Dr. Nivin Sharaf MD

LMCC- Pediatrics

*Pericardium and external features of the heart

*Objectives

By the end of this lectures the students should be able to:

-Discuss the gross anatomy of the pericardium

- Identify pericardial sac

-Differentiate between terms: serous pericardium, fibrous pericardium

- Recognize the importance of pericardial sinuses

*Definition

*Pericardium is a fibro serous sac that encloses the heart and the roots of the great vessels

*Extends between 2nd- 6th costal cartilages

*Anterior to 5th to 8th Thoracic vertebrae

*Pericardium/ layers

*Fibrous Pericardium

*Strong fibrous part of the sac

*Firmly attached below to the central tendon of diaphragm

*Attached to the back of the sternum by sterno pericadial ligament

*Fuses with the outer coats of the great blood vessles, that pass through it

*Aorta, pulmonary trunk, SVC, IVC, & Pulmonary veins

Fibrous Pericardium..notice

the central tendon of the diaphrgm

*Serous Pericardium

*LINES the fibrous pericardium, and COATS the heart

*DIVIDED INTO:

*Parietal “ wall”

*Visceral “ organ”

*Layers

*Visceral layer is closely applied to the heart and is also called “ EPICARDIUM”

*Pericardial cavity

*The space between the 2 layers of the serous pericardium

*Usually contains small amount of pericardial fluid “ about 50 ml”

*Pericardial fluid acts as lubricant to ease movements of the heart

1- Heart2- Fibrous pericardium3- Parietal layer of serous pericardium4- Visceral layer of serous pericardium5- Pericardial space6- Pleural cavity and lung

*Pericardial sinuses

*Oblique sinus:

*Reflection of the serous pericardium around the large veins forming a recess (posterior surface of the heart)

*Transverse Sinus:

*Passage that lies between the reflection of serous pericardium around the Aorta, and the Pulmonary trunk, and the reflection around the large veins

*Pericardial sinuses

*Nerve Supply of the Pericardium

*Fibrous pericardium, and the parietal layer of the Serous pericardium” Phrenic N.”

*Visceral layer of the serous pericardium “Vagus N., and the Sympathetic trunks”

*Refernces

*Clinical Anatomy by systems : RICHARD S. SNELL

*Recommended readings:P 154-158

*Images from :* anatomytopics.wordpress.com

* www.medicalstudent.com

* www.googleimages.com