Pericardium: Difference between revisions

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==Overview==
==Overview==


The '''pericardium''' is a double-walled sac that contains the [[heart]] and the roots of the [[great vessels]].   
*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.
*The pericardial sac rests posteriorly to the sternum at the level of second to '''sixth costal cartilages''' and '''T5-T8 vertebrae'''.
==Layers==
==Layers==
 
*The pericardium is made of two layers:
There are two layers to the [[pericardial sac]]: the [[fibrous pericardium]] and the [[serous pericardium]]. The serous pericardium, in turn, is divided into two layers, the ''parietal pericardium'', which is fused to and inseparable from the fibrous pericardium, and the ''visceral pericardium'', which is in fact the [[epicardium]], or the outer surface of the heart.
**'''Fibrous Pericardium'''
 
***Hard protective external layer
In between the parietal and visceral pericardial layers there is a [[potential space]] called the [[pericardial cavity]]. It is normally lubricated by a film of pericardial fluid. Too much fluid in the cavity (such as in a [[pericardial effusion]]) can result in [[pericardial tamponade]], which refers to compression of the heart within the pericardial sac.
***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 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.<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>


==Pericardial Sinuses==
==Pericardial Sinuses==
 
*There are two small chambers or sinuses are located where the visceral and parietal pericardia are continuous with one another within the pericardial cavity.
There are two small chambers or sinuses are 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.
The pericardial sinuses are:
**  Formed after dorsal mesocardium rupture embryonically
 
**Functional role is to allow the unhindered expansion of great arteries posteriorly during cardiac systole.
* Oblique [[pericardial sinus]]
**Utilized surgically to pass surgical clamps or place ligatures around great arteries.
* Transverse [[pericardial sinus ]]
*'''Oblique sinus:'''
**A blind recess (cul-de-sac) posterior to the left atrium between superior vena cava, right and left pulmonary veins inferior to the transverse sinus.
** 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>


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{{Heart}}
{{Heart}}
==References==
{{Reflist|2}}


[[Category:Cardiac anatomy]]
[[Category:Cardiac anatomy]]

Revision as of 23:55, 28 October 2012

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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.
  • The pericardial sac rests posteriorly to the sternum at the level of second to sixth costal cartilages and T5-T8 vertebrae.

Layers

  • The pericardium is made 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 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 are 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:
    • A blind recess (cul-de-sac) posterior to the left atrium between superior vena cava, right and left pulmonary veins inferior to the transverse sinus.
    • 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.[4][5][6]

Additional Images

Diseases of the Pericardium

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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