Pericardium: Difference between revisions

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==Layers==
==Layers==
*The [[pericardium]] is made up of two layers:
*The [[pericardium]] is made up of two layers:
**Fibrous Pericardium
**Fibrous pericardium
***Hard protective external layer
***Hard protective external layer
***Attached to [[sternum]] anteriorly by sterno-pericardial ligaments and fused with the central tendon of the [[diaphragm]] and great vessels to allow mobility of the pericardial sac against sudden cardiac overfilling
***Attached to [[sternum]] anteriorly by sterno-pericardial ligaments and fused with the central tendon of the [[diaphragm]] and great vessels to allow mobility of the pericardial sac against sudden cardiac overfilling
**Serous Pericardium
**Serous pericardium
***Smooth internal layer made up of 2 components:
***Smooth internal layer made up of 2 components:
****Parietal: reflects onto fibrous pericardium
****Parietal: reflects onto fibrous pericardium
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*There are two small chambers or sinuses located where the visceral and parietal pericardia are continuous with one another within the pericardial cavity.
*There are two small chambers or sinuses located where the visceral and parietal pericardia are continuous with one another within the pericardial cavity.
*Transverse sinus:
*Transverse sinus:
**Located posterior to the [[pulmonary trunk]] and [[ascending aorta]] at the level between the [[superior vena cava]] and [[aortic arch]].
**Located posterior to the [[pulmonary trunk]] and [[ascending aorta]] at the level between the [[superior vena cava]] and [[aortic arch]]
**Formed after dorsal mesocardium rupture embryonically.
**Formed after dorsal mesocardium rupture embryonically
**Functional role is to allow the unhindered expansion of great arteries posteriorly during cardiac [[systole]].
**Functional role is to allow the unhindered expansion of great arteries posteriorly during cardiac [[systole]]
**Utilized surgically to pass surgical clamps or place ligatures around great arteries.
**Utilized surgically to pass surgical clamps or place ligatures around great arteries.
*Oblique sinus:
*Oblique sinus:
**A blind recess (cul-de-sac) posterior to the [[left atrium]] between [[superior vena cava]], right and left [[pulmonary vein]]s inferior to the transverse sinus.
**A blind recess (cul-de-sac) posterior to the [[left atrium]] between [[superior vena cava]], right and left [[pulmonary vein]]s inferior to the transverse sinus
**Formed embryonically by the incorporation of the [[pulmonary vein]] tributaries into the [[left atrium]].
**Formed embryonically by the incorporation of the [[pulmonary vein]] tributaries into the [[left atrium]]
**Functional role believed to be the expansion of the left atrium upon normal collapse of the thorax.<ref = “Kishore”>Kishore, K. (2003). The Heart of Structural Development: The Functional Basis of the Location and Morphology of the Human Vascular Pump. J Postgrad Med, 49:282-4.</ref><ref = "Moore">Moore, K. L., Agur, A. M., & Dalley, A. F. (2011). Essential Clinical Anatomy - Fourth Edition. Lippincott Williams & Wilkins.</ref><ref = "Tank">Tank, P. W. (2009). Grant's Dissector - Fourteenth Edition. Lippincott Williams & Wilkins.</ref>
**Functional role believed to be the expansion of the left atrium upon normal collapse of the thorax<ref = “Kishore”>Kishore, K. (2003). The Heart of Structural Development: The Functional Basis of the Location and Morphology of the Human Vascular Pump. J Postgrad Med, 49:282-4.</ref><ref = "Moore">Moore, K. L., Agur, A. M., & Dalley, A. F. (2011). Essential Clinical Anatomy - Fourth Edition. Lippincott Williams & Wilkins.</ref><ref = "Tank">Tank, P. W. (2009). Grant's Dissector - Fourteenth Edition. Lippincott Williams & Wilkins.</ref>


