economic efficiency. Standard form contracting reduces transaction costs substantially by precluding the need for buyers and sellers of goods and services to negotiate the many details of a sale contract each time the product is sold.
On the other hand, there is the potential for inefficient, and even unjust, terms to be accepted by signatories to these contracts. Such terms might be seen as unjust if they allow the seller to avoid all liability or unilaterally modify terms or terminate the contract.[1] These terms often come in the form of, but are not limited to, forum selection clauses and mandatory arbitration clauses, which can limit or foreclose a party's access to the courts; and also liquidated damages clauses, which set a limit to the amount that can be recovered or require a party to pay a specific amount. They might be inefficient if they place the risk of a negative outcome, such as defective manufacturing, on the buyer who is not in the best position to take precautions.
There are a number of reasons why such terms might be accepted:[2][3]
Standard form contracts are rarely read
Lengthy boilerplate terms are often in fine print and written in complicated legal language which often seems irrelevant. The prospect of a buyer finding any useful information from reading such terms is correspondingly low. Even if such information is discovered, the consumer is in no position to bargain as the contract is presented on a “take it or leave it” basis. Coupled with the often large amount of time needed to read the terms, the expected payoff from reading the contract is low and few people would be expected to read it.
Access to the full terms may be difficult or impossible before acceptance
Often the document being signed is not the full contract; the purchaser is told that the rest of the terms are in another location. This reduces the likelihood of the terms being read and in some situations, such as software license agreements, can only be read after they have been notionally accepted by purchasing the good and opening the box. These contracts are typically not enforced, since common law dictates that all terms of a contract must be disclosed before the contract is executed.
Boilerplate terms are not salient
The most important terms to purchasers of a good are generally the price and the quality, which are generally understood before the contract of adhesion is signed. Terms relating to events which have very small probabilities of occurring or which refer to particular statutes or legal rules do not seem important to the purchaser. This further lowers the chance of such terms being read and also means they are likely to be ignored even if they are read.
There may be social pressure to sign
Standard form contracts are signed at a point when the main details of the transaction have either been negotiated or explained. Social pressure to conclude the bargain at that point may come from a number of sources. The salesperson may imply that the purchaser is being unreasonable if they read or question the terms, saying that they are "just something the lawyers want us to do" or that they are wasting their time reading them. If the purchaser is at the front of a queue (for example at an airport car rental desk) there is additional pressure to sign quickly. Finally, if there has been negotiation over price or particular details, then concessions given by the salesperson may be seen as a gift which socially obliges the purchaser to respond by being co-operative and concluding the transaction.
Standard form contracts may exploit unequal power relations
If the good which is being sold using a contract of adhesion is one which is essential or very important for the purchaser to buy (such as a rental property or a needed medical item) then the purchaser might feel they have no choice but to accept the terms. This problem may be mitigated if there are many suppliers of the good who can potentially offer different terms (see below), although even this is not always possible (for instance, a college freshman may be required to sign a standard-form dormitory rental agreement and accept its terms, because the college will not allow a freshman to live off-campus).
Some contend that in a competitive market, consumers have the ability to shop around for the supplier who offers them the most favorable terms and are consequently able to avoid injustice. However, in the case of credit cards (and other oligopolies), for example, the consumer while having the ability to shop around may still have access to only form contracts with like terms and no opportunity for negotiation. Also, as noted, many people do not read or understand the terms so there might be very little incentive for a firm to offer favorable conditions as they would gain only a small amount of business from doing so. Even if this is the case, it is argued by some that only a small percentage of buyers need to actively read standard form contracts for it to be worthwhile for firms to offer better terms if that group is able to influence a larger number of people by affecting the firm’s reputation.
Another factor which might mitigate the effects of competition on the content of contracts of adhesion is that, in practice, standard form contracts are usually drafted by lawyers instructed to construct them so as to minimize the firm’s liability, not necessarily to implement managers' competitive decisions. Sometimes the contracts are written by an industry body and distributed to firms in that industry, increasing homogeneity of the contracts and reducing consumer's ability to shop around.
Common law status[edit]
As a general rule, the common law treats standard form contracts like any other contract. Signature or some other objective manifestation of intent to be legally bound will bind the signor to the contract whether or not they read or understood the terms. The reality of standard form contracting, however, means that many common law jurisdictions have developed special rules with respect to them. In general, in the event of an ambiguity, the courts will interpret standard form contracts contra proferentem against the party that drafted the contract, as that party (and only that party) had the ability to draft the contract to remove ambiguity.
