2. Normal anatomy:
• The pleural cavity is a fluid filled space that
surrounds the lungs.
• It is bounded by a double layered serous
membrane called pleura.
• Pleura is formed by an inner visceral pleura
and an outer parietal layer.
• Between these two membranous layers is a
small amount of serous fluid held within
the pleural cavity.
• This lubricated cavity allows the lungs to
move freely during breathing
3. Pleuritis :
• Inflammation of both layers of pleurae which is parietal
and visceral
• If person have pleurisy, these tissues swell and become
inflamed.
• As a result, the two layers of the pleural lining rub
against each other like two pieces of sandpaper.
• This causes pain when you breathe in and out.
• The pleuritic pain lessens or stops when you hold your
breath.
6. Symptoms
• Chest pain become severe , sharp and
knifelike on deep inspiration (pleuritic
pain)
• Pain caused by pleurisy might worsen
with movement can spread to upper
shoulder
• Shortness of breath
• Intercostal tenderness on palpation
• Fever, cough, malaise
12. Treatment
Discover underlying cause and to relieve pain
bacterial infection is usually treated with antibiotics
Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
painkiller, such as paracetamol
13. Prognosis :
• Pleurisy and other disorders of pleura can be
serious on what caused them
• Generally pleurisy treatment has an excellent
prognosis, but if left untreated it can cause
severe complications.
• If pleurisy is caused by infection, it should go
away as you get better.
• If it's caused by an ongoing illness like cancer or
an autoimmune disease, you may always have
some risk of pleurisy coming back
14. Case study:
• A 33-year-old man presented to the emergency department with pain in the right side of his chest that
started 5 days earlier. It originated near his right shoulder blade and radiated throughout his right chest.
The pain was worse with deep inspiration and when he was lying down. He also noted mild swelling of
his lower legs during the past several weeks. He reported no cough, hemoptysis, sore throat, fever,
chills, shortness of breath, abdominal pain, nausea, diarrhea, rashes, joint pains, or recent travel,
including travel by air. He also reported that both his children had contracted streptococcal pharyngitis
1 month earlier.
• On presentation, he was not taking any medications. He had never smoked tobacco and did not use
alcohol or recreational drugs.
15. PATIENTS
HISTORY:
• The patient had a history of ulcerative colitis, which had
been diagnosed 4 years earlier when he presented to his
primary care physician with chronic diarrhea, weight loss,
and iron-deficiency anemia.
• A colonoscopy revealed diffuse colonic inflammation, and
biopsy specimens of the colon showed chronic active
colitis. The patient was treated with mesalamine, and he
stopped taking the medication after several months, when
his symptoms had completely resolved
16. EVALUATION:
• On physical examination, the patient's temperature was 36.9°C,
his pulse 110 beats per minute, his blood pressure 141/82 mm
Hg, his respiratory rate 16 breaths per minute, and his oxygen
saturation 98%. . No oropharyngeal erythema or exudate was
present.
• Both lungs were clear to auscultation. No tenderness was
detected on examination of the chest wall. A cardiac
examination revealed a regular rate and rhythm, with no
murmurs, rubs, or gallops. His abdomen was soft and
nontender to palpation.
17.
18. • Pulmonary computed tomographic (CT) angiography
revealed multiple subsegmental and segmental
pulmonary emboli in both lungs
• Right lower lobe that was consistent with an evolving
pulmonary infarction
• A small right pleural effusion was present
