Pleura Flashcards
Adheres to ALL surface of the lung
Reflected at the root of the lung & continues as parietal pleura
Visceral pleura
Adheres to crest wall, diaphragm & pericardial sac
Parietal pleura
Associated with the internal surface of sternum, corporal cartilages, ribs & sides of the thoracic vertebrae
Costal
Forms the pulmonary ligament (inferior to the root of the lung) which supports the lung
Mediastinal
Associated with root of the neck
Cervical
Parietal pleura has
Costal
Mediastinal
Diaphragmatic
Cervical
R & L costodiaphragmatic recesses
- normally sharp in PA radiograph
- blunted angle –> pathology of pleural space (excess fluid, blood, tumor, scar tissue)
R & L costomediastinal recesses
- slit-like
Pleural recesses
Lung base
Midclavicular line: 6th rib
Midaxillary line: 8th rib
Paravertebral line: 10th rib
Pleural base
Midclavicular line: 8th rib
Midaxillary line: 10th rib
Paravertebral line: 12th rib
Visceral pleura only –> no pain
Parietal pleura –> sharp local pain & referred pain to thoracic wall (intercostal nerve) & root of the neck (phrenic nerve C3-5)
Pleuritis
Most serious pleural neoplasm
Asbestos
Asbestos exposure
Malignant mesothelioma
Ruptured bleb (bulla) –> loss of neg
Intrapleural pressure –> collapsed lung
SSX: chest pain, cough, dyspnea
Spontaneous pneumothorax
Pleural cavity is opened to outside atmosphere
On inspiration –> air is sucked into the pleural cavity–> lung collapses
Causes: knife wound, thoracocentesis, transthoracic lung biopsy, mechanical ventilation, central line insertion
Open pneumothorax
Inspired air can’t leave the pleural cavity on expiration (check valve mechanism) –> collapsed lung on wound side, compressed lung on the opposite side
SSX: absent breath sounds, chest pain, dyspnea, hypotension (mediastinal shift compresses SVC & IVC
Tension pneumothorax
Types of pleura
Visceral pleura
Parietal pleura
