title: Physiology of the pleural space.
abstract: The pleural cavity is created between the 4(th) and 7(th) week of embryologic development. These embryonic components of visceral and parietal pleurae develop different anatomic characteristics with regard to vascular, lymphatic, and nervous supply. There are two layers: a superficial mesothelial cell layer facing the pleural space and an underlying connective tissue layer. The pleura might present inflammatory response and maintenance of the pleural fluid is observed. The latter function is especially important in the mechanical coupling of the lung and chest wall. Fluid is filtered into the pleural space according to the net hydrostatic oncotic pressure gradient. It flows downward along a vertical pressure gradient, presumably determined by hydrostatic pressure and resistance to viscous flow. There also may be a net movement of fluid from the costal pleura to the mediastinal and interlobar regions. In these areas, pleural fluid is resorbed primarily through lymphatic stomata on the parietal pleural surface. In the current review we will present the physiology of the pleural space in a step by step manner.
authors.affiliation: 1 Department of Anatomy-Medical School, Democritus University of Thrace, Alex-polis, Greece ; 2 Cardiothoracic Surgery Department, "Evangelismos" Hospital, Athens, Greece ; 3 Department of Medical Oncology, Aristotle University School of Medicine, Thessaloniki, Greece ; 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 6 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 9 Pathology Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 10 Oncology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Charalampos
authors.initials: C
authors.lastname: Charalampidis
authors.affiliation: 1 Department of Anatomy-Medical School, Democritus University of Thrace, Alex-polis, Greece ; 2 Cardiothoracic Surgery Department, "Evangelismos" Hospital, Athens, Greece ; 3 Department of Medical Oncology, Aristotle University School of Medicine, Thessaloniki, Greece ; 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 6 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 9 Pathology Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 10 Oncology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Andrianna
authors.initials: A
authors.lastname: Youroukou
authors.affiliation: 1 Department of Anatomy-Medical School, Democritus University of Thrace, Alex-polis, Greece ; 2 Cardiothoracic Surgery Department, "Evangelismos" Hospital, Athens, Greece ; 3 Department of Medical Oncology, Aristotle University School of Medicine, Thessaloniki, Greece ; 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 6 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 9 Pathology Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 10 Oncology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Lazaridis
authors.affiliation: 1 Department of Anatomy-Medical School, Democritus University of Thrace, Alex-polis, Greece ; 2 Cardiothoracic Surgery Department, "Evangelismos" Hospital, Athens, Greece ; 3 Department of Medical Oncology, Aristotle University School of Medicine, Thessaloniki, Greece ; 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 6 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 9 Pathology Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 10 Oncology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Sofia
authors.initials: S
authors.lastname: Baka
authors.affiliation: 1 Department of Anatomy-Medical School, Democritus University of Thrace, Alex-polis, Greece ; 2 Cardiothoracic Surgery Department, "Evangelismos" Hospital, Athens, Greece ; 3 Department of Medical Oncology, Aristotle University School of Medicine, Thessaloniki, Greece ; 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 6 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 9 Pathology Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 10 Oncology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Mpoukovinas
authors.affiliation: 1 Department of Anatomy-Medical School, Democritus University of Thrace, Alex-polis, Greece ; 2 Cardiothoracic Surgery Department, "Evangelismos" Hospital, Athens, Greece ; 3 Department of Medical Oncology, Aristotle University School of Medicine, Thessaloniki, Greece ; 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 6 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 9 Pathology Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 10 Oncology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Vasilis
authors.initials: V
authors.lastname: Karavasilis
authors.affiliation: 1 Department of Anatomy-Medical School, Democritus University of Thrace, Alex-polis, Greece ; 2 Cardiothoracic Surgery Department, "Evangelismos" Hospital, Athens, Greece ; 3 Department of Medical Oncology, Aristotle University School of Medicine, Thessaloniki, Greece ; 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 6 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 9 Pathology Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 10 Oncology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kioumis
authors.affiliation: 1 Department of Anatomy-Medical School, Democritus University of Thrace, Alex-polis, Greece ; 2 Cardiothoracic Surgery Department, "Evangelismos" Hospital, Athens, Greece ; 3 Department of Medical Oncology, Aristotle University School of Medicine, Thessaloniki, Greece ; 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 6 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 9 Pathology Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 10 Oncology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Georgia
authors.initials: G
authors.lastname: Pitsiou
authors.affiliation: 1 Department of Anatomy-Medical School, Democritus University of Thrace, Alex-polis, Greece ; 2 Cardiothoracic Surgery Department, "Evangelismos" Hospital, Athens, Greece ; 3 Department of Medical Oncology, Aristotle University School of Medicine, Thessaloniki, Greece ; 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 6 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 9 Pathology Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 10 Oncology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Antonis
