The atrioventricular branches of the human coronary arteries

Branches of the coronary arteries of normal human hearts, supplying both atria and ventricles, were found by fine dissection and have been named rami atrioventriculares. They comprise atrial branches from ventricular arteries and ventricular branches from atrial arteries. Their incidence was 74% in the 50 adult individuals studied. The subjects had committed suicide with a poison which did not damage the coronary arteries. The atrioventricular branches constitute communications across the coronary sulcus, thus establishing a continuity between the atrial and the ventricular arterial supply. Therefore, there is not invariably a sharp demarcation of blood supply between atria and ventricles, as has been commonly taught. Neither atrial nor ventricular branches consist exclusively of ascending and descending branches of the coronary arteries, as has been assumed. Atrioventricular branches can play a role in collateral circulation and may, in individuals who are born with them, provide an explanation for some of the variability in signs and symptoms incidental to heart attacks.     

Vascularization of the conducting system in the human heart

On 200 randomized specimens of the human heart, of either sex, from 20 to 80 years of age, we investigated the vascularization of the conducting system of the heart in relation to the type of coronary ramification, by the dissection, injection-corrosive, radiographic and coronarographic method. The symmetrical type of arterial vascularization was established in 24%, the right type in 63% and the left type in 13% of the cases investigated. The sinoatrial node is vascularized in 60% by the right and in 40% of the cases by the left coronary artery. The atrioventricular node and the stem of the atrioventricular bundle are vascularized by the right coronary artery in 85% of the cases investigated, in 13% by the left and in 2% by both arteries. The right fasciculus of the atrioventricular bundle is vascularized by the left artery, the left fasciculus by both arteries. The vascularization of the posterior strand in both ventricles is conformable to the type of arterial vascularization of the heart.     

Variations in coronary artery anatomy: Normal versus abnormal

We offer a comprehensive classification of coronary artery anomalies, together with angiographic examples of each entity. Minimal requirements for normality include the following criteria: (1) the dual aortic origin is from right and left coronary ostia; (2) the course of the right coronary artery follows the right atrioventricular groove; (3) the course of the left coronary artery follows the left atrioventricular groove and anterior interventricular groove; (4) the posterior descending branch originates from either the right or left coronary artery; (5) the major coronary branches flow epicardially; and (6) the coronary arteries terminate at the myocardial capillary level. This conception of "normal" coronary arteries has determined the classification of abnormalities presented here. Early and correct diagnosis of anomalies that may compromise the myocardial blood supply is stressed, and possible surgical solutions are offered. Selective coronary angiography is the technique of choice for precise visualization of the coronary artery system.     

Embryonic histogenesis of the atrioventricular segment of the heart conduction system of swine (Sus porcus L.)]

Histological, histochemical and neurochemical methods were used in order to study the features of the histogenesis of structures of the atrioventricular area of the conducting system of the heart and the formation of their cholinergic innervation in the postnatal period of the hog. Under study were 175 hearts of embryos of the hog at the age of 3, 4, 5, 6, 8, 10, 12, 14 and 15 weeks and 22 hearts of adult hogs. The formation of different areas of this system was shown to be asynchronous. The atrioventricular fascicle is formed during the 4th week, the atrioventricular node -- during the 6th week and the conducting muscle fibres--during the 8th week of embryogenesis. The fascicle and the node have a complicated structure and different cellular composition. In the process of prenatal ontogenesis the increased amount of glycogen and increased activity of phosphorylase were noted in the cytoplasm of myocytes of the atrioventricular area of the conducting system of the heart. The cholinergic nerve fibres grow up to the structures of the atrioventricular area of the conducting system of the heart during the 6th week of embryogenesis, and by the end of the prenatal development they form a thick network in all its structures.     

