Pleura

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Formation of Pleural cavity

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Pleural cavity decreased

Formation of Pleural cavity

Lung bud

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Layers of Pleura1. Visceral pleura – inner, adheres to lung

2. Parietal pleura – outer, lines thoracic wall,

diaphragm,

- 4 parts –cervical costal

diaphragmatic

mediastinal

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Parietal pleura

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Lungs with pleura: CS

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Lungs with pleura: TS

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Surface marking of pleura

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PLEURAL REFLECTIONS

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Pulmonary ligament

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Pleural recesses

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Pleural recesses

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Nerve supply of Pleura Parietal pleura – somatic nerves (IC nerves, phrenic nerve) pain sensitive

Visceral pleura - autonomic nerves (T2 to T5) pain insensitive

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Applied Anatomy

• Pleuritis/pleurisy

• Pleural effusion/hydrothorax

• Haemothorax

• Pneumothorax

• Pain at tip of shoulder from diaphragmatic pleura

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Pleural tap

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Pleural tapPleural tap

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Pneumothorax

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Tension Pneumothorax

• Distended neck veins• Tracheal shift• Decreased breath

sounds• Hyper resonance

(involved hemithorax)• Collapsed lung on

same side

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Tension pneumothoraxTension pneumothorax

Trapping of air created by one way valveTrapping of air created by one way valve

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Tension Pneumothorax

Needle decompression 2nd ICS in MCLNeedle decompression 2nd ICS in MCL

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LARGE HAEMOTHORAX

Haemothorax

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Liver

Trachea

Tracheal bifurcation

Hilar shadow

Right border of heart

Cardiophrenic angle

Right dome ofdiaphragm

Costodiaphragmaticangle

Clavicle

Aortic knuckle

Pulmonary trunk

Left border of heart

Cardiac apex

Left dome of diaphragm

Gas shadow under diaphragm

Coracoid process

CHEST X-RAY PA VIEW

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Thank U

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