Correlative Anatomy for the Electrophysiologist, Part I: The Pericardial Space, Oblique Sinus, Transverse Sinus.
Summary of "Correlative Anatomy for the Electrophysiologist, Part I: The Pericardial Space, Oblique Sinus, Transverse Sinus."
The Pericardial Space, Oblique Sinus, Transverse Sinus. There is an increasing need for invasive electrophysiologists to appreciate the exact anatomy of the epicardial space and the coronary veins. The location of the epicardial fat, the complementary relationship with the main cardiac veins, and the location of sensitive structures (arteries, phrenic nerve, esophagus) have become required knowledge for electrophysiologists, and accessing the epicardial space with this thorough knowledge of the pericardial sinuses and recesses is essential to allow radiographic correlation during catheter manipulation. In this review, we briefly describe the anatomy of the pericardial space and then discuss the specific correlation for the invasive electrophysiologist, highlighting epicardial access, catheter navigation, and avoidance of collateral injury with specific attention to the important recesses of the pericardial space, their regional anatomy, and radiographic correlation when navigating catheters to these locations. We also discuss the anatomy of the main cardiac veins in the context of catheter mapping and ablation of the epicardial substrate through the venous system and without subxiphoid pericardial access. In Part I of this two-part series, we discuss the regional anatomy of the pericardial space, oblique sinus, and transverse sinus. (J Cardiovasc Electrophysiol, Vol. pp. 1-6).
Affiliation
Department of Anatomy, Mayo Clinic, Rochester, Minnesota, USA.
Journal Details
This article was published in the following journal.
Name: Journal of cardiovascular electrophysiology
ISSN: 1540-8167
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20731740
- DOI: http://dx.doi.org/10.1111/j.1540-8167.2010.01872.x
Medical and Biotech [MESH] Definitions
Empyema, Subdural
An intracranial or rarely intraspinal suppurative process invading the space between the inner surface of the DURA MATER and the outer surface of the ARACHNOID. Bacteria and other pathogenic organisms may gain entrance to the subdural space from the FRONTAL SINUS; ETHMOID SINUS; middle ear (EAR, MIDDLE); MASTOID; or as the result of CRANIOCEREBRAL TRAUMA or NEUROSURGICAL PROCEDURES. This condition may be associated with intracranial sinus thrombosis (SINUS THROMBOSIS, INTRACRANIAL). Circumscribed collections of purulent material in the subdural space are referred to as subdural abscesses. (From Adams et al., Principles of Neurology, 6th ed, p709)
Maxillary Sinus
The air space located in the body of the MAXILLARY BONE near each cheek. Each maxillary sinus communicates with the middle passage (meatus) of the NASAL CAVITY on the same side.
Trochlear Nerve Diseases
Diseases of the fourth cranial (trochlear) nerve or its nucleus in the midbrain. The nerve crosses as it exits the midbrain dorsally and may be injured along its course through the intracranial space, cavernous sinus, superior orbital fissure, or orbit. Clinical manifestations include weakness of the superior oblique muscle which causes vertical DIPLOPIA that is maximal when the affected eye is adducted and directed inferiorly. Head tilt may be seen as a compensatory mechanism for diplopia and rotation of the visual axis. Common etiologies include CRANIOCEREBRAL TRAUMA and INFRATENTORIAL NEOPLASMS.
Transverse Sinuses
The two large endothelium-lined venous channels that begin at the internal occipital protuberance at the back and lower part of the CRANIUM and travels laterally and forward ending in the internal jugular vein (JUGULAR VEINS). One of the transverse sinuses, usually the right one, is the continuation of the SUPERIOR SAGITTAL SINUS. The other transverse sinus is the continuation of the straight sinus.
Paranasal Sinuses
Air-filled spaces located within the bones around the NASAL CAVITY. They are extensions of the nasal cavity and lined by the ciliated NASAL MUCOSA. Each sinus is named for the cranial bone in which it is located, such as the ETHMOID SINUS; the FRONTAL SINUS; the MAXILLARY SINUS; and the SPHENOID SINUS.
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