Dr. Nivin Sharaf MDLMCC- 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