Pericardium: Difference between revisions

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{{Infobox Anatomy |
{{Infobox Anatomy |
   Name        = {{PAGENAME}} |
   Name        = {{PAGENAME}} |
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   Image2      = Gray968.png |
   Image2      = Gray968.png |
   Caption2    = A transverse section of the [[thorax]], showing the contents of the middle and the posterior [[mediastinum]]. The [[pleural cavity|pleural]] and [[pericardial cavity|pericardial cavities]] are exaggerated since normally there is no space between parietal and visceral pleura and between pericardium and [[heart]] Paricardium is also known as cariac epidemis. |
   Caption2    = A transverse section of the [[thorax]], showing the contents of the middle and the posterior [[mediastinum]]. The [[pleural cavity|pleural]] and [[pericardial cavity|pericardial cavities]] are exaggerated since normally there is no space between parietal and visceral pleura and between pericardium and [[heart]] Paricardium is also known as cariac epidemis. |
  Precursor    = |
  System      = |
  Artery      = [[pericardiacophrenic artery]] |
  Vein        = |
  Nerve        = |
  Lymph        = |
  MeshName    = Pericardium |
  MeshNumber  = A07.541.795 |
  DorlandsPre  = |
  DorlandsSuf  = |
}}
}}
{{Pericarditis}}
{{Pericarditis}}
{{CMG}}
{{CMG}}; '''Assistant Editor(s)-in-Chief:''' [[User:Rim Halaby|Rim Halaby]]


==Overview==
==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 cartilage]]s and T5-T8 [[vertebrae]].
The '''pericardium''' is a double-walled sac that contains the [[heart]] and the roots of the [[great vessels]].


==Layers==
==Layers==
 
*The [[pericardium]] is made up 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 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.<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 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 vein]]s 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>


<div align="center">
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</gallery>
</gallery>
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</div>
==Diseases of the Pericardium==
* [[Pericarditis]] is an inflammatory condition of the pericardium.
* [[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.
* [[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]].


==Additional Images==
==Additional Images==
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  Image:Gray806.png|The phrenic nerve and its relations with the vagus nerve.
  Image:Gray806.png|The phrenic nerve and its relations with the vagus nerve.
  Image:Gray846.png|Thoracic portion of the sympathetic trunk.
  Image:Gray846.png|Thoracic portion of the sympathetic trunk.
  Image:Gray1088.png|Liver with the septum transversum. Human embryo 3 mm. long.
  Image:Gray1088.png|Liver with the septum transversum. Human embryo 3 mm long.
  Image:Gray1178.png|The thymus of a full-time fetus, exposed in situ.
  Image:Gray1178.png|The thymus of a full-time fetus, exposed in situ.
</gallery>
</gallery>
==Diseases of the Pericardium==
* [[Pericarditis]] is an inflammatory condition of the pericardium.
* [[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.
* [[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]].


{{Heart}}
{{Heart}}
 
==References==
{{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.

de:Herzbeutel it:Pericardio la:Pericardium ms:Perikardium nl:Pericard nn:Hjartepose fi:Perikardium


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