Armour J A, Murphy D A, Yuan B X, Macdonald S, Hopkins D A
Departments of Surgery, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Anat Rec. 1997 Feb;247(2):289-98. doi: 10.1002/(SICI)1097-0185(199702)247:2<289::AID-AR15>3.0.CO;2-L.
The extent and locations of intrinsic cardiac ganglia on the human heart were investigated to facilitate studying their function.
The locations and number of major intrinsic cardiac ganglia were determined in six human hearts by means of microdissection following methylene blue staining. Light and electron microscopic analyses were performed on right atrial and cranial medial ventricular ganglia obtained from 12 other human hearts.
Gross anatomy: Collections of ganglia associated with nerves, i.e., ganglionated plexuses, were observed consistently in five atrial and five ventricular regions. Occasional ganglia were located in other atrial and ventricular regions. Atrial ganglionated plexuses were identified on 1) the superior surface of the right atrium, 2) the superior surface of the left atrium, 3) the posterior surface of the right atrium, 4) the posterior medial surface of the left atrium (the latter two fuse medially where they extend anteriorly into the interatrial septum), and 5) the inferior and lateral aspect of the posterior left atrium. Ventricular ganglionated plexuses were located in fat 1) surrounding the aortic root, 2) at the origins of the right and left coronary arteries (the latter extending to the origins of the left anterior descending and circumflex coronary arteries), 3) at the origin of the posterior descending coronary artery, 4) adjacent to the origin of the right acute marginal coronary artery, and 5) at the origin of the left obtuse marginal coronary artery. Microscopic anatomy: Ganglia ranged in size from those containing a few neurons to large ganglia measuring up to 0.5 x 1 mm. The human heart is estimated to contain more than 14,000 neurons. Neuronal somata varied in size and shape. Many axon terminals in intrinsic cardiac ganglia contained large numbers of small, clear, round vesicles that formed asymmetrical axodendritic synapses, whereas a few axons contained large, dense-cored vesicles.
The human intrinsic cardiac nervous system is distributed more extensively than was considered previously, most of its ganglia being located on the posterior surfaces of the atria and superior aspect of the ventricles. Each ganglion therein contains a variety of neurons that are associated with complex synaptology.
研究人体心脏内源性心脏神经节的范围和位置，以促进对其功能的研究。
通过亚甲蓝染色后的显微解剖确定六颗人体心脏中主要内源性心脏神经节的位置和数量。对取自另外12颗人体心脏的右心房和颅内侧心室神经节进行光镜和电镜分析。
大体解剖：在五个心房和五个心室区域均一致观察到与神经相关的神经节集合，即神经节丛。其他心房和心室区域偶尔也有神经节。心房神经节丛位于：1）右心房上表面；2）左心房上表面；3）右心房后表面；4）左心房后内侧表面（后两者在向心房间隔前方延伸处内侧融合）；5）左心房后部的下外侧。心室神经节丛位于脂肪中：1）围绕主动脉根部；2）在左右冠状动脉起始处（后者延伸至左前降支和回旋支冠状动脉起始处）；3）在后降支冠状动脉起始处；4）紧邻右锐缘冠状动脉起始处；5）在左钝缘冠状动脉起始处。显微解剖：神经节大小不一，从含有少数神经元的小神经节到最大尺寸达0.5×1毫米的大神经节。估计人体心脏含有超过14,000个神经元。神经元胞体大小和形状各异。内源性心脏神经节中的许多轴突终末含有大量小而清亮的圆形囊泡，形成不对称的轴-树突触，而少数轴突含有大的、有致密核心的囊泡。
人体心脏内源性神经系统的分布比之前认为的更为广泛，其大多数神经节位于心房后表面和心室上侧。其中每个神经节都包含多种与复杂突触结构相关的神经元。
