1. Pleura
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2. Formation of Pleural cavity
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3. Pleural cavity
decreased
Formation of Pleural cavity
Lung bud
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4. Layers of Pleura
1. Visceral pleura – inner, adheres to lung
2. Parietal pleura – outer, lines thoracic wall,
diaphragm,
- 4 parts –cervical
costal
diaphragmatic
mediastinal
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5. Parietal pleura
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6. Lungs with pleura: CS
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7. Lungs with pleura: TS
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8. Surface marking of pleura
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9. PLEURAL REFLECTIONS
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10. Pulmonary ligament
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11. Pleural recesses
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12. Pleural recesses
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13. Nerve supply of Pleura
 Parietal pleura – somatic nerves
(IC nerves, phrenic nerve)
pain sensitive
 Visceral pleura - autonomic nerves (T2 to T5)
pain insensitive
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14. Applied Anatomy
• Pleuritis/pleurisy
• Pleural effusion/hydrothorax
• Haemothorax
• Pneumothorax
• Pain at tip of shoulder from
diaphragmatic pleura
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15. Pleural tap
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16. Pleural tapPleural tap
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17. Pneumothorax
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18. Tension Pneumothorax
• Distended neck veins
• Tracheal shift
• Decreased breath
sounds
• Hyper resonance
(involved hemithorax)
• Collapsed lung on
same side
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19. Tension pneumothoraxTension pneumothorax
Trapping of air created by one way valveTrapping of air created by one way valve
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20. Tension Pneumothorax
Needle decompression 2nd ICS in MCLNeedle decompression 2nd ICS in MCL
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21. LARGE HAEMOTHORAX
Haemothorax
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22. Liver
Trachea
Tracheal bifurcation
Hilar shadow
Right border of heart
Cardiophrenic angle
Right dome of
diaphragm
Costodiaphragmatic
angle
Clavicle
Aortic knuckle
Pulmonary trunk
Left border of heart
Cardiac apex
Left dome of diaphragm
Gas shadow under
diaphragm
Coracoid process
CHEST X-RAY PA VIEW
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24. Thank 24