Anatomy of the pleura

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Anatomy of the Pleura

Figure 1. Layers of the thoracic wall. B Anterolateral view of the pleurae with the ribs partially removed and the parietal pleura removed on the right lung. C Anterolateral view of the surfaces of the parietal pleura, with the ribs partially removed and the left lung removed completely.
Figure 2. Anterior and posterior view of the lines of pleural reflection.
Figure 3. Anterolateral view of the lungs showing the pleural recesses.
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The pleura is a thin membrane that covers each of our lungs and surrounding pulmonary cavity, and it can be subdivided into two layers, the visceral pleura which intimately adheres to the lungs, and the parietal pleura which lines the rest of the pulmonary cavity.

Between these two pleural layers there’s the pleural cavity, which is normally filled with a thin film of fluid in order to lubricate the pleural surfaces and allow them to slide smoothly over each other during each breath.

Now, on the medial part of each lung, there’s the pulmonary hilum, where the root of the lung passes through.

The root of the lungs is made of structures like the tracheobronchial tree, as well as arteries and veins.

At this level, the visceral and parietal pleura are continuous, making one continuous structure.

To make this easier, you can imagine an underinflated balloon through which you press your fist into, the fist representing the root of the lung and the balloon representing the visceral and parietal pleura.

As you can see, the parietal and visceral pleura are one continuous layer, however they are reflected on different surfaces.

Okay, the visceral pleura covers the entire lung and adheres intimately to all its surfaces, including the ones between the fissures of each lung.

The visceral pleura is continuous with the parietal pleura at the hilum of the lung.

The parietal pleura is thicker than the visceral one, lines the pulmonary cavities and adheres to the thoracic wall, mediastinum and diaphragm.

The parietal pleura actually has four parts: costal, mediastinal, diaphragmatic and cervical pleura.

The costal pleura covers the internal surface of the thoracic wall, from which it’s separated by the endothoracic fascia, a thin layer of loose connective tissue that comes in handy during surgical procedures, making it really easy to separate the lungs from the thoracic wall.

The mediastinal pleura covers the lateral aspects of the mediastinum, which is the space between the lungs and continues as cervical pleura superiorly in relation to the root of the neck.

It’s also continuous inferiorly with the diaphragmatic pleura and with the costal pleura anteriorly and posteriorly.

At the hilum, the mediastinal pleura changes direction laterally onto the root of the lung to become one with the visceral pleura.

Fuentes

  1. "Radiological review of pleural tumors" Indian Journal of Radiology and Imaging (2013)
  2. "Gray's Anatomy for Students" Churchill Livingstone (2014)
  3. "Gray's Anatomy" Churchill Livingstone (2007)
  4. "The fissure: interlobar collateral ventilation and implications for endoscopic therapy in emphysema" International Journal of Chronic Obstructive Pulmonary Disease (2016)
  5. "Anatomy, Thorax, Lung Pleura And Mediastinum" StatPearls Publishing (2021)
  6. "The structure of the parietal pleura and its relationship to pleural liquid dynamics in sheep" The Anatomical Record (1984)
  7. "Ultrastructural study on the pleural stomata in human" Funct Dev Morphol (1993)
  8. "Anatomy, thorax, lungs" In: StatPearls. StatPearls Publishing (2021)
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