1. Dr. Nivin Sharaf MD LMCC- Pediatrics

2. 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

3. * Pericardium is a fibro serous sac that encloses the heart and the roots of the great vessels * Extends between 2 nd - 6 th costal cartilages * Anterior to 5 th to 8 th Thoracic vertebrae

6. * 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

9. * 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”

10. * 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

11. 1- Heart 2- Fibrous pericardium 3- Parietal layer of serous pericardium 4- Visceral layer of serous pericardium 5- Pericardial space 6- Pleural cavity and lung

12. * 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

14. * Fibrous pericardium, and the parietal layer of the Serous pericardium” Phrenic N.” * Visceral layer of the serous pericardium “Vagus N., and the Sympathetic trunks”

15. * Clinical Anatomy by systems : RICHARD S. SNELL * Recommended readings:P 154-158 * Images from : * anatomytopics.wordpress.com * www.medicalstudent.com www.medicalstudent.com * www.googleimages.com www.googleimages.com