Pleura
Anatomy
The pleura is a vital component of the human respiratory system, specifically within the thoracic cavity. It is a thin serous membrane which folds back onto itself to form a two-layered, pleural membrane structure. The outer layer, known as the parietal pleura, is attached to the chest wall. The inner layer, or the visceral pleura, covers the lungs and adjoining structures, via blood vessels, bronchi and nerves. The pleural cavity, with a small amount of pleural fluid, lies between the two layers. This fluid acts as a lubricant, reducing friction between the two layers to facilitate the movement of the lungs during respiration
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Function
The primary function of the pleura is to cushion the lungs and reduce any friction that might occur during the respiratory process. The pleural fluid within the pleural cavity allows the two layers of the pleura to slide effortlessly against each other. This is essential during breathing, as it allows the lungs to expand and contract without any resistance. Additionally, the pleura helps compartmentalize the different organs within the thoracic cavity, preventing the spread of infections from one organ to another.
Clinical Significance
Various medical conditions can affect the pleura, leading to a range of respiratory complications. These conditions include pleurisy, pleural effusion, pneumothorax, and mesothelioma.
Pleurisy is a condition characterized by inflammation of the pleura, often leading to chest pain and difficulty in breathing. Pleural effusion, on the other hand, is a condition where excess fluid builds up in the pleural cavity, causing shortness of breath.
Pneumothorax refers to the presence of air or gas in the pleural cavity, leading to a collapsed lung. This condition can occur due to a blunt or penetrating chest injury, certain medical procedures, or damage from underlying lung disease. Lastly, mesothelioma is a type of cancer that develops in the pleura, often due to exposure to asbestos.
Diagnosis and Treatment
Diagnosis of pleural diseases often involves imaging tests such as X-rays, CT scans, or ultrasounds. In some cases, a pleural biopsy may be required, where a small sample of the pleural tissue is removed for examination under a microscope.
Treatment of pleural diseases depends on the underlying cause. For instance, pleurisy caused by a viral infection might resolve on its own without treatment. However, bacterial infections would require antibiotics. Pleural effusion and pneumothorax often require procedures to remove the excess fluid or air from the pleural cavity. In the case of mesothelioma, treatment options include surgery, radiation therapy, and chemotherapy.