United States[edit]
Generally[edit]
Standard form contracts are generally enforceable in the United States. The Uniform Commercial Code which is followed in most American states has specific provisions relating to standard form contracts for the sale or lease of goods. Furthermore, standard form contracts will be subject to special scrutiny if they are found to be contracts of adhesion.
Contracts of adhesion[edit]
The concept of the contract of adhesion originated in French civil law, but did not enter American jurisprudence until the Harvard Law Review published an influential article by Edwin W. Patterson in 1919.[4] It was subsequently adopted by the majority of American courts, especially after the Supreme Court of California endorsed adhesion analysis in 1962. See Steven v. Fidelity & Casualty Co., 58 Cal. 2d 862, 882 n.10 (1962) (explaining history of concept).[5]
For a contract to be treated as a contract of adhesion, it must be presented on a standard form on a "take it or leave it" basis, and give one party no ability to negotiate because of their unequal bargaining position. The special scrutiny given to contracts of adhesion can be performed in a number of ways:
If the term was outside of the reasonable expectations of the person who did not write the contract, and if the parties were contracting on an unequal basis, then it will not be enforceable. The reasonable expectation is assessed objectively, looking at the prominence of the term, the purpose of the term and the circumstances surrounding acceptance of the contract.
Section 211 of the American Law Institute's Restatement (Second) of Contracts, which has persuasive though non-binding force in courts, provides:
Where the other party has reason to believe that the party manifesting such assent would not do so if he knew that the writing contained a particular term, the term is not part of the agreement.
This is a subjective test focusing on the mind of the seller and has been adopted by only a few state courts.
The doctrine of unconscionability is a fact-specific doctrine arising from equitable[citation needed] principles. Unconscionability in standard form contracts usually arises where there is an "absence of meaningful choice on the part of one party due to one-sided contract provisions, together with terms which are so oppressive that no reasonable person would make them and no fair and honest person would accept them." (Fanning v. Fritz's Pontiac-Cadillac-Buick Inc.)
Shrink wrap contracts[edit]
Courts in the United States have faced the issue of shrink wrap contracts in two ways. One line of cases follows ProCD v. Zeidenberg which held such contracts enforceable (e.g. Brower v Gateway), and the other follows Klocek v. Gateway, Inc, which found them unenforceable. These decisions are split on the question of assent, with the former holding that only objective manifestation of assent is required while the latter require at least the possibility of subjective assent.
Canada[edit]
In Canada, exclusion clauses in a standard form contract cannot be relied on where a seller knows or has reason to know a purchaser is mistaken as to its terms (Tilden Rent-A-Car Co. v. Clendenning).
Australia[edit]
Standard form contracts have generally received little special treatment under Australian common law. A 2003 New South Wales Court of Appeal case (Toll (FGCT) Pty Limited v Alphapharm Pty Limited) gave some support for the position that notice of exceptional terms is required for them to be incorporated. However the defendant successfully appealed to the High Court so currently there is no special treatment of standard form contracts in Australia.
Since 1 January 2011, the Australian Consumer Law has been enacted in Australia at the national level, and due to a Council of Australian Governments (COAG) agreement this legislation is now part of each jurisdiction's (state's or territory's) Fair Trading laws.[6]
India[edit]
In India leonine contracts are generally deemed unconscionable contracts (though not all leonine contracts are unconscionable contracts) and are voidable. The 199th Law Commission report (2006) on "UNFAIR (PROCEDURAL & SUBSTANTIVE) TERMS IN CONTRACT" deals with it. The unfairness can be procedural or substantive.
Legislation[edit]
In recognition of the consumer protection issues which may arise, many governments have passed specific laws relating to standard form contracts. These are generally enacted on a state level as part of general consumer protection legislation and typically allow consumers to avoid clauses which are found to be unreasonable, though the specific provisions vary greatly. Some laws require notice to be given for these clauses to be effective, others prohibit unfair clauses altogether (e.g. Victorian Fair Trading Act 1999).
United Kingdom[edit]
Section 3 of the Unfair Contract Terms Act 1977 limits the ability of the drafter of consumer or standard form contracts to draft clauses which would allow him to exclude liability in what is termed an exclusion clause - the act does not per se render ineffective provisions in other areas which to the layman appear "unfair". Where a contract is negotiated the provisions of the act likely would not apply - the law protects from a lot of things but openly making a bad bargain is not one of them.
