5.

1 PLEURA & Peritoneum

 LEARNING OBJECTIVES

On a diagram, label the parietal and visceral

pleura

Explain how and why you would drain fluid

from the pleural cavity, in particular the
costodiaphragmatic recess
 OUTLINE

Parietal lining of the lungs

Visceral pleura of the lungs

Pleural Cavity: contains serous pleural fluid for

lubrication

Normally it is a “potential” space

Pleura are for : Reducing friction, creating

pressure gradient and compartmentalisation
THORACIC CAVITY
CONTENTS
•lungs in pleural cavities
•These are covered by the
membranes called
•parietal and
•visceral pleura
The Pleural sac
 PLEURA
2 layers of pleura –

1. Parietal pleura: lines rib cage – cervical, costal,

diaphragmatic and mediastinal parts
2. Visceral pleura: covers lung, invests into fissures and root of
lung
hilum Parietal
pleura

Visceral
pleura

Pleural cavity
Pressure differences
• Explain how two side by side differently
named membranes can be one and the same
structure?
• Explain the term intra-pleura and extra-pleura
space.
 Further reading
• The bilateral pulmonary cavities contain the lungs and the pleural membranes.
• The pleural membranes are continuous serous membranes that form a closed pleural cavity within each cavity. The
relationship of the lung to this membrane is the same as that of a fist (representing the lung) pushed into an underinflated
balloon (representing the pleural membrane). The fist becomes covered by the membrane of the balloon, but it is not
"inside" the balloon. In the case of the lung, the pleura in contact with the lung is the visceral pleura, and the outer layer,
which is in contact with the inner wall of the thorax and the mediastinum, is the parietal pleura. The space within the
pleural sac is the pleural cavity. Under normal conditions, the pleural cavity contains only a small amount of serous fluid
and has no functional open space. It is referred to as a "potential space" because a real space can be created if outside
material, such as blood, pathologic fluids, or air, is introduced into this space.
• The parietal pleura is subdivided into specific parts based on the part of the thorax it contacts. Costal pleura overlies the
ribs and intercostal spaces. In this region, the pleura is in contact with the endothoracic fascia, the fascial lining of the
thoracic cavity. The mediastinal and diaphragmatic pleura are named for their contact with these structures. The cervical
pleura extends over the cupola of the lung; above the first rib into the root of the neck, it is strengthened by the
suprapleural membrane, an extension of the endothoracic fascia over the cupola of lung. The lines of pleural reflection are
the locations along which the parietal pleura transitions from one region to the next. The sternal line of reflection is the
point at which costal pleura transitions to mediastinal pleura on the anterior side of the thorax. The costal line of pleural
reflection lies along the origin of the diaphragm at which the costal pleura transitions to diaphragmatic pleura. Both the
costal and sternal lines of reflection are very abrupt. The vertebral line of pleural reflection lies along the line at which
costal pleura becomes mediastinal pleura posteriorly. This angle of reflection is shallower than the other two. The parietal
pleura reflects onto the lung to become the visceral pleura at the root of the lung. A line of reflection descends from the
root of the lung, much like the sleeve of a loose robe hangs from the forearm, forming the pulmonary ligament. The visceral
pleura covers the entire surface of each lung, including the surfaces in the fissures, where the visceral pleura on one lobe is
in direct contact with the visceral pleura of the other lobe. On the surface of the lung, the visceral pleura is in contact with
the parietal pleura. The pleural cavity is the space inside the pleural membrane. It is a potential space that under normal
conditions contains only a small amount of serous fluid, which lubricates the movement of the visceral pleura against the
parietal pleura during respiration. During expiration, the lungs do not entirely fill the most inferior aspect of the pulmonary
cavity. This creates a region, along the costal line of reflection, in which the diaphragmatic and costal pleura come into
contact with each other with no intervening lung tissue. This space is the costodiaphragmatic recess.
PERITONEUM & ABDOMINAL
VISCERA
 LEARNING OBJECTIVES

Explain the function and importance of the

peritoneum

Give an example of each of the following

peritoneal reflections:
- Retroperitoneal
- Peritoneal ligament
- Inferior mesenteric
 LEARNING OBJECTIVES

Label the following structures on a diagram:

- Greater omentum
- Lesser sac
- Greater sac

List the organs of the gastro-intestinal tract

that are intra – peritoneal and retro –
peritoneal
 Re-call
• Membranes around lung?
– Pleural membrane – parietal, visceral pleura

• Membranes around heart?

– Pericardial – parietal, visceral pericardium
 Peritoneum

Thin, transparent serous membrane consists of

• parietal peritoneum: lines abdominal wall

• visceral peritoneum: covers viscera

 SUBDIVISIONS OF PERITONEAL CAVITY
• Lesser sac (omental
bursa)

• Greater sac

•Omental foramen is
opening between 2
sacs (near gall
bladder)
 PERITONEUM

Peritoneal Cavity

• peritoneal fluid (lubrication)

• enclosed in males, continuous with exterior via
uterine tubes (infection pathway)
 RETROPERITONEAL
• all or part of organ lies behind the peritoneum (e.g.
kidneys, part of liver, ascending colon)
 PERITONEAL LIGAMENT
 double layer connects an organ with abdominal wall
(e.g. falciform ligament of liver)
 OMENTUM
 double layered fold passing from stomach to adjacent
organ (lesser & greater omentum).
 Lesser omentum from lesser curvature of stomach and
proximal part of duodenum to liver
 MESENTERY
• double layer which encloses an organ and connects it to
abdominal wall; vessels lie in mesentery (e.g. small intestine,
stomach, transverse colon)
 SUMMARY
Peritoneum lines the abdominal cavity and pelvic
cavity
– covers abdominal organs (more detail later)
– permits movement of gut, conveys nerves and
arteries from body wall and contains lymphatics to
fight infection

Three main structures associated with peritoneum:

1. Peritoneal ligament – attach organs to body wall
2. Mesentary – convey vessels to organ
3. Omentum – fat storage, immune tissue
 SUMMARY
Divided into:
Lesser sac/omental bursa (behind stomach and liver)

Greater sac
Supracolic compartment (above transverse colon)
Infracolic compartment (below transverse colon

Organs within peritoneum are supplied by

Sympathetic (fight or flight) and Parasympathetic
(rest and digest) nervous systems