The parietal pleura is the outer layer of the pleura, lining the inner chest wall, the top of the diaphragm, the sides of the mediastinum and the dome above the lung. It is named by region: costal, diaphragmatic, mediastinal and cervical parts. Unlike the visceral pleura, it is very sensitive to pain.
| Location | Lines the inner surface of the ribs and intercostal spaces, the upper surface of the diaphragm, the lateral mediastinum and the cervical dome above the first rib. |
|---|---|
| Parts |
|
| Nerve Supply | Intercostal nerves (costal and peripheral diaphragmatic parts); Phrenic nerves (mediastinal and central diaphragmatic parts) |
| Blood Supply | Posterior and anterior intercostal arteries; Internal thoracic and musculophrenic arteries; Superior phrenic arteries |
| Venous drainage |
|
| Lymphatic drainage |
|
Lines the pleural cavity, produces and absorbs pleural fluid, and through its nerves signals pain when the chest wall lining is irritated.
Pain from the costal and outer diaphragmatic pleura travels in the intercostal nerves and is felt over the chest wall, while pain from the mediastinal and central diaphragmatic pleura travels in the phrenic nerve and is felt at the shoulder tip. Chest drains and pleural biopsies pass through it, and local anaesthetic must reach it for comfort. Pleural plaques from asbestos form on the parietal layer.
Inflammation of the parietal pleura causing sharp, stabbing chest pain on breathing in. Causes include viral infection, pneumonia and pulmonary embolism.
Benign patches of thickened, often calcified, parietal pleura after asbestos exposure. They mark past exposure but are not cancerous.
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