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* [[Pericarditis]] is an inflammatory condition of the pericardium.
* [[Pericarditis]] is an inflammatory condition of the pericardium.
* [[Pericardial effusion]] is fluid accumulation in the pericardial sac.
* [[Pericardial effusion]] is fluid accumulation in the pericardial sac.
* [[Constrictive pericarditis]] occurs when there is a scar encasing the heart that chronically constricts the filling of the heart.
* [[Constrictive pericarditis]] occurs when there is a scar encasing, the heart that chronically constricts the filling of the heart.
* [[Cardiac tamponade]] is a medical emergency in which fluid in the pericardial sac acutely restricts the filling of the heart. This requires surgical drainage or [[pericardiocentesis]].
* [[Cardiac tamponade]] is a medical emergency in which fluid in the pericardial sac acutely restricts the filling of the heart. This requires surgical drainage or [[pericardiocentesis]].


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==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
 
[[Category:Best pages]]
[[Category:Cardiac anatomy]]
[[Category:Cardiac anatomy]]
[[Category:Cardiology]]
[[Category:Cardiology]]

Latest revision as of 21:13, 17 January 2013

Template:Infobox Anatomy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor(s)-in-Chief: Rim Halaby

Overview

The pericardium is a double-walled sac that contains the heart and the roots of the great vessels. Morphologically, it is a conical-shaped, double-walled fibro-serous membrane. It rests posteriorly to the sternum at the level of second to sixth costal cartilages and T5-T8 vertebrae.

Layers

  • The pericardium is made up of two layers:
    • Fibrous pericardium
      • Hard protective external layer
      • Attached to sternum anteriorly by sterno-pericardial ligaments and fused with the central tendon of the diaphragm and great vessels to allow mobility of the pericardial sac against sudden cardiac overfilling
    • Serous pericardium
      • Smooth internal layer made up of 2 components:
        • Parietal: reflects onto fibrous pericardium
        • Visceral: reflects onto heart and great vessels and forms the epicardium, the external layer of the heart wall
  • Pericardial cavity: Potential space between parietal and visceral layers. It contains a serous fluid film that occupies the cavity and functions as lubricant against friction by all chest movements.[1][2][3]

Pericardial Sinuses

  • There are two small chambers or sinuses located where the visceral and parietal pericardia are continuous with one another within the pericardial cavity.
  • Transverse sinus:
    • Located posterior to the pulmonary trunk and ascending aorta at the level between the superior vena cava and aortic arch
    • Formed after dorsal mesocardium rupture embryonically
    • Functional role is to allow the unhindered expansion of great arteries posteriorly during cardiac systole
    • Utilized surgically to pass surgical clamps or place ligatures around great arteries.
  • Oblique sinus:

Diseases of the Pericardium

Additional Images

  • The phrenic nerve and its relations with the vagus nerve.

    The phrenic nerve and its relations with the vagus nerve.

  • Thoracic portion of the sympathetic trunk.

    Thoracic portion of the sympathetic trunk.

  • Liver with the septum transversum. Human embryo 3 mm long.

    Liver with the septum transversum. Human embryo 3 mm long.

  • The thymus of a full-time fetus, exposed in situ.

    The thymus of a full-time fetus, exposed in situ.

References

  1. ↑ Kishore, K. (2003). The Heart of Structural Development: The Functional Basis of the Location and Morphology of the Human Vascular Pump. J Postgrad Med, 49:282-4.
  2. ↑ Moore, K. L., Agur, A. M., & Dalley, A. F. (2011). Essential Clinical Anatomy - Fourth Edition. Lippincott Williams & Wilkins.
  3. ↑ Tank, P. W. (2009). Grant's Dissector - Fourteenth Edition. Lippincott Williams & Wilkins.
  4. ↑ Kishore, K. (2003). The Heart of Structural Development: The Functional Basis of the Location and Morphology of the Human Vascular Pump. J Postgrad Med, 49:282-4.
  5. ↑ Moore, K. L., Agur, A. M., & Dalley, A. F. (2011). Essential Clinical Anatomy - Fourth Edition. Lippincott Williams & Wilkins.
  6. ↑ Tank, P. W. (2009). Grant's Dissector - Fourteenth Edition. Lippincott Williams & Wilkins.

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