{"id":1797,"date":"2020-08-17T13:32:45","date_gmt":"2020-08-17T13:32:45","guid":{"rendered":"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/thorax\/respiratory-system\/pleura\/"},"modified":"2020-12-25T21:56:57","modified_gmt":"2020-12-25T19:56:57","slug":"pleura","status":"publish","type":"page","link":"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/thorax\/respiratory-system\/lungs\/pleura\/","title":{"rendered":"Pleura"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><div class=\"intro\">The pleura refers to the layers of serous membranes that cover the lungs.<\/div><\/p>\n\n\n\n<hr class=\"wp-block-separator\"\/>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><a href=\"http:\/\/meddists.com\/wp-content\/uploads\/2018\/09\/thoracic_wall_and_pleura.jpg\" target=\"_blank\" title=\"Pleura\"><img decoding=\"async\" src=\"http:\/\/meddists.com\/wp-content\/uploads\/2018\/09\/thoracic_wall_and_pleura.jpg\" alt=\"\" class=\"wp-image-5159\"\/><\/a><figcaption><strong>Figure 1. The thoracic wall and the pleura of the lungs<\/strong> (Credit: OpenStax, CC BY-SA 4.0)<\/figcaption><\/figure><\/div>\n\n\n<span class=\"block-heading\" id=\"header_1\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Description<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_1\">\n\n\n<p class=\"wp-block-paragraph\">The pleura of the lung is very similar to the serous pericardium; it consists of&nbsp;<strong>visceral<\/strong>&nbsp;(shiny) and&nbsp;<strong>parietal<\/strong>&nbsp;layers, with nothing but&nbsp;<strong>serous fluid<\/strong>&nbsp;in between.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The parts of the pleura are named after the surfaces they face:<\/p>\n\n\n\n<ol class=\"wp-block-list\"><li><strong>Diaphragmatic part<\/strong><\/li><li><strong>Costal part<\/strong><\/li><li><strong>Pericardial&nbsp;<\/strong>(or&nbsp;<strong>medisatinal<\/strong>)&nbsp;<strong>part<\/strong><\/li><li><strong>Cupula pleura&nbsp;<\/strong>(or&nbsp;<strong>cervical<\/strong>)&nbsp;<strong>part<\/strong><\/li><\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">Both visceral and parietal pleura are continuous with each other at the hilum \u2014&nbsp;<strong>pulmonary ligament<\/strong>.<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><a href=\"http:\/\/meddists.com\/wp-content\/uploads\/2018\/09\/lungs_pleura.jpg\" target=\"_blank\" title=\"Pleura\"><img decoding=\"async\" src=\"http:\/\/meddists.com\/wp-content\/uploads\/2018\/09\/lungs_pleura.jpg\" alt=\"\" class=\"wp-image-5379\"\/><\/a><figcaption><strong>Figure 2. Pleura of the lungs<\/strong><\/figcaption><\/figure><\/div>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><a href=\"http:\/\/meddists.com\/wp-content\/uploads\/2018\/09\/right_lung.jpg\" target=\"_blank\" title=\"Pleura\"><img decoding=\"async\" src=\"http:\/\/meddists.com\/wp-content\/uploads\/2018\/09\/right_lung.jpg\" alt=\"\" class=\"wp-image-5380\"\/><\/a><figcaption><strong>Figure 3. Medial surface of the right lun<\/strong>g<\/figcaption><\/figure><\/div>\n\n\n<\/span><span class=\"block-heading\" id=\"header_2\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Lines<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_2\">\n\n\n<p class=\"wp-block-paragraph\">Before we continue with the surface projections of the lungs and their pleurae, we\u2019ll have to split the body into several longitudinal lines. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">There are 12 of these lines in total:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>5 on each side plus 2 median lines \u2014 one anteriorly and one posteriorly, and they are all parallel to each other.<\/li><li>The anterior median line is also called the<strong>&nbsp;sternal line<\/strong>, as it passes directly through the sternum.<\/li><li>When lifting the arms and exposing the axillary fossae, these are the lines:<ol><li><strong>Midclavicular line<\/strong><\/li><li><strong>Parasternal line&nbsp;<\/strong>(between midclavicular and anterior median lines)<\/li><li><strong>Anterior axillary line<\/strong>&nbsp;(anterior axillary fold, lateral border of pectoralis major)<\/li><li><strong>Midaxillary line&nbsp;<\/strong>(apex of the axillary fossa)<\/li><li><strong>Posterior axillary line<\/strong>&nbsp;(posterior axillary fold, anterior part of latissimus dorsi and teres major)<\/li><li><strong>Paravertebral line<\/strong>&nbsp;(between scapular and posterior median lines)<\/li><li><strong>Scapular line<\/strong>&nbsp;(inferior angles of scapula)<\/li><\/ol><\/li><\/ul>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><a href=\"http:\/\/meddists.com\/wp-content\/uploads\/2018\/09\/body_lines.jpg\" target=\"_blank\" title=\"Pleura\"><img decoding=\"async\" src=\"http:\/\/meddists.com\/wp-content\/uploads\/2018\/09\/body_lines.jpg\" alt=\"\" class=\"wp-image-5381\"\/><\/a><figcaption><strong>Figure 4. Body lines<\/strong><\/figcaption><\/figure><\/div>\n\n\n\n<p class=\"wp-block-paragraph\">Anatomists and clinicians may use different terminologies to describe these lines \u2014 hence, some refrain from using the term parasternal line \u2014 they use \u201cparasternal region\u201d instead, which is the region between the sternal margin and the parasternal line.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_3\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Planes<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_3\">\n\n\n<p class=\"wp-block-paragraph\">A plane is a&nbsp;<strong>two-dimensional surface<\/strong> (opposed to a line \u2014 which is one-dimensional).