Excerpt from Diagnosis and Treatment of Diseases of the Heart
The cardiac region, including the heart, the origin of the large vessels, and the serous pericardium, is enclosed completely by the fibrous sac of the pericardium. The latter forms a pyramidal bos with three surfaces, and possesses the most complete fixation possible. Next to the pelvis the pericardial sac is the least movable region in the human body.
This triangular pyramid is fixed by its base to the aponeurotic centre of the diaphragm and indirectly to the vertebral column by the intervention of tendinous bands.
The apex of this pyramid is also fixed to the vertebral column, the hyoid bone, and the sternum, by very firm aponeurotic fibres. As all these ligaments have very slight extensibility, the fibrous sac forms as fixed a region as possible. This stability and protection are necessary for so important an organ as the heart, since it is the only one which is never at rest.
Situation. - Let us first determine the exact position of the pericardial sac. This is situated in the median line of the thorax (the whole extent of which it occupies) between the two lungs and pleur?.
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