pleuraleffusions胸膜渗出中山大学内科学.pptxVIP

PleuralEffusions胸膜渗出中山大学内科学会计学第1页/共41页Contents Anatomy and Mechanism of pleural fluids turnover Etiology and pathogenesis of pleural effusions Clinical manifestations Radiographic Examination Approach to the patient with pleural effusions Management of patient with pleural effusionsDr. Canmao xie第2页/共41页Introduction The pleural space is not really a space but rather a potential space between the lung and chest wall. It is a crucial feature of the breathing apparatus since pleurae serves as a coupling system between the lung and chest wall.Dr. Canmao xieIntroduction第3页/共41页There is normally a very thin layer of fluid (from 2 to 10 ?m thick) between the two pleural surfaces, the parietal pleura and visceral pleura. The pleural space and the fluid within it are not under static conditions. During each respiratory cycle the pleural pressures and the geometry of the pleural space fluctuate widely. Fluid enters and leaves the pleural space constantly . Dr. Canmao xie第4页/共41页Anatomy of the Pleural SpaceSC: Systemic capillaries PC: Pulmonary capillaries Dr. Canmao xieThe serous membrane covering the lung parenchyma is called the visceral pleura. The remainder of the lining of the pleural cavity is designated the parietal pleura. The parietal pleura receives its blood supply from the systemic capillaries. The visceral pleura is supplied predominantly by branches of the bronchial artery in humans.第5页/共41页Anatomy of the Pleural SpaceSC: Systemic capillaries PC: Pulmonary capillaries Dr. Canmao xieThe lymphatic vessels in the parietal pleura are in direct communication with the pleural space by means of stomas. These stomas are the only route through which cells and large particles can leave the pleural space.Although there are abundant lymphatics in the visceral pleura, these lymphatics do not appear to participate in the removal of particulate matter from the pleural space. 第6页/共41页stomaselectronic microscopystomasFigure 1. Anatomy of the pleural spaceSC