Pericardium

Question 1

What is the pericardium?

Answer 1

Double layered fibro-serous sac that encloses the heart & the roots of the great vessels

Question 2

Location of the pericardium

Answer 2

Posterior to the body of sternum and 2nd-6th costal cartilages
Anterior to T5-T8 vertebrae
1-1.5 cm to the right of the sternum
5-7.5 cm to the left of median plane at the level of 5th intercostal space

Question 3

Layers of the pericardium

Answer 3

Superficial to deep:
1. Fibrous pericardium
2. Serous pericardium: Parietal pericardium and visceral pericardium

Question 4

Attachment points of the fibrous pericardium

Answer 4

Superiorly: Continous with deep cervical fascia
Anteriorly: Posterior surface of the sternum by superior and inferior sterno-pericardial ligaments
Posteriorly: Bound by loose connective tissue to structures of the posterior mediastinum (esophagus, descending thoracic aorta and thoracic duct)
Inferiorly: Attached to central tendon of diaphragm
Laterally: Covered by mediastinal pleural

Question 5

What is the parietal pericardium?

Answer 5

Layer of the serous pericardium which is reflected onto the heart and the great vessels

Question 6

What is the visceral pericardium?

Visceral pericardium is also called epicardium

Answer 6

Layer of serous pericardium
Composed mainly of mesothelium
Lines the internal surface of the fibrous pericardium and the external surface of the heart

Question 7

What are the two pericardial sinuses?

Answer 7

Transverse pericardial sinus
Oblique pericardial sinus

Question 8

Location of the transverse pericardial sinus

Answer 8

Transverse passage in the pericardial cavity
Runs posteriorly to the pulmonary trunk and ascending aorta and anteriorly to the SVC

Question 9

Location of the oblique pericardial sinus

Answer 9

Passage between the four pulmonary veins

Provides expansion space for the left atrium

Question 10

What are the contents of the pericardium?

Answer 10

HALT TOP
Heart with cardiac vessels and nerves
Ascending aorta
Lower half of the superior vena cava
Terminal part of the inferior vena cava
Terminal parts of the pulmonary veins
Pulmonary trunk

Question 11

Arterial blood supply of the pericardium

Answer 11

Branch of the internal thoracic artery
Musculophrenic artery, bronchial, esophageal, and superior phrenic arteries
branches of the thoracic aorta (TEMPBT)

Question 12

Venous drainage of the pericardium

Answer 12

Tributaries of the internal thoracic (or brachiocephalic) veins
Pericardiacophrenic veins
Tributaries of the azygos venous system

Question 13

Nerve supply of the pericardium

Answer 13

Phrenic nerves (C3-C5)