Heart & Pericardium
Pericardium
**Fibroserous sac which encloses heart and the roots of great vessels
Pericardium
Fibrous pericardium Serous pericardium
Apex fuses with adventitia of great vessels
Parietal layer
Visceral layer
Base blends with central tendon. (E
Fused with fibrous (Epicardium)
pericardium Adherent to heart
(except along cardiac grooves)
Nerve supply → Phrenic nerve autonomic nerves
Pain sensitivity → sensitive Insensitive
Blood supply → 1) Internal thoracic Artery coronary vessels
2) Musculophrenic Artery
3) Descending aorta
Angina / cardiac pain originates in the cardiac muscle.
The pain of pericarditis originates in the parietal pericardium.
Embryological origin→ pleuropericardial membrane - mesothelium of septum transversum
• Parietal and visceral (epicardium) layers of pericardium
• Continuous at the root of great vessels Encloses
•
pericardial cavity → a potential space
1
, Sinuses of pericardium
Serous pericardium forms an arterial tube
around ascending aorta and pulmonary trunk.
&
A venous tube around vena cavae and
pulmonary veins.
Transverse sinus More
posteriorly
Horizontal gap related to
Lies between arterial and venous tubes oesophagus
Bounded,
o Anteriorly → arterial tube
o Posteriorly → superior vena cava
o Inferiorly → left atrium
When the pericardium is opened anteriorly
during a surgery, a finger placed in the
transverse sinus separates arteries from veins.
A hand placed under the apex and moved
superiorly, slips into the oblique sinus.
Oblique sinus
Bounded,
O Anteriorly – left atrium
O Posteriorly – parietal pericardium
o On right & left-reflections of the pericardium
A recess between left atrium and
parietal pericardium
Clinical
Pericardial effusion Collection of fluid in the
(cardiac tamponade) pericardial cavity
• Drained by puncturing -
th th
o Left 5 or 6 intercostals space just lateral to
sternum
o Left xiphicostal space
o Needle directed upward, backward and to the left
• Structures pierced by,
skin
superficial fascia
deep fascia
external intercostal muscle
internal intercostals
innermost intercostals
fibrous pericardium
parietal layer of serous pericardium
Pericarditis inflammatory condition of the pericardium.
2
Pericardium
**Fibroserous sac which encloses heart and the roots of great vessels
Pericardium
Fibrous pericardium Serous pericardium
Apex fuses with adventitia of great vessels
Parietal layer
Visceral layer
Base blends with central tendon. (E
Fused with fibrous (Epicardium)
pericardium Adherent to heart
(except along cardiac grooves)
Nerve supply → Phrenic nerve autonomic nerves
Pain sensitivity → sensitive Insensitive
Blood supply → 1) Internal thoracic Artery coronary vessels
2) Musculophrenic Artery
3) Descending aorta
Angina / cardiac pain originates in the cardiac muscle.
The pain of pericarditis originates in the parietal pericardium.
Embryological origin→ pleuropericardial membrane - mesothelium of septum transversum
• Parietal and visceral (epicardium) layers of pericardium
• Continuous at the root of great vessels Encloses
•
pericardial cavity → a potential space
1
, Sinuses of pericardium
Serous pericardium forms an arterial tube
around ascending aorta and pulmonary trunk.
&
A venous tube around vena cavae and
pulmonary veins.
Transverse sinus More
posteriorly
Horizontal gap related to
Lies between arterial and venous tubes oesophagus
Bounded,
o Anteriorly → arterial tube
o Posteriorly → superior vena cava
o Inferiorly → left atrium
When the pericardium is opened anteriorly
during a surgery, a finger placed in the
transverse sinus separates arteries from veins.
A hand placed under the apex and moved
superiorly, slips into the oblique sinus.
Oblique sinus
Bounded,
O Anteriorly – left atrium
O Posteriorly – parietal pericardium
o On right & left-reflections of the pericardium
A recess between left atrium and
parietal pericardium
Clinical
Pericardial effusion Collection of fluid in the
(cardiac tamponade) pericardial cavity
• Drained by puncturing -
th th
o Left 5 or 6 intercostals space just lateral to
sternum
o Left xiphicostal space
o Needle directed upward, backward and to the left
• Structures pierced by,
skin
superficial fascia
deep fascia
external intercostal muscle
internal intercostals
innermost intercostals
fibrous pericardium
parietal layer of serous pericardium
Pericarditis inflammatory condition of the pericardium.
2
