Human Anatomy Vol 1

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THORAX

Parietal pleura limits the expansion of the lungs.

Visceral pleura behaves in same way as the lung.

Parietal pleura has same nerve supply and blood

supply as the thoracic wall.

Pleural cavity normally contains a minimal serous

fluid for lubrication during movements of thoracic

cage.

Pleura lies beyond the thoracic cage at 5 places.

These are right and left cervical pleura, above the

1st rib and the clavicle; right and left costovertebral

angles and only right xiphicostal angle. Pleura is

likely to be injured at these places.

Paracentesis thoracis is done in the lower part of

the intercostal space to avoid injury to the main

intercostal vessels and nerve.

Pleural effusion is one of the sign of tuberculosis

of the lung.

high temperature, with pain in his right side of chest,

right shoulder and around umbilicus.

o What is the probable diagnosis?

. Why does pain radiate to right shoulder and
periumbilical region?
Ans: The most probable diagnosis is pneumeinia of
the right lung. The infection from pharynx spread
down to the lungs. Pleura consists of two layers,
visceral and parietal; the formeris insensitive to pain
and the latter is sensjtive to pain. e costal part of
parietal pleura is supplied L-ry intercostal neR.es and
the mediastinal and central parts r:f diaphragmatic
pleurae are supplied by phrenic (C ) nerve.
In pneumonia, there is always an element of
pleural infection. The pain of pleuritis radiates tcr
other areas" Due to infection in mediastinal and
central part af diaphragmatic pleura, the pain is
referred to tip of the right shoulder as this area is
supplied by supractavicular nerves with the sanre
root rralue as phrenic nerve (C4),
e costal pleura is supplied by intercostal nerves.
These nerves also supply ihe skin of anterior
abdominal wall. So the pain of lower part rsf costal
pleura gets referred to skin of abdomen, in the
periu ilical area.

A child about^10 years of age had been having sore

throat, cough and fever. On the third day, he

developed severe cough, difficulty in breathing and

1. Which of the following nerves innervate the costal
   pleura?
   a. Vagus
   c. Splanchnic


2. Which of the following nerves innervate the
   mediastinal pleura?
   a. Vagus b. Phrenic
   c. Intercostal d. Splanchnic


3. All the following arteries supply parietal pleura
   except'.
   a. Musculophrenic b. Internal thoracic
   c. Intercostal d. Bronchial

MUTTIPLE CHOICE OUESTIONS

ANSWERS

4. One of the following arteries supply the visceral
   pleura:
   a. Bronchial
   b. Musculophrenic
   c. Internal thoracic
   d. Superior epigastric


5. All are main big recesses of pleura except:
   a. Right costodiaphragmatic recess
   b. Left costodiaphragmatic recess
   c. Right costomediastinal recess
   d. Left costomediastinal recess

b. Intercostal

d. Phrenic

1.b 2.b 3.d 4.a 5.c