PATHOPHYSIOLOGY OF PLEURISY

When the visceral pleural membrane is irritated by mechanical,chemical or biological agents, it responds with the normal cascade of inflammation. This membrane however lack the nociceptors that sense for pain.During this period, there is little or no pain felt in the chest. however, as this inflammation proceeds and spreads to affect the parietal pleura, the receptors in the diaphragm and those in the subcutaneous layer around the chest pick the pain and transmit it for perception. At this point, the patient begins to feel the chest pain that aggravates with any activity that exerts pressure to the inflamed parietal pleura and surrounding structures like coughing, deep breathing or even movement. 

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