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Questions Answered: 21

Final Score 67%

14
7

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Anatomy

Abdomen

Question 37 of 180

The spleen occupies which of the following abdominal regions:

Answer:

The spleen lies in the left hypochondrium of the abdomen.

The intraperitoneal spleen is situated principally in the left hypochondriac region; it lies between the fundus of the stomach and the diaphragm. The spleen cannot normally be palpated on clinical examination.

Functional Overview

The spleen is an organ of the reticuloendothelial system and acts:

  • to filter blood to remove old and defective blood cells
  • as a blood reservoir
  • to produce white blood cells
  • to produce an immune response

Relations

The spleen lies posterior to the stomach, superior to the left colic flexure and lateral to the left kidney and tail of the pancreas.

Relations of the Spleen. (Image by Henry Vandyke Carter [Public domain], via Wikimedia Commons)

Surface Markings

The spleen projects onto the left side and back in the area of ribs 9 - 11. The spleen follows the contour of rib 10 and extends from the superior pole of the left kidney to just posterior to the midaxillary line.

By Henry Vandyke Carter [Public domain], via Wikimedia Commons

Surface Markings of Spleen (Posterior View). (Image by Henry Vandyke Carter [Public domain], via Wikimedia Commons)

By Henry Vandyke Carter [Public domain], via Wikimedia Commons

Surface Markings of Spleen (Lateral View). (Image by Henry Vandyke Carter [Public domain], via Wikimedia Commons)

Splenic Rupture

This most commonly occurs due to localised trauma to the left upper quadrant. It may be associated with left lower rib fractures. Because the spleen has an extremely thin capsule it is susceptible to injury even when there is no damage to surrounding structures and because the spleen is highly vascular, when ruptured, it bleeds profusely into the peritoneal cavity.

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  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

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