Clinical pleura

Question 1

Patient has pain over the lateral neck and the supraclavicular area, as well as pleuritic pain. Which part of the pleura is affected?

Answer 1

Mediastinal and Diaphragmatic pleura-innervated by C3,C4, C5 nerves (phrenic) hence affecting these dermatomes if damaged-> lateral neck and supraclavicular portion

Question 2

Patient has dull ache radiating across the chest? Which part of the pleura is damaged

Answer 2

Costal pleura which is innervated by intercostal nerves

Question 3

Patient has stony dullness in left lung base upon percussion. What is your working diagnosis?

Answer 3

Pleural effusion in left lung pleuritic space.

Fluid does not transmit sound as well as air

Question 4

Patient presents with hyperresonance in right lung base. What is your working diagnosis?

Answer 4

Pneumothorax in right lung.

Air transmits sound better than fluid