UTTARAKHAND AYURVED UNIVERSITY

GURUKUL CAMPUS HARIDWAR

SUBJECT - RACHNA SHARIRA

Presented by Submitted to :-
Aman Giri Dr.RK Gautam
Roll no - A230101009 (Professor & HOD )
Batch - 2023 Dr. Mohan Sharma
B.A.M.S Ist proff. ( Professor)
The Pleurae
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 The pleurae is a thin, smooth,
glistening, delicate serous membrane
which
Covers the lungs
Lines the wall of the thorax
This is a layer of mesothelial cells,
supported by connective tissue.

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 Layers of the Pleura

Two layers that are

contained by the
pleura:
(a) Visceral pleura
(b) Parietal pleura.
Pleural Cavity is a
potential space
between the viscera
and parietal pleura.
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 Structure of the Pleurae

Each pleura can be divided into two parts:

Parietal pleura- Covers the internal surface of
the thoracic cavity.
Visceral Pleura- Covers the lungs.
The visceral pleura covers the outer
surface of the lungs, and extends into the
interlobar fissures.
It is continuous with the parietal pleura at
the hilum of each lung (this is where structures
enter and leave the lung).
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 Parietal Pleura

The parietal pleura covers the internal

surface of the thoracic cavity. It is thicker
than the visceral pleura, and can be
subdivided according to the part of the body
that it is contact with:
Therefore parietal pleura is split into the
following 4 parts:
Costal pleura.
Diaphragmatic pleura.
Mediastinal pleura.
Cervical pleura.
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 Parietal Pleura
Mediastinal pleura – Covers the
lateral aspect of the mediastinum
(the central component of the
thoracic cavity, containing a number
of organ).
Cervical pleura – Lines the extension
of the pleural cavity into the neck.
Costal pleura – Covers the inner
aspect of the ribs, costal cartilages,
and intercostal muscles.
Diaphragmatic pleura – Covers the
thoracic (superior) surface of the
diaphragm.
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Visceral Pleura (Pulmonary
Pleura)
The visceral pleura entirely covers the
top layer of the lung with the exception
of at the hilum and along the connection
of the pulmonary ligament.
It also extends in the depths of the
fissures of the lungs.
It is firmly adherent to the lung surface
and can’t be divided from it.

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 Costal Pleura

It lines the inner surface of the thoracic

wall (being composed of ribs, costal
cartilages, and intercostal spaces) to
which it’s loosely connected by a thin
layer of loose areolar tissue
termed endothoracic fascia.
In living beings, endothoracic fascia is
easily separable from the thoracic wall.

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 Relations of the Costal
Pleura
ANTERIOR RELATIONS
The internal thoracic vessels are directly located on the pleura
within the first intercostal space.
Sternum
Costal cartilages
Ribs
Intercostal muscles
POSTERIOR RELATIONS
The costal pleura is related to the sympathetic chain as well as
its branches.
The intercostal nerve is located in the middle of the costal pleura
as well as the posterior intercostal membrane at the posterior
end of the intercostal space.

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 The Diaphragmatic
Pleura
The thoracic surface of the diaphragm is
covered by the diaphragmatic pleura.
Below the lower border of the lung, the costal
and diaphragmatic pleurae are in apposition to
each other in quiet respiration.
The margins of the base of the lung decline and
the costal and diaphragmatic pleurae split up in
deep inspiration.
On inspiration this lower zone of the pleural
cavity into which the lung enlarges is called the
Costo diaphragmatic recess.
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 Mediastinal Pleura

It lines the corresponding outermost

layer of the mediastinum and creates its
lateral boundary.
It is represented as a cuff over the root
of the lung and becomes constant with
the visceral pleura.

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 Cervical Pleura

It is the dome of parietal pleura, which

extends into the root of the neck about
1 inch (2.5 cm) above the medial end
of clavicle and 2 inches (5 cm) above
the 1st costal cartilage.
It is termed cupola and covers the apex
of the lung.
It is covered by the suprapleural
membrane.
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 Connections of Cervical
Pleura
Anteriorly:
Subclavian artery and scalenus anterior muscle.
Posteriorly:
Neck of 1st rib and structures passing in front of
it.
Laterally:
Scalenus Medius muscle.
Medially:
Great vessels of the neck.

