Pericardium

Pericardium. Contained in the middle mediastinum, it is a two-layered fibrous membrane that surrounds the heart and large vessels, separating them from neighboring structures. It forms a kind of bag or sac that completely covers the heart and extends to the roots of the great vessels. It has two parts, the serous pericardium and fibrous pericardium. Together they cover the whole heart so that it does not have any injury.

It is attached to the diaphragm by the pericardiophrenic ligament. It has an inverted cone shape (with the base down). Its external face, both in front and on the sides, has fatty formations. Its inner face is the parietal sheet of the serous pericardium.

Summary

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  • 1 Dimensions
  • 2 part
  • 3 Fibrous pericardium
  • 4 serous pericardium
  • 5 Irrigation and drainage
  • 6 Innervation
  • 7 References

Dimensions

It extends from the root of the great vessels to the diaphragm, laterally from one pleural cavity to the other, and anteroposteriorly from the sternum to the esophagus . At its upper point it experiences a reflection of its internal lamina that provides the formation of the superficial portion.

Part

A base and four faces, an anterior, a posterior or mediastinal, a right pleural, a left pleural and a vertex, origin of the great vessels. The base is a triangle with a right apex and a left base that sits on the diaphragm, in the leaflet of the central tendon of the diaphragm. In its posterior and right angle is the inferior vena cava (IVC). It contains a portal space, made up of connective tissue, separates from the diaphragm behind the adhesion zone, fixing the pericardium.

The anterior aspect extends below, from the diaphragm to the vascular root of the heart . It is triangular in shape, where the sharpest angle corresponds to the lower and left area, which is the vertex of the heart. It is oblique from the bottom up and from the front to the back, dividing into two parts: an inferior or cardiac part, and another superior or vascular part.

Two sinuses can be seen on this face, allowing the movement of the great vessels: the oblique pericardial posterior, at the level of the pulmonary veins, and the transverse pericardial posterior, behind the emergence of the aorta and pulmonary artery.

The posterior aspect is convex, and vertically extends from the diaphragm to the right pulmonary artery, transversely from one pulmonary hilum to the other, and between the right and left pulmonary veins; it is less high than the anterior face.

The right face is vertical, narrow, and extends from the diaphragm to the superior vena cava (VCS). Bring the front face together with the back face. In this, a channel is found below the pulmonary artery crossed by the superior right pulmonary vein.

The left face conforms to the shape of the left edge of the heart. It is convex, oblique up and back and is crossed by the left pulmonary veins.

Accidents: Brake-pericardial ligament:

  • Previous
  • Right side
  • Left side
  • Sternopericardialligaments
  • ligaments vertebropericardicos
  • Thyrotymopericardiallamina
  • Pericardial adiposeapparatus .

Fibrous pericardium

The fibrous pericardium is the outermost layer of the pericardium, it is resistant and inextensible and covers the parietal lamina of the serous pericardium. It consists of a cone-shaped pouch with its base on the diaphragm. The base is attached to the central tendon of the diaphragm. It is previously attached to the back of the sternum by the sternopericardial ligaments , thus maintaining the position of the heart in the thoracic cavity. The sac also limits cardiac bloating. The phrenic nerves that supply the diaphragm pass over the fibrous pericardium and supply it along its path.

Serous pericardium

The serous pericardium can be divided into two parts, visceral and parietal, separated from each other by the pericardial cavity and due to reflections produced in two areas: a superior reflection, which surrounds the arteries, the aorta and the pulmonary trunk, and another one The posterior one that surrounds the veins, the cavas and the pulmonary veins, is J-shaped and the bottom of the sac that forms inside it is the oblique pericardial sinus, posterior to the left atrium. A communication between the two reflection zones of the serous pericardium is the transverse paricardial sinus. The inner, or visceral, layer, also called the epicardium, separates from the myocardium at the level of the coronary vessels .

Irrigation and drainage

The pericardium is irrigated by various branches, from the internal thoracic artery , the pericardiophrenic , the inferior phrenic , thoracic aorta and arterioles from the bronchial , thyroid , imoesophageal and mediastinal arteries .

The veins of the pericardium enter the azygos system: posterior veins, the superior phrenic veins (lateral veins), and the superior or brachiocephalic vena cava . The lymphatic drainage is due to phrenic hips, and lower tracheobronchial lymph infradiaphragmatic.

Innervation

  • Parasympathetic:Vague nerves.
  • Sympathetic:Coronary branches forming the coronary plexus .

 

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