Fibrous (Parietal) Pericardium
The outer fibrous sac is composed primarily of collagen fibers with interspersed short elastic fibrils. The collagen fibers appear wavy and are arranged in a few layers with multidirectional orientation, thus the fibrous sac has the capacity to stretch to some degree. The fibrous envelope is continuous with the adventitia of the great vessels superiorly and is attached to the central tendon of the diaphragm inferiorly.
It is attached anteriorly to the sternum by sternopericardial ligaments. In the anteroinferior portion, the pericardium may come in direct contact with the costal cartilages of the left fourth to sixth ribs. The lateral surfaces are invested by the mediastinal part of the parietal pleura. Posteriorly, it is related to the major bronchi, esophagus and descending thoracic aorta.
The fibrous pericardium is made of dense collagen fibers with scant vascularization and invested by a single layer of mesothelial cells which are in turn the serosal pericardium.
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