Document Detail


The AV junction region of the heart: a comprehensive study correlating gross anatomy and direct three-dimensional analysis. Part II. Morphology and cytoarchitecture.
MedLine Citation:
PMID:  15072972     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This "Part II morphology and cytoarchitecture" study is based on paraffin-embedded specimens in which the extracellular and intracellular matrix are preserved; single parallel, perpendicular, and transverse serial sections of the entire atrioventricular (AV) junction region (AVJR) and their correlation with photographs of the tissue blocks. As in Part I, the same major new findings are: 1) a coronary sinus fossa is formed by the superoposterior right medial atria wall (MAW), the left atrium, and the coronary sinus roof; 2) the posterior MAW forms two myocardial bridges and is isolated from the sinus venarum by the floor of the inferior vena cava; 3) the tendon of Todaro terminates in the superior lip of the coronary sinus ostium; 4) only ordinary myocardium contacts the annulus fibrosus, and there is little to no collagen separating its myofibers and tissues; 5) the ventricular septum shoulder is humped shaped, completely overlaid by annular myocardium, and joined by struts of papillary muscle; 6) the membranous septum joining the ventricular septum shoulder to the crista supraventricularis forms part of the aortic valve sinus walls; and 7) myocardium of the atrionodal bundles is aggregated into numerous small fascicles encased by collagen and is outside of the MAW as are the other specialized tissues. The proximal AV bundle and medial atrionodal bundle are aligned to the medial leg of Koch's triangle and the tendon of Todaro. These data show, therefore, that the AVJR contains two overlapping atrial circuits. In the MAW, acivation of the posterior region is delayed because of the two myocardial bridges. Puncture of the AVJR can produce communication with an extracardiac space, posteriorly and medially, and with the aorta, anteriorly.
Authors:
Darlene K Racker
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American journal of physiology. Heart and circulatory physiology     Volume:  286     ISSN:  0363-6135     ISO Abbreviation:  Am. J. Physiol. Heart Circ. Physiol.     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-04-09     Completed Date:  2004-05-21     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  100901228     Medline TA:  Am J Physiol Heart Circ Physiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  H1853-71     Citation Subset:  IM    
Affiliation:
Department of Medicine, Cardiology and The Feinberg Cardiovascular Research Institute, Northwestern University Feinberg Medical School, Chicago, Illinois 60611, USA. darkrac@northwestern.edu
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MeSH Terms
Descriptor/Qualifier:
Animals
Atrioventricular Node / anatomy & histology*,  cytology
Bundle of His / anatomy & histology
Dogs
Heart Septum / anatomy & histology
Papillary Muscles / anatomy & histology
Grant Support
ID/Acronym/Agency:
HL-30557/HL/NHLBI NIH HHS; HL-40667/HL/NHLBI NIH HHS

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