Pleura (dave's notes)

Question 1

Describe the pleura

Answer 1

A membrane of fibrous tissue surfaced by a single layer of very flat cells (mesothelium) to make it slippery

Question 2

Describe the parietal layer of pleura

Answer 2

Lines the thoracic cavity attached by loose areolar tissue. Also covers the diaphragm, pericardium (strong attachment here), mediastinum and suprapleural membrane.

Question 3

From what is the visceral pleura formed?

Answer 3

From the lung root a cuff is invaginated to form the visceral pleura

Question 4

What does the visceral layer of pleura cover?

Answer 4

It coats the lungs and extends into the interlobar clefts

Question 5

What is the function of the pleura

Answer 5

To provide two low friction surfaces.

Question 6

What allows extra dead space

Answer 6

The pulmonary ligaments hang down (????)

Question 7

What is the nerve supply to the pleura?

Answer 7

The parietal pleura is supplied segmentally by the intercostal nerves over costal elements. Over the diaphragm it is supplied by the phrenic nerves over the domes, and the intercostal nerves at the peripheries of the diaphragm.
The visceral pleura has only autonomic supply

Question 8

What are the surface markings of the parietal pleura?

Answer 8

Laterally - the horizon of the thoracic cage, projecting above the medial 1/3rd of the clavicle by about 3cm.

Question 9

See Fig 4.30. Describe the line of pleural reflection.

Answer 9

• NB SC joint, then ribs 2,4,6,8,10,12
• Pleural line may be traced from the SC joint at the 2nd rib, -passing vertically down to the 4th costal cartilage: here the right continues vertically, the left descends laterally.
• Each turns laterally at the 6th costal cartilage
• Crosses the mid clavicular line at the 8th rib
• Crosses the mid axillary line at the 10th rib ( = the -costodiaphragmatic recess)
• Crosses the 12th rib at the lateral border of erector spinae