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English for doctors. Pleura (most important)

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38. Pleura

Visceral pleura is a thin serous membrane that covers the outer surface of the lungs. A delicate connective tissue layer of collagen and elastin, containing lymphatic channels, vessels, and nerves, supports the membrane. Its surface is covered by simple squamous mesothelium with microvilli.

Parietal pleura is that portion of the pleura that continues onto the inner aspect of the thoracic wall. It is continuous with the visceral pleura and is lined by the same me-sothelium.

The pleural cavity is a very narrow fluid-filled space that contains monocytes located between the two pleural membranes. It contains no gases and becomes a true cavity only in disease (eg, in pleural infection, fluid and pus may accumulate in the pleural space). If the chest wall is punctured, air may enter the pleural space (pneumotho-rax), breaking the vacuum, and allowing the lung to recoil. Parietal pleura lines the inner surface of the thoracic cavity; visceral pleura follows the contours of the lung itself.

Pleural cavity: The pleural cavity is the space between the parietal and visceral layers of the pleura. It is a sealed, blind space. The introduction of air into the pleural cavity may cause the lung to col lapse (pneumothorax).

It normally contains a small amount of serous fluid elaborated by mesothelial cells of the pleural membrane.

Pleural reflections are areas where the pleura changes direction from one wall to the other. The sternal line of reflection is where the costal pleura is continuous with the mediastinal pleura behind the sternum (from costal cartilages 2-4). The pleural margin then passes inferiorly to the level of the sixth costal cartilage. The costal line of reflection is where the costal pleura becomes continuous with the diaphragmatic pleura from rib 8 in the mid-clavicular line, to rib 10 in the midaxillary line, and to rib 12 lateral to the vertebral column. Pleural recesses are potential spaces not occupied by lung tissue except during inspiration deep. Costodiaphragmatic recesses are spaces below the inferior borders of the lungs where costal and diaphragmatic pleura are in contact. Costomedia-stinal recess is a space where the left costal and mediasti-nal parietal pleura meet, leaving a space due to the cardiac notch of the left lung. This space is occupied by the lingu-la of the left lung during inspiration.

In nervation of the parietal pleura: The costal and peripheral portions of the diaphragmatic pleura are supplied by intercostal nerves.

The central portion of the diaphragmatic pleura and the media astinal pleura are supplied by the phrenic nerve.

new words

visceral - visceral

pleura - pleura

dcollagen - collagen

elastin - elastin

lymphatic channels - lymphatic vessels

nerves - nerves

squamous - scaly

microvilli - microvilli

parietal pleura - parietal pleura

visceral pleura - visceral pleura

costal - costal

Author: Elena Belikova

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