Papillary muscle

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Papillary muscle
Papillary muscles.png
Interior of right side of heart. Papillary muscles labeled in purple.
Gray1218.png
Diagram showing relations of opened heart to front of thoracic wall.

Ant. Anterior segment of tricuspid valve.
A O. Aorta.
A.P. Anterior papillary muscle.
In. Brachiocephalic artery (Innominate).
L.C.C. Left common carotid artery.
L.S. Left subclavian artery.
L.V. Left ventricle.
P.A. Pulmonary artery.
R.A. Right atrium.
R.V. Right ventricle.
V.S. Ventricular septum.
Details
Identifiers
Latin musculus papillaris
MeSH D010210
TA98 A12.1.00.022
TA2 4043, 4066
FMA 12154
Anatomical terms of muscle

The papillary muscles are muscles located in the ventricles of the heart. They attach to the cusps of the atrioventricular valves (also known as the mitral and tricuspid valves) via the chordae tendineae and contract to prevent inversion or prolapse of these valves on systole (or ventricular contraction). [1]

Contents

Structure

There are five total papillary muscles in the heart; three in the right ventricle and two in the left. The anterior, posterior, and septal papillary muscles of the right ventricle each attach via chordae tendineae to the tricuspid valve. The anterolateral and posteromedial papillary muscles of the left ventricle attach via chordae tendineae to the mitral valve. [2]

Blood supply

The mitral valve papillary muscles in the left ventricle are called the anterolateral and posteromedial muscles. [3]

The posteromedial muscle ruptures more frequently because it only has one source of blood supply, hence RCA occlusion can cause papillary muscle rupture. [3]

Function

The papillary muscles of both the right and left ventricles begin to contract shortly before ventricular systole and maintain tension throughout. [1] This prevents regurgitation—backward flow of ventricular blood into the atrial cavities—by bracing the atrioventricular valves against prolapse—being forced back into the atria by the high pressure in the ventricles. [1]

Clinical significance

Papillary muscle rupture can be caused by a myocardial infarction, and dysfunction can be caused by ischemia. Rarely, blunt chest trauma can be the cause of papillary muscle rupture, resulting from the sudden deceleration or compression of the heart. [4] Complications may lead to worsening of mitral regurgitation. [5]

Additional images

See also

Related Research Articles

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<span class="mw-page-title-main">Coronary circulation</span> Circulation of blood in the blood vessels of the heart muscle (myocardium)

Coronary circulation is the circulation of blood in the arteries and veins that supply the heart muscle (myocardium). Coronary arteries supply oxygenated blood to the heart muscle. Cardiac veins then drain away the blood after it has been deoxygenated. Because the rest of the body, and most especially the brain, needs a steady supply of oxygenated blood that is free of all but the slightest interruptions, the heart is required to function continuously. Therefore its circulation is of major importance not only to its own tissues but to the entire body and even the level of consciousness of the brain from moment to moment. Interruptions of coronary circulation quickly cause heart attacks, in which the heart muscle is damaged by oxygen starvation. Such interruptions are usually caused by coronary ischemia linked to coronary artery disease, and sometimes to embolism from other causes like obstruction in blood flow through vessels.

<span class="mw-page-title-main">Heart valve</span> A flap of tissue that prevent backflow of blood around the heart

A heart valve is a biological one-way valve that allows blood to flow in one direction through the chambers of the heart. Four valves are usually present in a mammalian heart and together they determine the pathway of blood flow through the heart. A heart valve opens or closes according to differential blood pressure on each side.

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<span class="mw-page-title-main">Mitral valve</span> Valve in the heart connecting the left atrium and left ventricle

The mitral valve, also known as the bicuspid valve or left atrioventricular valve, is one of the four heart valves. It has two cusps or flaps and lies between the left atrium and the left ventricle of the heart. The heart valves are all one-way valves allowing blood flow in just one direction. The mitral valve and the tricuspid valve are known as the atrioventricular valves because they lie between the atria and the ventricles.

<span class="mw-page-title-main">Tricuspid valve</span> One-way valve present between right auricle and right ventricle

The tricuspid valve, or right atrioventricular valve, is on the right dorsal side of the mammalian heart, at the superior portion of the right ventricle. The function of the valve is to allow blood to flow from the right atrium to the right ventricle during diastole, and to close to prevent backflow (regurgitation) from the right ventricle into the right atrium during right ventricular contraction (systole).

<span class="mw-page-title-main">Systole</span> Part of the cardiac cycle when a heart chamber contracts

Systole is the part of the cardiac cycle during which some chambers of the heart contract after refilling with blood. Its contrasting phase is diastole, the relaxed phase of the cardiac cycle when the chambers of the heart are refilling with blood.

