The Pericardium

Question 1

What is the pericardium?

Answer 1

Fibro-serous, fluid filled sack surrounding muscular body of the heart and the roots of the great vessels

Question 2

What are the great vessels?

Answer 2

Aorta, pulmonary artery, pulmonary veins, superior and inferior vena cava

Question 3

Layers of pericardium

Answer 3

External fibrous pericardium (tough)
Internal serous pericardium (thin)

Question 4

Fibrous pericardium

Answer 4

Continuous with central tendon of diaphragm
Tough connective tissue
Non distension
Rigid structure prevents rapid overfilling of the heart

Question 5

Serous pericardium layers

Answer 5

Outer parietal layer
Inner visceral layer
Each layer made of single sheet of epithelial cells (mesothelium)

Question 6

Outer parietal layer

Answer 6

Lines internal surface of fibrous pericardium

Question 7

Internal visceral layer

Answer 7

Epicardium
Outer layer of heart

Question 8

What is between the outer and inner serous layers?

Answer 8

Pericardial cavity, contains lubricating serous fluid which minimises friction as heart contracts

Question 9

Fart Police Smell Villains

Answer 9

Fibrous layer of pericardium
Parietal layer of serous pericardium
Serous fluid
Visceral layer of serous pericardium

Question 10

Functions of the pericardium

Answer 10

Fixes the heart in the mediastinum and limits it’s motion (pericardium attached to diaphragm, sternum, tunica adventitia of the great vessels)
Prevents overfilling of the heart (inextensible fibrous layer of pericardium prevents heart increasing in size too rapidly)
Lubrication
Protection from infection (fibrous pericardium is a physical barrier between muscular body of heart and adjacent organs prone to infection eg lungs)

Question 11

Innervation of pericardium

Answer 11

Phrenic nerve (C3-C5), somatic innervation

Question 12

What provides motor and sensory innervation to the diaphragm?

Answer 12

Phrenic nerve (C3-C5)

Question 13

What is a common source of referred pain?

Answer 13

Phrenic nerve eg shoulder pain experienced due to pericarditis
Phrenic nerve travels from neck to thoracic cavity

Question 14

Pericarditis

Answer 14

Inflammation of pericardium
Caused by bacterial infection, myocardial infarction
Chest pain
Can cause acute cardiac tamponade due to accumulation of fluid in pericardial cavity

Question 15

Cardiac tamponade

Answer 15

When there is an Accumulation of fluid (pericardial effusion) within pericardial cavity, the rigid pericardium can’t expand, therefore heart increased pressure. Chambers become compressed compromising cardiac output