Pleurae - neurovascular & pneumothorax

Question 1

do the 2 parts of the pleurae have the same vascular supply?

Answer 1

NO

Question 2

what is the parietal pleura sensitive to?

Answer 2

pressure, pain, and temperature. It produces a well localised pain

Question 3

what is the parietal pleura innervated by?

Answer 3

the phrenic and intercostal nerves

Question 4

where is the blood supply to the parietal pleura derived from?

Answer 4

the intercostal arteries

Question 5

what is the visceral pleura sensitive to?

Answer 5

The visceral pleura is NOT sensitive to pain, temperature or touch. Its sensory fibres only detect stretch

Question 6

what do the sensory fibres of visceral pleura detect?

Answer 6

stretch

Question 7

where does the visceral pleura receives innervation from?

Answer 7

receives autonomic innervation from the pulmonary plexus

Question 8

what is the pulmonary plexus?

Answer 8

a network of nerves derived from the sympathetic trunk and vagus nerve

Question 9

where is the arterial supply to the visceral pleura via?

Answer 9

via the bronchial circulation (internal thoracic arteries)

Question 10

what else does the internal thoracic arteries supply?

Answer 10

the parenchyma of the lungs

Question 11

what is a pneumothorax commonly referred to as?

Answer 11

a collapsed lung

Question 12

when does a pneumothorax occur?

Answer 12

when air or gas is present within the pleural space

Question 13

what happens when there is air or gas in the pleural space?

Answer 13

This removes the surface tension of the serous fluid present in the space, reducing lung extension

Question 14

what are clinical features of pneumothorax?

Answer 14

chest pain, and shortness of breath, and asymmetrical chest expansion

Question 15

upon percussion, what might the affected side be like? why?

Answer 15

hyper-resonant (due to excess air within the chest)

Question 16

how many main classes of pneumothorax are there and what are they?

Answer 16

There are two main classes of pneumothorax – spontaneous and traumatic

Question 17

when does a spontaneous pneumothorax occur?

Answer 17

A spontaneous pneumothorax occurs without a specific cause

Question 18

what is a spontaneous pneumothorax subdivided into?

Answer 18

primary and secondary

Question 19

what is a primary spontaneous pneumothorax?

Answer 19

no underlying respiratory disease

Question 20

what is a secondary spontaneous pneumothorax?

Answer 20

underlying respiratory disease present

Question 21

when does a traumatic pneumothorax occur?

Answer 21

as a result of blunt or penetrating chest trauma, such as a rib fracture (often seen in road traffic collisions)

Question 22

what does treatment for pneumothorax depend upon?

Answer 22

Treatment depends on identifying the underlying cause

Question 23

what are the treatment for primary pneumothoraces?

Answer 23

treatment tend to be small and generally require minimal intervention

Question 24

what are treatment for secondary and traumatic pneumothoraces?

Answer 24

may require decompression to remove the extra air/gas in order for the lung to reinflate

Question 25

how is extra air/gas removed in order for lungs to reinflate?

Answer 25

insertion of a chest drain