Pericardium: Difference between revisions
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==Layers== | ==Layers== | ||
*The [[pericardium]] is made 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 of 2 components: | ***Smooth internal layer made up of 2 components: | ||
****'''Parietal''': reflects onto fibrous pericardium | ****'''Parietal''': reflects onto fibrous pericardium | ||
****'''Visceral''': reflects onto heart and great vessels and forms the epicardium, the external layer of the heart wall. | ****'''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 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> | ||
Revision as of 20:40, 26 November 2012
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Pericarditis Microchapters |
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Diagnosis |
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Treatment |
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Surgery |
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Case Studies |
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Pericardium On the Web |
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American Roentgen Ray Society Images of Pericardium |
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.
- 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 up of two layers:
- Fibrous Pericardium
- 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.
- Smooth internal layer made up of 2 components:
- 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]
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
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The phrenic nerve and its relations with the vagus nerve.
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Thoracic portion of the sympathetic trunk.
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Liver with the septum transversum. Human embryo 3 mm long.
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The thymus of a full-time fetus, exposed in situ.
Sources
- 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.
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.
- ↑ 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.
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