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Pericardium (fibrous, anatomy)

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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The fibrous pericardium is the outermost layer of the pericardial membranes around the heart. It is a tough, collagenous sheet that is superficial to the parietal layer of the serous pericardium. The two are separated by a thin layer of amorphous connective tissue. Conical in shape, it fuses and is continuous with:

  • inferiorly: the central tendon of the diaphragm
  • superoposteriorly: the adventitial layers of all the great vessels except the inferior vena cava which enters the pericardial cavity through the diaphragm
  • anteriorly: the sternopericardial ligaments
  • deep: the layers of the serous pericardium over the heart
  • superiorly: the pretracheal fascia

The relations of the fibrous pericardium are:

  • anterior: anterior diaphragmatic surfaces of pleura except for small 'bare area' exposed by the cardiac notch where fibrous pericardium is in direct contact with inferior left half of body of sternum
  • posterior, from superior to inferior: principal bronchi, oesophagus, descending aorta, posterior mediastinal surfaces of lung
  • laterally: mediastinal surface of pleura, phrenic nerves and vessels
  • inferiorly: diaphragm

The relatively high tensile strength of the fibrous pericardium and its firm attachments ensure that:

  • it provides a relatively unyielding barrier to the overexpansion of the heart and pericardial cavity
  • its shape and position is influenced by the position of the diaphragm
  • it keeps the heart and great vessels roughly central within the thoracic cavity

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