PERICARDIUM

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Pericardium
- fibrous pericardium
  - made up of conical sac of fibrous tissue
  - attached to its surface
    - parietal layer of serous pericardium
  - features
    - apex is blunt
      - lies at the level of sternal angle
      - fused with roots of great vessels and with pretracheal fascia
    - base is broad and inseparably blended with central tendon of diaphragm
    - posteriorly
      - principal bronchi
      - oesophagus with nerve plexus
      - descending thoracic aorta
    - anteriorly
      - sternopericardial ligaments
      - connects to upper and lower ends of body of sternum
      - superior and inferior ligaments
    - each side
      - mediastinal pleura
      - mediastinal surface of lung
      - phrenic nerve
      - pericardiophrenic vessels
    - protects heart
      - sudden overfilling
      - overexpansion of heart
- serous pericardium
  - thin double layered
    - serous membrane
      - lined by mesothelium
      - outer layer
        
        parietal pericardium
        
        fused with fibrous pericardium
      - inner layer
        
        visceral pericardium
        
        epicardium fused to heart
        
        except along cardiac grooves
      - the two layers are continuous
    - pericardial cavity
      - pericardial fluid
- sinuses of pericardium
  - transverse sinus
    - arterial tubes
      - encloses ascending aorta and pulmonary trunk
        
        at arterial end
    - venous tubes
      - encloses venacava and pulmonary veins
        
        at venous end
  - oblique sinus
    - narrow gap behind the heart
    - anteriorly by left atrium
    - posteriorly by parietal pericardium and esophagus
- contents of pericardium
  - heart with cardiac vessels and nerves
  - ascending aorta
  - pulmonary trunk
  - lower half of superior venacava
  - terminal part of inferior venacava
  - terminal part of pulmonary veins
- blood supply
  - internal thoracic artery
  - musculophrenic artery
  - descending thoracic aorta
  - veins drain in to corresponding veins
- nerve supply
  - fibrous and serous pericardium
    - phrenic nerves
  - pericarditis pain originates in epicardium
  - angina or cardiac pain
    - originates in cardiac muscles of vessels of heart