猪冠状动脉的解剖学观察

本文对50例健康的商品猪心脏的铸型标本进行了观察,结果如下:左冠状动脉旋枝与锥旁室间枝的夹角为74.4±2.07度。对角枝出现率为24％,并证明了对角枝出现率与其夹角大小呈正比关系。窦房结枝84％来自右冠状动脉。房室结枝98％来自右冠状动脉。左房旋枝出现率为8％。室间隔的供血由锥旁室间枝的分枝负担61％,约为3/5,窦下室间枝的分技负担39％,约为2/5。室上嵴技、Kugel动脉、室间隔中枝和室间隔背倒前枝的出现率分别为78％、20％、68％和28％。心尖区的血液由左、右冠状动脉共同供应。50例左、右冠状动脉始部外径之比为1.2∶1。左、右冠状动脉在心膈面的分布类型以右强型为主。本文还讨论了猪冠状动脉与狗、人冠状动脉的异同。     

Quantitative electron microscopic research on the structure of the myocytes in the atrioventricular node and perinodal myocardium of the rat interatrial septum

A quantitative electron microscopical examination of specialized conducting myocytes of types II and III in the atrioventricular node and working myocytes in perinodal region was performed. The volume fractions of myofibrils, mitochondria, nuclei, sarcoplasmic reticulum, glycogen, atrial granules and "clear" cytoplasm were measured, in addition to the diameters of conducting and working myocytes. These data were compared with those for conducting myocytes of types I, II, and III from sinoatrial region and internodal tracts of the rat heart, and with evidence for atrioventricular node of other animals. Principles of an universal classification of conducting myocytes of the heart are discussed.     

A histochemical study of the innervation of cerebral blood vessels in the snake

Summary Dual innervation of snake cerebral blood vessels by adrenergic and cholinergic fibres was demonstrated with the use of histochemical methods. Although the nerve plexuses are somewhat less dense, the essential features of innervation of the blood vessels are similar to those of mammals with the exception that the adrenergic plexuses are more prominent than the cholinergic plexuses. The major arteries of the cerebral carotid system have a rich nerve supply. However, the innervation is less rich in the basilar and poor in the spinal (vertebral) arteries. Although the arteries supplying the right side of head are poorly developed, three pairs of arteries, cerebral carotids, ophthalmics and spinals, supply the snake brain. The carotids and ophthalmics are densely innervated and are accompanied by thick nerve bundles, suggesting that the nerves preferentially enter the skull along those arteries. Some parenchymal arterioles are also dually innervated. Connection between the brain parenchyma and intracerebral capillaries via both cholinergic and adrenergic fibres was observed. In addition cholinergic nerve fibres, connecting capillaries and the intramedullary nerve fibre bundles, were noticed. Capillary blood flow may be influenced by both adrenergic and cholinergic central neurons. The walls of capillaries also exhibit heavy acetylcholinesterase activity. This may indicate an important role for the capillary in the regulation of intracerebral blood flow.     

The anatomic basis for the platysma skin flap

Meticulous anatomic dissection of the vasculature of the superficial anterolateral neck indicates that the platysma and overlying skin are supplied by direct cutaneous arteries measuring 0.5 mm in diameter. The small arteries are branches of the postauricular and occipital arteries in the upper lateral neck, the facial and submental arteries in the upper medial neck, the superior thyroid artery in the middle of the neck, the subclavian artery in the lower medial neck, and the transverse or superficial cervical arteries in the lateral aspect of the neck. These vessels traverse the undersurface of the platysma muscle to provide blood flow to the overlying skin. As opposed to this direct cutaneous system, the myocutaneous blood supply perforating through the sternocleidomastoid is scant. The platysma skin flap will survive if the blood supply from at least one region is preserved. In addition, it may be beneficial to include the external jugular and/or the communicating veins in the flap. By following these guidelines, the platysma flap has been successfully used for facial reconstruction in 7 of 8 consecutive patients.     

Numerical simulations of the blood flow in the patient-specific arterial cerebral circle region

The Cerebral Circle Region, also known as the Circle of Willis (CoW), is a loop of arteries that form arterial connections between supply arteries to distribute blood throughout the cerebral mass. Among the population, only 25% to 50% have a complete system of arteries forming the CoW. 3D time-varying simulations for three different patient-specific artery anatomies of CoW were performed in order to gain a better insight into the phenomena existing in the cerebral blood flow. The models reconstructed on the basis of computer tomography images start from the aorta and include the largest arteries that supply the CoW and the arteries of CoW. Velocity values measured during the ultrasound examination have been compared with the results of simulations. It is shown that the flow in the right anterior artery in some cases may be supplied from the left internal carotid artery via the anterior communicating artery. The investigations conducted show that the computational fluid dynamic tool, which provides high resolution in both time and space domains, can be used to support physicians in diagnosing patients of different ages and various anatomical arterial structures.     

