Pericardium and Pericardial Cavity – Heart (Cor)

by Craig Canby, PhD

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    00:01 Now here the fibrous pericardium and the underlying parietal serous pericardium have been cut along the margins that we see here. So we?ll follow the outline of the cut margins at the fibrous pericardium and the inner lining of the fibrous pericardium ? the parietal.

    00:27 We cannot really distinguish or discern the adherent component deep to the fibrous pericardium but it would be in this general area. It would be shiny when you open up the fibrous pericardium.

    00:41 And then here at the level of the great vessels, superior vena cava. Here?s your aorta. Here?s your pulmonary trunk. What will happen is there will be a reflexion of the parietal pericardium onto the surface of the heart. So everything we see here on the surface of the heart represents the visceral pericardium, also known as the epicardium.

    01:04 So when you?re in the dissection lab, if you?re looking at the heart and you see the vessels and you see the adipose tissue and you see the muscle fibres, those are lying deep to the visceral pericardium.

    01:22 The space or potential space that lies between the visceral and the parietal pericardium is known as the pericardial cavity. The best way to appreciate the pericardial cavity is through an axial section.

    01:42 So here?s an axial section through the thoracic cavity and we can see the heart situated within the middle mediastinum. We see the pericardial components here in green. The outer most layer here would be your fibrous pericardium and then, adherent to that, would be the parietal pericardium. And, again, we cannot discern or distinguish those two pericardial components.

    02:11 And then, adherent to the surface of the heart, is the visceral pericardium. And then the potential space that lies between the visceral and the parietal pericardium is your pericardial cavity.

    02:25 The pericardial cavity is a potential space. However, there is a clinical condition called cardiac tamponade. And one cause of cardiac tamponade is a result of a myocardial infarction leading to cell death of a portion of the left ventricular wall. This causes the left ventricular wall to become greatly weakened. And, if it?s greatly weakened, it can then result in an aneurysm ? so a portion of the left ventricular wall is bulging outwards.

    03:03 And at some point that aneurysm can rupture. And if that aneurysm ruptures, you?ll have blood loss into the pericardial cavity and blood will start to accumulate in the pericardial cavity. And, as it does so, it will compress the heart. The heart will beat again, force more blood into the pericardial cavity resulting in further compression of the heart. And now you?re in a vicious cycle. And at some point there can be so much fluid loss into the pericardial cavity that the heart is too compressed to function normally. And death could then ensue.

    03:41 The blood that?s accumulated in the pericardial cavity can be removed as this is an emergent condition. A needle can be inserted into the pericardial cavity and then the blood withdrawn.

    03:52 And certainly another aspect clinically of this situation would be to try to repair the aneurysm.

    04:00 There are some unique aspects of the pericardium. These result from the complex development of the heart. And as a result, if we take a look here, we?re looking at the inner lining of the fibrous pericardium. And so this is the parietal pericardium that?s shiny in through here. These are the cut ends of the pulmonary veins that would empty into the left atrium. And, if we take a look, we can see a reflexion of the pericardium here and we also have the fibrous pericardium here as well. And, if you were to put your fingers there up and under the heart toward the left atrium further, the pulmonary veins empty into them, you would reach this limit and you could push your fingers no further.

    04:55 This is a pericardial sinus. This is called the oblique pericardial sinus. We have another pericardial sinus running right in through here. And the entryway here is to run your fingers over anterior to the superior vena cava, which is this vessel here. Run them over and behind the aorta. And then all of a sudden your fingers are in this transverse pericardial sinus. And they will then run behind or posterior to the aorta and to the pulmonary trunk. For someone undergoing coronary bypass surgery, the cardiac surgeon will need to cross-clamp the aorta, for example, in the pulmonary trunk. And this is a way to identify and place the clamp.

    About the Lecture

    The lecture Pericardium and Pericardial Cavity – Heart (Cor) by Craig Canby, PhD is from the course Thoracic Viscera.

    Included Quiz Questions

    1. Shiny
    2. Transparent
    3. Difficult to visualize
    4. Striated
    5. Matted
    1. Visceral pericardium
    2. Fibrous pericardium
    3. Parietal pericardium
    4. Pericardial cavity
    5. Serous pericardial layer
    1. The visceral and parietal pericardium
    2. The cardiac muscle and the parietal pericardium
    3. The cardiac muscle and the visceral pericardium
    4. The ventricles and the semilunar valves
    1. Pericardial cavity
    2. External to fibrous pericardium
    3. Between the fibrous pericardium and the parietal pericardium
    4. Between the epicardium and the heart

    Author of lecture Pericardium and Pericardial Cavity – Heart (Cor)

     Craig Canby, PhD

    Craig Canby, PhD

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