Pericardium

pericardium and associated disorder and relations for 1st MBBS.

1. Fibrous Pericardium By HIMANI MALHOTRA FIRST YEAR MBBS D.Y. PATIL MEDICAL COLLEGE

2. PERICARDIUM Peri - Around Cardium - Heart It is a double walled-fluid filled fibro-serous sac. It contains the heart & the juxta -cardiac parts of its great vessels(aorta, vena cava &the pulmonary artery.)

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4. Functions of the pericardium- Keeps the heart bound in the thoracic cavity (Cardiac seatbelt). Prevents over expanding of the heart when blood volume increases. Limits the hearts movements. Acts as shock absorber with the help of fluid filled sac.

5. FIBROUS PERICARDIUM The fibrous pericardium is a sac made up of tough fibrous connective tissue. It is roughly conical & clothes the heart.

6. Development of the Pericardium The perietal layer of the serous pericardium & the fibrous pericardium , are derived from the somatopleuric mesoderm lining the ventral side of the pericardial cavity. The visceral serous pericardium is derived from the splanchnopleuric mesoderm lining the dorsal side of the pericardial cavity.

7. BLOOD SUPPLY Pericardiophrenic artery Musculophrenic artery Pericardial branches of bronchial,esophageal & the superior phrenic arteries. Coronary artery Azygous system Pericardiophrenic vein {tributaries of Internal thoracic veins}.

8. NERVE SUPPLY Phrenic nerve Vagus nerve Sympathetic trunk

9. ATTACHMENTS Superiorly it is continuous with the adventitia of the great vessels & also the pre-brachial fascia. Inferiorly it is attached to the central tendon of the diaphragm & a small muscular part of its left side.

10. Anteriorly,it is attached to posterior surface of the sternum by superior & inferior sternopericardial ligaments. The extents of these ligaments is extremely variable &the superior one is often undetectable. The pericardium is securely anchored by these attachments & maintain the general thoracic position of the heart, serving as Cardiac seat belt.

11. RELATIONS Anteriorly Seperated from the thoracic wall by the lungs & the pleural covering. But,in a small area behind the lower left half of the body of the sternum & the sternal ends of the left 4 th & 5thcostal cartilages, the pericardium is in direct contact with the thoracic wall.

12. Posteriorly The principle bronchi, the esophagus, the esophageal plexus, the descending thoracic aorta &the posterior parts of the mediastinal surface of both lungs. Laterally Pleural coverings of the mediastinal surfaces of the lungs. The phrenic nerve with its accompanying vessels descends between the mediastinal pleura & the fibrous pericardium on either side. Inferiorly The pericardium is seperated from the liver & the fundus of the stomach by the diaphragm.

13. PERICARDITIS Inflammation of the pericardium Cause can be viral infections, bacterial infections, tuberculosis & fungal infections. Patients suffering from AIDS frequently develop pericarditis . APPLIED ANATOMY

14. Pericarditis occur in upto 15% of patients who have acute myocardial infarction. Treatment: (a)Identifying the underlying cause. (b)Treating the underlying cause (c)Giving anti-inflammatory drugs. T