1. The Pericardium By: Sathish Rajamani Asst Professor

3. PERICARDIUM The pericardium is a fibroserous sac which encloses the heart and the roots of the great vessels. It is situated in the middle mediastinum. It consists of the fibrous pericardium and t.he serous pericardium

5. Fibrous pericardium encloses the heart and fuses with the vessels which enter/leave the heart. Heart is situated within the fibrous and serous pericardial sacs.

7. Fibrous Pericardium Fibrous pericardium is a conical sac made up of fibrous tissue. The apex is blunt and lies at the level of the sternal angle. The base is broad and inseparably blended with the central tendon of the diaphragm. It protects the heart against sudden overfilling.

8. Serous Pericardium Serous pericardium is thin, double-layered serous membrane lined by mesothelium. The outer layer of parietal pericardium is fused with the fibrous pericardium. The inner layer or the visceral pericardium, or epicardium is fused to the heart, except along the cardiac gooves, where it is separated from the heart by blood vessels. The two layers are continuous with each other at the roots of the great vessels, i.e. ascending aorta, pulmonary trunk, two venae cavae, and four pulmonary veins.

9. Serous Pericardium (Cont) The pericardial cavityis a potential space between the parietal pericardium and the visceral pericardium. It contains only a thin film of serous fluid which lubricates the apposed surfaces and allows the heart to move smoothly.

10. CONTENTS OF THE PERICARDIUM Heart with cardiac vessels and nerves. Ascending aorta. Pulmonary trunk lower half of the Superior vena cava Terminal part of the inferior vena cava. The terminal parts of the pulmonary veins.

11. PERICARDIAL SINUSES

12. SINUSES The sinuses are the connected systems of a hollow cavities. Pericardial Sinuses are two types: – Transverse Sinuses – Oblique Sinuses

13. TRANSVERSE SINUSES It is a horizontal gap between the arterial end of the heart tubes in front and venus ends behind. Anterior: Ascending aorta and Pulmonary trunk Posterior: SVC On each side it opens into Pericardial Cavity,

14. TRANSVERSE SINUSES

15. OBLIQUE SINUS It is a narrow gap behind the heart. Cul – De – Sac / Cardiac Sac Anteriorly – Left Atrium Posteriorly – Parietal Pericardium Right and Left Side – Reflections of Pericardium Below to the left – Opens into the pericardial cavity

16. OBLIQUE SINUS

17. BLOOD SUPPLY The fibrous and parietal pericardia are supplied by branches from: internal thoracic, and musculophrenic arteries, and the descending thoracic aorta.

18. NERVE SUPPLY The fibrous and parietal pericardia are supplied by the phrenic nerve. They are sensitive to pain. The epicardium is supplied by autonomic nerves of the heart, and is not sensitive to pain.

19. APPLIED ANATOMY Pericarditis – inflammation of the pericardium Pericardial Effusion – Excess fluid within pericardial sac. Constrictive Pericarditis – Abnormal thickening of the pericardium compressing the heart and impair its function.