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 Cervical Pleura

Cervical pleura is the topmost part of

parietal pleura, inside the root of the
neck which spreads out nearly 1 inch or 2.5
cm superior towards the medial end
of clavicle as well as 2 inches or 5 cm
superior towards the 1st costal cartilage.
It is called cupola and the apex of the lung is
enclosed by it.
It is enclosed by the suprapleural
membrane.
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Relations of the Cervical
Pleura
The scaleus anterior envelops the anterolateral part of the dome of the pleura,
parting it from the subclavian vein that terminates at the medial border of the
muscle.
The subclavian artery traverses directly superior towards the vein the dome below
its peak, and from the subclavian the vertebral artery rises above it.
The internal mammary artery goes downwards from the subclavian after it travels
behind the innominate vein.
The costocervical trunk arcs towards the back from the subclavian and goes
across the summit of the dome.
Its superior intercostal branch goes downwards behind the dome, in the middle of
the first intercostal nerve on the lateral side as well as the first thoracic
sympathetic ganglion on the medial side.
The vagus nerve goes down on the right side in front of the medial part of the
subclavian artery.
Its continuing laryngeal branch turns around the lower border of the artery.
The ansa subclavia is located towards the lateral side of the recurrent nerve.
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 Pleural Cavity

The pleural cavity is a potential

space between the parietal and visceral
pleura. It contains a small volume of serous
fluid, which has two major functions.
It lubricates the surfaces of the pleurae,
allowing them to slide over each other.
The serous fluid also produces a surface
tension, pulling the parietal and visceral
pleura together.
This ensures that when the thorax expands,
the lung also expands, filling with air.
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 Pleural Recesses
Anteriorly and posteroinferiorly, the pleural
cavity is not completely filled by the lungs. This
gives rise to recesses – where the opposing
surfaces of the parietal pleura touch.
There are two recesses present in each pleural
cavity:
Costo diaphragmatic – located between the costal
pleurae and the diaphragmatic pleura.
Costo mediastinal – located between the costal pleurae
and the mediastinal pleurae, behind the sternum.
These recesses are of clinical importance, as they provide
a location where fluid can collect (such as in a pleural
effusion).
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 Neurovascular Supply
The two parts of the pleurae receive a different
neurovascular supply:
Parietal Pleura
The parietal pleura is sensitive to pressure, pain, and
temperature. It produces a well localised pain, and is innervated
by the phrenic and intercostal nerves.
The blood supply is derived from the intercostal arteries.
Visceral Pleura
The visceral pleura is not sensitive to pain, temperature or touch.
Its sensory fibres only detect stretch. It also receives autonomic
innervation from the pulmonary plexus (a network of nerves
derived from the sympathetic trunk and vagus nerve).
Arterial supply is via the bronchial arteries (branches of the
descending aorta), which also supply the parenchyma of the
lungs.

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 Pneumothorax
A pneumothorax (commonly referred to a collapsed lung) occurs when
air or gas is present within the pleural space. This removes the
surface tension of the serous fluid present in the space, reducing lung
extension.

Clinical features include chest pain, and shortness of breath, and asymmetrical
chest expansion. Upon percussion, the affected side may be hyper-resonant (due
to excess air within the chest).
Spontaneous: A spontaneous pneumothorax occurs without a specific
cause. It is sub-divided into primary (no underlying respiratory
disease) and secondary (underlying respiratory disease present).
Traumatic: A traumatic pneumothorax occurs as a result of blunt or
penetrating chest trauma, such as a rib fracture (often seen in road
traffic collisions).
It may require decompression to remove the extra air/gas in order for the
lung to reinflate (this is achieved via the insertion of a chest drain).
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THAN
K
YOU!