Pericardium: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
No edit summary
Line 25: Line 25:
==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>


<div align="center">
<div align="center">
Line 65: Line 74:


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


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

Revision as of 23:55, 28 October 2012

Template:Infobox Anatomy

Pericarditis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

HIV
Post MI
Dressler's syndrome
Post-pericardiotomy
Radiation
Tuberculosis
Uremia
Malignancy

Differentiating Pericarditis from other Diseases

Epidemiology and Demographics

Screening

Natural History, Complications and Prognosis

Pericardial Effusion
Cardiac Tamponade
Constrictive Pericarditis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Pericardiocentesis
Pericardial Window
Pericardial Stripping

Treatment Related Videos

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Pericardium On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Google Images

American Roentgen Ray Society Images of Pericardium

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Pericardium

CDC on Pericardium

Pericardium in the news

Blogs on Pericardium

Directions to Hospitals Treating Type page name here

Risk calculators and risk factors for Pericardium

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

  • 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.

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.

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


Template:WikiDoc Sources

Retrieved from "https://www.wikidoc.org/index.php?title=Pericardium&oldid=782896"