Cutaneous blood supply of the penis

Twelve male cadaver specimens were injected with a latex solution to define the cutaneous blood supply of the penis. The cutaneous blood supply of the penile shaft is derived solely from a pair of axial arteries running in the dartos layer. Additional deep perforating arteries from the dorsal penile artery and corporal vessels supply the glans and subcoronal region. An understanding of this anatomy allows one to develop safely a variety of penile skin flaps for difficult reconstructive problems.     

Cardiac conducting system of Gallus domesticus with special reference to the atrial bundles

Gross anatomy and histology of the cardiac conducting system of Gallus domesticus has been studied. Detailed histology of the atrium revealed for the first time, in the avian heart, the presence of three atrial bundles which communicate between the sinuatrial node and the atrioventricular node. Purkinje fibres in the subendocardium of the right atrium are observed. An atrioventricular segment comprising of the posterior end of the interatrial septum and the atrioventricular nodal region has been reported in which the three atrial bundles converge. The role of the atrial bundles in the cardiac contraction has been discussed.     

Gender differences in myogenic regulation along the vascular tree of the gerbil cochlea

Regulation of cochlear blood flow is critical for hearing due to its exquisite sensitivity to ischemia and oxidative stress. Many forms of hearing loss such as sensorineural hearing loss and presbyacusis may involve or be aggravated by blood flow disorders. Animal experiments and clinical outcomes further suggest that there is a gender preference in hearing loss, with males being more susceptible. Autoregulation of cochlear blood flow has been demonstrated in some animal models in vivo, suggesting that similar to the brain, blood vessels supplying the cochlea have the ability to control flow within normal limits, despite variations in systemic blood pressure. Here, we investigated myogenic regulation in the cochlear blood supply of the Mongolian gerbil, a widely used animal model in hearing research. The cochlear blood supply originates at the basilar artery, followed by the anterior inferior cerebellar artery, and inside the inner ear, by the spiral modiolar artery and the radiating arterioles that supply the capillary beds of the spiral ligament and stria vascularis. Arteries from male and female gerbils were isolated and pressurized using a concentric pipette system. Diameter changes in response to increasing luminal pressures were recorded by laser scanning microscopy. Our results show that cochlear vessels from male and female gerbils exhibit myogenic regulation but with important differences. Whereas in male gerbils, both spiral modiolar arteries and radiating arterioles exhibited pressure-dependent tone, in females, only radiating arterioles had this property. Male spiral modiolar arteries responded more to L-NNA than female spiral modiolar arteries, suggesting that NO-dependent mechanisms play a bigger role in the myogenic regulation of male than female gerbil cochlear vessels.     

Vascularization of the corpus callosum in humans

The blood supply of the corpus callosum is studied in 20 brains by injecting the vascular system with gelatinous Indian ink. The arterial vascularization derives mainly from the anterior cerebral arteries, accessed from the median artery of the corpus callosum or from the terminal and choroidal branches of the posterior cerebral arteries. The various arteries give off perforating branches which are direct or indirect, short, of middle length or long. All these arteries concentrate on the peripheral wall of the corpus callosum. Inside of it these various arteries give off numerous terminal and collateral branches running between the nervous fibres and forming a characteristic vascular network which nourishes the capillary network. The venous vascularization of the corpus callosum is tributary to the deep venous system of the brain and concentrates on the central wall of the commissure.     

Comparative anatomical characteristics of the histological structure of the arteries at the base of the brain in various mammalian orders and species]

In 30 mammalian species specific peculiarities of the arterial structure has been revealed and their dependence on the type of the brain blood supply has been demonstrated. The architectonics of the blood supply sources is correlated with the structure of the wall in the arteries, immediately participating in dumping the blood stream during its transport to the brain.     

