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    From Cardiovascular System

    Left Inferior Pulmonary Vein
    Returns oxygenated blood from left lung.
    Femoral Arteries
    Main arteries supplying the thighs.
    Small Saphenous Vein
    Superficial vein of the posterior leg.
    External Carotid Artery
    Supplies blood to the face and scalp.
    Dorsalis Pedis Arteries
    Supply blood to the dorsal surface of the foot.
    Subclavian Arteries
    Supply blood to the arms and part of the brain.
    Abdominal Aorta
    Part of descending aorta within the abdomen.
    Basilic Veins
    Superficial veins of the medial upper limb.
    Left Coronary Artery
    Supplies blood to left side of heart.
    Internal Iliac Veins
    Drain pelvic organs.
    Great Saphenous Vein
    Longest vein in the body, running along the leg.
    Common Iliac Veins
    Drain blood from the pelvis and lower limbs.
    Cephalic Veins
    Superficial veins of the lateral upper limb.
    Common Iliac Arteries
    Branch from abdominal aorta to supply the lower limbs.
    Popliteal Veins
    Drain blood from the knee region.
    Internal Carotid Artery
    Supplies blood to the brain.
    Dorsal Venous Arch
    Superficial venous network on the dorsum of the foot.
    Middle Cardiac Vein
    Drains the posterior heart.
    Superior Vena Cava
    Returns deoxygenated blood from upper body.
    External Iliac Veins
    Drain lower limbs and join internal iliac veins.
    Inferior Vena Cava
    Returns deoxygenated blood from lower body.
    Moderator Band
    Muscular band of heart tissue found in the right ventricle.
    Femoral Veins
    Major deep veins of the thigh.
    Aortic Valve
    Valve between left ventricle and aorta.
    Left Pulmonary Artery
    Carries blood to left lung.

    Papillary Muscles

    Reviewed by our medical team

    Muscles that anchor the heart valves via chordae tendineae.

    Overview

    Papillary muscles are cone-shaped muscular projections from the inner walls of the ventricles of the heart. They attach to the atrioventricular (AV) valve leaflets — the mitral and tricuspid valves — via the chordae tendineae. Their primary role is to prevent prolapse or inversion of these valves during ventricular systole. By contracting in synchrony with the ventricular myocardium, they help maintain unidirectional blood flow and contribute to the mechanical efficiency of the heart.

    Location

    Papillary muscles are found in both ventricles of the heart:

    • Right ventricle: Contains three papillary muscles associated with the tricuspid valve — anterior, posterior, and septal papillary muscles.

    • Left ventricle: Contains two papillary muscles attached to the mitral valve — anterolateral and posteromedial papillary muscles.

    They originate from the ventricular walls and extend into the chamber, projecting toward the AV valves. The chordae tendineae link these muscles to the valve leaflets, forming an integrated mechanism that supports valve closure during contraction.

    Structure

    Each papillary muscle is a muscular ridge composed of:

    • Myocardial tissue: Composed of contractile cardiac muscle fibers.

    • Attachment base: Anchored to the ventricular wall.

    • Apex: Gives rise to chordae tendineae, fibrous cords that attach to the free edges of valve leaflets.

    The papillary muscles are an integral part of the valve complex. They have a rich blood supply, predominantly from branches of the coronary arteries — particularly the left anterior descending and right coronary arteries.

    Function

    The main function of the papillary muscles is to:

    • Stabilize valve leaflets during ventricular contraction (systole)

    • Prevent valve prolapse into the atria by maintaining tension via the chordae tendineae

    • Support effective valve closure to maintain unidirectional blood flow through the heart

    Their contraction is timed precisely with the contraction of the ventricular myocardium, ensuring that the valve leaflets close securely without inverting into the atria under high pressure.

    Physiological Role(s)

    Papillary muscles serve critical physiological roles in maintaining heart function:

    • Valve integrity: By anchoring the chordae tendineae, they preserve the geometry and function of the AV valves.

    • Hemodynamic stability: Proper function ensures efficient forward flow of blood, minimizing regurgitation.

    • Conduction synchronization: Papillary muscle contraction is coordinated with the ventricular electrical cycle via the Purkinje fibers, especially in the case of the moderator band and anterior papillary muscle of the right ventricle.

    Any disruption in their contraction or anatomy can result in compromised valve function and reduced cardiac output.

    Clinical Significance

    Papillary muscles are involved in several important cardiac conditions:

    • Papillary Muscle Rupture: A rare but life-threatening complication of myocardial infarction, especially involving the posteromedial papillary muscle (which typically has a single blood supply). It leads to acute mitral regurgitation and pulmonary edema.

    • Ischemic Papillary Dysfunction: Chronic ischemia can weaken these muscles, impairing their ability to tense the valve leaflets, resulting in functional mitral or tricuspid regurgitation.

    • Mitral Valve Prolapse (MVP): Elongated or weakened chordae tendineae, sometimes linked to papillary muscle dysfunction, can lead to leaflet prolapse and valve incompetence.

    • Hypertrophic Cardiomyopathy (HCM): Abnormal positioning or hypertrophy of papillary muscles can obstruct the left ventricular outflow tract and contribute to mitral regurgitation.

    • Echocardiographic Assessment: Papillary muscle motion is routinely evaluated in echocardiography to assess valvular function and detect infarction-related damage.

    • Surgical and Transcatheter Interventions: In mitral valve repair or replacement, preservation or reconstruction of papillary muscle-chordal integrity is crucial to restoring normal valve function.

    Recognition of papillary muscle anatomy, perfusion, and function is essential in diagnosing and managing valvular heart disease, post-infarction complications, and congenital abnormalities.

    Did you know? The heart is located between your lungs, slightly to the left.