Plèvre

In Anatomy, the plèvre represents a Séreuse delimiting a virtual space (i.e. vacuum in the normal situations) located between the Poumon S in inside and the thoracic wall outwards.

Anatomy

See also: Anatomy of the plèvre and the pleural cavity

One distinguishes the parietal plèvre , located against the thoracic wall , of the visceral plèvre , stuck to the lungs. The two pleural cavities (right-hand side and left) are not connected between them.

Physiology

See also: pleural Physiology

Like all séreuses, they have a role to decrease the frictions caused by the movements (respiratory in fact). They are papered by a epithelium secreting in minor amount a lubricating liquid.

Exploration

In the normal cases, the plèvres are fine and are not displayable.

When the pleural cavity contains a liquid ( épanchement ), this last can be detected, according to its abundance:

  • by the Clinical examination: typically with a reduction in the murmur vésiculaire (noise of breathing at the time of a Sounding with a Stethoscope) with matity (deaf noise with the percussion) of a base. These anomalies can however also correspond to a disease of the lungs.
  • by a Radiography of the lungs of face, ideally in position upright: simple filling of a cul-de-sac or opacity of a base delimited by a concave line upwards.

Naturally this épanchement can be visualized with the echography, the Tomographie, or by Imagerie by magnetic resonance (IRM).

If need be one can supplement the examination by a pleural Ponction and analyzes it taken liquid.

A thickening of a plèvre will be primarily visualized by tomography or magnetic resonance.

Disease of the plèvre

The presence of liquids in notable quantity in the pleural cavity constitutes a épanchement pleural which can be various origins:

The presence of air in the pleural cavity constitutes a Pneumothorax which can be:

  • traumatic (wound of the thoracic wall, fractures costal)
  • iatrogenic (accident of with a medical gesture)
  • spontaneous

The presence of Sang in the pleural cavity is called a hémothorax , of liquid and air a hydropneumothorax , blood and air a hémopneumothorax .

The plèvres can be thickened, without they containing a notable quantity of liquid: dry pleurisies.

The Cancer of the plèvre is a secondary pathology with the inhalation with the long course of Amiante: it is then about a Mésothéliome.

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