Israel[edit]
The Standard Form Contract Act 1982 defines a set of depriving conditions that may be canceled by a court of law, including unreasonable exclusion or limitation of liability, unreasonable privileges to unilaterally cancel, suspend or postpone the execution of the contract and to change any fundamental charges or pricing, transfer of liability for the execution of the contract to a third party, unreasonable obligation to use the services of a third party or to limit, in any way, the choice of contracting third parties, denial of legal remedy, unreasonable limitations on contractual remedies or setting unreasonable conditions for the consummation of the remedy, denying or limiting the right for legal procedures, exclusive rights to decide on the location of the trial or arbitration, obligatory arbitration with unilaterally control over the arbitrators or the location of the arbitration and setting the holder of the burden of proof contrary to common law. The act also establishes a Standard Form Contract Court, chaired by a district judge and consists of a maximum of 12 members, appointed by the justice minister, including an acting chairman (also a district judge), civil servants (no more than a third) and, at least, 2 consumer organization representatives. The court holds hearings regarding appeals against standard form contract clauses or approval of a specific standard form contract at the requests of a provider.
Lithuania[edit]
Standard conditions in Lithuania shall be such provisions which are prepared in advance for general and repeated use by one contracting party without their content being negotiated with another party, and which are used in the formation of contracts without negotiation with the other party. Standard conditions prepared by one of the parties shall be binding to the other if the latter was provided with an adequate opportunity of getting acquainted with the said conditions (Article 6.185. Standard conditions of contracts, Lithuanian Civil Code).[7] A consumer shall have the right to claim within the judicial procedure for invalidity of conditions in a consumer contract that are contrary to the criterion of good faith (Article 6.188).
Civil law countries[edit]
Russia[edit]
In July 2013, Russian Dmitry Agarkov won a court case against Tinkoff Bank after he altered the standard form contract he had received in the mail. The bank, failing to notice the changes, accepted the application and gave him an account based on the amended contract. The judge ruled that the bank was legally bound to the contract it had signed. Agarkov is further suing the bank for failing to comply with the terms he had added to the contract, which it had unwittingly agreed to by signing the contract. Agarkov's lawyer, Dmitry Mihalevich said – "They signed the documents without looking. They said what usually their borrowers say in court: 'We have not read it'." [8][9]
See also[edit]
Electronic Signatures in Global and National Commerce Act (ESIGN, USA)
Hobson's choice
Non est factum
Terms of service
References[edit]
Jump up ^ Download Menu Archived 2007-05-08 at the Wayback Machine.
Jump up ^ Standard-Form Contracting in the Electronic Age by Robert A. Hillman, Jeffrey J. Rachlinski :: SSRN Archived 2004-11-15 at the Wayback Machine.
Jump up ^ The Devil in the Details: The Interrelationship Among Citizenship, Rule of Law and Form-Adhesive Contracts by Zev J. Eigen :: SSRN Archived 2011-03-07 at the Wayback Machine.
Jump up ^ Patterson, E., The Delivery of a Life-Insurance Policy, 33 Harvard Law Review, 198 (1919); see also Friedrich Kessler, Contracts of Adhesion — Some Thoughts About Freedom of Contract, 43 Colum. L. Rev. 629 (1943).
Jump up ^ Steven v. Fidelity & Casualty Co. (1962) 58 C2d 862
Jump up ^ "Archived copy". Archived from the original on 2011-04-08. Retrieved 2011-05-02. Download at "Archived copy". Archived from the original on 2011-05-05. Retrieved 2011-05-02. (PDF or DOC or ZIP available) Also refer to each State and Territory Fair Trading Department's websites.
Jump up ^ Standard Contract Terms in Cross-Border Business Transactions Archived 2016-03-04 at the Wayback Machine. (A Comparative Study from the Perspective of European Union Law), PDF (by Attorney Dr. Gintautas Šulija, LL.M., LL.M.)
Jump up ^ Russian Man Who Got Bank to Sign Homemade Credit Card Contract Now Suing Them for Not Following Terms Archived 2016-09-18 at the Wayback Machine., Yahoo News, 8 Aug 2013. Retrieved 9 Aug 2013.
Jump up ^ $700k windfall: Russian man outwits bank with hand-written credit contract Archived 2013-08-09 at the Wayback Machine., RT News, 8 Aug 2013. Retrieved 9 Aug 2013.
External links[edit]
Joint Contracts Tribunal for United Kingdom Building Industry
CLAB Data Base of the European Commission
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Pulmonary artery
From Wikipedia, the free encyclopedia
Jump to: navigation, search
Pulmonary artery
Details
Precursor
truncus arteriosus
System
Cardiovascular, Respiratory
Source
right ventricle
Identifiers
Latin
arteria pulmonalis
MeSH
A07.231.114.715
Dorlands
/Elsevier
t_20/12826098
FMA
45842
Anatomical terminology
[edit on Wikidata]
A pulmonary artery is an artery in the pulmonary circulation that carries deoxygenated blood from the right side of the heart to the lungs. The largest pulmonary artery is the main pulmonary artery or pulmonary trunk from the heart, and the smallest ones are the arterioles which lead to the capillaries that surround the pulmonary alveoli.
