Pleura of lungs with its clinical aspects #lungs pleura #pleura of lungs ppt

1. Pleura of lung
serous membrane that covers the lung parenchyma, mediastinum, diaphragm and the rib
cage.
It comprise visceral and parietal layer
Pleural space :- Space between the two
pleura of lung is known as pleural space
Filled with pleural fluid.
Pleural fluid reduced the friction between
the two pleural membranes

2. Parietal Pleura
It lines the thoracic wall.
Covers the inner surface of rib cage, mediastinum and diaphragm.
It extends into the root of neck to line the undersurface of suprapleural membrane at
thoracic outlet
lines:-Cervical pleura
Costal pleura
Diaphragmatic pleura
Mediastinal pleura

3. Cervical pleura :-It extends from the superior thoracic aperture into
the root of neck, forming a cup shaped pleural dome
over the apex of lung.
Diaphragmatic pleura:- Covers the superior or thoracic surface of
diaphragm on each side of mediastium.
Mediastinal pleura:-It covers the lateral aspects of the mediastinum.
Costal pleura:-It covers the internal surface of
Ribs Costal cartilages
Intercostal spaces Sides of vertebral bodies
Back of sternum

4. Visceral pleura
Covers the lung .
Cannot be dissected from lungs
Insesitive to pain

5. Recesses of pleura :-Acts as a space or reserve space for lungs
to expand during Deep inspiration.
Two recess are formed:-Costomediastinal recesses
Costodiaphragmatic recesses

6. Costomediastinal
recesses
:-slit like spaces between the costal and the
mediastinal parietal pleura.
Costodiaphragmatic
recesses
:-spaces between the costal and diaphragmatic
parietal pleura.

7. Arterial supply
Costal pleura : small branches of intercostal arteries
Mediastinal pleura : supplied by pericardio phrenic artery
Diaphragmatic pleura : supplied by superior phrenic and muscles
Bronchial artery : supplies visceral pleura facing the mediastinum, pleura
covering the interlobular surface and part of the diaphragmatic surface.
Pulmonary artery : supplies remaining portion.

8. Venous drainage
Through the intercostal veins which empty into inferior venacava or brachio-cephalic trunk.
Nerve supply-Parietal pleura
Sensitive to pain, temperature, touch and pressure.
Costal pleura : innervated by segmental intercostal nerves.
PERIPHERAL diaphragmatic pleura : innervated by lower 6
intercostal nerves.
Central portion of diaphragmatic pleura and mediastinal
pleura :-innervated by phrenic nerve.

9. Nerve supply-VISCERAL PLEURA
Insensitive to common sensation such as pain and touch
Innervated by autonomic nerves from the spinal segments T4 and T5.
Pleural effusion Pleural effusion is excess fluid that accumulates between the two
pleural layers, the fluid-filled space that surrounds the lungs.

10. Thoracocentesis procedure to remove fluid from the space between the
lining of the outside of the lungs (pleura) and the wall of
the chest.