Anatomy of the heart the pericardium
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor(s)-in-Chief: Rim Halaby, Yazan Daaboul
Overview
The pericardium is a double-walled sac containing the heart and the roots of the great vessels.
The Pericardium
- The pericardium is a sac that embeds the heart. It is pierced by 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.
- 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.
- Smooth internal layer made of 2 components:
- Fibrous pericardium
- 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.
Pericardial Sinuses
- Pericardial sinuses are channels or chambers between the visceral and parietal pericardia.
- 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.[1][2][3]
- Below are images showing the pericardium and pericardial sinuses.
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The pericardium -
The pericardial sinuses
References
- ↑ 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.
- ↑ Moore, K. L., Agur, A. M., & Dalley, A. F. (2011). Essential Clinical Anatomy - Fourth Edition. Lippincott Williams & Wilkins.
- ↑ Tank, P. W. (2009). Grant's Dissector - Fourteenth Edition. Lippincott Williams & Wilkins.