Pleural cavity

The pleural cavity, pleural space, or interpleural space is the potential space between the pleurae of the pleural sac that surrounds each lung. A small amount of serous pleural fluid is maintained in the pleural cavity to enable lubrication between the membranes, and also to create a pressure gradient. The serous membrane that covers the surface of the lung is the visceral pleura and is separated from the outer membrane, the parietal pleura, by just the film of pleural fluid in the pleural cavity. The visceral pleura follows the fissures of the lung and the root of the lung structures. The parietal pleura is attached to the mediastinum, the upper surface of the diaphragm, and to the inside of the ribcage. In humans, the left and right lungs are completely separated by the mediastinum, and there is no communication between their pleural cavities. Therefore, in cases of a unilateral pneumothorax, the contralateral lung will remain functioning normally unless there is a tension pneumothorax, which may shift the mediastinum and the trachea, kink the great vessels and eventually collapse the contralateral cardiopulmonary circulation. The visceral pleura receives its blood supply from the parenchymal capillaries of the underlying lung, which have input from both the pulmonary and the bronchial circulation. The parietal pleura receives its blood supply from whatever structures underlying it, which can be branched from the aorta (intercostal, superior phrenic and inferior phrenic arteries), the internal thoracic (pericardiacophrenic, anterior intercostal and musculophrenic branches), or their anastomosis. The visceral pleurae are innervated by splanchnic nerves from the pulmonary plexus, which also innervates the lungs and bronchi. The parietal pleurae however, like their blood supplies, receive nerve supplies from different sources. The costal pleurae (including the portion that bulges above the thoracic inlet) and the periphery of the diaphragmatic pleurae are innervated by the intercostal nerves from the enclosing rib cage, which branches off from the T1-T12 thoracic spinal cord.