<span class="mw-page-title-main">Ventricle (heart)</span> Chamber of the heart

A ventricle is one of two large chambers located toward the bottom of the heart that collect and expel blood towards the peripheral beds within the body and lungs. The blood pumped by a ventricle is supplied by an atrium, an adjacent chamber in the upper heart that is smaller than a ventricle. Interventricular means between the ventricles, while intraventricular means within one ventricle.

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<span class="mw-page-title-main">Mitral regurgitation</span> Form of valvular heart disease

Mitral regurgitation (MR), also known as mitral insufficiency or mitral incompetence, is a form of valvular heart disease in which the mitral valve is insufficient and does not close properly when the heart pumps out blood. It is the abnormal leaking of blood backwards – regurgitation from the left ventricle, through the mitral valve, into the left atrium, when the left ventricle contracts. Mitral regurgitation is the most common form of valvular heart disease.

<span class="mw-page-title-main">Atrium (heart)</span> Part of the human heart

The atrium is one of the two upper chambers in the heart that receives blood from the circulatory system. The blood in the atria is pumped into the heart ventricles through the atrioventricular mitral and tricuspid heart valves.

<span class="mw-page-title-main">Chordae tendineae</span> Inelastic cords of fibrous connective tissue connecting papillary muscles to heart valves

The chordae tendineae or tendinous cords, colloquially known as the heart strings, are inelastic cords of fibrous connective tissue that connect the papillary muscles to the tricuspid valve and the mitral valve in the heart.

<span class="mw-page-title-main">Cardiac cycle</span> Performance of the human heart

The cardiac cycle is the performance of the human heart from the beginning of one heartbeat to the beginning of the next. It consists of two periods: one during which the heart muscle relaxes and refills with blood, called diastole, following a period of robust contraction and pumping of blood, called systole. After emptying, the heart relaxes and expands to receive another influx of blood returning from the lungs and other systems of the body, before again contracting to pump blood to the lungs and those systems.

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<span class="mw-page-title-main">Circumflex branch of left coronary artery</span> Artery of heart

The circumflex branch of left coronary artery is a branch of the left coronary artery. It winds around the left side of the heart along the atrioventricular groove. It supplies the posterolateral portion of the left ventricle.

<span class="mw-page-title-main">Trabeculae carneae</span> Muscular columns found in the heart

The trabeculae carneae are rounded or irregular muscular columns which project from the inner surface of the right and left ventricle of the heart. These are different from the pectinate muscles, which are present in the atria of the heart. In development, trabeculae carneae are among the first of the cardiac structures to develop in the embryonic cardiac tube. Further, throughout development some trabeculae carneae condense to form the myocardium, papillary muscles, chordae tendineae, and septum.

<span class="mw-page-title-main">Systolic heart murmur</span> Medical condition

Systolic heart murmurs are heart murmurs heard during systole, i.e. they begin and end between S1 and S2. Many involve stenosis of the semilunar valves or regurgitation of the atrioventricular valves.

Cardiac physiology or heart function is the study of healthy, unimpaired function of the heart: involving blood flow; myocardium structure; the electrical conduction system of the heart; the cardiac cycle and cardiac output and how these interact and depend on one another.

The heart is a muscular organ situated in the mediastinum. It consists of four chambers, four valves, two main arteries, and the conduction system. The left and right sides of the heart have different functions: the right side receives de-oxygenated blood through the superior and inferior venae cavae and pumps blood to the lungs through the pulmonary artery, and the left side receives saturated blood from the lungs.

References

  1. 1 2 3 Moore KL, Dalley AF, Agur AM (2007). Clinically Oriented Anatomy (3rd ed.). Baltimore: Lippincott Williams & Wilkins. pp. 92, 94. ISBN   978-0-7817-6274-8.
  2. Netter's Atlas of Human Anatomy, plates 216B and 217A
  3. 1 2 Fradley, M. G.; Picard, M. H. (7 March 2011). "Rupture of the Posteromedial Papillary Muscle Leading to Partial Flail of the Anterior Mitral Leaflet". Circulation. 123 (9): 1044–1045. doi: 10.1161/CIRCULATIONAHA.110.984724 . PMID   21382906.
  4. Simmers, Timothy A; Meijburg, Huub W.J; Brutel de la Rivière, Aart (July 2001). "Traumatic papillary muscle rupture" . The Annals of Thoracic Surgery. 72 (1): 257–259. doi:10.1016/S0003-4975(00)02498-X.
  5. Elizabeth D Agabegi; Agabegi, Steven S. (2008). Step-Up to Medicine (Step-Up Series). Hagerstwon, MD: Lippincott Williams & Wilkins. pp.  40. ISBN   978-0-7817-7153-5.