1 pericardium

PericardiumPericardium

Maj Dr. Poonam SinghMaj Dr. Poonam Singh

PericardiumPericardium Fibroserous sac surrounding heart & root of Fibroserous sac surrounding heart & root of

great vessels.great vessels.

Two components: outer fibrous pericardiumTwo components: outer fibrous pericardium Inner serous pericardiumInner serous pericardium

Outer parietal layer inner visceral layerOuter parietal layer inner visceral layer

Two are continuous at root of great vesselsTwo are continuous at root of great vessels

Narrow fluid filled space -pericardial cavityNarrow fluid filled space -pericardial cavity

Layers of PericardiumLayers of Pericardium

Sagittal section : Sagittal section : PericardiumPericardium

Fibrous Fibrous Pericardium:Pericardium:

Apex blunt,fused to roots of great vessels and PTfasciaApex blunt,fused to roots of great vessels and PTfascia Base inseparable from the diaphragm (central tendon)Base inseparable from the diaphragm (central tendon)

Ant attached to sternum by Sternopericardial lig.Ant attached to sternum by Sternopericardial lig. Post related to principal bronchi & oesophagusPost related to principal bronchi & oesophagus On each side related to mediastinal pleura, Phrenic On each side related to mediastinal pleura, Phrenic

nervenerve

Phrenic N innervating diaphragm passes through FP & Phrenic N innervating diaphragm passes through FP & innervates itinnervates it

Protects heart from sudden overfillingProtects heart from sudden overfilling

Fibrous Pericardium - relations

Phrenic nerve Phrenic nerve innervationsinnervations

Serous Serous Pericardium:Pericardium: Thin double layered serous membrane lined by Thin double layered serous membrane lined by

MesotheliumMesothelium

Outer Parietal and inner Visceral PericardiumOuter Parietal and inner Visceral Pericardium

two layers continuous with each other at the two layers continuous with each other at the root of great vessels ( ascg aorta, SVC, IVC, pulm root of great vessels ( ascg aorta, SVC, IVC, pulm trunk & pulm veins)trunk & pulm veins)

Visceral layer - adherent to the heartVisceral layer - adherent to the heart

P cavity is a potential space b/w these two layersP cavity is a potential space b/w these two layers

Contains a thin film of capillary fluid that helps Contains a thin film of capillary fluid that helps to lubricateto lubricate

Pericardial sinuses Transverse sinusTransverse sinus Oblique sinusOblique sinus

Reflections of visceral layer of peritoneum around great vessels of the heart

Transverse Sinus Horizontal gap between

the arterial ends of heart tubes in front and venous ends behind

Ant: Ascending aorta Pulmonary trunk Post: SVC

On each side it opens into P cavity

Transverse Sinus

Horizontal gap between the arterial ends of heart tubes in front and venous ends behind

Ant: Ascending aorta Pulmonary trunk Post: SVC

On each side it opens into P cavity

Oblique Sinus:Oblique Sinus: Formed by reflections Formed by reflections

of pericardium onto of pericardium onto pulm veins of heartpulm veins of heart

Cul-de-sac/cardiac Cul-de-sac/cardiac bursabursa

Ant: by the Lt Atrium Ant: by the Lt Atrium Post: by PPPost: by PP

below it opens into below it opens into the P cavitythe P cavity

Blood Blood supply: :

Brs of Int Th artery, musculophrenic artery and

descending thoracic aorta

Nerve Supply: FP & PP - by Phrenic nerve, pain sensitive.

VP - by ANS: Cardiac plexus. pain insensitive

Applied:Applied: Pericarditis: Pericarditis: Inflammation of the Inflammation of the

pericardiumpericardium

Pericardial Effusion: Pericardial Effusion: Excess fluid within Excess fluid within pericardial sac- may lead to pericardial sac- may lead to Cardiac Cardiac TamponadeTamponade compressing the heart compressing the heart

Constrictive Pericarditis: Constrictive Pericarditis: Abnormal Abnormal thickening of the pericardium compresses the thickening of the pericardium compresses the heart impairing heart functionheart impairing heart function

APEX BEAT PALPATION

PERICARDIAL EFFUSION

Pericardial EffusionPericardial Effusion

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PericardiocentesisPericardiocentesis

1 pericardium

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