Pleura: structure, functions and the most common diseases

The pleura is part of the respiratory system. She may have her own diseases and pathologies.

Content

There are many organs and systems in the human body. All of them are important and are of particular importance for the functioning of the body. Pleura - Part of the respiratory system. This organ has its own structure and illness. Provides air absorption, which is important for the functioning of the lungs.

Read on our website another article on the topic: “Human anatomy - internal organs on the left under the ribs, in front and back, higher and below the ribs”. You will find a scheme with a description, and find out what can hurt on the left under the ribs.

This article describes what is a pleura, as well as its functions, diseases and much more. Below you will find useful information on how to treat pathologies of this body, as well as which doctors to contact, and which diagnostics. Read further.

What is inter -laeal pleura (breast, diaphragmatic) of the lungs - structure, anatomy: preferentic, visceral (pulmonary), pleural cavity, lung structure, pleura

The pleura of the lungs (thoracic, diaphragmatic) is a serous membrane that lines the chest cavity from the inside and covers the lungs. Such an internal shell has two sheets: one is closely fought with the lungs and is called visceral (pulmonary), the second - the parietal covers the intrathoracic cage. Here is the scheme of the structure of the lungs - anatomy:

Playing scheme of the pleura:

The parietal pleura is anatomically divided into 3 parts:

Diaphragmatic
Mediastinal (mediastinal)
Rib

In the places of their transition in the pleural cavity there are sinuses:

Rib-diafragmal
Diaphragmatic mediastinal
Rib-mediastinal

In sinuses there are no lungs and in pathological processes, any liquid accumulates precisely in them. The mediastinal part of the parietal leaf is fraught with the pericardium - the outer shell of the heart. Between the sheets of the inter -lane pleura, space forms - the pleural cavity. It is filled with a small amount of liquid, which reduces the friction of the sheets. The preferent pleura is one solid bag surrounding the lung, but in order to describe it, it is divided into departments.

The lungs are a paired organ lying its base on the diaphragm. As well as the parietal sheet of pleura, the lungs have 3 surfaces:

Mediastinal
Rib
Diaphragmatic

On the mediastinal surface there are a gates of the lungs, consisting of a bronchus, arteries and two veins. Each lung consists of a share, in their right 3, in the left 2. The shares are divided into segments (10 in the right, 8 in the left light), and those in turn into slices. The respiratory tract of the lungs consists of bronchi, they go into bronchioles, which fill the slices. Each bronchiola ends with acinus-a structural-functional unit of lungs. Acinus consists of respiratory bronchioles, and they, in turn, turn into alveoli - special bags in which the gas exchange process takes place.

Functions of the spray

Since the pleural cavity is hermetically closed, the pressure in it is always negative, which provides air absorption during inspiration due to pressure gradients. Thanks to the pressure and elasticity of the sheets, the lungs are not falling. In addition, the pleural lungs performs a protective function, and the fluid in the cavity has a bactericidal effect.

Pleural diseases: acute, chronic empyema, exudative pleurisy and others

The most common pleurisy disease is pleurisy. This is inflammation of the sheets of pleura. There are three types of this disease:

Dry (fibrinous) -it is characterized by the deposition of fibrin threads on the surface of the leaflets.
Exudation - This is a pleurisy that appears when the accumulation of a large amount of liquid in the cavity.
Diaphragmatic - pleura lies on the diaphragm. It becomes difficult for a person to breathe.

It is worth knowing: Pleurisy very rarely develops independently, usually it occurs against the background of other diseases (for example, pneumonia, tuberculosis, autoimmune diseases, tumors).

Clinically dry pleurisy is manifested by pricking pain in the chest, which intensify during movements, deep inhalation and cough. Breathing becomes superficial, the affected part often lags behind the healthy breathing. With exudative pleurisy, a reflex dry cough, dull pain and growing shortness of breath appear in the forefront. The affected party is significantly inferior in the act of breathing, and the intercostal spaces expand. Against the background of local manifestations, general symptoms arise:

Subfebrile temperature
Sweating
Loss of appetite

With diaphragmatic pleurisy, the clinic can have erased in nature and disguised as gastrointestinal diseases, symptoms such as bloating, heaviness, hiccups, and hypochondrium pain will come to the fore.

