Dila Larasati

130110110173|C3 CVS

Anatomy & Histology of Pericardium

The pericardium is a fibroserous membrane that covers the heart and the beginning of its great vessels. It is
located in middle mediastinum, a closed sac composed of two layers:
1. Fibrous pericardium, the tough external layer
Superior: continuous with the tunica adventitia of the
great vessels entering and leaving the heart and with the
pretracheal layer of deep cervical fascia.
Anterior: attached to the posterior surface of the
sternum by the sternopericardial ligaments.
Posterior: bound by loose connective tissue to
structures in the posterior mediastinum
Inferior: continuous with the central tendon of the
diapraghm, has been referred to as the
pericardiophrenic ligament.
The fibrous pericardium protects the heart against suddens
overfilling because it is so unyielding and closely related to the
great vessels that pierce it superiorly.
2. Serous pericardium, composed mainly of mesothelium, a single
layer of flattened cells forming an epithelium that lines the
internal surface of fibrous pericardium and external surface of
the heart. Divided into:
Parietal layer, lines the internal surface of the fibrous
pericardium.
Visceral layer, forms the epicardium, continuous with
the parietal layer (1) where the aorta and pulmonary
trunk leave the heart and (2) where the SVC, IVC, and
pulmonary veins enter the heart.

Pericardial cavity
Is the potential space between the parietal and visceral layers of
serous pericardium.
Normally contain a thin film of fluid that enables the heart to
move and beat in a frictionless environment.

Pericardial sinus
Transverse pericardial sinus, a transversely running passage within the pericardial cavity between the
two groups of vessels and the reflections of serous pericardium around them.
Oblique pericardial sinus, a wide pocket-like recess in the pericardial cavity posterior to the base of
the heart, formed by the left atrium.

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 Dila Larasati
130110110173|C3 CVS

Arterial supply
Mainly from a branch of the internal thoracic artery, the
pericardiacophrenic artery.
Musculophrenic artery, a terminal branch of the internal
thoracic artery.
Bronchial, esophageal, and superior phrenic arteries,
branches of the thoracic aorta.
Coronary arteries, the first branches of the aorta
(visceral layer of serous pericardium only).

Venous drainage
Pericardiacophrenic veins, tributaries of the
brachiocephalic veins.
Variable tributaries of the azygos venous system.

Nerve supply
Phrenic nerves (C3-C5), primary source of sensory fibers.
Vagus nerves, function uncertain.
Sympathetic trunks, vasomotor.

References:
Moores Clinically Oriented Anatomy, 6th Ed
http://www.e-heart.org/Pages/10_Pericardial_Disease/10_Pericardial_Disease_Normal_Pericardium_Histology_001.html