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.)

3. Pericardium
Inner serous
layer
Inner
Visceral
Outer
Parietal
Outer
fibrous layer
Single layer

4. 0000000000000..

5. 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.

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

7. 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.

8. 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}.

9. NERVE SUPPLY
 Phrenic nerve
Vagus nerve
Sympathetic trunk

10. 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.

11. 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.

12. 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 4th &
5thcostal cartilages,
the pericardium is
in direct contact
with the thoracic
wall.

13. 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.

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

16. 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.