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Pleura

Layers
1. Visceral
  1. inner layer which covers the lung & lines its fissures
2. Pariatal
  1. lines thoracic wall from inside & lines chest wall & covers the mediastinum.
3. The visceral and parietal pleurae are continuous together around the root of the lung.
Pulmonary Ligament
1. The pleura extends downwards as a fold below the root called the pulmonary ligament.
2. Functions : Provides DEAD SPACE into which the :
  1. Lung root descends with descent of the diaphragm.
  2. Pulmonary veins can expand (exercise).
Pleural Cavity
1. The closed cavity between the visceral and parietal pleurae
2. contains a thin film of fluid (PLEURAL FLUID) and encloses the lung.
  1. Lubricates the pleural surfaces and allows the layers of pleura to slide smoothly over each other during respiration
3. Inflammation of the pleura makes the pleural surfaces rough. The resulting friction (pleural rub) is detectable with a stethoscope.
Visceral Pleura
1. Absent in :
  1. Hilum of the Lung
  2. Between the 2 layers of pulmonary ligament
Pariatal
1. Costal Pleura
  1. Lining the :
    1. Sternum
    2. Ribs
    3. Costal Cartilages
    4. Intercostal spaces
    5. Sides of vertebral column
2. Diaphragmatic pleura
3. Cervical Pleura
  1. covers the apex of the lung.
  2. It is attached above by the suprapleural membrane
4. Mediastinal Pleura
  1. which covers the sides of the mediastinum.
  2. Relations: as mediastinal surface of the lungs.
Pleural Recesses
1. They are narrow extensions of the pleural cavity.
2. Allows the lungs to expand during deep inspiration.
3. Sites
  1. Costodiaphragmatic recess {Costophrenic angle}
    1. lies between the costal & diaphragmatic pleura along the INFERIOR MARGIN of the pleura
    2. Accumulation of fluid in the pleural cavity , the fluid tends to gravitate towards the recesses >> obliterates the costophrenic angle will cause an opacity which obliterates the angle. Pleural Effusion { HYDROTHORAX }
    3. In thoracocentesis, inserting the needle into the 9th intercostal space in the mid-axillary line during expiration will avoid the inferior border of the lung.
  2. Costomediastinal recess
    1. lies between the costal and mediastinal pleura along the anterior margin of the pleura
    2. Overlies the heart.
    3. Lies at the anterior ends of the left 4th and 5th intercostal spaces.
    4. During full inspiration it becomes occupied by the lingula of the left lung.

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Pleura

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	Created by Farah Mansour about 8 years ago