Blood supply of the human cervical sympathetic chain and ganglia

OBJECTIVE: Cadaveric studies of the blood supply to the human cervical sympathetic chain and ganglia are lacking in the English literature. This study seeks to elucidate the gross blood supply of the cervical sympathetic chain so as to avoid surgical disruption of these vessels and thus decrease the risk of vascular insufficieny and subsequent dysfunction of thoracolumbar autonomic outflow to the head and neck. METHODS: Twelve (24 sides) human cadavers (8 male and 4 female) were dissected and their brachiocephalic veins, internal carotid arteries, and vertebral arteries cannulated. Red and blue latex was injected into the arteries and veins respectively. Dissection of the neck was carefully performed and the blood supply of the cervical sympathetic chain identified. RESULTS: The primary arterial supply to the sympathetic chain and ganglia were from superior to inferior the ascending pharyngeal, ascending cervical, thyrocervical trunk, and supreme intercostal arteries. The primary venous drainage of these structures was primarily by direct posterior branches into the internal jugular vein. In addition, we have found an area at the junction of the lower two-thirds and upper one-third of the neck, which is deficient in blood supply (both arterial and venous). CONCLUSIONS: Although sympathetic injury is a rare consequence of cervical operations, the current data should be useful to the surgeon who operates in the cervical region so as to avoid potential complications from disruption of the primary blood supply of the cervical sympathetic chain and ganglia. Also, future techniques of selective iatrogenic disruption of the blood supply to portions of these structures e.g. stellate ganglion may be helpful in treating entities such as hyperhydrosis.     

Features of the structure of arteries of the lower extremities in man

A comparative investigation has been performed on structural peculiarities of muscle arteries having various caliber in the lower extremities and in the anterior thoracic wall (section material, 40 observations). An essential predominance of the muscle tunic thickness and deterioration of blood supply has been stated in the arterial wall and in the distal parts of the lower extremities. The structural peculiarities revealed in the arteries of the extremities are connected with functional conditions of blood supply in the zone at the vertical position of the human body (orthostatic arterial hypertension).     

Enzyme histochemical studies on the conducting system of the human heart

Summary In this communication, the results of applying various histochemical techniques for the localization of oxidoreductases, transferases, hydrolases and isomerases in the human heart are presented. The Purkinje fibres of the atrioventricular conducting system of the human heart differ from the myocardium proper in containing a slightly higher activity of most of the glycolytic and gluconeogenetic enzymes investigated. The relatively higher activity of 6-phosphofructokinase, the key enzyme in anaerobic carbohydrate metabolism, is especially noteworthy. On the other hand, the activities of some of the enzymes that play a part in the aerobic energy metabolism is slightly less than those in the myocardium fibres.As for the activity of the NADPH regenerating enzymes, the activity of 6-phosphogluconate dehydrogenase and malate dehydrogenase (oxaloacetate-decarboxylating) is somewhat higher, and the activity of glucose-6-phosphate dehydrogenase similar, in the Purkinje fibres compared to that in the myocardial fibres. The activity of myosin ATPase is similar for both types of fibre. Likewise, the fibres of the conducting system and of the myocardium show a similar activity of acid phosphatase, -glucuronidase, non-specific naphthylesterase and peroxidase. The neurogenic function of the conducting system of the human heart was demonstrated by the high activity of acetylcholinesterase in the Purkinje fibres and in the atrioventricular node. All these histochemical findings in Purkinje fibres are similar at widely differing levels of the conducting system.     

川金丝猴脑的动脉供应

为了探讨川金丝猴脑动脉供应的形态学特征,为脑生物学研究提供结构基础,用血管铸型和组织透明方法追踪观察了川金丝猴幼体脑动脉的来源和分支分布。结果表明川金丝猴与人脑的动脉供应基本相同,也由颈内动脉和椎动脉供应。上述动脉的分支于垂体周围形成大脑动脉环。颈内动脉通过大脑前动脉和大脑中动脉主要供应大脑半球前部的血液,椎动脉参与形成基底动脉、小脑动脉系和大脑后动脉,供应脑干、小脑和大脑后部的血液。另外,川金丝猴幼体左、右大脑前动脉间缺少前交通动脉。     

An extra atrioventricular node in an anomalous heart of a calf

An extra atrioventricular node in a double outlet ventricle with a quite normal inflow septum in a calf is described. The anomaly resembles the topography of the conducting system in the calf heart in the embryonic stages from 13.5 mm-90 mm.