Contents
[hide]
1 Pulmonary arterial tree
2 Development
3 Function
4 Clinical significance
5 Additional images
6 See also
7 References
8 External links
Pulmonary arterial tree[edit]
Volume rendering of a high resolution CT scan of the thorax. The anterior thoracic wall, the airways and the pulmonary vessels anterior to the root of the lung have been digitally removed in order to visualize the different levels of the pulmonary circulation.
In order of blood flow, the pulmonary arteries start as the pulmonary trunk or main pulmonary artery. The main pulmonary artery begins at the base of the right ventricle. It is short and wide—approximately 5 centimetres (2.0 in) in length and 3 centimetres (1.2 in) in diameter.
The main pulmonary artery splits into the right and the left main pulmonary artery.[1] The left main pulmonary artery is shorter and somewhat smaller than the right, passes horizontally in front of the descending aorta and left bronchus to the root of the left lung. Above, the left main pulmonary artery is connected to the concavity of the proximal descending aorta by the ligamentum arteriosum.[2] It then divides into two lobar arteries, one for each lobe of the left lung. The right main pulmonary artery follows a longer and more horizontal course as it crosses the mediastinum. It passes underneath the aortic arch, behind the ascending aorta, and in front of the descending aorta. It courses posterior to the superior vena cava and in front of the right bronchus. Upon reaching the hilum of the right lung the right main pulmonary artery divides into two branches:
truncus anterior — supplies blood to the right upper lobe.
interlobar artery — inferior and larger branch, supplies blood to the middle and inferior lobes of the lung.
At the far end, pulmonary arteries (labeled at bottom) become capillaries at the pulmonary alveoli.
The right and left main pulmonary arteries give off branches that roughly correspond to the lung lobes, and can in such cases be termed lobar arteries. The lobar arteries branch into segmental arteries (roughly 1 for each lobe segment), which in turn branch into subsegmental pulmonary arteries.[3] These eventually form intralobular arteries.[4]
Development[edit]
The pulmonary arteries originate from the truncus arteriosus and the sixth pharyngeal arch. The truncus arteriosis is a structure that forms during the development of the heart as a successor to the conus arteriosus. [5]
By the third week of development, the endocardial tubes have developed a swelling in the part closest to the heart. The swelling is known as the bulbus cordis and the upper part of this swelling develops into the truncus arteriosus [6] The structure is ultimately mesodermal in origin.[5] During development of the heart, the heart tissues undergo folding, and the truncus arteriosus is exposed to what will eventually be both the left and right ventricles. As a septum develops between the two ventricles of the heart, two bulges form on either side of the truncus arteriosus. These progressively enlarge until the trunk splits into the aorta and pulmonary arteries. [7]
During early development, the ductus arteriosis connects the pulmonary trunk and the aortic arch, allowing blood to bypass the lungs.[8]
Function[edit]
The pulmonary artery carries deoxygenated blood from the right ventricle to the lungs. The blood here passes through capillaries adjacent to alveoli and becomes oxygenated as part of the process of respiration.[citation needed]
In contrast to the pulmonary arteries, the bronchial arteries supply nutrition to the lungs themselves.[9]
The pulmonary artery pressure (PA pressure) is a measure of the blood pressure found in the main pulmonary artery. This is measured by inserting a catheter into the main pulmonary artery.[10] :190–191 The mean pressure is typically 9 - 18 mmHg,[11] and the wedge pressure measured in the left atrium may be 6-12mmHg. The wedge pressure may be elevated in left heart failure,[10]:190–191 mitral valve stenosis, and other conditions, such as sickle cell disease.[12]
Clinical significance[edit]
The pulmonary artery is relevant in a number of clinical states. Pulmonary hypertension is used to describe an increase in the pressure of the pulmonary artery, and may be defined as a mean pulmonary artery pressure of greater than 25mmHg.[10]:720 As can be measured on a CT scan, a diameter of more than 29 mm diameter is often used as a cut-off to indicate pulmonary hypertension.[13] This may occur as a result of heart problems such as heart failure, lung or airway disease such as COPD or scleroderma, or thromboembolic disease such as pulmonary embolism or emboli seen in sickle cell anaemia.[10]:720–721
Pulmonary embolism refers to an embolus that lodges in the pulmonary circulation. This may arise from a deep venous thrombosis, especially after a period of immobility. A pulmonary embolus is a common cause of death in patients with cancer and stroke.[10]:720–721 A large pulmonary embolus which becomes lodged in the bifurcation of the pulmonary trunk with extensions into both the left and right main pulmonary arteries is called a saddle embolus.[14]
Additional images[edit]
Image showing main pulmonary artery coursing ventrally to the aortic root and trachea, and the right pulmonary artery passes dorsally to the ascending aorta, while the left pulmonary artery passes ventrally to the descending aorta.