<\/p>\n\n\n\n<ol class=\"wp-block-list\"><li><strong>Transpyloric plane<\/strong>&nbsp;(a horizontal plane passing through the pylorus of the stomach \u2014 located between the jugular notch and the superior border of the pubic symphysis, at the level of the L1 vertebral body and the costal cartilage of the 9th rib)<\/li><li><strong>Subcostal plane<\/strong>&nbsp;(a horizontal plane passing through the inferior borders the costal arches, at the level of the L3 vertebral body)<\/li><li><strong>Supracristal plane&nbsp;<\/strong>(a horizontal plane passing through the iliac crests, at the level of the L4 vertebral body)<\/li><li><strong>Transtubercular<\/strong>&nbsp;(or&nbsp;<strong>intertubercular<\/strong>)<strong>&nbsp;line<\/strong>&nbsp;(a horizontal passing through the iliac tubercles, at the level of the L5 vertebral body \u2014 also equals to one of the external diameters of the pelvis)<\/li><\/ol>\n\n\n<\/span><span class=\"block-heading\" id=\"header_4\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Pleural projections<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_4\">\n\n\n<ol class=\"wp-block-list\"><li><strong>Parasternal line<\/strong>&nbsp;\u2014 2-4 ribs (L), 2-6 ribs (R)<\/li><li><strong>Midclavicular line<\/strong>&nbsp;\u2014 7th rib<\/li><li><strong>Anterior axillary line<\/strong>&nbsp;\u2014 10th rib<\/li><li><strong>Scapular mine&nbsp;<\/strong>\u2014 11th rib<\/li><li><strong>Paravertebral line<\/strong>&nbsp;\u2014 12th rib<\/li><\/ol>\n\n\n<\/span><span class=\"block-heading\" id=\"header_5\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Recesses<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_5\">\n\n\n<p class=\"wp-block-paragraph\">There are three&nbsp;<strong>sinuses<\/strong>&nbsp;formed by the junction of the pleurae:<\/p>\n\n\n\n<ol class=\"wp-block-list\"><li><strong>Costomediastinal recess<\/strong><\/li><li><strong>Costodiaphragmatic<\/strong>&nbsp;(or&nbsp;<strong>phrenicocostal<\/strong>)&nbsp;<strong>recess<\/strong><\/li><li><strong>Phrenicomediastinal recess<\/strong><\/li><\/ol>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><a href=\"http:\/\/meddists.com\/wp-content\/uploads\/2018\/09\/thorax_section-1.jpg\" target=\"_blank\" title=\"Pleura\"><img decoding=\"async\" src=\"http:\/\/meddists.com\/wp-content\/uploads\/2018\/09\/thorax_section-1.jpg\" alt=\"\" class=\"wp-image-5617\"\/><\/a><figcaption><strong>Figure 5. Cross-section at the level of T4 vertebra, the costomediastinal recess (sinus) is visible to the sides of the anterior mediastinum<\/strong><\/figcaption><\/figure><\/div>\n\n\n<\/span><span class=\"block-heading\" id=\"header_6\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Clinical information<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_6\">\n\n\n<p class=\"wp-block-paragraph\">Physiologically, these recesses are empty apart from the thin layer of serous fluid, allowing movement and expansion of the lungs (the lungs descend towards the costodiaphragmatic recess, being the biggest and most important). In some cases, however, blood or pus can accumulate in the<strong>&nbsp;costodiaphragmatic recesses<\/strong>. We can collect the fluid and examine it via a needle.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In your practice, you might be asked to find the costodiaphragmatic recess. To do so, you should place your hand along the side of the ribs, above the diaphragm.<\/p>\n\n\n\n<figure class=\"wp-block-image\" id=\"attachment_9728\"><img decoding=\"async\" src=\"https:\/\/meddists.com\/wp-content\/uploads\/2019\/03\/Costodiaphragmatic_recess.jpg\" alt=\"\" class=\"wp-image-9728\"\/><figcaption><strong>Figure 6. The costodiaphragmatic recess (red circle)<\/strong><\/figcaption><\/figure>\n<\/span><div id=\"the_titles\" style=\"display:none;\"><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Description<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Lines<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Planes<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Pleural projections<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Recesses<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Clinical information<\/h4><\/div>","protected":false},"excerpt":{"rendered":"<p>Description The pleura of the lung is very similar to the serous pericardium; it consists of&nbsp;visceral&nbsp;(shiny) and&nbsp;parietal&nbsp;layers, with nothing but&nbsp;serous fluid&nbsp;in between. The parts of the pleura are named after the surfaces they face: Diaphragmatic part Costal part Pericardial&nbsp;(or&nbsp;medisatinal)&nbsp;part Cupula pleura&nbsp;(or&nbsp;cervical)&nbsp;part Both visceral and parietal pleura are continuous with each other at the hilum \u2014&nbsp;pulmonary [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":1798,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1797","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Pleura &#8211; Meddists<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/thorax\/respiratory-system\/lungs\/pleura\/\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/anatomy\\\/thorax\\\/respiratory-system\\\/lungs\\\/pleura\\\/\",\"url\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/anatomy\\\/thorax\\\/respiratory-system\\\/lungs\\\/pleura\\\/\",\"name\":\"Pleura &#8211; 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