Chapter 4 - Thoracic Cavity and Pleurae

Question 1

Visceral pleura

Answer 1

• Pulmonary pleura
• Develops from splanchnopleuric mesoderm
• covers surface and fissures of lung
• continuous with parietal pleura at hilum and pulmonary ligament

Question 2

Parietal pleura

Answer 2

• Somatopleuric mesoderm
  1. Costal pleura: Lines thoracic wall, ribs and intercostal spaces. Attached by areolar tissue called endothoracic fascia
  2. Medistinal pleura: Lines medistinal surface
  3. Cervical pleura: Extends above clavicle and covers apex of lung.
  4. Diaphragmatic pleura: Lines superior part of diaphragm and covers base of lung.

Question 3

Pulmonary ligament

Answer 3

• Parietal pleura surrounding root of lung extends downwards as a fold - pulmonary ligament
• Contains loose areolar tissue, lymphatics
• Provides dead space for pulmonary veins to expand

Question 4

Costomediastinal recess

Answer 4

• Lies anteriorly
• Between costal and mediastinal pleurae
• Filled up by anterior margin of lungs during breathing

Question 5

Costodiaphragmatic recess

Answer 5

• Between costal and diaphragmatic pleurae

- Extends from 8th-10th ribs along midaxillary line

Question 6

Blood supply, Nerve supply and Lymphatics of visceral pleura

Answer 6

-Bronchial vessels

• Sympathetic- T2-T5 ganglia
• Parasympathetic- Vagus

–Bronchopulmonary lymph nodes

Question 7

Blood supply and Lymphatics of parietal pleura

Answer 7

• Intercostal, internal thoracic, musculophrenic A
• Azygos, internal thoracic V
• Intercostal, internal mammary, posterior mediastinal, diaphragmatic lymph nodes

Question 8

Nerve supply of parietal pleura

Answer 8

• Costal + peripheral part of diaphagmatic pleura: Intercostal N
• Medistinal + central part of diaphragmatic pleura: Phrenic N

Question 9

Paracentesis thoracis

Answer 9

• Aspiration of fluid from thoracic cavity
• 8th intercostal space
• needle passed through lower part of space to avoid injury to VAN

Question 10

Pleurisy

Answer 10

• Inflammation of pleura
• May be dry/ fluid may collect in cavity
• Dry pleurisy is more painful as both layers come into contact during inspiration causing friction

Question 11

Pneumothorax, Haemothorax, Hydropneumothorax, Empyema

Answer 11

Pneumo- air in pleural cavity
Haemo- blood in cavity
Hydropneumo- fluid and air in cavity
Empyema- pus in cavity

Question 12

Pain from costal and peripheral diaphragmatic pleura is reffered to

Answer 12

Thoracic/Abdominal walls through intercostal N

Question 13

Pain from mediastinal and central diaphragmatic pleura is reffered to

Answer 13

Tip of shoulders through phrenic N

Question 14

Pleura extends beyond thoracic cage in which areas?

Answer 14

1. Right xiphicostal angle
2. Right and left costovertebral angle
3. Root of neck as cervical pleura