A 25-year-old man is admitted to the emergency department with a bullet wound in the neck just above the middle of the right clavicle and first rib. Radiographic examination reveals collapse of the right lung and a tension pneumothorax. Injury to which of the following respiratory structures resulted in the pneumothorax?
The parietal pleura can be divided regionally into costal, diaphragmatic, mediastinal, and cervical portions, depending upon local topographic relations. Another name for the cervical pleura is the cupula. This forms the dome of the plura, projecting into the neck above the first rib and corresponding to the area of injury. The costal pleura lines the internal surfaces of the ribs and intercostal spaces. The mediastinal pleura lies between the lungs and the organs in the mediastinum. The right primary bronchus and upper lobe bronchus are not in the vicinity of the right clavicle or first rib.
Costal pleura
Cupula
Right mainstem bronchus
Right upper lobe bronchus
Thorax