question regarding lung anatomy and pneumothorax

[backtochitown]

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Hello,

Gotta (strange) question here. I was wondering, is there another lining of epithelial cells (besides alveolar epithelium) between the visceral pleura and the actual lung itself? So say you were the remove the pleural sac from the lung. What would be the layer of tissue you would see, now right on the lung?

So for example, if I were to do a thought experiment, and enter the lung from the outside, it would be skin, subcutaneous tissue, fascia, parietal pleura, visceral pleura, and alveoli, correct?


In regards to primary spontaneous pneumothorax, which classically caused by rupture of the alveoli, and the air escapes to the pleural space (the definition of pneumothorax). Will air ALWAYS escape to the pleural space, after an alveolar rupture? So say you had a rupture of an alveoli in the center of the lung parenchyma; can't air just get stuck in the lung parenchyma itself, and not find its way to the pleural space? If so, what would that condition be called?

Thanks guys!

 

[AndyRSC]

Nope, the visceral pleura directly overlies the lung - and is tightly adherent at that, so removing it isn't really feasible.

Your thought experiment is correct, although you'd most likely pass through muscles to get to the pleural cavity.

No, when the rupture doesn't occur into the pleural cavity, it simply occurs into the adjacent alveolus, as the septum separating them is broken. This commonly occurs in emphysema; as smoking or inherited deficiency allows elastases to weaken alveolar septa, more and more break down into large cavities (bullae). This leads to the clinical constellation of the loss of elasticity, hyperinflation, hypoventilation, pulmonary hypertension, hypercapnia, etc, etc. Once a bulla ruptures into the pleural cavity, pneumothorax and its attendant clinical problems ensue.