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Pericardium - want to learn more about it?

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Pericardium

The pericardium is a fibroserous double-walled sac that encloses the heart, the pericardial fluid and the roots of the great vessels, and is situated within the inferior middle mediastinum. Its function is to protect and lubricate the moving surfaces of the heart. In this article, the anatomy of the pericardium will be discussed in detail along with the pathological disorder known as pericarditis.

Recommended video: Pericardium
Anatomy, function, definition and diagram of the pericardium.

Fibrous Pericardium

The outermost layer of the pericardium is known as the fibrous layer and consists of dense connective tissue. It is attached to the central tendon of the diaphragm via the pericardiacophrenic ligament whose fibers merge with the tunica adventitia of the vessels which enter and exit the heart. The pericardial sac also attaches via ligamentous fibers to the sternum and due to these attachments it is affected by the movements of the heart, the great vessels, the sternum and the diaphragm.

Pericardium - ventral view

This fibrous exterior lining mechanically functions to prevent the heart from overfilling, because the fibrous tissue as a whole is resilient and although flexible, it does not stretch.

Serous Pericardium

The inner layer of the pericardium is known as the serous pericardium. It consists two layers:

  • a parietal layer, which is fused and inseparable from the fibrous pericardium. It is reflected back onto the heart at the great vessels entering and leaving the heart becoming the...
  • visceral layer, which is attached to the outer surface of the heart itself. It’s also sometimes referred to as the epicardium. This is a simple squamous mesothelial layer, which is supported but loose connective tissue and associated neurovasculature. 

Epicardium - histological slide

Pericardial Cavity

The pericardial cavity is a potential space found between the two layers of the serous pericardium. It contains lubricating serous fluid known as pericardial fluid.

Therefore, the pericardial cavity reduces friction during heartbeats by lubricating the surfaces of the serous pericardium, facilitating free movement of the heart. It too prevents over dilation of the heart when the volume of blood within the heart increases.

Pericardial cavity - ventral view

Two sinuses exist within the cavity that include the transverse sinus and the oblique sinus. The transverse pericardial sinus extends transversely across the pericardium in between the roots of the great vessels, posterior to the ascending aorta and the pulmonary trunk and anterior to the superior vena cava. The oblique pericardial sinus exists in the posterior part of the pericardium and is bordered laterally by the pulmonary veins which enter the heart and inferiorly by the inferior vena cava which is also returning to the heart.

Vascularization

The blood supply of the pericardium comes from the pericardiacophrenic arteries and the internal thoracic arteries.

Internal thoracic artery - ventral view

The internal thoracic veins are responsible for the venous drainage of the area.

Innervation

The innervation of the pericardium is governed by several different branches, including the phrenic nerves which give sensory fibers that control pain sensation, and the sympathetic trunks which carry vasomotor fibers.

Phrenic nerve - ventral view

Pericarditis

Pericarditis is the inflammation of the pericardium which causes it to swell. It has acute, recurring and chronic forms. In most cases the etiology is unknown, although a bacterial or viral infection is usually suspected. Other known causes include a chest injury, cancer and its varying forms of treatment. Those who are immunosuppressed can be prone to recurrent pericarditis, due to their increased risk of infection. Treatment includes nonsteroidal antiinflammatory drugs and antibiotics.

Pericardium - want to learn more about it?

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Sign up for your free Kenhub account today and join over 852,397 successful anatomy students.

“I would honestly say that Kenhub cut my study time in half.” – Read more. Kim Bengochea Kim Bengochea, Regis University, Denver

Show references

References:

  • Frank H. Netter, MD, Atlas of Human Anatomy, Fifth Edition, Saunders - Elsevier, Chapter 3 Thorax, Subchapter 22 Heart, Guide Thorax: Heart Page 111 to 114.
  • Michael Schuenke et al., Atlas of Anatomy: Neck and Internal Organs, First Edition, Thieme, Thorax Chapter 2 Organs, 2.14 to 2.22 Heart, Page 96 to 112.
  • Neil S. Norton, Ph.D. and Frank H. Netter, MD, Netter’s Head and Neck Anatomy for Dentistry, 2nd Edition, Elsevier Saunders, Chapter 22 Introduction to the Upper Limb, Back, Thorax and Abdomen, Page 586 to 588.
  • O'Rahilly, Muller, Carpenter & Swenson: Basic Human Anatomy, Chapter 23: The pericardium and heart, acessed on 20/07/2014.
  • Mayo Clinic: Pericarditis, accessed on 20/07/2014
  • NHS Choices: Pericarditis, accessed on 20/07/2014

Author:

  • Dr. Alexandra Sieroslawska

Illustrators:

  • Pericardium - ventral view - Yousun Koh
  • Epicardium - histological slide - Smart In Media
  • Pericardial cavity - ventral view - Paul Kim
  • Internal thoracic artery - ventral view - Begoña Rodriguez
  • Phrenic nerve - ventral view - Yousun Koh
© Unless stated otherwise, all content, including illustrations are exclusive property of Kenhub GmbH, and are protected by German and international copyright laws. All rights reserved.

Related Atlas Images

Heart in situ

Contents of the mediastinum

Thoracic surface of the diaphragm

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