Transcript Pericardium

Pericardium and External
features of Heart
Dr. Sama ul Haque
Dr Rania Gabr
Objectives
• Define pericardium.
• Differentiate between fibrous and serous pericardium.
• Define pericardial sinuses.
• Identify the borders and surfaces of the heart.
• Describe the structure of the heart
Pericardium
Pericardium is a
fibroserous sac that
encloses the heart and
roots of the great
vessels.
Relations of Pericardium:
Anterior:
 Body of Sternum
 2nd to 6th costal
cartilages
Posterior:
 5th to 8th thoracic
vertebrae
Layers of the Pericardium
1. Fibrous Pericardium
Attached anteriorly to
the sternum by
Sternopericardial
ligaments.
2. Serous Pericardium
Two Layers:
a. Parietal
b. Visceral
Serous Pericardium
Pericardial Sinuses
Pericardial Sinuses
The lines of reflection between visceral and
parietal pericardium form two pericardial sinuses,
the transverse pericardial sinus and the oblique
pericardial sinus.
The transverse pericardial sinus lies anterior to
the superior vena cava and posterior to the
ascending aorta and pulmonary trunk.
The oblique pericardial sinus lies posterior to the
heart in the pericardial sac.
Nerve supply of the Pericardium
1.
Fibrous Pericardium and Parietal layer of serous
Pericardium:
By Phrenic nerves
2.
Visceral layer of Serous Pericardium:
By Sympathetic trunk and vagus nerves
Location of the Heart
Angle of Louis
It is the angle at which the
manubrium and sternum
meet/articulate. It is an anatomical
landmark for finding the second rib,
approx. area of the carina
Location of Heart
Location of the Heart
• It lies in the middle
mediastinum.
• The Heart is somewhat
pyramidal in shape, having:
• Apex
• Sterno-costal (anterior
surface)
• Base (posterior surface).
• Diaphragmatic (inferior
surface)
• It consists of 4 chambers, 2
atria (right& left) & 2
ventricles (right& left)
Borders of the Heart
Right border: formed by right atrium
Left border: formed by left auricle and left ventricle
Lower border: formed by right atrium & mainly by right
ventricle + apical part of left ventricle
Upper border: Is formed by the 2 atria
Surfaces of the Heart
Sternocostal surface (Anterior surface):
Mainly formed by right atrium and right ventricle.
Diaphragmatic surface (Inferior surface):
Mainly formed by right and left ventricles. Small portion is
formed by right atrium.
Base (Posterior surface):
Mainly formed by left atrium.
Apex: formed by left ventricle
Apex of the heart
• Directed downwards,
forwards and to the left.
• It is formed by the left
ventricle.
• lies at the level of left 5th
intercostal space 3.5 inch
from midline.
Note that the base of the heart is called the base because
the heart is pyramid shaped; the base lies opposite the
apex. The heart does not rest on its base; it rests on its
diaphragmatic (inferior) surface
Sterno-costal (anterior)surface
This surface is formed
mainly by the right atrium
and the right ventricle.
• Divided by coronary (atrioventricular) groove into :

Atrial part, formed mainly by right
atrium.
 Ventricular part , the right 2/3 is
formed by right ventricle, while the
left l1/3 is formed by left ventricle.
 The 2 ventricles are separated by
anterior interventricular groove,
which lodges :
 Anterior interventricular artery
(branch of left coronary).
 Great cardiac vein.
 The coronary groove lodges
right coronary artery.
Diaphragmatic (Inferior)surface
 Formed by the 2-ventricles,
mainly left ventricle (left 2/3).
 Slightly concave as it rests on
diaphragm.
 Directed inferiorly & backward.
Separated from base of heart by
posterior part of coronary sulcus.
The 2-ventricles are separated by
posterior interventricular groove
which lodges:
Posterior interventricular artery
 Middle cardiac vein
Base of the Heart (posterior surface)
It is formed by the 2 atria, mainly
left atrium, into which open the 4
pulmonary veins.
It is directed backwards.
Left
atrium
Lies opposite middle thoracic
vertebrae (5-7).
 Is separated from the vertebral
column by descending aorta,
esophagus and oblique sinus of
pericardium.
Bounded inferiorly by post. part
of coronary sulcus , which lodges
the coronary sinus.
Heart (Anterior Surface)
Anterior Surface
Apex
Heart (Posterior and inferior surfaces)
Base
Inferior Surface
Heart (Anterior view)
SVC: Superior vena cava
AA: Ascending Aorta
SVC
PT: Pulmonary Trunk
RA: Right Auricle
AA PT
RV: Right ventricle
LV: Left ventricle
RA
RV
IVC: Inferior vena cava
IVC
LV
Heart (Posterior view)
LA: Left auricle
RA: Right auricle
LV: Left ventricle
IVC: Inferior vena cava
LA
LV
RA
IVC
Heart (Posterior view)
Heart (Anterior interventricular Sulcus or Groove)
AIS
Heart (Posterior interventricular Sulcus or Groove)
Coronary or Atrioventricular Sulcus or Groove
CS
PIS
Coverings & Wall of the Heart