Pulmonary circuit
Transverse section of thorax, showing relations of pulmonary artery.
Pulmonary artery
Pulmonary artery.Deep dissection.Anterior view.
CT scan of a normal lung, with different levels of pulmonary arteries.
Bronchial anatomy
See also[edit]
Pulmonary artery sling
Rasmussen's aneurysm
References[edit]
Jump up ^ "Pulmonary Vasculature". University of Virginia School of Medicine. 2013. Retrieved 2017-06-24.
Jump up ^ D. Cheitlin, Melvin; C. Ursell, Philip (2011). "Cardiac Anatomy". In Chatterjee, Kanu. Cardiology: An Illustrated Textbook. JP Medical Ltd. p. 6. ISBN 9789350252758.
Jump up ^ "Pulmonary Artery Anatomy". University of Virginia School of Medicine. 2013. Retrieved 2017-06-24.
Jump up ^ Takahashi M, Fukuoka J, Nitta N, Takazakura R, Nagatani Y, Murakami Y, Otani H, Murata K (2008). "Imaging of pulmonary emphysema: a pictorial review". Int J Chron Obstruct Pulmon Dis. 3 (2): 193–204. PMC 2629965  . PMID 18686729.
^ Jump up to: a b Larsen 2009, p. 157.
Jump up ^ Larsen 2009, pp. 159-160.
Jump up ^ Larsen 2009, pp. 176-179.
Jump up ^ Braunwald, Eugene. Heart Disease: A Textbook of Cardiovascular Medicine (Fourth ed.). p. 791.
Jump up ^ Braunwald, Eugene. Heart Disease: A Textbook of Cardiovascular Medicine (4th ed.). p. 790.
^ Jump up to: a b c d e edited by Nicki R. Colledge, Brian R. Walker, Stuart H. Ralston ; illustrated by Robert Britton (2010). Davidson's principles and practice of medicine. (21st ed.). Edinburgh: Churchill Livingstone/Elsevier. ISBN 978-0-7020-3084-0. CS1 maint: Multiple names: authors list (link)CS1 maint: Extra text: authors list (link)
Jump up ^ Edwards Lifesciences LLC > Normal Hemodynamic Parameters – Adult 2009
Jump up ^ Pashankar FD, Carbonella J, Bazzy-Asaad A, Friedman A (April 2008). "Prevalence and risk factors of elevated pulmonary artery pressures in children with sickle cell disease". Pediatrics. 121 (4): 777–82. PMID 18381543. doi:10.1542/peds.2007-0730.
Jump up ^ Prof Frank Gaillard; et al. "Pulmonary hypertension". Radiopaedia. Retrieved 2017-05-27. CS1 maint: Explicit use of et al. (link)
Jump up ^ Jeremy Jones; et al. "Saddle pulmonary embolism". Radiopaedia. Retrieved 2017-10-08. CS1 maint: Explicit use of et al. (link)
Schoenwolf ... [et al.], Gary C. (2009). Larsen's human embryology (4th ed., Thoroughly rev. and updated. ed.). Philadelphia: Churchill Livingstone/Elsevier. pp. "Development of the Urogenital system". ISBN 9780443068119.
External links[edit]
Anatomy photo:20:01-0106 at the SUNY Downstate Medical Center – "Heart: The Pericardial sac and Great vessels"
Anatomy photo:20:07-0105 at the SUNY Downstate Medical Center – "Heart: Openings of Great Vessels into the Pericardial Sac"
Anatomy figure: 19:05-06 at Human Anatomy Online, SUNY Downstate Medical Center – "Mediastinal surface of the right lung"
Anatomy figure: 19:06-02 at Human Anatomy Online, SUNY Downstate Medical Center – "Mediastinal surface of the left lung"
Histology image: 13802loa – Histology Learning System at Boston University
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This page was last edited on 8 October 2017, at 14:28.
Text is available under the Creative Commons Attribution-ShareAlike License; additional terms may apply. By using this site, you agree to the Terms of Use and Privacy Policy. Wikipedia® is a registered trademark of the Wikimedia Foundation, Inc., a non-profit organization.
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