Pericardium
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Pericardium | |
---|---|
Details | |
Location | A sac around the heart |
Artery | Pericardiacophrenic artery |
Nerve | Phrenic nerve |
Identifiers | |
Latin | pericardium |
Greek | περίκάρδιον |
MeSH | D010496 |
TA98 | A12.1.08.001 A12.1.08.002 A12.1.08.005 |
TA2 | 3341 |
FMA | 9869 |
Anatomical terminology |
The pericardium (pl.: pericardia), also called pericardial sac, is a double-walled sac containing the
The English name originates from the Ancient Greek prefix peri- (περί) 'around' and the suffix -cardion (κάρδιον) 'heart'.
Anatomy
The pericardium is a tough fibroelastic sac which covers the heart from all sides except at the cardiac root (where the great vessels join the heart) and the bottom (where only the serous pericardium exists to cover the upper surface of the central tendon of diaphragm).[4] The fibrous pericardium is semi-rigid, while the serous pericardium is quite pliable.
The same mesothelium that constitutes the serous pericardium also covers the heart as the
Fibrous
The fibrous pericardium is the outside layer of the pericardium, made up of
Serous
The serous pericardium, in turn, is divided into two parts:
- The parietal serous pericardium, which lines the interior side of the superficial portion of the pericardial sac, is fused to and inseparable from the fibrous pericardium
- The visceral serous pericardium, also known as the epicardium, covers the endocardialto the epicardial surface.
Both of these layers function in lubricating the heart to prevent friction during heart activity.
The visceral serous pericardium extends to the root of the
Anatomical relationships
- Surrounds heart and bases of pulmonary artery and aorta.
- Deep to sternumand anterior chest wall.
- The right phrenic nervepasses to the right of the pericardium.
- The left phrenic nervepasses over the pericardium of the left ventricle.
- Pericardial arteries supply blood to the dorsal portion of the pericardium.
Function
The pericardium sets the heart in mediastinum and limits its motion, protects it from infection, lubricates it and prevents excessive dilation in cases of acute volume overload.
Clinical significance
Inflammation of the pericardium is called pericarditis. This condition typically causes chest pain that spreads to the back and is made worse by lying flat. In patients suffering with pericarditis, a pericardial friction rub can often be heard when listening to the heart with a stethoscope. Pericarditis is often caused by a viral infection (glandular fever, cytomegalovirus, or coxsackievirus), or more rarely with a bacterial infection, but may also occur following a myocardial infarction. Pericarditis is usually a short-lived condition that can be successfully treated with painkillers, anti-inflammatories, and colchicine. In some cases, pericarditis can become a long-term condition causing scarring of the pericardium which restricts the heart's movement, known as constrictive pericarditis. Constrictive pericarditis is sometimes treated by surgically removing the pericardium in a procedure called a pericardiectomy.[10]
Fluid can build up within the pericardial space, referred to as a
The congenital absence of pericardium is rare. When it happens, it usually occurs on the left side. Those affected usually do not have any symptoms and they are usually discovered incidentally. About 30 to 50 percent of the affected people have other heart abnormalities such as atrial septal defect, patent ductus arteriosus, bicuspid aortic valve, and lung abnormalities. On chest X–ray, the heart looks posteriorly rotated. Another feature is the sharp delineation of pulmonary artery and transverse aorta due to lung deposition between these two structures. If there is partial absence of pericardium, there will be bulge of the left atrial appendage. On CT and MRI scans, similar findings as chest X–ray can be shown. The left sided partial pericardium defect is difficult to see because even a normal pericardium is difficult to be seen on CT and MRI. A complete pericardial defect will show the heart displaced to the left with part of the lungs squeezed between inferior border of heart and diaphragm.[12]
Additional images
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Fibrous pericardium
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mesothelial cells that line the pericardium, with typical features.[13] Wright's stain.
-
3D still showing the pericardium layer.
References
- ^ "Pericardiectomy". Johns Hopkins Medicine. 19 November 2019. Retrieved 20 Sep 2020.
- ^ ISBN 978-0-323-39226-6, retrieved 2020-11-17
- S2CID 80814860, retrieved 2020-11-17
- ISBN 978-1-4160-6257-8.
- ISBN 978-0-471-78931-4.
- PMID 29489245, retrieved 2021-09-12
- ^ Winieski, Lawrence E. Snell's Clinical Anatomy By Regions. Wolters Kluwer. p. 241.
- ^ ISBN 978-1-60327-371-8.
- ^ a b Dixon, Andrew; Hacking, Craig. "Pericardial recesses". Radiopaedia. Retrieved 2019-07-08.
- PMID 12475875.
- ^ Davidson's 2010, pp. 638–639.
- S2CID 53872634.
- PMID 35126608.
External links
- Anatomy photo:21:st-1500 at the SUNY Downstate Medical Center – "Mediastinum: Pericardium (pericardial sac)"
- thoraxlesson4 at The Anatomy Lesson by Wesley Norman (Georgetown University) (heartpericardium)
- Atlas image: ht_pericard2 at the University of Michigan Health System – "MRI of chest, lateral view"