PERICARDIUM ANATOMYShahd AlAli

Located in the middle mediastinum It’s a double walled fibroserous

membrane Fibrous pericardium “embryological

origin”, collagen and elastic fibers Serous pericardium “mesothelium”

partial visceral “epicardium”

Pericardial fluid volume & pressure

The functions of the pericardium: • Maintains the

position of the heart

• Barrier to infections

• Lubrication between visceral and partial layers

Pericardial Sinuses

Transverse sinuous Oblique sinuous

Development of the Pericardial Sinuous

• The oblique sinuses separates the esophagus from the left atrium

Surgical Significance of Transverse Pericardial Sinuous

coronary artery bypass grafting

surgical clumps

Relations of the Pericardium

• Anterior • Inferior • Lateral

Posterior Relations DATET5-T8

Attachments

Superiorly tunica adventitia (perivascular connective tissue)

Inferiorly to the diaphragm Sternum attachment Posterior by loose connective tissue

Affected by their movement

Arterial Supply

Mainly from the pericardiophrenic artery

Smaller contribution from the Musclophrenic artery Bronchial artery Esophageal Superior phrenic artery Coronary artery supplies the visceral

layer ONLY

Venous drainage

Pericardiophrenic veins Azygos venous system

Innervations

Phrenic nerve (C3-C5) sensory fibers

Partial & Fibrous “Sensitive to pain”

Vagus nerve & Sympathetic (vasomotor)

Cardiac Tamponade

Clinical ~

Pericardiocentesis: Parasternalleft 5th or 6th intercostal spaces.

Subxiphoidal approach

Thoracocentesis ???