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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 ...
This is called the pleural cavity (also pleural space). [2] It contains a tiny amount of serous fluid (pleural fluid) secreted by the pleurae, at an average pressure that is below the atmospheric pressure under healthy conditions. The two lungs, each bounded by a two-layered pleural sac, almost fill the thoracic cavity.
The A arrow shows fluid layering in the right pleural cavity. The B arrow shows the normal width of the lung in the cavity. When a pleural effusion has been determined to be exudative, additional evaluation is needed to determine its cause, and amylase, glucose, pH and cell counts should be measured.
With pleural effusion, fluid often builds up in the costophrenic angle (due to gravity). This can push the lung upwards, resulting in "blunting" of the costophrenic angle. The posterior angle is the deepest. Obtuse angulation is sign of disease. Chest x-ray is the first test done to confirm an excess of pleural fluid.
The person sits upright and leans on a table. Excess fluid from the pleural space is drained into a bag. Once the presence of an excess fluid in the pleural cavity, or pleural effusion, is suspected and location of fluid is confirmed, a sample of fluid can be removed for testing. [14]
The thoracic cavity is the space that includes the pleura, lungs, and heart, while the pleural space is only the space between the parietal pleura and visceral pleura surrounding lungs. Intrapleural pressure depends on the ventilation phase, atmospheric pressure, and the volume of the intrapleural cavity. [2]
Whether a chylothorax occurs in the left or right pleural space is a consequence of the thoracic duct's anatomic location in the body and depends on the level where the duct was injured. If the thoracic duct is injured above the fifth thoracic vertebra , then a left-sided chylothorax results. [ 5 ]
Massive right sided pleural effusion later confirmed to be a hemothorax. Hemothorax, or accumulation of blood in the pleural space, can result from trauma or surgical procedures in the chest. This accumulation of blood can grow large enough to compress the lung and push away other structures in the chest, thus causing a mediastinal shift. [6]