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Intercalated disc
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<h2 id="structure">Structure</h2> <p>Intercalated discs are complex structures that connect adjacent <a href="/facts/Cardiac_muscle_cell/fE40oTQz">cardiac muscle cells</a>. The three types of <a href="/facts/Cell_junction/tJ4ItRfq">cell junction</a> recognised as making up an intercalated disc are <a href="/facts/Desmosome/yoolx79n">desmosomes</a>, <a href="/facts/Fascia_adherens/GzAxEVYg">fascia adherens junctions</a>, and <a href="/facts/Gap_junction/nhAEWww4">gap junctions</a>.<a class="footnote-ref" id="fnref:2" href="#fn:2"><sup>2</sup></a> </p> <ul><li><a href="/facts/Fascia_adherens/GzAxEVYg">Fascia adherens</a> are anchoring sites for <a href="/facts/Actin/Hu3qIUL9">actin</a>, and connect to the closest sarcomere.<a class="footnote-ref" id="fnref:3" href="#fn:3"><sup>3</sup></a></li> <li><a href="/facts/Desmosome/yoolx79n">Desmosomes</a> prevent separation during contraction by binding <a href="/facts/Intermediate_filament/ocjFHTvJ">intermediate filaments</a>, anchoring the cell membrane to the intermediate filament network, joining the cells together. <a class="footnote-ref" id="fnref:4" href="#fn:4"><sup>4</sup></a><a class="footnote-ref" id="fnref:5" href="#fn:5"><sup>5</sup></a></li> <li><a href="/facts/Gap_junctions/nhAEWww4">Gap junctions</a> connect the cytoplasms of neighboring cells electrically allowing <a href="/facts/Cardiac_action_potential/CJu2rTR8">cardiac action potentials</a> to spread between cardiac cells by permitting the passage of ions between cells, producing <a href="/facts/Depolarization/qGX8lFXE">depolarization</a> of the heart muscle.<a class="footnote-ref" id="fnref:6" href="#fn:6"><sup>6</sup></a><a class="footnote-ref" id="fnref:7" href="#fn:7"><sup>7</sup></a></li></ul> <p>All of these junctions work together as a single unit called the area composita.<a class="footnote-ref" id="fnref:8" href="#fn:8"><sup>8</sup></a> </p> <h2 id="clinical-significance">Clinical significance</h2> <p>Mutations in the intercalated disc gene are responsible for various <a href="/facts/Cardiomyopathies/rhXF3Vcj">cardiomyopathies</a> that can lead to <a href="/facts/Heart_failure/7fckX3Jm">heart failure</a>.<a class="footnote-ref" id="fnref:9" href="#fn:9"><sup>9</sup></a> </p> <p>Ruptured intercalated discs, when seen on <a href="/facts/Histopathology/9Eggjrg4">histopathology</a>, have two main causes: </p> <ul><li><a href="/facts/Microtome/FcQ21HIL">Microtome</a> sectioning, thereby being a <a href="/facts/Visual_artifact/sKfdQVPU">visual artifact</a>.<a class="footnote-ref" id="fnref:10" href="#fn:10"><sup>10</sup></a></li> <li>Forceful myocardial contraction, in turn mainly caused by <a href="/facts/Ventricular_fibrillation/7rCnI7zf">ventricular fibrillation</a><a class="footnote-ref" id="fnref:11" href="#fn:11"><sup>11</sup></a> or <a href="/facts/Electrical_injury/LmUdx0Ew">electrical injury</a>.<a class="footnote-ref" id="fnref:12" href="#fn:12"><sup>12</sup></a></li></ul> <p>Additional signs indicating forceful myocardial contraction are:<a class="footnote-ref" id="fnref:13" href="#fn:13"><sup>13</sup></a><a class="footnote-ref" id="fnref:14" href="#fn:14"><sup>14</sup></a> </p> <ul><li>Alternating bundles of hypercontracted myocytes with hyperdistended ones.</li> <li>Square-shaped myocardiocyte nuclei.</li> <li>Hyperdistended myocardiocytes with detached sarcomeres, and in proximity of hypercontracted myocardiocytes.</li></ul> <h2 id="external-links">External links</h2> <ul><li><a href="https://www.bu.edu/phpbin/medlib/histology/p/22502loa.htm">Histology image: 22502loa</a> – Histology Learning System at Boston University — "Ultrastructure of the Cell: cardiac muscle, intercalated disk "</li></ul> <h2 id="references">References</h2> <ol> <li id="fn:1"><p>This article incorporates text available under the CC BY 4.0 license. Betts, J Gordon; Desaix, Peter; Johnson, Eddie; Johnson, Jody E; Korol, Oksana; Kruse, Dean; Poe, Brandon; Wise, James; Womble, Mark D; Young, Kelly A (June 8, 2023). Anatomy & Physiology. Houston: OpenStax CNX. 10.7 Cardiac muscle tissue. ISBN 978-1-947172-04-3. <a href="978-1-947172-04-3" target="_blank">978-1-947172-04-3</a> <a href="#fnref:1" class="footnote-back-ref">↩</a></p></li> <li id="fn:2"><p>Zhao, G; Qiu, Y; Zhang, HM; Yang, D (January 2019). "Intercalated discs: cellular adhesion and signaling in heart health and diseases". Heart Failure Reviews. 24 (1): 115–132. doi:10.1007/s10741-018-9743-7. PMID 30288656. S2CID 52919432. