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The pleura is the membrane in which there is a serous fluid called the pleura. Its main function is to help the lungs to move around in the breathing process. How is it built and is the pleural fluid dangerous?

Pleura(Latinpleura ) is the thin, serous membrane that surrounds the lungs - a separate pleura isolates the right lung and a separate left lung. The pleura is a moistened membrane, which makes it effective in minimizing the friction of lung movement while breathing.

Additionally, in each pleural cavity there are several milliliters of pleural fluid, which makes this operation even more painless.

The pleura and the cavities filled with fluid form a kind of inflated cushions that allow the lungs to change its volume during inhalation and exhalation, without having to touch the hard walls of the chest.

Although the pleura is a thin membrane, the existence of which few people know, it is worth being aware that, unfortunately, abnormalities often occur within it. Patients present then most often with symptoms such as:

  • shortness of breath
  • chest pain
  • cough
  • chills etc.

Generally, the cause of these ailments is the fluid in the pleura, which prevents the lungs from moving properly, causing breathing problems. Other reasons may include :

  • pleural abscess
  • traumatic or idiopathic pneumothorax
  • pleurisy

Find out how to diagnose pleural diseases and whether they are complicated procedures.

Where is the pleura and how is it built?

The pleura is located in the chest and line it on the inside, which makes it fill the space between the skeleton and the left and right lungs. The pleura does not connect with each other, and between them there are, among others, esophagus, heart and great vessels.

The most important point, however, is that the lungs are not closed in the pleura, but only pressed into them. You can easily imagine it on the example of a balloon - the pleura is the outer edge of the balloon, and in its center is the pleural cavity with the serous fluid.

The cone-shaped lung presses from the outside of the balloon and causes the pleura to deform under the pressuresurrounds them and practically completely surrounds them (the border of the pulmonary pleura is at the point where the bronchi meet the lung). This is how the pleura separates the lungs from the chest wall.

The pleura is distinguished by:

  • pulmonary pleura- also called pleural plaque, which is directly adjacent to the lung
  • parietal pleura- also known as pleural plaque that adheres to the chest wall

Sometimes it also divides the pleura depending on where exactly it is located, i.e. we have:

  • costal pleura(outer part of the chest)
  • diaphragmatic pleura(lower chest)
  • mediastinal pleura(middle part of the chest)
  • pleural caps(upper chest, next to neck)

The places where specific parts of the pleura connect are called recesses - there are pleural recesses:

  • rib-diaphragm
  • ribo-mediastinal
  • diaphragm-medial

Moreover, the pleura is an innervated membrane which is insensitive to pain on the side of the pulmonary pleura, but sensitive to stretching and sensitive to pain on the side of the parietal pleura. Pain sensation is possible thanks to the somatic nerves - the diaphragmatic and intercostal nerves are distinguished.

Pleural fluid - symptoms

Pleural fluid fills the pleural cavity and is a good condition. However, if it is in excess, it means an undesirable and dangerous situation.

Most often, too much serous fluid accumulates in the cavity due to e.g. high blood pressure in the blood vessels of the parietal pleura, difficulty in draining tissue fluid from the lymph vessels, or low oncotic blood pressure.

The accumulation of fluid in the pleura makes it difficult to breathe, which makes the patients noticeably difficult to move the chest (strong asymmetry, especially lack of movement at the site of fluid accumulation). Symptoms such as pain, shortness of breath, and an audible pleural friction may also appear.

The nature of the pleural effusion can vary. The most common are exudate or transudate, less frequently hematoma or lymphorrhea.

Leakage fluidusually accumulates in diseases such as:

  • cirrhosis of the liver
  • heart failure
  • pulmonary embolism
  • nephrotic syndrome
  • hypothyroidism

The exudative fluidis most often accumulated as a result of:

  • inflammation - e.g. pneumonia
  • cancer
  • diseasespancreas
  • heart attack
  • esophageal ruptures

Hematoma and lymphorrhea occur very rarely. The first of them, for example, due to drainage, and the second - most often in patients with lymphoma type neoplasms.

Is pleural fluid dangerous?

When fluid appears in the pleura, the patient must be hospitalized immediately. It is a dangerous situation that may result in death without medical intervention.

It is important with what symptoms the patient will go to the hospital. If it turns out that severe pain is the result of a large amount of fluid accumulated in the pleura, it must be removed. In such cases, you need to get rid of it as soon as possible by means of drainage.

In turn, if the amount is small and the cause is found, conservative treatment will be applied.

In this situation, the specific cause of exudate, transudate, hematoma, or lymphorrhea must be diagnosed in order to initiate treatment. And if the doctor determines that this condition is the result of, for example, pancreatic diseases or hypothyroidism, he will recommend treatment of the underlying disease and refer you to appropriate specialists.

However, if it is a result of, for example, cancer or esophageal rupture, surgery may be necessary. In other diseases, doctors can also use pharmacological treatment.

The most common pleural diseases - symptoms

  • Pleurisy

The common pleural diseases include its inflammation, which occurs as a result of complications from tuberculosis or complications following thoracic surgery. The patient shows abnormal chest mobility, as well as symptoms such as coughing and chest pain. Additionally, there may also be exudates.

  • Pneumothorax

Another situation is pneumothorax, in which air enters the pleural cavity. Pneumothorax may be spontaneous or traumatic, but regardless of its type, the patient's condition is then defined as unstable and requires immediate surgical intervention.

  • Pleural abscess

In turn, when purulent discharge accumulates in the pleura, it may be caused by a pleural empyema. Patients then develop symptoms such as severe chest pain, chills and fever.

  • Pleural neoplasm

Another disease is pleural cancer, which is most often diagnosed as mesothelioma. The cancer is diffused on the pleural surface, it forms nodules, and also very often leads to exudation, which makes the patient feel short of breath.

Diagnostics of pleural diseases

Pleural diseases are diagnosed in many ways and it depends, among others, on on the patient's symptoms.

First of all, at the beginning there is a routine examination of the patient - first an interview, and then auscultation. Already at this stage it can be stated that, for example, there is fluid in the pleura, which gives characteristic noises during the examination. If the doctor is not sure about the diagnosis, he or she may order additional tests, such as chest X-ray.

If there is a suspicion that problems with the pleura are caused, for example, by a cancer, then computed tomography and ultrasound of the pleural cavity are additionally ordered.

In addition, the diagnosis of the disease also involves the collection of pleural fluid for examination, which can detect not only neoplasms, but also infections, inflammations and other causes of pleural ailments.

About the authorSonia Młodzianowska Journalist, editor, copywriter. He publishes in he alth and parenting magazines and portals. He belongs to the Journalists for He alth Association.

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Category:

Respiratory system