Positions of septal papillary muscles in human hearts

Septal papillary muscles, similarly to other papillary muscles, are essential elements of the heart valvular system. Damage to their structure may lead to a considerable life risk. Of all the papillary muscles, the septal papillary muscles are characterized by the greatest topographical and morphological variability. However, information about these muscles is scarce and fragmentary. The objective of this study was to ascertain their occurrence and the region in which they are placed in the inter-ventricular septum. One hundred and eleven human hearts were examined. The hearts belonged to the Clinical Anatomy Department of the Medical University of Gdańsk. They were fixed in formalin with ethanol and came from middle-aged and older individuals of both sexes, devoid of pathological changes and birth defects. During the tests, classic anatomical methods were applied. The region where the papillary muscles are found covers a sizeable surface of the septum, from the conus arteriosus up to the back angle of the right chamber. Depending on their location the following septal papillary muscles (musculi papillares septales, MPS) were singled out: 1) lying on the front wall of the septum (anterior papillares septales), 2) in the central part of the septum (central muscles), and 3) in the posterior section of the septum (posterior papillares septales). A trial to determine the types of MPS was based on this diversity of location. Consequently, five types of MPS were specified: type I: anterior-central (44.1%); type II: anterior (15.3%); type III: anterior-posterior (13.5%); type IV: anterior-central-posterior (24.3%); and type V: uniform (2.75%). This study is an attempt to systematize and standardize the terminology of these structures. (Folia Morphol 2010; 69, 2: 101-106

Microscopic study of right fibrous annulus

The term annulus fibrous is still used in anatomical and clinical terminology but does not exist in anatomical nomenclature. This structure is proposed as an anatomical substrate for circus movement of excitation. Multiple cardiac damage after blunt chest trauma is rare, but usually affects the septal part of the right fibrous annulus. Histological observation confirms the results of our previous macroscopic study and shows that the most stable part of fibrous annulus is the septal part and the region of anterior angle of the right ventricle, and the most labile parts are the lateral and posterior angles of the right ventricle and the posterior part of the fibrous annulus. Our histological study shows that the right fibrous annulus is a heterogeneous structure and may play a role in changes of shape of the right atrio-ventricular ostium during human life

The morphology and distribution of the tendinous chords and their relation to the papillary muscles in the tricuspid valve of the human heart

The tendinous chords of the tricuspid valve are the predominant type of connection between the papillary muscles and the tricuspid valve. Studies describing the evolutionary line of these connections are well known. The flexibility of particular leaflets of the tricuspid valve varies, as does the tension of the blood stream in particular cusps. The present study was performed on a group of 96 formalin-fixed adult human hearts, which ranged in age from 18 to 90 years and gave no evidence of congenital malformations or pathological changes. The valves were divided into five types according to earlier studies and analysis was made in terms of these types. The tendinous chords and their ramifications were counted. The surfaces of particular leaflets were measured. The ratio of marginal to ventricular leaflets was counted for each type of leaflet in particular types of valves. The parts of the main leaflets supported by specific papillary muscles were counted for types 1, 2 and 3. The number of tendinous chords decreased in leaflets in particular types of tricuspid valve, but the ratio of chords attached to the margins and ventricular surfaces was similar. The number of chords for the surface of leaflets (measured in mm2) was similar in particular types of valve for all cusps. The most differentiated were commissural chords in all types of valve. The ratio of chords attached to the margins and ventricular surfaces does not depend on the surface area of the leaflets

The relationship between the membranous part of the interventricular septum and the septal part of the attachment of the tricuspid valve in adult human hearts

The membranous septum is a difficult structure to demonstrate in vivo. It is possible to measure its dimensions in a cadaver after the introduction of light into the aorta, but difficult to do so otherwise. The present study was performed on a group of 107 formalin-fixed adult hearts from both sexes and 18-90 years of age. The hearts were divided into groups depending on sex and age. The length of the septal part of the attachment of the tricuspid valve was divided by the length of the supravalvular part of the membranous interventricular septum

The morphometry of the accessory leaflets of the tricuspid valve in a four cuspidal model

The tricuspid valve is of great importance because of the progress made in operative techniques and invasive cardiology accidents. This structure is more differentiated during evolution than the mitral valve. Accessory leaflets, their frequency and role are still controversial, despite the fact that they have been known from the beginning of the 20th century. The number of leaflets in the tricuspid valve grows in an evolutionary line, but the rules governing their appearance are still not known. The samples were taken from a group of 107 human adult hearts. The four-cuspidal form of the tricuspid valve was used as the simplest model to show the appearance of accessory leaflets for anatomical and statistical examination. On the basis of the results of this study we conclude that the separation of accessory leaflets is a complex process

Morphometric features of the right atrioventricular orifice in adult human hearts

