Anatomy clinical correlates: Pleura and lungs

Before you start watching this video, relax, and take a deep breath.

Think about the air filling up your lungs, which are located on either side of your thoracic cavity.

Now, we often take breathing for granted because it is under autonomic control, and it’s not until we have trouble breathing when we realize just how important our lungs are.

There are many conditions that can affect the lungs, which can have a huge impact on our day to day lives.

Now let’s look at some causes for lung ailments, starting with injuries of the cervical pleura and lung apex.

Both these structures project through the superior thoracic aperture into the neck.

So when there’s an injury involving the base of the neck, the lungs and pleural sacs can be injured as well, which can cause a pneumothorax.

The pleura is also exposed to potential injury in its inferior portion, because it descends below the costal margin in three regions, where a penetrating injury may enter into the pleural sac.

The first is the right part of the infrasternal angle, the other two parts are the right and left posterior costovertebral angles which are inferomedial to the 12th ribs and posterior to the superior poles of the kidneys.

So kidney surgery can pose a risk for pleural injury.

When discussing injuries to the pleura and lungs, it’s important to understand what pleuritic chest pain means.

Pleuritic chest pain is caused by irritation to the pleura, which results in a classical ‘sharp’, stabbing pain that gets worse when you breathe in, and is exacerbated even further by deep inhalation and exhalation.

Pleuritic chest pain can have multiple causes, including a pneumothorax, which is when there’s air trapped within the pleural cavity, or a pleural effusion, when fluid builds up in the pleural cavity.

Inflammation of the pleura can cause pleuritic chest pain, which is often the result of infection or inflammatory diseases such as rheumatoid arthritis, and may even result in an empyema where infected fluid builds up in the pleural cavity.

Pulmonary emboli can also result in irritation of the pleura, resulting in pleuritic chest pain.