Author: Alexandra Sieroslawska MD•Reviewer: Dimitrios Mytilinaios MD, PhDLast reviewed: October 28, 2021Reading time: 3 minutes

The cardiac skeleton or anulus fibrosus is no a bony structure like the human being body’s really skeleton, however a fibrous structural assistance for the love chambers.

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This article will to mark the anatomical prominence of this structure and also its functions, as well as describing its architecture within the heart and a potential pathological condition.


The cardiac skeleton has actually four major functions. Firstly, that anchors the love valve cusps come the interior walls the the heart, which stabilizes the thin petal favor sections that the valves and also prevents them from malfunctioning, which can be potentially fatal. Secondly, the keeps the atrioventricular valves and the semilunar valves that the love open, without allowing them come distend. This borders the danger of potential tears in the valvular cusps and prevents backflow that the blood into the room it to be released from.

Thirdly, the provides a point of insertion because that the majority of the love muscle and also effectively the end the atria native the ventricles in bespeak to do so. Lastly, that acts together an electrical insulator by avoiding the radiating electric impulses indigenous passing through the atrial muscles to the ventricles, thus avoiding a singular contraction, i beg your pardon in turn allows the ventricles to to fill up v blood.


The cardiac structure is composed of a dense connective tissue network that develops a fibrous skeleton. It reinforces the myocardial wall surfaces internally and anchors the cardiac muscle. The thickness the the collagen and also elastin fibers that the anulus fibrosus different from area to area and consists of four rings, 2 trigones and one ligament. The precise position of this scaffolding have the right to be plainly seen ~ above the outside side that the heart, where the good vessels exit and also enter it, within the coronary sulcus.

Fibrous ring of tricuspid valve (cranial view)

The left fibrous ring encircles the bicuspid valve and also the right fibrous ring surrounding the tricuspid valve. The pulmonary ring synchronizes to the pulmonary valve together does the aortic ring come the aortic valve. The right fibrous trigone runs approximately both the ideal fibrous ring and also the aortic ring together, conversely, the left fibrous trigone runs about the left fibrous ring and the aortic ring. Lastly, a tendinous band known as the ligament makes up the posterior border the the conus arteriosus.

Left fibrous trigone (cranial view)

Clinical notes

If the heart to be to sustain any kind of damage from a trauma, one injury to the cardiac skeleton would certainly be fatal, uneven corrected immediately. Without the rigidity the is offered by the anulus fibrosus, the musculature the the heart would not be upheld and also the caries of the atria and ventricles and also the cardiac valves would certainly collapse.

This would avoid the heart and also the circulation practically entirely and also the peripheral tissues would certainly suffer significant ischemia, leaving the human body to enter shock.




Fibrous ring that tricuspid valve (cranial view) - Yousun KohLeft fibrous trigone (cranial view) - Yousun Koh

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