Pleura ( Handout ) Flashcards
Inner membrane of the lung
A. Parietal
B. Visceral
B. Visceral
Outer membrane of the lung
A. Visceral
B. Parietal
B. Parietal
Insensitive to pain because it receives no nerves of general sensation
Visceral pleura
Visceral pleura receives an autonomic nerve supply from
Pulmonary plexus
3 compartments of the thoracic cavity
R pulmo cavity
L pulmo cavity
Mediastinum
Closely covers the lungs including the fissures
Visceral pleura
Adheres firmly to the lungs and provides the lungs with smooth slippery surface
Visceral pleura
Lines the pulmonary cavities
Parietal pleura
Pleura that is thicker than the other
Parietal thicker than visceral
Continuous with the parietal pleura at the hilum of the lung
Visceral pleura
Sensitive to pain, touch, and pressure
Parietal pleura
Nerves of the parietal pleura
Intercostal nerves
Phrenic nerve
Innervates the costal pleura and the peripheral part of the diaphragmatic pleura
Intercostal nerves
Innervates the mediastinal pleura and the central part of the diaphragmatic pleura
Phrenic nerve
Parts of the parietal pleura
Costal
Mediastinal
Diaphragmatic
Cervical
Parietal pleura: covers the internal surfaces of the thoracic wall A. Costal B. Mediastinal C. Diaphragmatic D. Cervical
A. Costal
The costal pleura is separated from the internal surfaces of the thoracic wall by?
Endothoracic fascia
Parietal Pleura: covers and forms the lateral boundary of the mediastinum A. Costal B. Mediastinal C. Diaphragmatic D. Cervical
B. Mediastinal
Parietal Pleura: continuous with the visceral pleura at the hilum of the lung A. Costal B. Mediastinal C. Diaphragmatic D. Cervical
B. Mediastinal
Parietal Pleura: covers the thoracic surface of the diaphragm A. Costal B. Mediastinal C. Diaphragmatic D. Cervical
C. Diaphragmatic
Connects the diaphragmatic pleura with the muscle fibers of the diaphragm
Phrenicopleural fascia
Parietal Pleura: dome-shaped cap that covers the apex of the lungs A. Costal B. Mediastinal C. Diaphragmatic D. Cervical
D. Cervical
The summit of the cervical pleura is ________ inches superior to the level of medial third of clavicle
1-1.5 inches
The cervical pleura is reinforced by
Sibson’s fascia or suprapleural membrane
Where the parietal pleura abruptly changes direction
Lines of pleural reflection
What are the lines of pleural reflection?
Anterior / sternal
Inferior / costal
Posterior / vertebral
Where costal pleura becomes continuous with the mediastinal pleura anteriorly
A. Sternal line
B. Costal line
C. Vertebral line
A. Sternal line
Where the costal pleura becomes continuous with the diaphragmatic pleura inferiorly
A. Sternal line
B. Costal line
C. Vertebral line
B. Costal line
Passes obliquely at the 8th rib (MCL), 10th rib (MAL), and 12th rib at its neck
A. Sternal line
B. Costal line
C. Vertebral line
B. Costal line
Where the costal pleura becomes continuous with the mediastinal pleura posteriorly
A. Sternal line
B. Costal line
C. Vertebral line
C. Vertebral line
Parallel the vertebral column running in the paravertebral plane from T1 to T12
A. Sternal line
B. Costal line
C. Vertebral line
C. Vertebral line
Potential spaces of the lungs
Costodiaphragmatic recess
Costomediastinal recess
Slit-like space between the costal and diaphragmatic pleura
A. Costodiaphragmatic recess
B. Costomediastinal recess
A. Costodiaphragmatic recess
Located at the most inferior limits of the parietal pleura
A. Costodiaphragmatic recess
B. Costomediastinal recess
A. Costodiaphragmatic recess
Slit-like spaces between the mediastinal and costal pleura
A. Costodiaphragmatic recess
B. Costomediastinal recess
B. Costomediastinal recess
Located posterior to the sternum
A. Costodiaphragmatic recess
B. Costomediastinal recess
B. Costomediastinal recess
What is larger, the left or the right costomediastinal recess?
Left recess is larger
Potential space between the layers of the pleura
Pleural cavity / pleural space
Condition that increases the production of fluid or impairs the drainage of fluid
Pleural effusion
Pleural effusion can be detected clinically when ________ ml of fluid is contained in the costodiaphragmaticnrecess
300ml
What are the conditions that can increase the production of pleural fluid
Inflammation
Malignancy
CHD
Condition that impairs drainage of fluid in the pleural cavity
Collapsed lung
Decreased lung expansion
Decreased breath sounds
Dullness on percussion
- all are clinical signs of what condition?
Pleural effusion
Condition wherein blood is present in the pleural cavity
Hemothorax
An injury to intercostal or internal thoracic vessel will result to what condition
Hemothorax
Entry of air in pleural cavity will result to what condition
Pneumothorax
A penetrating wound or fractures ribs will result to what condition
A. Hemothorax
B. Pneumothorax
B. Pneumothorax
Sudden entry of air in pleural cavity due to a ruptured bulla (bleb) will result to what condition
Spontaneous pneumothorax
What is the clinical condition?
Air + serous fluid
A. Hydropneumothorax
B. Pyopneumothorax
C. Hemopneumothorax
D. Empyema
A. Hydropneumothorax
What is the clinical condition?
Air + pus
A. Hydropneumothorax
B. Pyopneumothorax
C. Hemopneumothorax
D. Empyema
B. Pyopneumothorax
What is the clinical condition?
Air + blood
A. Hydropneumothorax
B. Pyopneumothorax
C. Hemopneumothorax
D. Empyema
C. Hemopneumothorax
What is the clinical condition?
Pus - air (without air)
A. Hydropneumothorax
B. Pyopneumothorax
C. Hemopneumothorax
D. Empyema
D. Empyema
When a lung collapses, the pleural cavity becomes a real space. This condition is called
Atelectasis
Amount of ______ and ______ determines the extent of pulmonary collapse
Blood and air
Atelectasis: failure of a lung to inflate birth
A. Primary
B. Secondary
A. Primary
Atelectasis: collapse of a previously inflated lung
A. Primary
B. Secondary
B. Secondary
Vulnerable to injury during infancy and childhood
Cervical pleura
Inflammation of pleura secondary to inflammation of lung
Pleuritis
S/s: (+) pleural rub
sharp stabbing pain
Pleuritis
Common causes of pleuritis
TB
Pneumonia
Lung abscess
Presence of white tumor nodules due to exposure to asbestos that may arise from either the visceral or parietal pleura
Mesothelioma
S/s: (+) pleural rub
Chest pain
Dyspnea
Pleural effusion
Gross: (+) pleural adhesion
Mesothelioma
In performing thoracentesis in an upright position, the needle is inserted where?
9th ICS MAL
Diagnostic an therapeutic procedure wherein small incision is made into the pleural cavity
Thoracoscopy
Where do you insert a chest tube?
5th - 6th ICS in MAL
Insertion of chest tube is directed towards what pleura? Or to what recess?
Cervical pleura
Costodiaphragmatic recess
