Pleura

What is the pleura?

Your pleura is a thin, watery (serous) tissue (membrane) that lines the walls of your chest (thorax) and wraps around the outside of your lungs. It’s part of your respiratory system.

What is the function of the pleural membrane?

The function of your pleura is to help cushion your lungs and prevent them from rubbing against your chest wall.

Where is the pleura located?

Your pleura:

• Lines your chest wall (thoracic wall).
• Extends around your heart to form the side walls of the middle section of your chest cavity (mediastinum).
• Covers the surface of your lungs.

What are the parts of the pleura?

A hollow area (pleural space) lies between the layers of your pleura. Your pleural space contains a thin layer of pleural fluid. Pleural fluid helps your pleura move as you breathe.

The pleura has two layers:

• Visceral pleura. This is the inner layer of your pleura. It covers your lungs, blood vessels, bronchi and nerves. The visceral pleura doesn’t have sensory nerves, so they aren’t sensitive to pain.
• Parietal pleura. This is the other layer of your pleura. It attaches to your chest wall. The parietal pleura is sensitive to pain.

What are the common conditions and disorders that affect the pleura?

Common pleural disorders include:

• Pleurisy. Pleurisy is inflammation in your pleura.
• Pleural effusion. Pleural effusion is when too much pleural fluid builds up in your pleural space.
• Hemothorax. Hemothorax occurs when blood enters your pleural space, usually after an injury. It puts extra pressure on your lungs.
• Pneumothorax. Pneumothorax occurs when air enters your pleural space and puts pressure on your lungs. It may occur after an injury. But it can also occur if you smoke or experience drastic changes in air pressure, like flying or scuba diving.
• Hemopneumothorax. Hemopneumothorax occurs when blood and air enter your pleural space at the same time. It usually occurs after an injury.
• Pleural mesothelioma. Pleural mesothelioma is cancer that forms in your pleura.

What happens if the pleura is damaged?

Pleural damage may cause sharp pain that worsens when you breathe normally, take deep breaths or cough. You may feel like you can’t get enough air in your lungs (dyspnea). Damage may occur after an injury to your chest, like a fall, a contact-sport injury, a car accident, or a knife or gunshot (puncture) wound.

If you have symptoms of severe pleural damage, call 911 or your local emergency number immediately.

What are common tests to check the health of the pleura?

Healthcare providers may order the following tests to diagnose a condition that affects your pleura:

• Imaging tests. These may include a chest X-ray, CT scan or ultrasound.
• Thoracentesis. A provider inserts a thin needle between your ribs to remove a pleural fluid sample.
• Thoracoscopy. A provider uses a small tube with a light and camera at the end to look inside your lungs.

How do you fix the pleura?

It depends on what condition affects your pleura and its severity. Treatments may include:

• Medications to treat an infection or relieve symptoms.
• Oxygen therapy.
• Draining fluid or air from your chest.
• Surgery.
• Mechanical ventilation.
• Radiation therapy, chemotherapy or immunotherapy to treat cancer.

How do I keep my pleura healthy?

You can help reduce your risk of pleural damage by:

• Avoiding tobacco products, including smoking and vaping.
• Wearing a seatbelt any time you’re in an automobile.
• Wearing protective padding while playing contact sports.
• Limiting activities that involve drastic changes in air pressure, like flying or scuba diving.
• Regularly washing your hands to help prevent bacterial infection and viral infection.
• Avoiding asbestos.