WordNet

soft decayed area in a tooth; progressive decay can lead to the death of a tooth (同)caries, dental_caries, tooth decay
space that is surrounded by something (同)enclosed space
(anatomy) a natural hollow or sinus within the body (同)bodily cavity, cavum
located around the heart or relating to or affecting the pericardium; "pericardial space" (同)pericardiac

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へこみ,くぼみ,空洞 / 虫歯の穴 / (人体内の)腔(こう)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/03/18 18:23:34」(JST)

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The pericardium (from the Greek περί, "around" and κάρδιον, "heart") is a double-walled sac containing the heart and the roots of the great vessels. The pericardial sac has two layers, a serous layer and a fibrous layer. It encloses the pericardial cavity which contains pericardial fluid.

The pericardium fixes the heart to the mediastinum, gives protection against infection, and provides the lubrication for the heart.

Structure

The pericardium is a tough double layered fibroserous sac which covers the heart.^[1] The space between the two layers of serous pericardium (see below), the pericardial cavity, is filled with serous fluid which protects the heart from any kind of external jerk or shock. There are two layers to the pericardial sac: the outermost fibrous pericardium and the inner serous pericardium.

Fibrous pericardium

The fibrous pericardium is the most superficial layer of the pericardium. It is made up of dense and loose connective tissue,^[2] which acts to protect the heart, anchoring it to the surrounding walls, and preventing it from overfilling with blood. It is continuous with the outer adventitial layer of the neighboring great blood vessels.

Serous pericardium

The serous pericardium, in turn, is divided into two layers, the parietal pericardium, which is fused to and inseparable from the fibrous pericardium, and the visceral pericardium, which is part of the epicardium. Both of these layers function in lubricating the heart to prevent friction during heart activity.

The visceral layer extends to the beginning of the great vessels (the large blood vessels serving the heart) becoming one with the parietal layer of the serous pericardium. This happens at two areas: where the aorta and pulmonary trunk leave the heart and where the superior vena cava, inferior vena cava and pulmonary veins enter the heart.^[3]

In between the parietal and visceral pericardial layers there is a potential space called the pericardial cavity, which contains a supply of lubricating serous fluid known as the pericardial fluid.

When the visceral layer comes into contact with heart (not the great vessels) it is known as the epicardium. The epicardium is the layer immediately outside of the heart muscle proper (the myocardium).^[3] The epicardium is largely made of connective tissue and functions as a protective layer. During ventricular contraction, the wave of depolarisation moves from the endocardial to the epicardial surface.

Anatomical relationships

A transverse section of the thorax, showing the contents of the middle and the posterior mediastinum. The pleural cavity and the pericardial cavity are exaggerated since normally there is no space between the pleurae or between the pericardium and heart. Pericardium is also known as cardiac epidermis.

Surrounds heart and bases of pulmonary artery and aorta.
Deep to sternum and anterior chest wall.
The right phrenic nerve passes to the right of the pericardium.
The left phrenic nerve passes over the pericardium of the left ventricle.
Pericardial arteries supply blood to the dorsal portion of the pericardium.

Functions

Sets heart in mediastinum and limits its motion
Protects it from infections coming from other organs (such as lungs)
Prevents excessive dilation of the heart in cases of acute volume overload
Lubricates the heart

Clinical significance

Inflammation of the pericardium is called pericarditis, and may be detected by the medical sign pericardial friction rub.

An excess of fluid in the cavity (such as in a pericardial effusion) can result in cardiac tamponade (compression of the heart within the pericardial sac). A pericardiectomy is sometimes needed to remedy this. The surgical removing of the epicardium is referred to as epicardiectomy.^{[citation needed]}

Additional images

Cutaway illustration of pericardial sac
Fibrous pericardium

References

^ Dorland's (2012). Dorland's Illustrated Medical Dictionary (32nd ed.). Elsevier Saunders. p. 1412. ISBN 978-1-4160-6257-8.
^ Tortora, Gerard J.; Nielsen, Mark T. (2009). Principles of Human Anatomy (11th ed.). John Wiley & Sons. pp. 84–5. ISBN 978-0-471-78931-4.
^ ^a ^b Laizzo, P.A. (2009). Handbook of Cardiac Anatomy, Physiology, and Devices (2nd ed.). Humana Press. pp. 125–8. ISBN 978-1-60327-371-8.

