Pleural Cavities

Question 1

List the muscles of the chest wall.

Answer 1

1 - Intercostal muscles.

2 - Pectoralis major.

3 - Pectoralis minor.

4 - Serratus anterior.

5 - External oblique.

6 - Internal oblique.

7 - Rectus abdominis.

8 - Transversus thoracis.

Question 2

Where is the endothoracic fascia?

Answer 2

• Immediately deep to the ribs.

- It separates the parietal pleura from the chest wall.

Question 3

What is the triangle of auscultation?

Answer 3

A thinning of the musculature of the back used for auscultation.

Question 4

What are the borders of the triangle of auscultation?

Answer 4

• Superomedially: The inferior aspect of the trapezius.
• Inferiorly: The latissimus dorsi.
• Laterally: The medial border of the scapula.

Question 5

Why is the triangle of auscultation used for auscultation?

Answer 5

Due to the thinning of the musculature, the posterior thoracic wall is closer to thin skin surface in the triangle of auscultation, making for clearer respiratory sounds.

Question 6

Why are patients asked to fold their arms across their chest when auscultating the triangle of auscultation?

Answer 6

Folding the arms laterally rotates the scapulae, which normally cover the triangle of auscultation.

Question 7

What lies deep to the triangle of auscultation on the left side only?

Answer 7

The cardiac orifice (the opening of the oesophagus into the stomach).

Question 8

What does the neurovascular bundle consist of?

Answer 8

1 - An intercostal nerve.

2 - An intercostal artery.

3 - An intercostal vein.

Question 9

What is a thoracocentesis?

Answer 9

A procedure in which a needle is inserted into the pleural space between the lungs and the chest wall to remove excess fluid from the pleural space.

Question 10

Where is the site of insertion in a thoracocentesis?

Answer 10

At the 5th intercostal space.

Question 11

What are the types of pleura?

Answer 11

Visceral and parietal.

Question 12

List the segments of the parietal pleura.

Answer 12

1 - Diaphragmatic pleura.

2 - Costal.

3 - Mediastinal.

4 - Cervical (pleural cupula).

Question 13

What is Sibson’s fascia / the suprapleural membrane?

Where is it?

What is its function?

Answer 13

• The endothoracic fascia associated with the cervical pleura / pleural cupula.
• It covers the apex of the lung.
• It projects into the neck, superior to the 1st rib.
• It strengthens the pleural cupula / cervical pleura.

Question 14

What is the pleural cupula?

Answer 14

Cervical pleura; the portion of the parietal pleura that extends into the neck.

Question 15

What are the anterior and posterior attachments of the pleural cupula?

Answer 15

• Anteriorly: The first rib.

- Posteriorly: The transverse process of the 7th cervical vertebra.

Question 16

Where is the pleural cavity?

Answer 16

Between the parietal and visceral pleura.

Question 17

Where is the visceral pleura?

Answer 17

It is adherent to the surfaces of the lung.

Question 18

Where is the parietal pleura?

Answer 18

It lines the inner surface of the chest wall.

Question 19

What is the name of the epithelium that lines the pleura?

Answer 19

Mesothelium.

Question 20

At which sites do the lungs not fully occupy the pleural cavity inferiorly during quiet inspiration?

Answer 20

Pleural recesses:

• The right and left costodiaphragmatic recesses.
• The right and left costomediastinal recesses.

Question 21

Why are the pleural recesses clinically important?

Answer 21

Because they provide spaces in which fluid can collect.

Question 22

What is the hilum of the lung?

Answer 22

The wedge-shaped area located on the medial aspect of each lung where the bronchi, arteries, veins and nerves enter and exit the lungs.