Another common pleural disease is empyemor Piotorax is a cluster of pus in the pleural cavity. It can be acute and chronic. At its core, Empiem is one of the varieties of exudative pleurisy, which is distinguished as a separate nosological unit. The disease occurs with infectious lung lesions. Three phases are distinguished in the development of the disease:

Exudation
Fibrinous-frog
Organizing

In the first stage, pus accumulates in the cavity, purulent pockets are formed in the second, and scars are organized and formed in the third exudate. The clinic is similar to other pleurisy:

Cough
Dyspnea
Breast pain
Other general clinical symptoms are subfebrile temperature, headache, chills, etc.

The third, but no less complex pathology, pneumothorax acts. This is the presence of air in the pleural cavity, which is accompanied by an increase in pressure and the collapse of the lung. The disease can occur independently or as a complication of other diseases, for example, with the breakdown of tumors, tuberculosis, or after injury. There are several types of pneumothorax:

Closedin which the air in the cavity does not connect to atmospheric air
Open It is characterized by the connection of the pleural cavity and the environment.
Valve - During inspiration, the air enters, but when exhaling it does not come out. The manifestation of the disease varies from acute pain, shortness of breath, chest pain, dry cough to shock and cardiac arrest.

Except pneumo - there is also hemotorax - This is a blood accumulation between pleural sheets. It occurs with bleeding from the vessels of any mediastinal organs. Most often, the cause of the chest or vascular decay in cancer or tuberculosis is the cause. Also, such a pathology can develop due to various surgical operations. Gemothorax is distinguished by the amount of blood:

Small - blood fills the sinuses
Medium - fluid level corresponds to the angle of the shoulder blade
Total - blood occupies the entire pleural cavity

Symptoms of the disease are similar to others, but signs of internal bleeding join them:

Tachycardia
Decrease in blood pressure
The pallor of the skin

The mediastinal organs are shifted to the healthy side.

What doctors to contact for examination and treatment of pleura

If any of the symptoms of pleural diseases occur, you must seek help. What doctors to contact for examination and treatment of pleura? The first specialist to turn to - therapist.

This doctor will be able to suspect the problem and choose the correct diagnostic, and soon therapeutic tactics.

If the doctor has problems in making a diagnosis, he can direct the patient to a narrower specialist - pulmonologist.

This is a doctor who is engaged in pathologies of the respiratory system, including pleura.

In extremely severe cases, there is a need for radical treatment methods such as surgical intervention. Such a need may occur with pneumothorax organizing the stage of emphyem, metastases in the pleura, massive spray and the like.

For such a treatment you need a thoracic surgeon.

And another specialist who takes part in the diagnosis of pleural diseases - functional diagnostician.

Thanks to this doctor, it becomes possible to establish an accurate diagnosis.

Read more about diagnostic methods described below. Read further.

Diagnosis of pleura: what tests to take?

Diagnosis of pleural diseases is not very complicated. It is worth starting with general clinical tests:

General blood test
General urine analysis
Biochemical blood test

These studies can indicate the cause of the disease. So with pleurisy of bacterial origin is determined formula's leukocyte formula and a high number of neutrophils, a high indicator ESR. In the case of viral pleurisy, the blood is determined increase level of lymphocytes. Inflammatory indicators also increase - perenophaase proteins.

Further, an important stage in the diagnosis is a physics examination, which includes palpation, percussion and auscultation. With each disease of the pleura, the indicators of these studies differ. With pleurisy, auscultatively listens to the noise of the pleura, with pneumothorax, percussbly determines boxing sound, and with hemothorax demolification of percussion sound, auscultative breathing is weakened or does not listen at all.

Be sure to conduct instrumental diagnostics. Radiography of the chest organs Allows you to determine the liquid (exudate, pus, blood, etc.) in the pleural cavity, as well as the displacement of the mediastinal organs. For the same purpose, they use Ultrasound of the pleural cavity, CT of the chest organs.

The valuable diagnostic method is considered pleural puncture - taking a small amount of fluid accumulated in the pleural cavity using a special needle. Further, this liquid passes a number of specific tests, thanks to which the cellular composition, biochemical indicators are determined, tuberculosis tests are carried out.