HWN Suggests

My love affair with the pleural space

The pleural space is one of the most slippery mysteries of the body. It is formed by two opposing serous membranes with a small amount of fluid in between holding the surfaces together. It is a “space” that is not really there; a sort of double negative existential wonder whose meaning seems perpetually out of reach. To deepen the mystery, when the pleural space is removed, the lungs function perfectly well. Clearly, however, the pleura and space between serve some purpose. A space that isn’t there and doesn’t have to be there; you can see why it’s so easy to love.

read full article

Featured

 The pleural cavity: Guardians of lung health and function

The pleural cavity, with its serous membranes and pleural fluid, serves as a critical component of the respiratory system, contributing to lung health and function. From lubricating lung movements to protecting against infections and maintaining pressure balance, the pleural cavity plays a vital role in ensuring efficient respiration... The pleural cavity helps maintain the pressure balance necessary for proper lung expansion. The slight negative pressure within the pleural cavity relative to the atmospheric pressure keeps the lungs in an expanded state, preventing lung collapse. This pressure differential allows the lungs to fill with air during inhalation and passively deflate during exhalation...

Articles of Interest

The pleura in health and disease

A wide variety of local, regional, and systemic diseases may have pleural manifestations. The scope of this pathology encompasses a wide spectrum ranging from minimal inflammatory changes to highly malignant neoplasms.

Physiology and pathophysiology of pleural fluid turnover

Tight control of the volume and composition of the pleural liquid is necessary to ensure an efficient mechanical coupling between lung and chest wall. Liquid enters the pleural space through the parietal pleura down a net filtering pressure gradient. Liquid removal is provided by an absorptive pressure gradient through the visceral pleura, by lymphatic drainage through the stomas of the parietal pleura, and by cellular mechanisms. Indeed, contrary to what was believed in the past, pleural mesothelial cells are metabolically active, and possess the cellular features for active transport of solutes, including vesicular transport of protein.

Pleura space anatomy

In human, there is no anatomical connection between the pleural cavities. The visceral pleura receives its blood supply from the bronchial circulation and the parietal pleura receives its blood supply from the intercostal arteries. Only in cases of pneumonothorax (tension-simultaneous) may collapse the contralateral parenchyma and blood vessels. Normally visceral pleura glides on parietal without sound or pain, but when the pleura are in action sounds can be auscultated. If fluid then distends cavity, the sounds disappear and the lung gradually the heart and mediastinum being displaced towards the lung. Air the cavity, rupture of the lung as the elastic tissue of the lung recoils. The pleura crosses the rib at the region is above the reflexion.

Ultrasound for Pleural Disease. Beyond a Pocket of Pleural Fluid

The evolution of pleural disease imaging modalities through the years has helped the scientific community understand and treat various disease states. Ultrasound (US) has been an image modality that has reigned superior to those used in the past such as chest X-ray and computed tomographic scan in terms of cost effectiveness, portability, and reduction in unwarranted radiation exposure to patients.

What Are Pleural Disorders?

There are three types of pleural disorders — pleurisy, pleural effusion, and pneumothorax — and they have varying causes. Pleurisy is inflammation of the pleura. Pleural effusion and pneumothorax occur when an infection, medical condition, or chest injury causes fluid, pus, blood, air, or other gases to build up in the pleural space.

What Is the Pleura?

The pleura is a vital component of the respiratory system, playing several crucial roles in maintaining lung health and function. This double-layered membrane surrounds the lungs and lines the chest cavity, providing both protection and support.

Why Doesn't the Elephant Have a Pleural Space?

The elephant is the only mammal whose pleural space is obliterated by connective tissue. This has been known for 300 years but never explained. The elephant is also the only animal that can snorkel at depth. The resulting pressure differences require changes in the pleural membranes and pleural space.

Resources

KenHub

The pleura is a double-layered serous membrane that covers each lung and lines the thoracic cage. The outer layer (parietal pleura) attaches to the chest wall. The inner layer (visceral pleura) covers the lungs, neurovascular structures of the mediastinum and the bronchi. The space between the parietal and visceral pleurae is called the pleural cavity which contains a small amount of serous fluid (pleural fluid). It is important to note that there is no connection between the right and left pleural cavities.

StatPearls

Within the thoracic cavity, the lungs are separated from the thoracic wall by the visceral and parietal pleurae. Between these two layers exists a potential space called the pleural cavity. It is clinically significant, as pathologic processes can result in fluid accumulations within this space. The pleural cavity also maintains a negative intrapleural pressure, which resists the lungs’ natural tendency to collapse and facilitates proper function during respiration.

TeachMe Anatomy

There are two pleurae in the body: one associated with each lung. They consist of a serous membrane – a layer of simple squamous cells supported by connective tissue. This simple squamous epithelial layer is also known as the mesothelium.