authors.initials: A
authors.lastname: Papaiwannou
authors.affiliation: 1 Department of Anatomy-Medical School, Democritus University of Thrace, Alex-polis, Greece ; 2 Cardiothoracic Surgery Department, "Evangelismos" Hospital, Athens, Greece ; 3 Department of Medical Oncology, Aristotle University School of Medicine, Thessaloniki, Greece ; 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 6 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 9 Pathology Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 10 Oncology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Karavergou
authors.affiliation: 1 Department of Anatomy-Medical School, Democritus University of Thrace, Alex-polis, Greece ; 2 Cardiothoracic Surgery Department, "Evangelismos" Hospital, Athens, Greece ; 3 Department of Medical Oncology, Aristotle University School of Medicine, Thessaloniki, Greece ; 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 6 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 9 Pathology Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 10 Oncology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Kosmas
authors.initials: K
authors.lastname: Tsakiridis
authors.affiliation: 1 Department of Anatomy-Medical School, Democritus University of Thrace, Alex-polis, Greece ; 2 Cardiothoracic Surgery Department, "Evangelismos" Hospital, Athens, Greece ; 3 Department of Medical Oncology, Aristotle University School of Medicine, Thessaloniki, Greece ; 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 6 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 9 Pathology Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 10 Oncology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Katsikogiannis
authors.affiliation: 1 Department of Anatomy-Medical School, Democritus University of Thrace, Alex-polis, Greece ; 2 Cardiothoracic Surgery Department, "Evangelismos" Hospital, Athens, Greece ; 3 Department of Medical Oncology, Aristotle University School of Medicine, Thessaloniki, Greece ; 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 6 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 9 Pathology Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 10 Oncology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Eirini
authors.initials: E
authors.lastname: Sarika
authors.affiliation: 1 Department of Anatomy-Medical School, Democritus University of Thrace, Alex-polis, Greece ; 2 Cardiothoracic Surgery Department, "Evangelismos" Hospital, Athens, Greece ; 3 Department of Medical Oncology, Aristotle University School of Medicine, Thessaloniki, Greece ; 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 6 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 9 Pathology Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 10 Oncology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Kapanidis
authors.affiliation: 1 Department of Anatomy-Medical School, Democritus University of Thrace, Alex-polis, Greece ; 2 Cardiothoracic Surgery Department, "Evangelismos" Hospital, Athens, Greece ; 3 Department of Medical Oncology, Aristotle University School of Medicine, Thessaloniki, Greece ; 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 6 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 9 Pathology Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 10 Oncology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Leonidas
authors.initials: L
authors.lastname: Sakkas
authors.affiliation: 1 Department of Anatomy-Medical School, Democritus University of Thrace, Alex-polis, Greece ; 2 Cardiothoracic Surgery Department, "Evangelismos" Hospital, Athens, Greece ; 3 Department of Medical Oncology, Aristotle University School of Medicine, Thessaloniki, Greece ; 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 6 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 9 Pathology Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 10 Oncology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Ipokratis
authors.initials: I
authors.lastname: Korantzis
authors.affiliation: 1 Department of Anatomy-Medical School, Democritus University of Thrace, Alex-polis, Greece ; 2 Cardiothoracic Surgery Department, "Evangelismos" Hospital, Athens, Greece ; 3 Department of Medical Oncology, Aristotle University School of Medicine, Thessaloniki, Greece ; 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 6 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 9 Pathology Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 10 Oncology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Sofia
authors.initials: S
authors.lastname: Lampaki
authors.affiliation: 1 Department of Anatomy-Medical School, Democritus University of Thrace, Alex-polis, Greece ; 2 Cardiothoracic Surgery Department, "Evangelismos" Hospital, Athens, Greece ; 3 Department of Medical Oncology, Aristotle University School of Medicine, Thessaloniki, Greece ; 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 6 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 9 Pathology Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 10 Oncology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Zarogoulidis
authors.affiliation: 1 Department of Anatomy-Medical School, Democritus University of Thrace, Alex-polis, Greece ; 2 Cardiothoracic Surgery Department, "Evangelismos" Hospital, Athens, Greece ; 3 Department of Medical Oncology, Aristotle University School of Medicine, Thessaloniki, Greece ; 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 6 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 9 Pathology Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 10 Oncology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Paul
authors.initials: P
authors.lastname: Zarogoulidis
keywords: Pneumothorax; physiology; pleural space