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The pericardial sinuses are impressions in the
pericardial sac The pericardium, also called pericardial sac, is a double-walled sac containing the heart and the roots of the great vessels. It has two layers, an outer layer made of strong connective tissue (fibrous pericardium), and an inner layer made of ...
formed between the points where
great vessels Great vessels are the large vessels that bring blood to and from the heart. These are: *Superior vena cava *Inferior vena cava *Pulmonary arteries * Pulmonary veins *Aorta Transposition of the great vessels is a group of congenital heart defec ...
enter it.


Structure

There are three pericardial sinuses: superior, transverse and oblique. * The superior sinus is anterior to the ascending aorta and the
pulmonary trunk A pulmonary artery is an artery in the pulmonary circulation that carries deoxygenated blood from the right side of the heart to the lungs. The largest pulmonary artery is the ''main pulmonary artery'' or ''pulmonary trunk'' from the heart, and ...
. It cannot be assessed in
electrophysiology Electrophysiology (from Ancient Greek, Greek , ''ēlektron'', "amber" ee the Electron#Etymology, etymology of "electron" , ''physis'', "nature, origin"; and , ''-logy, -logia'') is the branch of physiology that studies the electrical propertie ...
procedures. * The oblique sinus is an inverted J-shaped reflection of the
venae cavae In anatomy, the venae cavae (; singular: vena cava ; ) are two large veins (great vessels) that return deoxygenated blood from the body into the heart. In humans they are the superior vena cava and the inferior vena cava, and both empty into the ...
and
pulmonary veins The pulmonary veins are the veins that transfer oxygenated blood from the lungs to the heart. The largest pulmonary veins are the four ''main pulmonary veins'', two from each lung that drain into the left atrium of the heart. The pulmonary vei ...
. It lies behind the atria (particularly the
left atrium The atrium ( la, ātrium, , entry hall) is one of two upper chambers in the heart that receives blood from the circulatory system. The blood in the atria is pumped into the heart ventricles through the atrioventricular valves. There are two at ...
), and in between left and right pulmonary veins. * The transverse sinus is the tunnel-shaped passage posterior to the
aorta The aorta ( ) is the main and largest artery in the human body, originating from the left ventricle of the heart and extending down to the abdomen, where it splits into two smaller arteries (the common iliac arteries). The aorta distributes o ...
and
pulmonary trunk A pulmonary artery is an artery in the pulmonary circulation that carries deoxygenated blood from the right side of the heart to the lungs. The largest pulmonary artery is the ''main pulmonary artery'' or ''pulmonary trunk'' from the heart, and ...
, and anterior to the
superior vena cava The superior vena cava (SVC) is the superior of the two venae cavae, the great venous trunks that return deoxygenated blood from the systemic circulation to the right atrium of the heart. It is a large-diameter (24 mm) short length vein th ...
. This sinus is clinically important because passing one end of clamp through the sinus, and the other end anterior to the aorta/pulmonary trunk will allow complete blockage of blood output. This is performed during some heart surgeries.


Clinical significance

During
pericardial effusion A pericardial effusion is an abnormal accumulation of fluid in the pericardial cavity. The pericardium is a two-part membrane surrounding the heart: the outer fibrous connective membrane and an inner two-layered serous membrane. The two layers of t ...
, fluid may build up in the pericardial sinuses. This may be diagnosed with transoesophageal echocardiography.


References


External links

* - "Heart: Transverse and Oblique Pericardial Sinuses" * () {{Authority control Cardiac anatomy