Pleurisy (cont.)

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How does the pleura work?

The pleura is composed of two layers of thin lining tissue. The layer covering the lung (visceral pleura) and the parietal pleura that covers the inner wall of the chest are lubricated by pleural fluid. Normally, there is about 10-20 ml of clear liquid that acts as a lubricant between these layers. The fluid is continually absorbed and replaced, mainly through the outer lining of the pleura. Pressure inside the pleura is negative (as in sucking) and becomes even more negative during inspiration (breathing in). The pressure becomes less negative during exhalation (breathing out). Therefore, the space between the two layers of pleura always has a negative pressure. The introduction of air (positive pressure) into the space (such as from a knife wound) will result in a collapse of the lung.

Picture of pleural effusion in the pleural space
Picture of pleural effusion in the pleural space

What are the symptoms of pleurisy?

Symptoms of pleurisy include:

  • pain in the chest that is aggravated by breathing,
  • shortness of breath, and/or
  • a "stabbing" sensation.

The most common symptom of pleurisy is pain that is generally aggravated by inspiration (breathing in). Although the lungs themselves do not contain any pain nerves, the pleura contains abundant nerve endings. When extra fluid accumulates in the space between the layers of pleura, the pain usually is a less severe form of pleurisy. With very large amounts of fluid accumulation, the expansion of the lungs can be limited, and shortness of breath can worsen.

Medically Reviewed by a Doctor on 12/4/2013

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