External links

Anatomy photo:21:st-1500 at the SUNY Downstate Medical Center - "Mediastinum: Pericardium (pericardial sac)"
thoraxlesson4 at The Anatomy Lesson by Wesley Norman (Georgetown University) (heartpericardium)
Atlas image: ht_pericard2 at the University of Michigan Health System - "MRI of chest, lateral view"
1496645690 at GPnotebook

UpToDate Contents

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1. 心臓傷害後症候群 post cardiac injury syndromes
2. 急性心膜炎の臨床症状および診断的評価 clinical presentation and diagnostic evaluation of acute pericarditis
3. 心嚢液貯留の診断および治療 diagnosis and treatment of pericardial effusion
4. 悪性腫瘍関連心膜疾患 pericardial disease associated with malignancy
5. 収縮性心膜炎 constrictive pericarditis

English Journal

Giant epicardial cyst presenting as acute cardiac tamponade in a 2-year-old boy.

Masuoka A1, Sakurai H2, Shiraishi M3, Yoshiba S3, Katogi T4, Suzuki T4.
Asian cardiovascular & thoracic annals.Asian Cardiovasc Thorac Ann.2015 Sep;23(7):866-8. doi: 10.1177/0218492314566331. Epub 2015 Jan 14.
Cystic structures within the pericardial cavity are rare. They are divided into epicardial and pericardial variants. Pericardial and epicardial cysts rarely cause symptoms. This report describes a case of epicardial cyst with acute cardiac tamponade in a 2-year-old boy with no previous cardiac histo
PMID 25593209

Primary malignant melanoma of the thymus: report of a case.

Taniguchi T1, Kawaguchi K, Fukui T, Nishimura M, Yokoi K.
Surgery today.Surg Today.2015 Sep;45(9):1187-9. doi: 10.1007/s00595-014-0998-x. Epub 2014 Jul 29.
A 61-year-old male was admitted to our hospital complaining of bloody sputum. A chest roentgenogram revealed a clearly demarcated mass located in the anterior mediastinum. Positron emission tomography revealed abnormal accumulation of (18)F-fluorodeoxy glucose only in the anterior mediastinal tumor.
PMID 25069423

Japanese Journal

高度縦隔偏位を伴った左肺全摘術後症例に対する僧帽弁置換術

内田徹郎,皆川忠徳,金哲樹,前川慶之,水本雅弘,山下淳,中村健,吉村幸浩,貞弘光章,ウチダテツロウ,ミナカワタダノリ,キムチョルス,マエカワヨシユキ,ミズモトマサヒロ,ヤマシタアツシ,ナカムラケン,ヨシムラユキヒロ,サダヒロミツアキ,Uchida Tetsuro,Minakawa Tadanori,Kim Cholsu,Maekawa Yoshiyuki,Mizumoto Masahiro,Yamashita Atsushi,Nakamura Ken,Yoshimura Yukihiro,Sadahiro Mitsuaki
山形大学紀要. 医学 : 山形医学 31(1), 9-12, 2013-02-15
症例は64歳、女性、肺結核に対する左肺全摘術の既往を有する。呼吸困難と動悸を認め、僧帽弁閉鎖不全症、三尖弁閉鎖不全症および心房細動と診断された。胸部CTで、心臓は高度に左方偏位し、右肺は正中を越えて張り出していた。胸骨正中切開で内胸動脈採取用の開胸器を使用し、左胸腔に張り出した右肺を胸壁から剥離した。大腿動静脈と上大静脈から体外循環を確立し、経心房中隔アプローチで僧帽弁置換術と三尖弁形成術を施行し …
NAID 110009552265

Costal Mesenchymal Chondrosarcoma with Diffuse Pleural and Pericardial Explantation in a Pygmy Goat

LOMBARDINI Eric D.,DE LA CONCHA Andres,PIERCE Virginia,POOL Roy R.
Journal of Toxicologic Pathology, 2013
… The animal died and at necropsy, the parietal pleural surfaces and the pericardial surface were noted to be covered with firm, white, variably sized nodules that often formed linear arrays or coalesced into larger clumped aggregates. … Histopathological and immunohistochemical evaluation of the submitted tissues revealed a diagnosis of mesenchymal chondrosarcoma with extensive seeding throughout the thoracic cavity. …
NAID 130003382472

Related Pictures

★リンクテーブル★

リンク元	「心膜腔」
関連記事	「pericardial」「cavity」

「心膜腔」

Pericardium
	Walls of the heart, showing pericardium at right.
	Posterior wall of the pericardial sac, showing the lines of reflection of the serous pericardium on the great vessels
Details
Artery	Pericardiacophrenic artery
Nerve	Phrenic nerve
Identifiers
Latin	Pericardium
Greek	περίκάρδιον
MeSH	A07.541.795
TA	A12.1.08.001
FMA	9869
	Anatomical terminology [edit on Wikidata]