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Innervation

Authoring team

The innervation of the pleura can be considered in terms of:

  • visceral pleura:
    • no sensory afferents
    • supplied only by autonomic fibres
  • parietal pleura:
    • costal pleura:
      • supplied by somatic nerve fibres from overlying intercostal space
      • hence, costal pleural disease may refer pain to overlying thoracic wall
    • diaphragmatic pleura:
    • supplied by phrenic nerve centrally
      • supplied by lower intercostal nerves peripherally
      • hence, may refer diaphragmatic pleural disease to overlying thoracic wall or shoulder
    • mediastinal pleura: supplied by phrenic nerve during its descent, hence may again refer pain to the shoulder

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