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:2" class="footnote-back-ref">↩</a></p></li> <li id="fn:3"><p>Feher, Joseph (2012-01-01), Feher, Joseph (ed.), "5.7 - The Cellular Basis of Cardiac Contractility", Quantitative Human Physiology (Second Edition), Boston: Academic Press, pp. 547–555, doi:10.1016/b978-0-12-800883-6.00051-3, ISBN 978-0-12-800883-6, retrieved 2020-12-28 <a href="978-0-12-800883-6" target="_blank">978-0-12-800883-6</a> <a href="#fnref:3" class="footnote-back-ref">↩</a></p></li> <li id="fn:4"><p>Zhao, G; Qiu, Y; Zhang, HM; Yang, D (January 2019). "Intercalated discs: cellular adhesion and signaling in heart health and diseases". Heart Failure Reviews. 24 (1): 115–132. doi:10.1007/s10741-018-9743-7. PMID 30288656. S2CID 52919432. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:4" class="footnote-back-ref">↩</a></p></li> <li id="fn:5"><p>Feher, Joseph (2012-01-01), Feher, Joseph (ed.), "5.7 - The Cellular Basis of Cardiac Contractility", Quantitative Human Physiology (Second Edition), Boston: Academic Press, pp. 547–555, doi:10.1016/b978-0-12-800883-6.00051-3, ISBN 978-0-12-800883-6, retrieved 2020-12-28 <a href="978-0-12-800883-6" target="_blank">978-0-12-800883-6</a> <a href="#fnref:5" class="footnote-back-ref">↩</a></p></li> <li id="fn:6"><p>Feher, Joseph (2012-01-01), Feher, Joseph (ed.), "5.7 - The Cellular Basis of Cardiac Contractility", Quantitative Human Physiology (Second Edition), Boston: Academic Press, pp. 547–555, doi:10.1016/b978-0-12-800883-6.00051-3, ISBN 978-0-12-800883-6, retrieved 2020-12-28 <a href="978-0-12-800883-6" target="_blank">978-0-12-800883-6</a> <a href="#fnref:6" class="footnote-back-ref">↩</a></p></li> <li id="fn:7"><p>Zhao, G; Qiu, Y; Zhang, HM; Yang, D (January 2019). "Intercalated discs: cellular adhesion and signaling in heart health and diseases". Heart Failure Reviews. 24 (1): 115–132. doi:10.1007/s10741-018-9743-7. PMID 30288656. S2CID 52919432. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:7" class="footnote-back-ref">↩</a></p></li> <li id="fn:8"><p>Zhao, G; Qiu, Y; Zhang, HM; Yang, D (January 2019). "Intercalated discs: cellular adhesion and signaling in heart health and diseases". Heart Failure Reviews. 24 (1): 115–132. doi:10.1007/s10741-018-9743-7. PMID 30288656. S2CID 52919432. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:8" class="footnote-back-ref">↩</a></p></li> <li id="fn:9"><p>Zhao, G; Qiu, Y; Zhang, HM; Yang, D (January 2019). "Intercalated discs: cellular adhesion and signaling in heart health and diseases". Heart Failure Reviews. 24 (1): 115–132. doi:10.1007/s10741-018-9743-7. PMID 30288656. S2CID 52919432. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:9" class="footnote-back-ref">↩</a></p></li> <li id="fn:10"><p>Page 38 in: Giorgio Baroldi (2004). The Etiopathogenesis of Coronary Heart Disease: A Heretical Theory Based on Morphology, Second Edition. CRC Press. ISBN 9781498712811. <a href="9781498712811" target="_blank">9781498712811</a> <a href="#fnref:10" class="footnote-back-ref">↩</a></p></li> <li id="fn:11"><p>Page 55 in: Vittorio Fineschi, Giorgio Baroldi, Malcolm D. Silver (2016). Pathology of the Heart and Sudden Death in Forensic Medicine. CRC Press. ISBN 9781420006438.{{cite book}}: CS1 maint: multiple names: authors list (link) <a href="9781420006438" target="_blank">9781420006438</a> <a href="#fnref:11" class="footnote-back-ref">↩</a></p></li> <li id="fn:12"><p>Fineschi, Vittorio; Karch, Steven B.; D'Errico, Stefano; Pomara, Cristoforo; Riezzo, Irene; Turillazzi, Emanuela (2005). "Cardiac pathology in death from electrocution". International Journal of Legal Medicine. 120 (2): 79–82. doi:10.1007/s00414-005-0011-8. ISSN 0937-9827. PMID 16078070. S2CID 24759863. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:12" class="footnote-back-ref">↩</a></p></li> <li id="fn:13"><p>Page 55 in: Vittorio Fineschi, Giorgio Baroldi, Malcolm D. Silver (2016). Pathology of the Heart and Sudden Death in Forensic Medicine. CRC Press. ISBN 9781420006438.{{cite book}}: CS1 maint: multiple names: authors list (link) <a href="9781420006438" target="_blank">9781420006438</a> <a href="#fnref:13" class="footnote-back-ref">↩</a></p></li> <li id="fn:14"><p>Fineschi, Vittorio; Karch, Steven B.; D'Errico, Stefano; Pomara, Cristoforo; Riezzo, Irene; Turillazzi, Emanuela (2005). "Cardiac pathology in death from electrocution". International Journal of Legal Medicine. 120 (2): 79–82. doi:10.1007/s00414-005-0011-8. ISSN 0937-9827. PMID 16078070. S2CID 24759863. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:14" class="footnote-back-ref">↩</a></p></li> </ol>