Pericardium

The pericardium or pericardial (Latin pericardium , Latin form of ancient Greek περί "around" and καρδιά "heart") is a connective tissue sac that the heart surrounds and is the heart through a narrow sliding layer free movement capability. As a lubricant, it contains a small amount (in humans 10–15 ml) of serous fluid ( liquor pericardii ).

Ventral view of a human pericardium. The dorsal part is largely exposed (the heart is dissected out). In the area of the aorta, the pericardium is shown largely closed.

anatomy

The pericardium almost completely encloses the heart. The outgoing vessels of the heart are excluded. The pericardium has two parts:

the pericardium fibrosum made from collagen fibers to protect against overstretching the heart as well
the pericardium serosum between the pericardium fibrosum and the heart

The pericardium serosum, like all serous membranes, is divided into two areas. The lamina visceralis lies directly on the heart and is also called the epicardium . The lamina parietalis is firmly fused with the pericardium fibrosum.

In humans there is about 10-15 ml of serous fluid ( liquor pericardii ) between the two leaves . At the starting point of the vessels of the heart, the leaves turn over into one another. This transition from the inner leaf of the pericardium to the outer leaf takes place in two separate envelope lines, one of which encloses all arteries ( crista aortae ascendentis ) and the other all veins.

The pericardium is firmly and tightly connected to the tendon plate of the diaphragm by the ligamenta phrenicopericardiaca . At the back, the pericardium connects elastically with the diaphragm and windpipe via the bronchopericardiaca membrane . Tender lines of connective tissue, known as the ligamenta sternopericardiaca , extend to the sternum .

The assignment of the pericardium to the heart results in two free spaces in the pericardium. The sinus transversus pericardii (the free area between the envelope lines) separates the outgoing vessels ( aorta and pulmonary trunk in the porta arteriosa) from the supplying vessels ( vena cava inferior , vena cava superior and venae pulmonales in the porta venosa). The sinus obliquus pericardii (a bulge that is formed by the fold line surrounding the veins) is located between the venae pulmonales leading to the heart.

The pericardium is innervated by a branch of the phrenic nerve ( Ramus pericardiacus ) . The vessel supplying the pericardium, the arteria pericardiacophrenica , arises from the arteria thoracica interna .

Diagnosis

The fastest way to visualize the pericardium is by means of ultrasound . Calcifications can be seen better in the X-ray image of the thorax (chest) or in the computer tomography . In the case of effusions, a cytological examination of the fluid obtained by puncture can be carried out.

Diseases

An inflammation of the pericardium is called pericarditis . It can arise from a viral infection or be rheumatic in nature. In the past, tuberculosis also played a major role as a cause. So-called aseptic inflammation can occur in the end-stage uremia .

Pericarditis can lead to a hardened pericardial pouch ( pericarditis constrictiva ) or to calcifications ( pericarditis calcarea , "armored heart") due to scarring . The pathological increase in pericardial fluid or the accumulation of other body fluids (e.g. blood) in the pericardium are called pericardial effusion . They can lead to a pericardial tamponade .

The Dressler syndrome (post-myocardial infarction syndrome) is characterized by anginal pain after a heart attack from. Pericardial tumors are rare.

literature

Alfred Benninghoff (founder), Detlev Drenckhahn (ed.): Anatomie. Volume 2: Cardiovascular system, lymphatic system, endocrine system, nervous system, sensory organs, skin. 16th, completely revised edition. Elsevier Urban & Fischer, Munich 2004, ISBN 3-437-42350-9 , pp. 197-203.
Uwe Gille: Cardiovascular and immune system, Angiologia. In: Franz-Viktor Salomon, Hans Geyer, Uwe Gille (Ed.): Anatomy for veterinary medicine. Enke, Stuttgart 2004, ISBN 3-8304-1007-7 , pp. 404-463.
Klaus Holldack, Klaus Gahl: Auscultation and percussion. Inspection and palpation. Thieme, Stuttgart 1955; 10th, revised edition, ibid. 1986, ISBN 3-13-352410-0 , pp. 205-208 ( diseases of the pericardium ).

Web links

Wiktionary: pericardium - explanations of meanings, word origins, synonyms, translations

Individual evidence

↑ Gerhard Aumüller et al .: Dual series of anatomy . Georg Thieme Verlag, 3rd edition 2014, ISBN 9783131528636 , p. 614.
^ Klaus Holldack, Klaus Gahl: Auscultation and percussion. Inspection and palpation. 1986, p. 205 f.

[1] Gerhard Aumüller et al .: Dual series of anatomy . Georg Thieme Verlag, 3rd edition 2014, ISBN 9783131528636 , p. 614.

[2] Klaus Holldack, Klaus Gahl: Auscultation and percussion. Inspection and palpation. 1986, p. 205 f.