Anatomy Thoracic Cavity and Pleura
Where on the body does it hurt when the pain fibers of the mediastinal and central diaphragmatic regions get triggered?
Pain in shoulder and neck because of dermatomes.
What is the parietal pleura?
Portion adhering to the internal surface of thorax.
What is the visceral pleura?
Portion of the pleura that is intimately investing and adhering to the lung.
What type of nerve innervates visceral pleura?
GVE (sympathetic and parasympathetic)
What is it called if blood is introduced to the pleural cavity?
Hemothorax
What is the root of the lungs called?
Hilus
What veins drain parietal pleura?
intercostal veins internal thoracic veins musculophrenic veins -azygos system
What does the mediastinal pleura cover?
lateral borders of mediastinum (continued with the costal pleura
What subdivision of parietal pleura is connected to the visceral pleura at the hilus?
mediastinum pleura
Where is the lymphatic drainage for the parietal pleura?
-Parasternal nodes -diaphragmatic nodes -intercostal nodes
How is the parietal pleura subdivided?
-costal -diaphragmatic -mediastinal -cervical
What is the purpose of the fluid in the pleural cavity?
-reduces friction -permits easy expansion and contraction of the lungs -Forms surface tension to keep lungs suctioned to the thoracic wall.
What does the costal parietal pleura cover?
-sternum -costal cartilages -ribs (right and left sides do NOT communicate at the sternum)
What does the cervical pleura cover?
-superior apex of lung
What arteries supply the parietal pleura?
-supreme intercostal artery -intercostal arteries -internal thoracic -musculophrenic
How does parietal pleura feel pain?
A LOT! Very sensitive. GSA fibers.
Describe the membrane that surrounds each lung.
A delicate double walled serous membrane. It is really actually a closed sack. (Like a hand punching into a balloon.)
What exists between the parietal and visceral pleura?
A thin space willed with fluid.
What is a pleural recess?
Area where parietal pleura comes into contact with parietal pleura.
What is the costodiphragmatic recess?
At costal reflection where costal pleura becomes continuous with diaphragmatic pleura.
What is the costomediastinal recess?
At sternal reflection where costal pleura becomes continuous with mediastinal pleura anteriorly.
Why is the endothoracic fascia thick around the cupula parietal pleura?
Because it is not protected by bony structures.
What is the artery supply of the visceral pleura?
Bronchial arteries.
What is it called if lymph is introduced to the pleural cavity?
Chylothorax
What innervates parietal pleura?
Costal and peripheral diaphagmatic subsections: Intercostal nerves mediatinal and central diaphragmatic subsections: phrenic nerves
What forms the sternal reflection?
Costal pleura and mediastinal pleura
Where do the left bronchial arteries originate?
From the thoracic aorta.
What is it called if fluid is introduced to the pleural cavity?
Hydrothorax
What is the clinical importance of lines of pleural reflection?
Indicate limits of pleural cavities and can be mapped on surface of the chest.
How does visceral pleural feel pain?
It doesn't. Only GVE nerves.
What are lines of pleural reflection?
Lines formed where subdivisions or parietal pleura intersect.
What is the clinical note for pleural recesses?
Provides a possible site for thoracentisis. (because a bit of space is formed)
How does the visceral pleura drain blood?
Right: azygos vein Left: accessory hemiazygos or left superior intercostal
What does the diaphragmatic pleura cover?
Superior surface of the diaphragm
What happens if the pleural space actually becomes a space?
The lung will collapse
What forms the costal reflection?
costal pleura and diaphragmatic pleura
What is it called if air is introduced to the pleural cavity?
pneumothorax
Where does the right bronchial artery originate?
right posterior intercostal artery or from the thoracic aorta.
Where is the lymphatic drainage for the visceral pleura?
subpleural lymphatic plexus of lung. -bronchopulmonary nodes
What makes up the pulmonary ligament?
two layers of parietal pleura. Helps to stabilize the lung
