Pleura

Question 1

What is pleura

Answer 1

Serous membrane consisting of
Visceral layer - lines the lungs
Parietal layer - lines the internal surface of each hemi thorax (thoracic cage, diaphragm and mediastinal surface)

Question 2

Where are the visceral and parietal pleura continuous with each other

Answer 2

At the hilum of each lung

Question 3

Is the parietal or visceral pleura thicker

Answer 3

Parietal is thicker

Question 4

Blood supply of the parietal pleura

Answer 4

Intercostal arteries and veins

Question 5

Blood supply of the visceral pleura

Answer 5

Internal thoracic arteries and veins

Question 6

Innervation of the parietal pleura

Answer 6

Somatic and autonomic

Phrenic and intercostal nerves

Question 7

Innervation of the visceral pleura

Answer 7

Autonomic 
Pulmonary plexus (derived from the sympathetic trunk and vagus nerve)

Question 8

Sensations of the pleura

Answer 8

Parietal - pressure, pain, temperature

Visceral - stretch

Question 9

What is the pleural cavity

Answer 9

Potential space between the parietal and visceral pleura containing serous fluid

Question 10

What produces the pleural fluid

Answer 10

Parietal pleura

Question 11

What absorbs pleural fluid

Answer 11

Parietal lymphatic symptoms

Question 12

Functions of the pleural fluid

Answer 12

Lubricates the pleura to allow the layers to slide over each other
Produces a surface tension which provides cohesion that keeps the lung surface in contact with the thoracic wall

Question 13

Subdivisions of the parietal pleura

Answer 13

Mediastinal
Cervical
Costal
Diaphragmatic

Question 14

Where is the mediastinal pleura

Answer 14

Covers the lateral aspect of the mediastinum

Question 15

Where is the cervical pleura

Answer 15

Lines the extension of the pleural cavity into the neck

Question 16

Where is the costal pleura

Answer 16

Covers the inner aspect of the ribs, costal cartilages and intercostal muscles

Question 17

Where is the diaphragmatic pleura

Answer 17

Covers the thoracic surface of the diaphragm

Question 18

Where does the visceral pleura extend

Answer 18

Into the Interlobar fissures

Question 19

What are lines of pleural reflection

Answer 19

Lines along which the parietal pleura changes direction as it passes from one wall of the pleural cavity to another

Question 20

What are the 3 lines of pleural reflection

Answer 20

Sternal
Costal
Diaphragmatic

Question 21

How many pleural recesses are there

Answer 21

4 (2 in each pleural cavity)

Question 22

What are the pleural recesses

Answer 22

Costodiaphragmatic

Costomediastinal

Question 23

What is a pleural recess

Answer 23

Areas where the opposing surfaces of parietal pleura touch (where the pleural cavity isn’t filled by lungs)

Question 24

Clinical significance of pleural recesses

Answer 24

Fluid can collect in them e.g after pleural effusion

Question 25

Where is the costodiaphragmatic recess

Answer 25

Between the costal pleura and the diaphragmatic pleura

Question 26

Where is the costomediastinal recess

Answer 26

Between the costal pleura and the mediastinal pleura behind the sternum

Question 27

What is pneumothorax

Answer 27

Presence of gas within the pleural space which removes the surface tension of pleural fluid, reducing lung extension

Question 28

Features of pneumothorax

Answer 28

Chest pain
SOB
Asymmetrical chest expansion
Affected side is hyper-resonant on percussion

Question 29

Types of pneumothorax

Answer 29

Spontaneous

Traumatic

Question 30

Types of spontaneous pneumothorax

Answer 30

Primary - no underlying respiratory disease

Secondary - underlying respiratory disease present

Question 31

What is traumatic pneumothorax

Answer 31

Due to blunt or penetrating chest trauma

Question 32

Treatment for primary spontaneous pneumothorax

Answer 32

Minimal intervention (usually small)

Question 33

Treatment for secondary spontaneous and traumatic pneumothorax

Answer 33

Decompression to remove extra gas via the insertion of a chest drain
(May require minimal intervention)