The normal data of the tricuspid valve complex is of great clinical importance in the light of progress in cardiosurgery and the development of novel operating techniques. A range of measurements for the right atrioventricular orifice in 96 human adult hearts was examined by means of anatomical dissection, inspection, examination, and statistical analyses. The length of the attachment of the anterior leaflet increased significantly between group I (aged 18-40 years) and group II (aged 41-64 years) in women only. In men there were no significant differences in this parameter between any of the three age groups. In addition, the attachment length of the posterior leaflet in women increased statistically in the second age group. In men, in contrast, the attachment length of the posterior leaflet did not increase significantly between the first and second age groups and became significantly larger only in oldest age group, consisting of men aged over 65. No statistically significant differences between the three age groups were found for the attachment length of the septal leaflet (p > 0.05). In female hearts significant increases in the frontal and sagittal dimensions of the tricuspid valve orifice were observed between the second age group and the group aged over 65. In male hearts both the frontal and sagittal dimensions increased significantly with advanced age. The right atrioventricular orifice expressed as the ellipse area was statistically greater than the triangular area (p < 0.01) in each age group. It should be noticed that both areas increased significantly during ageing. This study has demonstrated that the shape of the right atrioventricular orifice evolves during life, from a triangular shape to a more elliptical shape. (Folia Morphol 2008; 67: 53-57

The role of a warship's doctor in aiding shipwrecked persons at sea

Udział naszych okrętów w realizacji misji wynikających z przynależności do NATO odbywanych w różnych częściach świata, zwłaszcza w basenie morza Bałtyckiego i Afryki Północnej powodować może konieczność udzielenia pomocy rozbitkom. W pracy przedstawiono obowiązki lekarza okrętowego w przypadku ratowania rozbitków. Przy udzielaniu pomocy uwzględniono również czynniki, które niekorzystnie oddziałują na organizm rozbitka i te, które mają wpływ na utrzymanie go przy życiu. Możliwości ratownicze omówiono na przykładzie ORP "Wodnik".The participation of Polish Navy ships in missions in different parts of the world, especially in the Baltic Sea and the Mediterranean, arising in a large part from Poland’s NATO membership, may result in medical aid being provided to shipwrecked persons or survivors of accidents at sea. The aim of this paper is to present the duties of a warship’s doctor in aiding such persons. Life-threatening and life-support factors are also discussed. This case study is based on the potential of ORP Wodnik

Selected gastroenterologic problems in the tropics (peacekeeping missions, work)

W pracy przedstawiono zagrożeniami ze strony czynników środowiska zewnętrznego, które mogą stać się przyczyną chorób przewodu pokarmowego, zarówno górnego, jak i dolnego odcinka u turystów, osób wyjeżdżających służbowo, jak żołnierzy, którzy biorą udział w Misjach Pokojowych w tropiku. Uwzględniono także te jednostki chorobowe, które z uwagi na rozpowszechnienie występują również we własnym kraju, np. infekcje Helicobacter pylori,wirusowe zapalenia wątroby, a także te, które z powodu warunków sanitarno – higienicznych, klimatycznych mogą wywoływać objawy choroby górnego i dolnego odcinka przewodu pokarmowego. Kontakt z chorobami typowymi dla klimatu tropikalnego, szczególnie przy dłuższym pobycie zwiększa szanse- przywlekania niektórych chorób tropikalnych do Polski co może stanowić duży problem dla służby zdrowia.Research shows a potential threat from external environmental factors which might be the cause of upper and lower gastrointestinal diseases in tourists, or soldiers engaged in tropical peacekeeping missions. The research includes infections which due to their spread are also present in their home countries such as Helicobacter pylori infections, viral hepatitis as well as infections which might cause symptoms of upper and lower gastrointestinal tract diseases as a result of poor sanitary and unhygienic conditions. Contact with diseases typical of the tropical climate, especially during longer stays, increases the chances of bringing some tropical diseases back to Poland, which can be problematic for the domestic health care service

Does diving present an increased risk of upper respiratory tract and ear infection when compared with the activity of recreational or professional swimming?

Przebywanie w środowisku wodnym (nurkowanie, pływanie) zwiększa ryzyko zapadalności na choroby górnego odcinka układu oddechowego. Celem pracy była próba porównania częstości zachorowań na choroby górnego odcinka układu oddechowego w grupie nurków z grupami osób w tym samym wieku, uprawiającymi pływanie wyczynowo lub sporadycznie. Uzyskane wyniki badań potwierdziły większą częstość występowania infekcji górnych dróg oddechowych w grupie nurków i grupie osób uprawiających pływanie wyczynowo w stosunku do grupy osób uprawiających pływanie sporadycznie. Różnice statystycznie istotne dotyczyły stanów zapalnych błony śluzowej gardła i upośledzenia powietrzności zatok. Nie stwierdzono różnic statystycznie istotnych w częstości występowania tych chorób między nurkami i pływakami wyczynowymi z wyjątkiem urazu ciśnieniowego zatok.Water sports such as diving and swimming increase the risk of upper respiratory tract illnesses. The aim of this paper is to compare the frequency of the upper respiratory tract morbidity in a group of divers with groups of persons of the same age that swim professionally or sporadically. The results obtained confirmed that infections of upper respiratory tract occur more frequently in the group of divers and professional swimmers than in the group of sporadic swimmers. The statistically significant differences concerned pharyngitis and impaired sinus aeration. There were no statistically significant differences concerning the incidence of those illnesses among divers and professional swimmers, except for sinus barotrauma